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Electron Microscopy of Mesothelioma

Dr Sampurna Roy MD 





Ultrastructural studies have greatest utility in distinguishing epithelial mesotheliomas from carcinomas.

No single feature is characteristic of mesothelioma.

In more poorly differentiated mesotheliomas and adenocarcinomas there is some overlap of features.

Mesotheliomas are characterized by having long, narrow, branching microvilli with a length to width ratio of around 10-16:1

Diagram of electron microscopic features of mesothelioma showing long, narrow, branching microvilli.

By contrast, adenocarcinomas have short, stubby microvilli with core rootlets.

Intermediate filaments are abundant and show perinuclear condensation in mesothelioma whereas they are less prominent in adenocarcinoma.

Electron microscopy can also be used to confirm the absence of features of adenocarcinoma, such as intracellular mucin and membrane-bound secretory granules.

Zymogen vacuoles are not seen in mesothelioma and are useful indicator of adenocarcinoma.

Sarcomatoid and biphasic variants  show ultrastructural features transitional between epithelial and mesenchymal cells that will allow differentiation between mesothelioma and sarcoma or reactive fibroblasts.

Spindled cells of mesothelioma lack microvilli , but sometimes cells intermediate between epithelial and spindled with long microvilli can be found in predominantly spindled tumours.


Further reading:


Electron Microscopy Remains the Gold Standard for the Diagnosis of Epithelial Malignant Mesothelioma: A Case Study.

Tumor exosomes induce tunneling nanotubes in lipid raft-enriched regions of human mesothelioma cells.

The diagnosis of thoracic malignant mesothelioma: practical considerations and recent developments.

Tumour-derived exosomes as antigen delivery carriers in dendritic cell-based immunotherapy for malignant mesothelioma.

Trends in asbestos and non-asbestos fibre concentrations in the lung tissues of Japanese patients with mesothelioma.

Environmental scanning electron microscopy technique to identify asbestos phases inside ferruginous bodies.

Use of back-scatter electron signals to visualise cell/nanowires interactions in vitro and in vivo; frustrated phagocytosis of long fibres in macrophages and compartmentalisation in mesothelial cells in vivo.



Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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