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EP24444
Poster Title: BAP1 immunohistochemistry and p16 FISH in the diagnosis of malignant peritoneal mesothelioma
Submitted on 26 Sep 2016
Author(s): Toshiaki Kawai, M.D.1,2, Koji Kameda, M.D.2, Kuniaki Nakanishi, M.D.2, Kenzo Hiroshima, M.D.3
Affiliations: 1Toda Central Medical Laboratory, Toda, 2Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, 3Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo, Japan
This poster was presented at XXXI International Congress of the IAP and 28th Congress of the ESP
Poster Views: 1,879
Submitted on 26 Sep 2016
Author(s): Toshiaki Kawai, M.D.1,2, Koji Kameda, M.D.2, Kuniaki Nakanishi, M.D.2, Kenzo Hiroshima, M.D.3
Affiliations: 1Toda Central Medical Laboratory, Toda, 2Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, 3Tokyo Women’s Medical University Yachiyo Medical Center, Yachiyo, Japan
This poster was presented at XXXI International Congress of the IAP and 28th Congress of the ESP
Poster Views: 1,879
Abstract: Objective: Peritoneal malignant mesothelioma (PMM) is an uncommon tumor, only 7-9% of all mesothelioma in Japan. Differential diagnosis between PMM and primary peritoneal serous carcinoma (PPSC), a high-grade serous carcinoma, may be difficult, and separating reactive mesothelial hyperplasia (RMH) from PMM can be even more challenging.
Methods: To help differentiate PMM from PPSC and RMH, we used immunohistochemistry to examine BAP1, and FISH to examine for homozygous deletion of 9p21. We used formalin-fixed, paraffin-embedded blocks from 22 PMMs (M:F=18:4; subtypes: 16 epithelioid, 6 biphasic), 11 PPSCs, and 10 RMHs.
Results: Seventeen of the mesotheliomas were classified as diffuse, while 5 were localized. Loss of BAP1 was seen in 10/21 (45%) of PMM, but all PPSC and all RMH were BAP1-positive. For the differentiation of PMM from PPSC and RMH of the peritoneum, the sensitivity and specificity for BAP1 in mesothelioma were 43% and 100%, respectively. FISH analysis revealed homozygous deletion of the 9p21 locus in 11/13 (85%) of PMM, but in none of RMH.
Conclusion: BAP1 loss is not a sensitive test, although specificity is very high for differentiating PMM from both PPSC and RMH. Homozygous deletion of 9p21 may be helpful for differentiating PMM from RMH.
Summary: In order to differentiate peritoneal malignant mesothelioma (PMM) from primary peritoneal serous carcinoma (PPSC) and reactive mesothelial hyperplasia (RMH), we used immunohistochemistry to examine for BAP1, and FISH to examine for homozygous deletion of p16. References: 1. The prognostic significance of BAP1, NF2, and CDKN2A in malignant peritoneal
mesothelioma. Singhi et al. Mod Pathol 2015 14-24
2. Peritoneal malignant mesothelioma, and primary peritoneal serous carcinoma and
reactive mesothelial hyperplasia of thr peritoneum. Kawai et al. J Clin Pathol 2016;706-
712
Methods: To help differentiate PMM from PPSC and RMH, we used immunohistochemistry to examine BAP1, and FISH to examine for homozygous deletion of 9p21. We used formalin-fixed, paraffin-embedded blocks from 22 PMMs (M:F=18:4; subtypes: 16 epithelioid, 6 biphasic), 11 PPSCs, and 10 RMHs.
Results: Seventeen of the mesotheliomas were classified as diffuse, while 5 were localized. Loss of BAP1 was seen in 10/21 (45%) of PMM, but all PPSC and all RMH were BAP1-positive. For the differentiation of PMM from PPSC and RMH of the peritoneum, the sensitivity and specificity for BAP1 in mesothelioma were 43% and 100%, respectively. FISH analysis revealed homozygous deletion of the 9p21 locus in 11/13 (85%) of PMM, but in none of RMH.
Conclusion: BAP1 loss is not a sensitive test, although specificity is very high for differentiating PMM from both PPSC and RMH. Homozygous deletion of 9p21 may be helpful for differentiating PMM from RMH.
Summary: In order to differentiate peritoneal malignant mesothelioma (PMM) from primary peritoneal serous carcinoma (PPSC) and reactive mesothelial hyperplasia (RMH), we used immunohistochemistry to examine for BAP1, and FISH to examine for homozygous deletion of p16. References: 1. The prognostic significance of BAP1, NF2, and CDKN2A in malignant peritoneal
mesothelioma. Singhi et al. Mod Pathol 2015 14-24
2. Peritoneal malignant mesothelioma, and primary peritoneal serous carcinoma and
reactive mesothelial hyperplasia of thr peritoneum. Kawai et al. J Clin Pathol 2016;706-
712
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