- Tsao A.S.
- Lindwasser O.W.
- Adjei A.A.
- et al.
- Tsao A.S.
- Lindwasser O.W.
- Adjei A.A.
- et al.
Sample Types and Classification
- Rice D.
- Rusch V.
- Pass H.
- et al.
Proposals for Updating the Histologic Subtyping of Mesothelioma
|Diffuse malignant mesothelioma|
|Epithelioid mesothelioma||Composed of rounded rather than spindle-shaped cells usually showing a cohesive architecture, although epithelioid cells can show single cell growth within fibrous stroma.|
|Sarcomatoid mesothelioma, including desmoplastic variant||Composed of spindle-shaped (greater than two times longer than wide). The spindle cells may lie in varying amounts of fibrous stroma, or they can form solid sheets.|
|Biphasic mesothelioma||Showing at least 10% of both epithelioid and sarcomatoid morphology. This rule is limited to definitive resections, namely, extended EPD and EPP. For smaller samples, until more data are collected, the group proposes that the diagnosis of “biphasic” can be rendered regardless of the percentages of each component present and that the diagnosis should be accompanied by a comment indicating the percentages of each component.|
|Localized malignant mesothelioma|
|Well-differentiated papillary mesothelioma||A rare localized mesothelial neoplasm characterized by an exophytic papillary architecture lined by relatively bland mesothelium with no or only minimal areas of invasion. Diagnosis requires exclusion of diffuse malignant mesothelioma with papillary architecture.|
Localized Malignant Mesothelioma
- Marchevsky A.M.
- Khoor A.
- Walts A.E.
- et al.
Diffuse Malignant Mesothelioma
Well-Differentiated Papillary Mesothelioma
|Diffuse malignant mesothelioma|
Some architectural patterns and cytologic and stromal features are important for prognostic significance whereas some are included only for clarity to avoid pathology misdiagnoses. When generating reports, please note that multiple architectural patterns and cytologic and stromal features may be present in a tumor and all patterns/features seen in a tumor should be included in the report.
|Epithelioid malignant mesothelioma|
|Architectural patterns (Give percentages for EPD/EPP and document patterns present for all other samples)|
| Transitional pattern|
|Cytologic features (Give percentages for EPD/EPP. For all other samples, state “with … features present”)|
|Stromal features (Give percentages for EPD/EPP. For all other samples, state “with … features present”)|
|Sarcomatoid malignant mesothelioma (Give percentages for EPD/EPP. For all other samples, state “with … features present”)|
|With heterologous differentiation|
| Transitional pattern|
|Biphasic malignant mesothelioma (For EPD/EPP, any combination of patterns of epithelioid and sarcomatoid mesothelioma with at least 10% of each component. For all other samples, the consensus was to propose that the diagnosis of “biphasic” can be made regardless of percentages of each component and to include a comment indicating the percentages of each component in the sample.)|
|Localized malignant mesothelioma (Any of the above subtypes may be present, with tumor limited to an isolated mass lesion)|
|Well-differentiated papillary mesothelioma|
Malignant Mesothelioma In Situ
- Berg K.B.
- Dacic S.
- Miller C.
- Cheung S.
- Churg A.
- Churg A.
- Galateau-Salle F.
- Roden A.C.
- et al.
Grading of MPM
Nuclear atypia score: _____ (1 for mild, 2 for moderate, 3 for severe)
Mitotic count: ____ (1 for low [≤1 per 2mm2], 2 for intermediate [2-4 per2mm2], 3 for high [5+ per 2mm2])
Sum: _____ (2 or 3 = nuclear grade I, 4 or 5 = nuclear grade II, 6 = nuclear grade III)
Necrosis: Present / Absent
Low-grade = Nuclear grades I and II without necrosis
High-grade = Nuclear grade II with necrosis, Nuclear grade III with or without necrosis
Use of Diagnostic and Predictive IHC and Molecular Assays
- Berg K.B.
- Dacic S.
- Miller C.
- Cheung S.
- Churg A.
Current Inter-Relationship Between Molecular Pathology and Cellular Pathology
Tissue Acquisition for Molecular Studies
Tissue Acquisition, Volume, and Processing
- Rice D.
- Rusch V.
- Pass H.
- et al.
Depth, Number, and Location of Surgical Samples
The Impact of Histopathologic Subtypes of Mesothelioma on Decision Making for Systemic Treatment
The Impact of Histopathologic Subtypes of Mesothelioma on the Outcome After Cytotoxic Chemotherapy
- van Meerbeeck J.P.
- Gaafar R.
- Manegold C.
- et al.
Histopathologic Subtype as a Criterion for Treatment With Antiangiogenic Agents
Does Histopathologic Subtype Modulate the Efficacy of Immune Checkpoint Inhibitors in Mesothelioma?
The Use of Biomarkers in the Clinic for Systemic Treatments
- Muller S
- Victoria Lai W
- Adusumilli PS
- et al.
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- Supplementary Data 2
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Disclosure: Dr. Nowak has received grants from AstraZeneca and Douglas Pharmaceuticals; has received honoraria from Bayer Pharmaceuticals, Roche, Boehringer Ingelheim, Merck Sharp & Dohme; has received consulting fees to institution from Douglas Pharmaceuticals; and has received travel funding from Beohringer Ingelheim and AstraZeneca. Dr. Armato has received personal fees from Aduro Biotech, Inc; and receives royalties and licensing fees from The University of Chicago related to computer-aided diagnostic technology. Dr. Bueno has received grants from Roche/Genentech, Epizyme, HTG, Gritstone, Merck Oncology, Novartis, Verastem, and Siemens. Dr. De Perrot has received personal fees from Bayer. Dr. Baas has received grants from Bristol-Myers Squibb, MSD, and Roche. Dr. Brcic has received grants from AstraZeneca; has received personal fees from MSD, Roche, and AstraZeneca; and has received nonfinancial support from Abbvie, MSD, Roche, AstraZeneca, and Pfizer. Dr. Chirieac has received personal fees from medicological work related to mesothelioma. Dr. Perol has received personal fees from Eli Lilly, Roche, Bristol-Myers Squibb, Merck, AstraZeneca, and Beohringer Ingelheim. Dr. Scherpereel has received grants from MSD and Sandoz; has received personal fees from AstraZeneca, Bristol-Myers Squibb, Janssen, MSD, and Roche. Dr. Tazelaar has received personal fees from Cipla Ltd. Dr. Tsao has received grants from Merck, AstraZeneca, Pfizer, and Bayer; and has received personal fees from Merck, AstraZeneca, Bristol-Myers Squibb, Pfizer, Bayer, Takeda, and Roche Genentech. Dr. Rusch has received support from the National Institutes of Health Thoracic Malignancy Steering Committee. The remaining authors declare no conflict of interest.
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