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Letter to the Editor

To the Editor: I have read with a great interest the article by Kushitani et al. about immunohistochemical markers to distinguish between epithelioid mesothelioma and adenocarcinoma of the lung. I criticize this manuscript as a pathologist who has had some difficulty in distinguishing between mesothelioma and lung adenocarcinoma in routine diagnostic work. In their study the authors included 90 (71 epithelioid and 19 biphasic) mesothelioma cases. They compared immunoreactivity between epithelioid mesotheliomas and epithelioid components of biphasic mesotheliomas in Table 8 in the article. According to that table vimentin had wider reactivity in the epithelioid component of biphasic mesothelioma. In contrast, cytokeratin (CK)5/6 and mesothelin had wider reactivity in epithelioid mesothelioma. But the authors used the term ‘epithelioid mesotheliomas’ instead of ‘epithelioid and biphasic mesotheliomas’ in the manuscript. This causes confusion and puts the conclusion in question. For example: the authors stated that there was no significant difference in mesothelin immunoreactivity between epithelioid mesotheliomas and lung adenocarcinomas (P = 0.907), but according to the whole article they were referring to both epithelioid and biphasic mesotheliomas. Epithelioid mesotheliomas had a wider mesothelin reactivity than lung adenocarcinomas (Table 1).