Cytopathology of Asbestos-Associated Diseases
Cytology specimens have shown utility for the diagnosis of asbestos-associated diseases in the clinical setting and for detection of asbestos bodies in the occupational setting. Effusion cytology specimens are of particular clinical importance as effusions are an important sequela in asbestos-associated disease. Cytomorphologic interpretation is aided by several immunocytochemical markers that can facilitate discrimination between reactive and malignant mesothelial populations and confirm metastatic disease. While tissue studies have historically been the gold standard for pathologic diagnosis of mesothelioma, recent advances in cytology ancillary testing with BAP-1 (BRCA1-associated protein 1) immunocytochemistry and CDKN2A (cyclin-dependent kinase inhibitor 2A) fluorescence in-situ hybridization add support for cytology to serve as a primary diagnostic modality. Bronchoalveolar lavage and sputum specimens occupy an important role in the occupational setting for analysis and quantification of asbestos bodies and determination of disease causation.
