Mesothelioma Therapy Diagnosis and Biomarkers for Mesothelioma 2

Question 1

What is the gold standard method for confirming a diagnosis of mesothelioma?

Accepted Answer

Tissue biopsy with histopathological and immunohistochemical examination

Answer

Analysis of pleural fluid cytology alone

Answer

CT-guided fine needle aspiration cytology

Answer

Serum biomarker panel testing

Question 2

Which procedure provides the highest diagnostic yield for mesothelioma by allowing direct visualization of the pleural surface and collection of multiple large biopsies?

Accepted Answer

Video-assisted thoracoscopic surgery (VATS)

Answer

CT-guided needle biopsy

Answer

Ultrasound-guided pleural biopsy

Answer

Bronchoscopy with transbronchial biopsy

Question 3

Why is pleural fluid cytology alone considered insufficient for a definitive mesothelioma diagnosis?

Accepted Answer

Cytology has limited sensitivity and cannot reliably distinguish malignant mesothelioma from reactive mesothelial proliferation without immunohistochemistry on tissue

Answer

Pleural effusions are rarely seen in mesothelioma

Answer

Pleural fluid volumes are too small to allow adequate cellular analysis

Answer

Cytology requires specialized equipment unavailable in most hospitals

Question 4

Which immunohistochemical markers are characteristically positive in epithelioid mesothelioma and help differentiate it from adenocarcinoma?

Accepted Answer

Calretinin and WT-1

Answer

TTF-1 and Napsin A

Answer

CEA and MOC-31

Answer

CK7 and CK20

Question 5

What is the most common histological subtype of mesothelioma?

Accepted Answer

Epithelioid

Answer

Sarcomatoid

Answer

Biphasic (mixed)

Answer

Desmoplastic

Question 6

Which marker is characteristically positive in pulmonary adenocarcinoma but negative in mesothelioma, making it valuable in differential diagnosis?

Accepted Answer

TTF-1 (thyroid transcription factor-1)

Answer

Calretinin

Answer

Mesothelin

Answer

Cytokeratin 5/6

Question 7

In which clinical scenario would medical thoracoscopy be preferred over CT-guided needle biopsy for mesothelioma diagnosis?

Accepted Answer

When the patient has a large pleural effusion requiring both diagnosis and therapeutic drainage

Answer

When the patient has undergone previous ipsilateral thoracic surgery

Answer

When focal pleural thickening is accessible from the chest wall without effusion

Answer

When the patient cannot tolerate any form of sedation