Histologic classification and differential diagnosis of mesothelioma

Controversy surrounds the diagnosis, classification, and therefore the epidemiology of those tumors which have been designated as mesotheliomas. The group includes lesions which are as broadly different as benign fibrous lesions which some authors refer to as fibromas and anaplastic tumors which are extremely difficult to differentiate from peripheral lung cancers. The former are benign tumors which are usually readily resected and therefore cured. The latter are unresectable tumors which are invariably fatal and which may terminate with extensive metastatic disease. The reasons for including all of these lesions under the category of mesothelioma and the differential diagnosis of the various types is discussed.