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Mesothelioma: HELP
Articles from Manitoba
Based on 5 articles published since 2009

These are the 5 published articles about Mesothelioma that originated from Manitoba during 2009-2019.
+ Citations + Abstracts
1 Review Selected topics in peritoneal pathology. 2014

Baker, Patricia M / Clement, Philip B / Young, Robert H. ·Department of Pathology (P.M.B.), Health Sciences Centre, Faculty of Medicine, University of Manitoba, Winnipeg, MB Vancouver General Hospital (P.B.C.), University of British Columbia, Vancouver, BC Massachusetts General Hospital, Harvard Medical School (R.H.Y.), Boston, Massachusetts. ·Int J Gynecol Pathol · Pubmed #24901399.

ABSTRACT: This essay considers selected peritoneal lesions many of which were the subject of studies coauthored by Dr Robert E. Scully. His article on multilocular peritoneal inclusion cysts has largely led to these lesions being considered non-neoplastic, eschewing the term cystic mesothelioma. These cysts are often associated with reactive mural mesothelial proliferations that can potentially lead to a misdiagnosis of mesothelioma. Clinical findings, such as a common association with endometriosis or prior operations, can prompt consideration of a reactive lesion. Mesothelial hyperplasia may be difficult to distinguish, when florid, from mesothelioma but a variety of gross and microscopic features will aid their recognition. Nodular peritoneal aggregates of histiocytes (sometimes admixed with mesothelial cells) may occasionally be a striking finding that can be misdiagnosed as a metastasis if the patient has a known neoplasm. Appreciation of their bland nuclear features and histiocytic nature, confirmed by immunohistochemical markers, facilitate the diagnosis. Various forms of peritonitis are briefly considered including sclerosing peritonitis, a process sometimes associated with luteinized thecomas (thecomatosis) of the ovaries, an entity first appreciated by Dr Scully. Mesotheliomas are briefly reviewed emphasizing the caution that should be used in applying the designation "well-differentiated papillary mesothelioma." Many interpret the latter as benign, but multifocal lesions must be thoroughly examined histologically because of potential overlapping features with malignant mesothelioma. The morphologic spectrum of malignant mesothelioma and its usually straightforward distinction from müllerian neoplasms is considered, as is its occasional presentation as a dominant ovarian mass. The spectrum of low-grade serous peritoneal neoplasms including the "psammocarcinoma" is reviewed. Finally, various benign müllerian lesions, particularly endometriosis and endosalpingiosis, may be conspicuous in peritoneal specimens and sometimes are grossly striking. The usual presence of benign endometrioid epithelium and stroma should facilitate the correct diagnosis of endometriosis, but in cases in which the stroma is atrophic or the sole component (stromal endometriosis), diagnostic problems may arise.

2 Review Asbestos-related pleural disease. 2012

Myers, Renelle. ·Department of Internal Medicine, University of Manitoba, Canada. rmyers2@exchange.hsc.mb.ca ·Curr Opin Pulm Med · Pubmed #22617814.

ABSTRACT: PURPOSE OF REVIEW: Asbestos exposure is the cause of significant pleural disease - both benign and malignant. Although there is increased awareness, individuals continue to be exposed, and we will continue to see its sequelae for years to come because of the delay between exposure and disease manifestation. Asbestos-related pleural disease includes pleural plaques, diffuse pleural thickening, benign asbestos-related pleural effusions (BAPEs), and malignant pleural mesothelioma (MPM). RECENT FINDINGS: Several recent studies are highlighted throughout this review, including a comparative analysis of diagnostic imaging modalities for identifying and characterizing pleural plaques, the effect of pleural plaques on lung volumes and flows, and how pain is a relatively common feature in patients with pleural plaques. Advances in the treatment of MPM are limited, but a recent publication highlights the increased morbidity associated with surgical debulking procedures and questions the benefit of these procedures. SUMMARY: Asbestos-related pleural disease will continue to present a significant burden of illness. Recent publications have suggested potential treatment benefit and point to areas that would require further investigation.

3 Clinical Trial A Phase II Study of PF-03446962 in Patients with Advanced Malignant Pleural Mesothelioma. CCTG Trial IND.207. 2016

Wheatley-Price, Paul / Chu, Quincy / Bonomi, Maria / Seely, Jean / Gupta, Ashish / Goss, Glenwood / Hilton, John / Feld, Ronald / Lee, Christopher W / Goffin, John R / Maksymiuk, Andrew / Murray, Nevin / Hagerman, Linda / Bradbury, Penelope A. ·Ottawa Hospital Cancer Centre/Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. Electronic address: pwheatleyprice@toh.on.ca. · Cross Cancer Institute, Edmonton, Alberta, Canada. · Canadian Cancer Trials Group, Queen's University, Ontario, Canada. · Ottawa Hospital Cancer Centre/Ottawa Hospital Research Institute, Ottawa, Ontario, Canada. · Princess Margaret Cancer Centre, Toronto, Ontario, Canada. · British Columbia Cancer Agency-Fraser Valley Centre, Surrey, British Columbia, Canada. · Juravinski Cancer Centre at Hamilton Health Sciences, Hamilton, Ontario, Canada. · CancerCare Manitoba, Winnipeg, Manitoba, Canada. · British Columbia Cancer Agency-Vancouver Centre, Vancouver, British Columbia, Canada. ·J Thorac Oncol · Pubmed #27449804.

ABSTRACT: There is no approved second-line systemic therapy option for malignant pleural mesothelioma (MPM), but targeting angiogenesis is an area of investigation. PF-03446962 is a fully human antibody against activin receptor-like kinase 1, which is commonly expressed in tumor vasculature. We performed a multicenter, open label, single-arm, two-stage phase II study of PF-03446962 in patients with MPM and progressive disease after platinum-based chemotherapy. In total, 17 patients were enrolled, but no partial or complete responses were observed. The trial did not meet the prespecified response criterion for moving to the second stage. There were only three grade 3 (G3) or higher nonhematological toxicities observed (G3 hypertension [n=2] and G3 fatigue [n=1]) and just one episode of G3 lymphopenia. In conclusion, PF-03446962, despite being generally well tolerated, failed to demonstrate efficacy in the treatment of advanced MPM as a single agent. There are no plans for further investigation of this agent in MPM.

4 Article Malignant mesothelioma in situ. 2018

Churg, Andrew / Hwang, Harry / Tan, Larry / Qing, Gefei / Taher, Altaf / Tong, Amy / Bilawich, Ana M / Dacic, Sanja. ·Department of Pathology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada. · PhenoPath Laboratories, Seattle, WA, USA. · Division of Thoracic Surgery, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. · Department of Pathology, Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, Canada. · Department of Pathology, Memorial University of Newfoundland, St John's, NF, Canada. · Department of Medicine, Memorial University of Newfoundland, St John's, NF, Canada. · Department of Radiology, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada. · Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. ·Histopathology · Pubmed #29350783.

ABSTRACT: AIMS: The existence of malignant mesothelioma in situ (MIS) is often postulated, but there are no accepted morphological criteria for making such a diagnosis. METHODS AND RESULTS: Here we report two cases that appear to be true MIS on the basis of in-situ genomic analysis. In one case the patient had repeated unexplained pleural unilateral effusions. Two thoracoscopies 9 months apart revealed only visually normal pleura. Biopsies from both thoracoscopies showed only a single layer of mildly reactive mesothelial cells. However, these cells had lost BRCA1-associated protein 1 (BAP1) and showed loss of cyclin-dependent kinase inhibitor 2 (CDKN2A) (p16) by fluorescence in-situ hybridisation (FISH). NF2 was not deleted by FISH but 28% of the mesothelial cells showed hyperploidy. Six months after the second biopsy the patient has persisting effusions but no evidence of pleural malignancy on imaging. The second patient presented with ascites and minimal omental thickening on imaging, but no visual evidence of tumour at laparoscopy. Omental biopsy showed a single layer of minimally atypical mesothelial cells with rare tiny foci of superficial invasion of fat. BAP1 immunostain showed loss of nuclear BAP1 in all the surface mesothelial cells and the invasive cells. There was CDKN2A deletion, but no deletion of NF2 by FISH. CONCLUSIONS: These cases show that morphologically bland single-layered surface mesothelial proliferations with molecular alterations seen previously only in invasive malignant mesotheliomas exist, and presumably represent malignant MIS. More cases are need to understand the frequency of such changes and the time-course over which invasive tumour develops.

5 Article Diffuse intrapulmonary malignant mesothelioma masquerading as interstitial lung disease: a distinctive variant of mesothelioma. 2013

Larsen, Brandon T / Klein, Julianne R H / Hornychová, Helena / Nuti, Rathna / Thirumala, Seshadri / Leslie, Kevin O / Colby, Thomas V / Tazelaar, Henry D. ·*Division of Anatomic Pathology, Mayo Clinic, Rochester, MN ¶Division of Anatomic Pathology, Mayo Clinic, Scottsdale, AZ †Department of Pathology, University of Manitoba, Winnipeg, MB, Canada ‡Department of Pathology, Faculty of Medicine and University Hospital, Charles University in Prague, Hradec Kralove, Czech Republic §School of Medicine, Texas Tech University Health Science Center ∥AmeriPath, Lubbock, TX. ·Am J Surg Pathol · Pubmed #23797722.

ABSTRACT: Malignant mesothelioma typically encases lungs as a thick rind, while relatively sparing lung parenchyma. We describe an unusual presentation of mesothelioma characterized by diffuse intrapulmonary growth, with absent or inconspicuous pleural involvement, clinically simulating interstitial lung disease (ILD). We identified 5 patients (median age 56 y, all men) with diffuse intrapulmonary malignant mesothelioma in our pathology consultation practice from 2009 to 2012. Clinical history, imaging, and pathology materials were reviewed. Symptoms included chronic dyspnea (4 cases), cough (3), and acute dyspnea with bilateral pneumothorax (1). Chest imaging showed irregular opacities (5), reticulation (4), pleural effusions (2), and subpleural nodular densities (1), without radiologic evidence of pleural disease or masses. A clinicoradiologic diagnosis of ILD was made in all cases, and wedge biopsies were performed. Histologic evaluation revealed a neoplastic proliferation of bland epithelioid or spindled cells, showing various growth patterns simulating silicotic nodules, desquamative interstitial pneumonia, organizing pneumonia, and Langerhans cell histiocytosis. Some areas mimicked adenocarcinoma, with lepidic, acinar, micropapillary, and solid patterns. Initial diagnoses by referring pathologists included reactive changes (1), hypersensitivity pneumonitis versus drug reaction (1), desquamative interstitial pneumonia versus neoplasm (1), and mesothelioma (2). Microscopic pleural involvement was identified in 4 cases. Immunohistochemistry confirmed the characteristic immunophenotype of mesothelioma in all cases. Median survival of 3 patients treated with chemotherapy was 28 months. Two patients received no therapy and survived 3 and 4 weeks, respectively. "Diffuse intrapulmonary malignant mesothelioma" is a rare variant with a distinctive presentation that clinically mimics ILD. Recognition is essential to avoid misdiagnosis.