Mesothelioma Diagnosis Biopsy and Pathology

Question 1

Which procedure is considered the gold standard for diagnosing malignant pleural mesothelioma?

Accepted Answer

Video-assisted thoracoscopic surgery (VATS) biopsy

Answer

Thoracentesis alone

Answer

CT-guided FNA

Answer

Bronchoscopy

Question 2

Immunohistochemistry (IHC) is essential in mesothelioma pathology primarily to:

Accepted Answer

Distinguish mesothelioma from adenocarcinoma

Answer

Measure tumor size

Answer

Assess vascular invasion

Answer

Determine asbestos fiber burden

Question 3

Which IHC marker is characteristically positive in epithelioid mesothelioma?

Accepted Answer

Calretinin

Answer

TTF-1

Answer

CEA

Answer

Napsin A

Question 4

TTF-1 (thyroid transcription factor-1) positivity in a pleural biopsy would support a diagnosis of:

Accepted Answer

Metastatic lung adenocarcinoma

Answer

Epithelioid mesothelioma

Answer

Sarcomatoid mesothelioma

Answer

Pleural fibroma

Question 5

What is the minimum tissue requirement for a definitive mesothelioma diagnosis according to current guidelines?

Accepted Answer

Core biopsy with sufficient tissue for IHC

Answer

Cytology from thoracentesis alone

Answer

Fine needle aspirate only

Answer

Imaging findings without biopsy

Question 6

Loss of BRCA1-associated protein 1 (BAP1) expression on IHC is significant in mesothelioma because:

Accepted Answer

It confirms malignancy and distinguishes from reactive mesothelial proliferation

Answer

It indicates favorable prognosis

Answer

It is present in all benign pleural disease

Answer

It rules out sarcomatoid differentiation