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reactive mesothelial hyperplasia

Wednesday 26 September 2012


- in a hernia sac (WebPathology)

Differential diagnosis

Yet despite the advent of immunohistochemistry as an essential adjunct to the pathological diagnosis of MM, consistent and reliable diagnosis continues to be problematical in some cases, especially for small biopsies.

Many anatomical pathologists emphasise the identification of neoplastic invasion as the definitive criterion for definitive diagnosis of malignant mesothelioma as opposed to reactive mesothelial hyperplasia.

Accordingly, Churg and Galateau-Sallé stated in 2012 that, after allowance for pseudoinvasive findings such as en face sections and benign entrapment of mesothelioma as a consequence of fibro-inflammatory processes: ‘… invasion of the stroma continues to be by far the most reliable criterion for separating benign from malignant mesothelial proliferations. Fat is the stroma most frequently encountered and the finding of mesothelial cells in fat makes the proliferation malignant unless there is an extraordinarily good reason to believe otherwise. The same comment applies [even more so] to invasion of muscle or invasion of lung or another organ.