Journal article
Mesotheliomas and Benign Mesothelial Tumors: Update on Pathologic and Imaging Findings
Radiographics, Vol.43(3), pp.e220128-e220128
03/01/2023
DOI: 10.1148/rg.220128
PMID: 36757881
Abstract
A diverse spectrum of benign entities and malignant neoplasms originate from the monotonous mesothelium that lines the serosal membranes of the pleural, pericardial, and peritoneal cavities. The mesothelium of myriad sites shows a common origin from the lateral plate mesoderm; primary me-sothelial tumors thus demonstrate similar pathogenesis, imaging findings, and treatment options. Significant changes have been made in the 2021 World Health Organization (WHO) classification schemata of the pleural and pericardial tumors on the basis of recent advances in pathology and genetics. While malignant mesotheliomas are biologically aggressive malig-nancies that occur primarily in patients exposed to asbestos with attendant poor survival rates, well-differentiated papillary mesothelial tumors and adenomatoid tumors charter a benign clinical course with an excellent prognosis. Mesothelioma in situ is a newly characterized entity represented by recurrent unexplained pleural effusions without any identifiable mass at imaging or thoracoscopy. Immunohistochemical markers based on BAP1, MTAP, CDKN2A, and TRAF7 gene mutations help differentiate diffuse mesotheliomas from benign mesothelial proliferations and localized meso-theliomas. Cross-sectional imaging modalities, including US, CT, MRI, and fluorine 18-fluorodeoxyglucose (FDG) PET/CT, permit diagnosis and play a major role in staging and assessing surgical resectability. Imaging studies are invaluable in providing noninvasive and quantitative assessment of tumor response in patients with unresectable disease. Owing to significant overlap in patient characteristics and pathomorphology, accurate diagnosis based on advanced histopathology techniques and genetic abnormalities is imperative for optimal management and prognostication. While patients with nonepithelioid pleural mesotheliomas benefit from immunotherapy, novel targeted therapies for CDKN2A-, NF2-, and BAP1-altered mesothelio-mas are under consideration.
Details
- Title: Subtitle
- Mesotheliomas and Benign Mesothelial Tumors: Update on Pathologic and Imaging Findings
- Creators
- Apurva Bonde - The University of Texas Health Science Center at San AntonioRamandeep Singh - Massachusetts General HospitalSrinivasa R. Prasad - The University of Texas MD Anderson Cancer CenterDhiraj Kamireddy - The University of Texas Health Science Center at San AntonioAarushi Aggarwal - The University of Texas Health Science Center at San AntonioNisha Ramani - The University of Texas MD Anderson Cancer CenterSachin Saboo - The University of Texas Health Science Center at San AntonioKrishna Shanbhogue - NYU Langone HealthAnil K. Dasyam - University of Pittsburgh Medical CenterVenkata S. Katabathina - The University of Texas Health Science Center at San Antonio
- Resource Type
- Journal article
- Publication Details
- Radiographics, Vol.43(3), pp.e220128-e220128
- Publisher
- RADIOLOGICAL SOC NORTH AMERICA (RSNA)
- DOI
- 10.1148/rg.220128
- PMID
- 36757881
- ISSN
- 0271-5333
- eISSN
- 1527-1323
- Number of pages
- 18
- Language
- English
- Date published
- 03/01/2023
- Academic Unit
- Radiology
- Record Identifier
- 9984697633102771
Metrics
6 Record Views