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Malignant-Primary (MAL-P) (Mesothelioma)

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The International System for Serous Fluid Cytopathology

Abstract

The diagnosis of malignant mesothelioma by cytology has been accepted in the last decade and guidelines for the diagnosis were previously published. This chapter focuses on the diagnosis and reporting of malignant mesothelioma by cytology and represents the consensus view of the authors and contributors who make the diagnosis of definitive malignant mesothelioma by effusion cytology on a regular basis. This chapter elaborates on the general approach to mesothelial effusions, key morphologic criteria of malignancy, appropriate utilization of immunohistochemistry, and the role of molecular and soluble biomarkers. A practical guideline is provided for the suggested diagnosis based on the constellation of findings. Fluids with atypical mesothelial cells can be cytologically diagnosed as malignant, suspicious, or atypical based on the cytologic findings and/or ancillary tests. The explanatory notes that follow provide detailed discussions of the differential diagnosis, diagnostic pitfalls, and useful ancillary studies to achieve an accurate diagnosis.

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Authors and Affiliations

  1. Department of Pathology, Case Western Reserve University, University Hospitals Case Medical Center, Cleveland, OH, USA

    Claire Michael

  2. Department of Pathology, Tokyo Women’s Medical University, Yachiyo, Japan

    Kenzo Hiroshima

  3. Department of Laboratory Medicine, Division of Clinical Pathology/ Cytology, Karolinska Institutet, Karolinska University Hospital Huddinge, Huddinge, Sweden

    Anders Hjerpe

  4. Cytology Unit, National Health Laboratory Service, University of the Witwatersrand, Johannesburg, South Africa

    Pam Michelow

  5. Department of Pathology & Cytology, Ankara Diskapi Teaching and Research Hospital, Istanbul, Turkey

    Binnur Önal

  6. Department of Anatomical Pathology, PathWest, QEII Medical Centre, Perth, WA, Australia

    Amanda Segal

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  1. Claire Michael
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  2. Kenzo Hiroshima
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  3. Anders Hjerpe
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  4. Pam Michelow
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  5. Binnur Önal
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  6. Amanda Segal
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Correspondence to Claire Michael .

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Editors and Affiliations

  1. Cellular Pathology, Guy’s and St. Thomas’ NHS Foundation Trust, London, UK

    Ashish Chandra

  2. Gynecology, Breast and Cytopathology Joint Pathology Center, Silver Spring, MD, USA

    Barbara Crothers

  3. University of Wisconsin School of Medicine and Public Health, Department of Pathology and Laboratory Medicine and Wisconsin State Laboratory of Hygiene, Madison, WI, USA

    Daniel Kurtycz

  4. Department of Pathology, Medical Faculty of Porto University and Unit of Molecular Pathology, Institute of Molecular Pathology and Immunology Porto University, Porto, Portugal

    Fernando Schmitt

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Michael, C., Hiroshima, K., Hjerpe, A., Michelow, P., Önal, B., Segal, A. (2020). Malignant-Primary (MAL-P) (Mesothelioma). In: Chandra, A., Crothers, B., Kurtycz, D., Schmitt, F. (eds) The International System for Serous Fluid Cytopathology. Springer, Cham. https://doi.org/10.1007/978-3-030-53908-5_6

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  • DOI: https://doi.org/10.1007/978-3-030-53908-5_6

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