{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T23:00:48Z","timestamp":1789426848020,"version":"build-2803163510"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:p>Distinguishing reactive mesothelial proliferation from malignant mesothelioma (MM) can be difficult, particularly on small biopsies. In this scenario, a diagnosis of atypical mesothelial proliferation might be rendered. However, the distinction between a reactive process and MM is important for prognosis and treatment. Recently, loss of BRCA1-associated protein 1 (BAP1) expression and\/or homozygous deletion of <jats:italic toggle=\"yes\">CDKN2A<\/jats:italic> were identified in some MM, but not in reactive mesothelial proliferations. We studied 34 cases of atypical mesothelial proliferation from our institutional files (1993 to 2016) for BAP1 expression, deletion of <jats:italic toggle=\"yes\">CDKN2A<\/jats:italic>, and clinical outcome. Fifteen of 34 patients (44%) were subsequently diagnosed with MM. BAP1 expression was lost in 6 of these 15 (40%) patients. Ten of 15 (67%) patients died of disease within a median time of 18.2 months. BAP1 expression was also lost in 1 case of probable MM. In this case atypical mesothelial proliferation was identified in the pleura during a lobectomy procedure for lung adenocarcinoma. Follow-up of 57.0 months was remarkable for visceral and parietal pleural thickening with continued unilateral effusion identified on imaging studies but no subsequent definitive diagnosis of MM. <jats:italic toggle=\"yes\">CDKN2A<\/jats:italic> studies by fluorescence in situ hybridization (performed in 31 cases) found no homozygous deletion of that gene in any case. In conclusion, loss of BAP1 expression in atypical mesothelial proliferation helps to predict MM and is a useful adjunct test in these cases. Homozygous deletion of <jats:italic toggle=\"yes\">CDKN2A<\/jats:italic> in mesothelial cell proliferations did not prove to be useful to predict MM in cases of atypical mesothelial proliferation.<\/jats:p>","DOI":"10.1097\/pas.0000000000000976","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T03:35:50Z","timestamp":1509075350000},"page":"256-263","source":"Crossref","is-referenced-by-count":36,"title":["Loss of BAP1 Expression in Atypical Mesothelial Proliferations Helps to Predict Malignant Mesothelioma"],"prefix":"10.1097","volume":"42","author":[{"given":"Raghavendra","family":"Pillappa","sequence":"first","affiliation":[{"name":"Department of Laboratory Medicine and Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph J.","family":"Maleszewski","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William R.","family":"Sukov","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick P.","family":"Bedroske","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia T.","family":"Greipp","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer M.","family":"Boland","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunhee S.","family":"Yi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Peikert","sequence":"additional","affiliation":[{"name":"Division of Pulmonary and Critical Care Medicine"},{"name":"Department of Immunology, Mayo Clinic Rochester, Rochester, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie Christine","family":"Aubry","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anja C.","family":"Roden","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R1-20240215","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1016\/j.jtho.2015.11.005","article-title":"The 2015 World Health Organization classification of tumors of the pleura: advances since the 2004 classification","volume":"11","author":"Galateau-Salle","year":"2016","journal-title":"J Thorac Oncol"},{"key":"R2-20240215","doi-asserted-by":"crossref","first-page":"647","DOI":"10.5858\/arpa.2012-0214-OA","article-title":"Guidelines for pathologic diagnosis of malignant mesothelioma: 2012 update of the consensus statement from the International Mesothelioma Interest Group","volume":"137","author":"Husain","year":"2013","journal-title":"Arch Pathol Lab Med"},{"key":"R3-20240215","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/j.ejcts.2007.09.044","article-title":"Malignant pleural mesothelioma: clinicopathologic and survival characteristics in a consecutive series of 394 patients","volume":"33","author":"Borasio","year":"2008","journal-title":"Eur J Cardiothorac Surg"},{"key":"R4-20240215","doi-asserted-by":"crossref","first-page":"e0145039","DOI":"10.1371\/journal.pone.0145039","article-title":"Determinants of survival in malignant pleural mesothelioma: a surveillance, epidemiology, and end results (SEER) study of 14,228 patients","volume":"10","author":"Taioli","year":"2015","journal-title":"PLoS One"},{"key":"R5-20240215","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1046\/j.1365-2559.2003.01686.x","article-title":"The use of immunohistochemistry in distinguishing reactive from neoplastic mesothelium. 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