relevance of image analysis in differentiating computed tomography guided fine needle aspiration biopsy of lung adenocarcinoma versus pleural mesothelioma in Egypt

ABSTRACT

Mesothelioma is a very serious illness that can have dangerous, long-term health effects. Catching the disease early on is often the best way to combat it, knowing the signs and process for diagnosis of the disease can help make it easier. Mesothelioma can be difficult to diagnose. This is because there are many different types of cells that can make up a mesothelioma tumor. Sometimes it can be very difficult for a pathologist to diagnose pleural mesothelioma as it can look like other types of lung cancer. The differentiation of mesothelioma and lung adenocarcinoma can be challenging, as proper classification is essential for determination of treatment regimen for these diseases. The present work aim to clarify if the use of image analysis can replace the more expensive immunohistochemical technique in differentiating lung adenocarcinoma from malignant mesothelioma [epithelial type] of the pleura. In our study we investigated computed tomography guided fine needle biopsy [CT-guided FNA] from 20 cases of pleural mesothelioma and 20 cases of lung adenocarcinoma. The pleural mesothelioma cases were confirmed by specific immunohistochemical panel then were investigated by image analysis. These data showed insignificant variation [p value <0.05] in the nuclear area and cell area in pleural mesotheliomas and lung adenocarcinomas. From the cytological morphology, the malignant pleural mesothelioma in fine needle aspiration has somehow a special pattern for arrangement with nuclear crowding then those of the peripheral lung adenocarcinoma. The results were not significant enough for the substitution of immunohistochemistry technique by image analysis on cytological specimens yet it may give different results when applied on tissue specimen which need further investigation