The term ‘histopathology’ refers to the microscopic examination of cells to observe physical characteristics that denote the type of cancer a patient is facing.
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In the laboratory, potentially cancerous cells are tested under the principles of histopathology in two primary ways. First, they are observed under a microscope to establish their general appearance. Second, they undergo testing for the presence of oncoproteins (proteins associated with cancer growth) and other molecules that are produced by specific types of cancer cells.
The classic histopathology of mesothelioma is a biphasic tumor with both an epithelioid and sarcomatoid or spindle cell component. From this description, it can be readily appreciated how the diagnosis may be very difficult to confirm. The task of the pathologist is to separate the mesothelioma from its many mimics including adenocarcinoma from the lung (in pleural cases) and soft tissue sarcomas such as malignant fibrous histiocytoma (in peritoneal cases). Immunoperoxidase studies and electron microscopy may aid in this distinction.
Under a microscope, mesothelioma cells can be distinguished from healthy cells by their shape and other differences in appearance. Further tests are needed to determine the exact histological nature of the cells. These tests evaluate the types of proteins that are present on the surface of the cells. Evaluating the surface proteins allows a pathologist to determine if the cells are malignant mesothelioma, another type of cancer, or healthy cells. The application of histopathology in the diagnosis of mesotheliomas is primarily to differentiate epithelial mesotheliomas from mucin-producing adenocarcinoma.
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