Mesothelioma

Question 1

IHC Markers for meso

Answer 1

+
Markers indicative of the diagnosis of mesothelioma are calretinin, D2-40, WT1, cytokeratin 5/6 and podoplanin, while

• TTF
  MOC 31

Question 2

Stage 1 Mesothelioma

Answer 2

Tumor limited to the ipsilateral parietal pleura with or without mediastinal pleura and with or without diaphragmatic pleural involvement

Question 3

Stage 2 Mesothelioma

Answer 3

Tumor involving each of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least 1 of the following:

a. Involvement of the diaphragmatic muscle
b. Extension of tumor from the visceral pleura into the underlying pulmonary parenchyma

Question 4

Stage 3 Mesothelioma

Answer 4

Locally advanced but potentially resectable tumor;
tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least 1 of the following:

1. Involvement of the endothoracic fascia
2. Extension into the mediastinal fat
3. Solitary, completely resectable focus of tumor extending into the soft tissue of the chest wall
4. Nontransmural involvement of the pericardium

Question 5

Stage 4 mesothelioma

Answer 5

Locally advanced, technically unresectable tumor; tumor involving all of the ipsilateral pleural surfaces (parietal, mediastinal, diaphragmatic, and visceral pleura) with at least 1 of the following:

• Diffuse extension or multifocal masses of tumor in the chest wall, with or without associated rib destruction
• Direct diaphragmatic extension of the tumor to the peritoneum
• Direct extension of the tumor to the contralateral pleura
• Direct extension of the tumor to a mediastinal organ
• Direct extension of the tumor into the spine
• Tumor extending through to the internal surface of the pericardium with or without a pericardial effusion or tumor involving the myocardium

Question 6

Chemo for meso

Answer 6

cisplatin and pemetrexed (Table 1).