Subscribe to RSS
DOI: 10.1055/s-2008-1004808
© Georg Thieme Verlag Stuttgart · New York
Pathologie der primären Pleuratumoren
Pathology of Primary Tumours of the PleuraPublication History
Publication Date:
19 June 2008 (online)
![](https://www.thieme-connect.de/media/zblchir/200803/lookinside/thumbnails/10.1055-s-2008-1004808-1.jpg)
Zusammenfassung
Die WHO-Klassifikation der primären Pleuratumoren unterscheidet mesotheliale und mesenchymale Tumoren sowie lymphoproliferative Erkrankungen. Dabei stellen maligne Mesotheliome den häufigsten primären Pleuratumor dar. Histologisch wird eine prognostisch relevante Differenzierung in epitheloide (40-60 %), sarkomatoide (20-30 %) und biphasische Mesotheliome (20-30 %) vorgenommen. Differenzialdiagnostisch sind maligne Pleuramesotheliome neben den selteneren anderen primären Pleuratumoren von Pleurakarzinosen intra- und extrapulmonaler Malignome abzugrenzen. Die Differenzierung gegenüber reaktiven Pleuraveränderungen erfordert insbesondere in frühen Tumorstadien eine enge interdisziplinäre Zusammenarbeit mit sorgfältiger Korrelation von histopathologischem Befund und klinischem Krankheitsbild.
Abstract
In the WHO classification, pleural tumours of mesothelial and mesenchymal origin as well as lymphoproliferative disorders are distinguished, with malignant mesotheliomas forming the most common primary pleural tumour. Histologically, a prognostically relevant differentiation between epitheloid (40-60 %), sarcomatoid (20-30 %), and biphasic mesotheliomas (20-30 %) is made. Besides other rare primary tumours of the pleura, the differential diagnoses of malignant mesotheliomas comprise carcinomatous pleuritis of intra- and extrapulmonary malignancies. Especially in early tumour stages, the differentiation from reactive pleural changes requires a close interdisciplinary cooperation with a careful correlation between histopathological findings and clinical presentation.
Schlüsselwörter
malignes Pleuramesotheliom - Pleurakarzinose - solitärer fibröser Pleuratumor - WHO-Klassifikation
Key words
malignant pleural mesothelioma - carcinomatous pleuritis - solitary fibrous tumour of the pleura - WHO classification
Literatur
- 1 Brockmann M. Malignes diffuses Pleuramesotheliom - Heterogenität, Differentialdiagnose und Histogenese. HVBG, St. Augustin 1992
- 2 de Perrot M, Uy K, Anraku M et al. Impact of lymph node metastasis on outcome after extrapleural pneumonectomy for malignant pleural mesothelioma. J Thorac Cardiovasc Surg. 2007; 133 111-116
- 3 Galateau-Sallé F. Pathology of malignant mesothelioma. Springer, London 2006
- 4 Hodgson J T, Darnton A. The quantitative risk of mesothelioma and lung cancer in relation to asbestos exposure. Ann Occup Hyg. 2000; 44 565-601
- 5 Jones J SP, Lund C, Planteydt H T. Colour atlas of mesothelioma. MTP-Press, Lancaster, Boston, The Hague, Dordrecht 1985
- 6 Junker K, Lindner M, Schütte W et al. Diagnostik und Therapie des Pleuramesothelioms. Onkologie. 2007; 30 (Suppl. 1) 7-10
- 7 Kim Y, Ton T V, DeAngelo A B et al. Major carcinogenic pathways identified by gene expression analysis of peritoneal mesotheliomas following chemical treatment in F344 rats. Toxicol Appl Pharmacol. 2006; 214 144-151
- 8 Krismann M, Jaworska M, Müller K M et al. Severe chromosomal aberrations in pleural mesotheliomas with unusual mesodermal features - CGH evidence for a mesothelioma subgroup. J Mol Diag. 2000; 2 209-216
- 9 Krismann M, Jaworska M, Müller K M et al. Molecular cytogenetic differences between histological subtypes of malignant mesotheliomas - DNA cytometry and comparative genomic hybridisation of 90 cases. J Pathology. 2002; 197 363-371
- 10 Krismann M, Thattamparambil P, Simon F et al. Praktische Differenzialdiagnose präneoplastischer Veränderungen der Pleura und früher mesothelialer Neoplasien. Pathologe. 2006; 27 99-105
- 11 Leigh J, Davidson P, Hendrie L et al. Malignant mesothelioma in Australia, 1945-2000. Am J Ind Med. 2002; 41 188-201
- 12 Pass H I, Liu Z, Wali A et al. Gene expression profiles predict survival and prognosis of pleural mesothelioma. Clin Cancer Res. 2004; 10 849-859
- 13 Peto R, Darby S, Deo H et al. Smoking, smoking cessation, and lung cancer in the UK since 1950: combination of national statistics with two case-control studies. BMJ. 2000; 321 323-329
- 14 Scharmach M, Neumann V, Müller K M et al. Vergleich der Metastasierungsmuster maligner Mesotheliome und pulmonaler Karzinome. Pneumologie. 2006; 60 277-283
- 15 Travis W D, Brambilla E, Müller-Hermelink H K , et al. WHO-Classification of tumours. Pathology and genetics of tumours of the lung, pleura, thymus and heart. IARC-Press, Lyon 2004
- 16 Wagner J C, Sleggs C A, Wagner J C. Diffuse pleural mesothelioma and asbestos exposure in the North-West Cape Province. Br J Ind Med. 1960; 17 260-271
- 17 White N W, Abratt R P. Epidemiologie des Pleuramesothelioms. In: Manegold C (Hrsg). Pleuramesotheliom. Springer, Heidelberg 2005; 1-6
- 18 Wittekind C, Meyer H J, Bootz F. TNM-Klassifikation maligner Tumoren. 6. Auflage. Springer, Berlin, Heidelberg, New York 2002
Prof. Dr. med. K. Junker
Zentrum für Pathologie · Klinikum Bremen-Mitte
St.-Jürgen-Str. 1
28177 Bremen
Phone: 04 21 / 4 97 25 74
Fax: 04 21 / 4 97 25 83
Email: klaus.junker@klinikum-bremen-mitte.de