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Correspondence
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Volume 354:305-307 January 19, 2006 Number 3
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Malignant Mesothelioma

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 by Robinson, B. W.S.
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To the Editor: In their review article, Robinson and Lake (Oct. 13 issue)1 write that membranous immunoreactivity of malignant cells in effusions with epithelial membrane antigen (EMA) is highly suggestive of malignant mesothelioma. If this were true, then the cytologic diagnosis of mesothelioma would be far less challenging than is the case in current practice. Not all malignant mesotheliomas are EMA-positive.2 Moreover, reactive mesothelial cells may demonstrate membranous staining with EMA, albeit in only 3 to 4 percent of cases.3 Finally, some adenocarcinomas (14 percent) may also have a membranous EMA staining pattern.4 The experience of several experts in the . . . [Full Text of this Article]


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