Cancer - mesothelioma
Description
- Malignancy of mesothelial cells; pleura ~80-90%, peritoneum ~10%, rarely pericardium or tunica vaginalis
- Almost always asbestos-related - and therefore a medico-legal as well as a medical diagnosis
Histological subtypes - prognostically dominant
| Subtype | % | Median survival |
|---|---|---|
| Epithelioid | ~60% | ~18-24 mo (best; the only one considered for surgery) |
| Biphasic (mixed) | ~25% | ~12 mo |
| Sarcomatoid | ~15% | ~6-8 mo (worst; desmoplastic variant hardest to distinguish from fibrous pleuritis) |
- IHC: calretinin, WT-1, CK5/6, D2-40, mesothelin positive; TTF-1, CEA, claudin-4, Ber-EP4 negative (excludes adenocarcinoma)
- BAP1 loss and CDKN2A/p16 homozygous deletion distinguish malignant mesothelioma from reactive mesothelial hyperplasia
6 more sections, plus exam facts
Premium unlocks every note across every specialty, and the full exam fact library behind it.
Get premium access