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The Use of p16 FISH and BAP1 Immunohistochemistry in the Diagnostic Evaluation of Atypical Mesothelial Proliferations

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Mesothelial cell proliferations that are not unequivocally malignant are termed atypical mesothelial proliferations or atypical mesothelial hyperplasia. Frequently, pathologists are challenged with regards to classifying such mesothelial proliferations as representing a malignancy (i.e. mesothelioma) or benign reactive hyperplasia. This presentation will focus on the combined use of p16INK4a FISH and BAP1 immunohistochemistry as a diagnostic tool for the evaluation of such atypical mesothelial proliferations. A short overview of the diagnostic work-up of mesothelioma versus benign reactive mesothelial proliferations will be presented as well. Lastly, the impact on patient care for BAP1 and P16 FISH testing in this setting will be discussed.

Learning Objectives:

  1. Review of atypical mesothelial proliferations versus mesothelioma from a pathologist point of view.
  2. Diagnostic use of BAP1 IHC and p16 FISH will be discussed.
  3. Immunohistochemical and molecular testing for diagnosis of mesothelioma will be reviewed.
  4. Criteria for diagnosis of mesothelioma will also be reviewed and discussed.

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