Histology is a branch of medical biology that studies cells and tissues in living beings. The structure and composition of these cells and tissues are studied on a slide under a microscope to learn more about the cells, the differences between various types, and ultimately determine classifications. Studying diseased cells, such as mesothelioma tumors, is a branch of histology called histopathology. The examination of mesothelioma cancer cells is usually conducted by board-certified pathologists, who study the diagnosis of disease and are responsible for the accuracy of laboratory tests. Both pathologists and histologists are important figures in the medical treatment of mesothelioma patients. They are problem-solvers and interpreters, critical in mesothelioma diagnosis because of the array of cancer cell types. Each of these mesothelioma cell types respond differently to treatments and affect the patient in different ways, so an accurate classification is imperative. After a treatment plan is decided upon and administered, histologists and pathologists continue to study the cancerous cells to provide insight on the effectiveness of the treatment.
Mesothelioma attorneys at Pintas & Mullins Law Firm highlight the importance of histology for mesothelioma patients. The analysis of cell type helps solidify the cause of the cancer, which, in most cases, is exposure to asbestos fibers. Mesothelioma can be categorized histologically as epithelioid type, sarcomatoid type, biphasic type, or desmoplastic type; the three major types are epithelioid (60%), sarcomatoid (20%), and biphasic (20%).
In females with peritoneal extension, the ovary should be carefully examined as the primary site of the tumor because the differential diagnosis between ovarian cancer and peritoneal mesothelioma is difficult and can only be made on the basis of histological analyses.
The histochemical staining of hyarulonic acid and electron microscopic studies have been widely used in the past for making a differential diagnosis between mesothelioma and other tumors. However, immunohistochemical stains are currently the method of choice because of the simplicity and ease of these techniques. Many antibodies have been detected for use in immunohistochemical staining techniques aimed at diagnosing mesothelioma, but as yet there is no antibody that is completely specific for mesothelioma and on which a pathological diagnosis of mesothelioma can be singly based.
In the compensation system for occupational exposures to asbestos and in the law for non-occupational exposure to asbestos, if the diagnosis of mesothelioma is certain, it can almost always be presumed to be related to asbestos exposure and the patients can receive compensation or relief. Therefore, the accuracy of the pathological diagnosis as mesothelioma is very important. In particular, the pathologists must improve the accuracy of the pathological diagnosis using adequate immunohistochemical stains.
Sacromatoid mesothelioma has many histological mimics and differentiating can by challenging. The diagnosis of malignant mesothelioma is complex and usually requires a multimodal approach that includes careful clinical history and physical examination, imaging studies, and tissue sampling for multimodal evaluation including routine histology, histochemistry, electron microscopy, and immunohistochemical tests. Of these, immunohistochemistry has emerged as the most valuable and readily available modality for the routine evaluation of these tumors. Unfortunately, no specific antibodies have yet been developed that can be accepted as exclusive for these tumors.
Additionally, the selection and utility of the various positive and negative
markers can vary considerably based on a constellation of circumstances,
including patient sex, histologic appearance of the tumor (ie, epithelioid
vs. sarcomatoid, etc), and various other clinical circumstances.
New diagnostic tools and techniques are desirable for cases where immunohistochemical and other established methods cannot provide a clear entity diagnosis, and in order to improve malignant mesothelioma treatment. Individual mesothelial markers are of low sensitivity and specificity for mesothelioma. However, diagnostic accuracy is improved by the use of antibody panels. To date there are no antibodies that help distinguishing mesothelioma from reactive pleura.
The histological study of mesothelioma cells is growing and still being researched around the world. The extended period between initial exposure to asbestos and the development of mesothelioma means that the number of cases will continue to rise each year into the foreseeable future. If you developed mesothelioma from asbestos exposure, contact a lung cancer lawyer immediately for a free consultation of your legal claims.