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CytoJournal 2015,  12:26

Guidelines for cytopathologic diagnosis of epithelioid and mixed type malignant mesothelioma. Complementary statement from the International Mesothelioma Interest Group, also endorsed by the International Academy of Cytology and the Papanicolaou Society of Cytopathology

1 Department of Laboratory Medicine, Division of Clinical Pathology/Cytology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE 14186 Huddinge, Sweden
2 Department of Radiological, Oncological and Pathological Sciences, Sapienza University, Rome, Italy
3 Department of Pathology, Rush University Medical College, Chicago, Illinois, USA
4 Leiden Cytology and Pathology Laboratory, Leiden, Netherlands
5 National Centre for Asbestos Related Disease, School of Medicine and Pharmacology, University of Western Australia, QEII Medical Centre, WA 6009, Sydney
6 Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, N 0310 Oslo, Norway
7 Department of Laboratory Medicine, Lund University, Malmo University Hospital, SE 205 02 Malmo, Sweden
8 Department of Laboratory Medicine, Division of Clinical Pathology/Cytology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE 14-86 Huddinge, Sweden
9 Department of Medicine, University of Padova, 35121 Padova, Italy
10 Department of Anatomical Pathology, St. Vincents Hospital, Sydney
11 Department of Pathology, Istanbul University, Istanbul Faculty of Medicine, Capa, Fatih 34093, Istanbul, Turkey
12 Department of Pathology, Yamaguchi Grand Medical Center, Hofu City, Yamaguchi Pref, 747-8511, Osaka, Japan
13 Cancer Education and Research Center, Osaka University Graduate School of Medicine, Osaka, Japan
14 Department of Pathology, Case Western Reserve University, University Hospitals Case Medical Center, MSPTH 5077, Cleveland, OH 44106, USA
15 Department of Pathology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
16 Department of Tissue Pathology, Pathwest Laboratory Medicine WA, QE2 Medical Centre, Western Australia 6009, Australia
17 Department of Biopathology, Gustave Roussy Comprehensive Cancer Center, 94805 Vilejuif Cedex, France

Correspondence Address:
Anders Hjerpe
Department of Laboratory Medicine, Division of Clinical Pathology/Cytology, Karolinska Institutet, Karolinska University Hospital Huddinge, SE 14186 Huddinge
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/1742-6413.170726

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To provide practical guidelines for the cytopathologic diagnosis of malignant mesothelioma (MM). Cytopathologists involved in the International Mesothelioma Interest Group (IMIG) and the International Academy of Cytology (IAC), who have an interest in the field contributed to this update. Reference material includes peer-reviewed publications and textbooks. This article is the result of discussions during and after the IMIG 2012 conference in Boston, followed by thorough discussions during the 2013 IAC meeting in Paris. Additional contributions have been obtained from cytopathologists and scientists, who could not attend these meetings, with final discussions and input during the IMIG 2014 conference in cape town. During the previous IMIG biennial meetings, thorough discussions have resulted in published guidelines for the pathologic diagnosis of MM. However, previous recommendations have stated that the diagnosis of MM should be based on histological material only. [1],[2] Accumulating evidence now indicates that the cytological diagnosis of MM supported by ancillary techniques is as reliable as that based on histopathology, although the sensitivity with cytology may be somewhat lower. [3],[4],[5] Recognizing that noninvasive diagnostic modalities benefit both the patient and the health system, future recommendations should include cytology as an accepted method for the diagnosis of this malignancy. [6],[7] The article describes the consensus of opinions of the authors on how cytology together with ancillary testing can be used to establish a reliable diagnosis of MM.


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