p16 FISH Deletion in Surface Epithelial Mesothelial Proliferations Is Predictive of Underlying Invasive Mesothelioma

@article{Hwang2014p16FD,
  title={p16 FISH Deletion in Surface Epithelial Mesothelial Proliferations Is Predictive of Underlying Invasive Mesothelioma},
  author={Harry C. Hwang and Christopher H Tse and Stephanie A Rodriguez and Allen M. Gown and Andrew Churg},
  journal={The American Journal of Surgical Pathology},
  year={2014},
  volume={38},
  pages={681–688}
}
  • H. HwangC. Tse A. Churg
  • Published 1 May 2014
  • Medicine, Biology
  • The American Journal of Surgical Pathology
An atypical mesothelial proliferation along the pleural or peritoneal surface without evidence of invasive tumor poses a diagnostic challenge. Homozygous deletion of p16 (CDKN2A) by fluorescence in situ hybridization (FISH) has been shown to be a good marker of malignancy in mesothelial proliferations, but correlations of p16 status between atypical surface proliferations and underlying mesothelioma have not been described. We used p16 FISH to investigate 11 pleural and 7 peritoneal… 

Deletion status of p16 in effusion smear preparation correlates with that of underlying malignant pleural mesothelioma tissue

In cases with clinical and radiologic evidence of a diffuse pleural tumor, detection of p16 deletion in cytologic smear samples may permit MPM diagnosis without additional tissue examination, however, the absence of p 16 deletion in centrifugal smear samples does not preclude MPM.

Loss of BAP1 Expression in Atypical Mesothelial Proliferations Helps to Predict Malignant Mesothelioma

Loss of BAP1 expression in atypical mesothelial proliferation helps to predict malignant mesothelioma and is a useful adjunct test in these cases, while homozygous deletion of CDKN2A in mesotheric cell proliferations did not prove to be useful to predict MM.

BAP1 Immunohistochemistry and p16 FISH to Separate Benign From Malignant Mesothelial Proliferations

Together, BAP1 IHC and p16 FISH testing is not highly sensitive, and negative results do not rule out a mesothelioma, but the test characteristics of previously proposed markers EMA, p53, GLUT1, IMP3 suggest that these markers are not useful tools in this clinical setting.

New Markers for Separating Benign From Malignant Mesothelial Proliferations: Are We There Yet?

In the context of a mesothelial proliferation, the finding of homozygous deletion of p16 by FISH or loss of BAP1 by immunohistochemistry is, thus far, 100% specific for malignant mesothelioma.

Malignant mesothelioma in situ diagnosed by methylthioadenosine phosphorylase loss and homozygous deletion of CDKN2A: a case report

The case of a MIS is reported in a 73-year-old male with a history of asbestos exposure presenting with massive pleural effusion in the right thoracic cavity, leading to the diagnosis of MIS.

BAP1 (BRCA1-associated protein 1) is a highly specific marker for differentiating mesothelioma from reactive mesothelial proliferations

BAP1 immunostain represents an excellent biomarker with an unprecedented specificity in the distinction between benign and malignant mesothelioma and other mesothelial proliferations and is commonly associated with homozygous BAP1 deletion.

Utility of BAP1 Immunohistochemistry and p16 (CDKN2A) FISH in the Diagnosis of Malignant Mesothelioma in Effusion Cytology Specimens

Both BAP1 immunohistochemistry and p16 FISH analysis provide reliable markers of mesothelial malignancy in effusion cytology specimens, especially where the atypical mesothelioma proliferation is well sampled.

Use of p16 FISH for differential diagnosis of mesothelioma in smear preparations

It was shown that the p16 deletion status of MPM cells in pleural effusions reflected that of the underlying invasive MPM tissues, indicating the usefulness of p16 FISH in effusion smear cytology for MPM diagnosis, and proposed to perform p 16 FISH as often as possible for differentiating MPM from RMC.

The pathologists and team at PhenoPath

Combined BAP1/p16 FISH testing is not highly sensitive, and negative results do not rule out a mesothelioma, but test characteristics of previously proposed markers EMA, p53, GLUT1, IMP3 suggest that, even in combination, these markers are not useful tools in this clinical setting.

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