Histochemical Studies In The Diagnosis Of Mesothelioma

Our plain-English summary of Histochemical Studies In The Diagnosis Of Mesothelioma, by M. Kannerstein, J. Churg, D. Magner (1973).

The study

• Authors: M. Kannerstein, J. Churg, D. Magner
• Published: Biological Effects Of Asbestos (J.C. Wagner, Editor), Lyon: Iarc Scientific Publications, Volume 8, Pp. 62-64 (1973)
• Type of article: Conference paper
• Our copy: from Johns-Manville's own medical library, J-M no. 002396. The article is still under copyright, so we describe it here rather than post it.

In plain English

This study tested whether simple tissue stains help diagnose mesothelioma. The authors reviewed 70 pleural and peritoneal mesotheliomas, drawn at random from over 200 cases graded definite, probable or possible, and compared them with 26 carcinomas. Sections were stained with periodic acid-Schiff after diastase (DPAS) and with colloidal iron (CI) for acid mucosubstance. Comparing CI staining before and after hyaluronidase indicated how much acid mucosubstance was hyaluronic acid, a term the authors used only in a histochemical sense. Of the 70 mesotheliomas, 64 showed no DPAS reaction and six a minimal or questionable one. Overall, 40% reacted with the CI stain and 60% did not. Positive reactions were most likely in definite cases, found in a little over one third of probable cases, and least likely in possible cases. The CI-positive carcinomas were also DPAS-positive, with one exception, and hyaluronidase did not change their CI staining. The authors concluded that these stains play a contributory role and are helpful often enough to warrant routine use. They added that CI staining is limited, especially in less typical cases.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Histochemical (tissue-staining) study of a series of mesothelioma cases, with a comparison group of carcinomas
• Who was studied: 70 mesothelioma cases (pleural and peritoneal), taken at random from a group of over 200 cases that the authors divided into definite, probable and possible categories, plus 26 carcinoma cases for comparison (thirteen adenocarcinomas, 7 of them from the lung; the others solid carcinomas, 4 of pulmonary origin). No dates or locations of the cases are given.
• Exposure: Asbestos exposure was not studied. The study examined tissue stains: periodic acid-Schiff after diastase (DPAS), and Hale colloidal iron stain before (CI) and after (HCI) testicular hyaluronidase.
• Main results:
  • Mesotheliomas: 64 of 70 showed no reactivity to DPAS; six showed a minimal or questionable reactivity
  • Mesotheliomas: 40% reacted distinctively with the colloidal iron stain
  • Mesotheliomas: 60% of the series did not react with the colloidal iron stain
  • Definite mesotheliomas: the likelihood of a positive colloidal iron reaction was greatest
  • Probable (intermediate) mesotheliomas: a little over one third were positive
  • Possible mesotheliomas: a positive reaction was least likely
  • Carcinomas: those positive with colloidal iron were also DPAS-positive, with one exception
  • Carcinomas: colloidal iron staining was not altered by hyaluronidase
  • In possible cases, a positive DPAS and non-hyaluronic acid mucosubstance helped in some cases in deciding against mesothelioma and in favour of carcinoma
• The authors' conclusion: The authors concluded that histochemical methods do not solve all problems in diagnosing mesothelioma but play a contributory role, and that these simple stains are helpful often enough to warrant routine use.
• Limitations the authors state:
  • The 60% of cases that were negative with colloidal iron may reflect either lack of acid mucosubstance production or its loss during fixation or processing
  • The diagnostic value of colloidal iron staining was limited, particularly in the less typical cases
  • The authors were not certain what the small amounts of DPAS-positive material in some mesotheliomas were, nor what the hyaluronidase-resistant acid mucosubstances were
  • The terms mucosubstance and hyaluronic acid were used only in their histochemical sense, not as biochemical identifications

Topics

Medical terms in this study, explained in our Lexicon: Mesothelioma, Peritoneal Mesothelioma, Carcinoma, Hyaluronic Acid.

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