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The role of immunohistochemistry in the diagnosis of malignant mesothelioma.

Malignant mesothelioma (MM) can place the pathologist in a diagnostic dilemma because of its morphological variability. The contribution of immunohistochemistry to a more accurate recognition of the mesothelial histogenesis of serosal tumours is widely acknowledged. The immunohistochemical diagnosis of epithelial MM is currently mainly one of exclusion based on prevailing negative staining with several tissue markers of adenocarcinomatous differentiation. The contribution of immunohistochemistry to a definite diagnosis of MM has only been established for the sarcomatous forms, which are positively labelled by anticytokeratin antibodies. A few antimesothelial antibodies have been generated in recent years and two of them have recently been marketed although they have yet to be validated on a wide scale in routine laboratory practice. However, none of them appears a priori as the ideal single positive marker for an unequivocal diagnosis of MM.