Mesothelioma pp 99-122 | Cite as

Pathological Diagnosis of Mesothelioma

  • Gabriella FontaniniEmail author
  • Greta Alì
  • Rossella Bruno


The diagnosis of mesothelioma is one of the most difficult challenges faced by pathologists. Its histologic diagnosis is stepwise and should be based on morphological assessment, associated with clinical and radiological findings, and supported by immunohistochemistry as well as more recent molecular tests. This neoplasm displays a wide variety of histologic patterns and the major dilemmas consist in differential diagnosis with benign mesothelial proliferations and other mimicking malignant tumors.

The histological findings of mesothelioma could facilitate its diagnosis and provide important prognostic information. The immunohistochemical approach should lie on the application of a panel including positive (mesothelial-related) and negative markers, which should be selected on the basis of morphology and clinical information. In challenging cases, molecular markers could help distinguish between benign and malignant mesothelial proliferations.

This chapter is an update of the morphological, immunohistochemical, and molecular features, with particular regard to diffuse malignant mesothelioma diagnosis.


Diffuse malignant mesothelioma Reactive mesothelial proliferations Pathological diagnosis Immunohistochemistry Molecular markers 


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Gabriella Fontanini
    • 1
    Email author
  • Greta Alì
    • 2
  • Rossella Bruno
    • 2
  1. 1.Department of Surgical, Medical, Molecular Pathology, and Critical AreaUniversity of PisaPisaItaly
  2. 2.Unit of Pathological AnatomyAzienda Ospedaliero Universitaria PisanaPisaItaly

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