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The Pericardium
Published in P. Chopra, R. Ray, A. Saxena, Illustrated Textbook of Cardiovascular Pathology, 2013
Mesothelioma can often be difficult to distinguish from mesothelial hyperplasia and adenocarcinoma (Table 11.1). This is an exercise which has to be conducted and systematic evaluation needs to be done for a definitive diagnosis. Microscopic features such as cytologic atypia, high nuclear cytoplasmic ratio, pleomorphism, mitotic figures, large cytoplasmic vacuoles, necrosis of cells and infiltration favor a diagnosis of mesothelioma rather than hyperplasia (Figs 11.3, 11.21). Immuno-histochemistry is helpful in that membrane staining is obtained with antibody to EMA and HMFG-2 in mesothelioma cells. Differentiation of mesothelioma from adenocarcinoma can also be extremely challenging. Mesothelioma cells generally have prominent intracytoplasmic vacuoles. There is strong reactivity with colloidal iron and alcian blue which is sensitive to hyaluronidase. This reaction is seen in both reactive mesothelial cells and mesotheliomas. Positive reaction with neutral mucins like hyaluronidase resistant mucicarmine and PAS after diastase digestion suggest adenocarcinoma. This test is relatively insensitive. The histochemical stains suffer several artefacts of interpretation and are less often performed. Immunohistochemistry when judiciously performed aids in the differential diagnosis of mesothelioma. Membrane staining with EMA is observed in mesothelioma cells while carcinoma cells exhibit strong cytoplasmic staining. Adenocarcinoma cells also show strong reaction with CEA.
Nonmalignant Versus Malignant Proliferations on Pleural Biopsy
Published in Philip T. Cagle, Timothy C. Allen, Mary Beth Beasley, Diagnostic Pulmonary Pathology, 2008
Françoise Galateau-Salié, Philip T. Cagle
In cases that are cytologically or architecturally worrisome, the diagnosis of atypical mesothelial hyperplasia is recommended. Atypical mesothelial hyperplasia ranges from highly reactive proliferations to proliferations that may represent malignancy but do not present conclusive finding of invasion. When an early, incipient, or adjacent malignancy cannot be ruled out, the diagnosis of atypical mesothelial hyperplasia should be followed by the phrase “of undetermined malignant potential” and close follow-up and/or additional tissue samples suggested. Although the concept of an “in situ” phase of mesothelioma is a useful theory, a diagnosis of pure in situ mesothelioma is not recommended at present, since the diagnosis cannot be made unless an adjacent invasive component is identified (10,41).
Myocarditis and carotidynia caused by Granulocyte-Colony stimulating factor administration
Published in Modern Rheumatology Case Reports, 2020
Elena Corral de la Fuente, Arantza Barquín Garcia, Cristina Saavedra Serrano, Juan José Serrano Domingo, Roberto Martín Huertas, María Fernández Abad, Noelia Martínez Jáñez
She was diagnosed with myocarditis with hemodynamic repercussion due to cardiogenic shock and was admitted to the Coronary Care Unit. Due to precious recovery, empirical antibiotics (tazobactam-piperacillin and vancomycin) as well as high-dose steroids were administrated starting at the ED. She also required advanced life support. After five days since admission, Cardiac Magnetic Resonance Image (MRI) and PET/CT showed metabolic enhancement (SUV 5.40) with myocardial diffuse thickening in basal inferolateral segment of left ventricle with severe pericardial effusion (Figure 3). A pericardial window was performed after ten days since admission. Pericardial biopsy and cytology showed unspecific chronic and acute inflammation signs, rich in lymphocytes with mesothelial hyperplasia, without malignant cells, and microbiological study resulted negative.
Diagnosis of asbestos-related lung diseases
Published in Expert Review of Respiratory Medicine, 2019
Edward J. A. Harris, Arthur Musk, Nicholas de Klerk, Alison Reid, Peter Franklin, Fraser J. H. Brims
Ultimately, in order to make a firm diagnosis of primary or metastatic malignant pleural disease histological/cytological sampling is required. Pleural aspiration or fine needle biopsy of the pleura, with cytological examination, is the most common initial investigation. Differentiation of MPM (particularly epithelioid containing) from reactive mesothelial hyperplasia, adenocarcinoma, and poorly differentiated squamous cell carcinoma is required. In an experienced, specialized laboratory, cytology alone is sufficient for a diagnosis of MPM [70,71], with the formation of a cell block using cytocentrifugation, with paraffin-embedded material available for immunohistochemical and molecular studies.
Severe recurrent endometriomas in a young woman with congenital von Willebrand disease
Published in Gynecological Endocrinology, 2019
Francesca Rizzello, Eleonora Ralli, Chiara Romanelli, Maria Elisabetta Coccia
In May 2010, while still taking COCs, the patient was subjected to a laparotomy with a bilateral ovarian cystectomy and the excision of endometriotic nodules and adhesiolysis. A histological examination showed a hemorrhagic ovarian cyst and endometriosis associated with peritoneal mesothelial hyperplasia. After the surgery, the patient continued her therapy with combined oral contraceptives.