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Identifying malignant mesothelioma by a pathological survey using the São Paulo state hospital cancer registry, Brazil

Identifying malignant mesothelioma by a pathological survey using the São Paulo state hospital cancer registry, Brazil

Fabiola Del Carlo Bernardi 1, Eduardo Algranti2, Marisa Dolhnikoff3, Clóvis Antônio Lopes Pinto4, Ivanir Martins de Oliveira5, Ester Nei Aparecida Martins Coletta6, Eduardo Caetano Albino da Silva7, Adauto José Ferreira Nunes8, Donaldo Botelho Veneziano9, Carolina Terra de Moraes Luizaga10, Ricardo Luiz Lorenzi11, Diego Rodrigues Mendonça e Silva12, Thais Mauad3

ABSTRACT

Objective: To review the pathological diagnosis of possible cases and/or hidden cases of malignant mesothelioma (MM) between 2000 and 2012 using the Hospital-Based Cancer Registry database in the state of São Paulo, Brazil. Methods: Possible cases were retrieved by assessing the database. Inclusion criteria were being older than 30 years of age and having ICD-O-3 topography and morphology codes related to MM. A board of expert pathologists reviewed the pathology reports and requested paraffin blocks in cases that demanded revision. After staining with calretinin, D2-40, WT-1 (as positive MM markers) and Ber-EP4 and MOC31 (as negative MM markers), cases were divided and studied independently by a pair of pathologists to confirm or discard the diagnosis of MM. Results: Our sample comprised 482 cases from 25 hospitals, and 130 needed further histological revision. We received 73 paraffin blocks with adequate material. After board analysis, there were 9 cases with a definitive diagnosis of MM, improving the diagnostic rate in 12%. Two cases of previously diagnosed MM were discarded by review. Conclusions: Our results confirm that part of MM underdiagnosis and underreporting in Brazil is due to incomplete or mistaken pathological diagnosis.

Keywords: Mesothelioma, malignant/pathology; Mesothelioma, malignant/diagnosis; Immunohistochemistry; Registries.

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