9p21 Deletion in the diagnosis of malignant mesothelioma in serous effusions additional to immunocytochemistry, DNA-ICM, and AgNOR analysis
✍ Scribed by Onofre, Fabiana Botelho de Miranda ;Onofre, Alexandre Sherlley Casimiro ;Pomjanski, Natalia ;Buckstegge, Birgit ;Grote, Hans Juergen ;Böcking, Alfred
- Publisher
- John Wiley and Sons
- Year
- 2008
- Tongue
- English
- Weight
- 308 KB
- Volume
- 114
- Category
- Article
- ISSN
- 0008-543X
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✦ Synopsis
Background:
The diagnosis of malignant mesothelioma (mm) in serous effusions is difficult but may be achieved by the application of adjuvant methods.
Methods:
The authors cytologically diagnosed 33 effusions as suspicious or positive for mm cells by using dna-image cytometry (dna-icm), immunocytochemistry and agnor analysis. the authors further detected 9p21 deletions by chromosomal fluorescence in situ hybridization (fish). in addition, 31 cases of metastatic carcinomas and 39 of tumor cell-negative effusions were investigated. all diagnoses were confirmed by histologic and/or clinical follow-up.
Results:
Dna aneuploidy was found in 71% of mms, 100% of metastatic carcinomas, and in none of the negative effusions. calretinin was positive in 100% of mms, in none of the metastatic carcinomas, and in 94.9% of negative effusions. berep4 showed positivity in 15.6% of mms, 87.1% of metastatic carcinomas, and in none of the negative effusions. with agnor analysis, 89.3% of mms and 96.7% of metastatic carcinomas showed >or=2.5 agnor dots as satellites and >or=4.5 as total agnor counts. 9p21 deletions were demonstrated in 90.9% of mm cases, 45.2% of metastatic carcinomas, and in none of the negative effusions. by cytology alone, 81.8% of mms were identified unequivocally. addition of dna-icm improved the prevalence of tumor cell detection to 87.9% and of agnor analysis to 97%. the introduction of 9p21 deletions by fish improved this prevalence to 100%.
Conclusions:
Because of these results, the authors propose the sequential application of immunocytochemistry, dna-icm, and agnor analysis to establish a cytological diagnosis of malignant mesothelioma in serous effusions. in persistent doubtful diagnoses, the authors recommend fluorescence in situ hybridization to analyze the 9p21 deletion.