Present Role of Cytology in Diagnosing Malignant Pleural Mesothelioma

The possibility to diagnose malignant pleural mesothelioma (MPM) based on an effusion gives cytology a central role in handling of these patients. Audits have shown that effusion cytology, supported by one or more ancillary techniques, can diagnose a majority of all MPMs. When a definite diagnosis is obtained, this is beneficial for both patient and clinic. The cytological sample is easily accessible with less invasive means. However, the sensitivity for reaching this diagnosis based on cytology is 60-75%, i.e., somewhat lower than for the histopathologic examination of a biopsy, the exact level depending on the extent of ancillary analyses available. The cytological diagnoisis require support from immunohistochemistry and/or electron microscopy, and the sensitivity can be improved by testing soluble biomarkers (hyaluronan and mesothelin).

Keywords: Cytology, desmin, EMA, malignant pleural mesothelioma, pleural effusion.