Abstract
While malignant mesothelioma is a relatively rare neoplasm, it provokes a lot of anxiety due to its poor prognosis, the litigation that follows such a diagnosis, and the difficulty in establishing the diagnosis itself. Mesothelioma presents with large serosal effusion in over 90% of patients,1 a fact that situates cytology as the primary mode of evaluation and diagnosis. Yet, there is a general perception that a definitive diagnosis cannot be rendered by cytology and hence the need for tissue biopsy despite ample literature to the contrary.2 This concern is probably due to the fact that most general pathologists do not have adequate experience with mesothelioma due to its rarity and the salient features of the exfoliated malignant cells that can be misinterpreted as reactive mesothelium or adenocarcinoma. However, with the availability of new immunocytochemical stains, the last decade has witnessed a plethora of literature confirming that mesothelioma can be distinguished from carcinoma with a high degree of accuracy.3,4
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Michael, C.W. (2012). Malignant Mesothelioma. In: Davidson, B., Firat, P., Michael, C. (eds) Serous Effusions. Springer, London. https://doi.org/10.1007/978-0-85729-697-9_5
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