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Mesothelial hyperplasia with reactive atypia: Diagnostic pitfalls and role of immunohistochemical studies—a case report

✍ Scribed by Andrea Lee; Zubair W. Baloch; Gordon Yu; Prabodh K. Gupta


Publisher
John Wiley and Sons
Year
2000
Tongue
English
Weight
321 KB
Volume
22
Category
Article
ISSN
8755-1039

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✦ Synopsis


The cytomorphologic features of highly reactive mesothelial cells can be diffıcult to distinguish from malignant cells. We report on an unusual case of mesothelial hyperplasia in a pericardial effusion. The specimen contained bizarre-shaped cells and large tissue fragments in a patient with a history of lung carcinoma. The atypical cells were negative for CEA and LeuM-1 and positive for cytokeratins (AE1/3) and HBME-1. Strong HBME-1 positivity supported a mesothelial origin of the atypical cells and led to the diagnosis of reactive mesothelium. While HBME-1 cannot be used as the sole marker to establish an mesothelial origin; its use in a immunohistochemistry panel may be useful in individual cases to distinguish reactive mesothelial cells from carcinoma in effusion cytology.