Open Access
About JournalArchiveSearchFor AuthorsFor ReviewersHelpOnline-Submission
Vol.48, No.6, 2014
Current Issue
Archive (2009~
Archive-the Korean Journal of Pathology(1967~2008)
Archive-the Korean Journal of Cytopathology(1990~2008)
Most Read Articles
  Vol.43, No.5:458-466, October 2009
Original articles
Malignant Mesothelioma in Body Fluids - with Special Reference to Differential Diagnosis from Metastatic Adenocarcinoma -

Jin Ho Paik, Jin-Haeng Chung, Baek-Hui Kim, Gheeyoung Choe

Department of Pathology, Seoul National University

Background : Malignant mesothelioma (MM) is a rare malignant neoplasm occurring in pleura,
pericardium, and peritoneum. The differential diagnosis between MM and metastatic adenocarcinoma
(MA) causes diagnostic, staging, and therapeutic dilemmas. Herein, we investigated
characteristic cytologic features of MM.

Methods : Cytologic specimens of MM (n=10),
MA (n=25), and reactive mesothelial hyperplasia (n=10) were retrieved and reviewed from
archival materials in the Department of Pathology, Seoul National University Bundang Hospital
from May 2003 to July 2008.

Results : MM showed tumor cell clusters and singly scattered
malignant tumor cells forming single cell populations with sparse reactive benign mesothelial
cells. In contrast, MA showed distinct two cell populations of tumor cell clusters and scattered
reactive mesothelial cells. Furthermore, MM frequently exhibited a characteristic long
chain-like arrangement (hand-in-hand appearance) and intercellular windows, which were
rarely evident in MA. Variable nuclear size, relatively consistent nuclear-cytoplasmic ratio, bior
multi-nucleation, and lacy cytoplasmic borders were also frequently observed in MM. Conclusions
: Differential diagnosis of MM from MA in body fluids is possible based on meticulous
examination of certain cytologic parameters, which could have significant implications in
staging and treatment.
Key Words : Cytology; Mesothelioma; Adenocarcinoma; Body fluids; Diagnosis, Differential

Copyright(c) 2008 By the Korean Society of Pathologists & the Korean Society for Cytopathology
Room 1209 Gwanghwamun Officia, 163 Sinmunno 1-ga, Jongno-gu, Seoul 110-999, Korea
Tel: +82-2-795-3094, Fax: +82-2-790-6635, E-mail:
#406 Lilla Swami Bldg, 391-18, Yangjae-dong, Seocho-gu, Seoul 137-130, Korea
Tel: +82-2-593-6943 Fax: +82-2-593-6944, E-mail: