Reactive Mesothelial Cells In Pleural Fluid Cytology

Bap1 a new marker that is helpful in distinguishing reactive mesothelial cells from malignant mesothelioma.

Reactive mesothelial cells in pleural fluid cytology.

Atypical mesothelial cell proliferation. Mesothelial cells form conspicuous layer of regularly spaced bland cuboidal cells along pleural surface. Epithelial or lining cells most commonly mesothelial cells 1 the appearance and presentation of nucleated cells found in pleural fluid and whether they are considered common benign or abnormal is discussed below. Larger clusters of hyperplastic mesothelial cells showing mildly nuclear atypia with small nucleoli.

Mesothelial cytopathology is a large part of cytopathology. An introduction to cytopathology is in the cytopathology article. Papanicolaou x100 breast adenocarcinoma cells in pleural effusion. The article deals with cytopathology specimens from spaces lined with mesothelium i e.

Many of the false positives in effusion fluid cytology are caused by the atypical features of reactive mesothelial cells associated with a variety of underlying benign processes including acute pancreatitis 2 tuberculosis 1 ovarian fibroma 1 pulmonary infarction 3 chemotherapy 4 and cirrhosis. Reactive pleural effusion showing acute and chronic cells normal mesothelial cells and alveolar macrophages in aggregates and dispersed cells with rounded nuclei and vacuolated cytoplasm. Reactive mesothelial cells reactive mesothelial cells in pleural fluid reactive mesothelial cells are found when there is infection or inflammation present in a body cavity. Hyperplastic mesothelial cells with slightly enlarged nuclei micronucleoli and a clear space or window between adjacent cells present singly and in small clusters.

Neoplastic transformation of mesothelial cells results in malignant mesothelioma an aggressive tumor especially the pleura. 9 14 these studies suggest that 2. Common cells present in pleural fluid include neutrophils lymphocytes monocytes mesothelial cells and red blood. It deals with pericardial fluid peritoneal fluid and pleural fluid.

Because of the difficulty in distinguishing reactive mh from mm even in tissue specimens such as small pleural biopsies several studies have used immunohistochemical markers to distinguish between reactive and neoplastic mesothelial cells 3 8 or between adenocarcinoma reactive mh and mm in serous effusions. The mesothelial cells have central round nuclei with a moderate amount of light purple cytoplasm and a corona or fringe to the cytoplasmic borders. The distinction between reactive and malignant mesothelial cells has long been a challenge in effusion cytology.