|
Malignant mesothelioma of the pleura is a relatively rare neoplasm that
has been estimated to account for 20 deaths per million males per year in
North America and Europe. A causative association has been well established
with asbestos exposure. Paradoxically, the incidence of this tumor continues
to rise despite public efforts to reduce, contain or eliminate exposure to
asbestos fibers over the past few decades. Another paradoxical feature of
the disease is that the majority of malignant mesotheliomas represent
morphologically low-grade, well-differentiated neoplasms, yet they follow a
relentlessly aggressive and virtually uniformly fatal outcome. For this
reason, identification of clinical, morphologic, immunohistochemical or
molecular genetic parameters is of extremely limited value for
prognostication. Surprisingly, for a disease that currently has no known
cure, one of the major problems still lies in establishing the correct
diagnosis. Diagnosis acquires a particular relevance in light of the
medicolegal ramifications of this disease, and diagnosis of malignant
mesothelioma is still fraught with difficulties. Despite the advances in
modern diagnostic techniques, no specific markers or morphologic features
exist that are exclusive to these tumors. Herein, the current status of
malignant mesothelioma diagnosis is reviewed, including the possible
contributions of modern molecular techniques for their diagnosis.
Pubmed
|