Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
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Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
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Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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ATUALIZAÇÃO PARA PATOLOGIA CIRÚRGICA 2018
Dr. Marcelo BalancinMédico Assistente DAP HC-FMUSP
Pós Graduando (DD) Departamento de Patologia FMUSP
0
100
200
300
400
500
600
700
800
1900 1920 1940 1960 1980 2000 2020 2040
PubMed.gov "Mesothelioma"
2010 – 527
2018 – 695
31.8%
0
10
20
30
40
50
60
70
80
1980 1985 1990 1995 2000 2005 2010 2015 2020
PubMed.gov "Mesthelioma"AND "Target"
2010 – 21
2018 – 55
262%
ROTEIRO PARA PATOLOGIA CIRÚRGICA
Rever Critérios OMS 2015-2018 (Julho, Lyon)Mesoteliomas Bifásicos
BAP1Mesotelioma in situ
Grau Nuclear
Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio
Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio
“Amianto”
Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélioMesotélio
Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélio
Mesotélio
MesotélioMesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélioMesotélio Mesotélio
Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélioMesotélio
MesotélioMesotélioMesotélio
Perda de BAP1
Churgh A. OMS 2015
Mesotélio
Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio
Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélioMesotélio
Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélio
Mesotélio
MesotélioMesotélio
Mesotélio
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Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélioMesotélio Mesotélio
Mesotélio
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Mesotélio
MesotélioMesotélioMesotélio
MesotélioMesotélioMesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Churgh A. OMS 2015
Mesotélio Mesotélio Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio Mesotélio
Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélioMesotélio
Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélio
Mesotélio
MesotélioMesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
MesotélioMesotélioMesotélio Mesotélio
Mesotélio
Mesotélio
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MesotélioMesotélioMesotélio
MesotélioMesotélioMesotélio
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Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Churgh A. OMS 2015
Mesotélio Mesotélio Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Mesotélio
Classificação OMS (2015)
MESOTELIOMA MALIGNO DIFUSOEpitelioideSarcomatoideDesmoplásico
Bifásico
MESOTELIOMA LOCALIZADOEpitelioideSarcomatoideBifásico
MESOTELIOMA PAPILÍFERO BEM DIFERENCIADOTUMOR ADENOMATOIDE
MENSAGENS PARA LEVAR (“TAKE HOME MESSAGES”)
Monte seus paineis com base na morfologiaNão é necessário história de exposição ou identificação de corpos
ferruginosos
Painel para ME é diferente de MSPara ME: 2 + ME e 2 + Adenocarcinoma
MEAbdome / Pelve: Tumor adenomatoide e Carcinoma de
células renaisTórax: Adenocarcinoma
MSSarcoma Sinovial, Sarcoma Pleomórfico, Melanoma
Desmoplásico, Carcinoma Sarcomatoide
Hiperplasia Atípica?Recomendar BAP1 e p16 FISH
Diagnóstico de M Bifásico em questionamento (“Grupo Transicional”)
ROTEIRO PARA PATOLOGIA CIRÚRGICA
Rever Critérios OMS 2015-2018 (Julho, Lyon)Mesoteliomas Bifásicos
BAP1Mesotelioma in situ
Grau Nuclear
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
Mesotelioma
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