Differentiation between Pleural Mesothelioma versus Pseudo-Mesothelioma Demonstrated in Eight Autopsy Cases

Review Data

Q: Is the topic relevant to the journal area of interest? Is it contemporary and interesting for

researchers?

A: Very good

Abstract & Keywords

Q: Are all required components included in the abstract? Are the keywords appropriately chosen?

A: Excellent

Goal

Q: Is the goal explicitly stated in the Introduction? Is its formulation clear and unambiguous?

A: Very good

Structure

Q: Is the paper's structure coherent? Is it in coherence with the goal of the paper?

A: Good

Comments:

Minor errors found in the manuscript (already corrected in the galley proof) are as follows:

• The word “pseudo-mesothelioma” should be hyphenated throughout the text to maintain consistency.

·       The spellings of the words “hemaroxilin”, “overbiew” and “parenxchmyma” should be corrected to “hematoxylin”, “overview” and “parenchyma” respectively in the figure legend 1B.

Tools and Methods

Q: Are methods the author uses adequate and well used?

A: Very good

Discussion & Conclusion

Q: Is it related to the results presented before? Do you consider them as coherent?

A: Very good

Comments:

The study is well designed and executed. The Methods and Results are adequately described. The Discussion elaborates on the rationale behind the importance of immunohistochemistry playing an important role in distinguishing between real and pseudo mesothelioma. It also adequately discusses the literature. The patient with renal cell carcinoma is discussed more in detail since it presents a very rare and special case of pseudo-mesothelioma. Lastly, the discussion section summarizes from the results of the study that the biology and dynamics of pleural metastases is still poorly understood and investigated and deserves more focus in the future.

Literature

Q: Does the author utilize relevant literature?

A: Very good

Author's knowledge

Q: What is the level of the author’s knowledge? Does the author utilize all recent contributions relevant to the topic?

A: Good

Length

Q: Is the length of the paper adequate to the significance of the topic? Do you suggest shortening the paper without losing its value?

A: Good

Figures & Tables

Q: Does the author use them suitably? Are legend and notations clear?

A: Very good

Writing style

Q: Is it clear and understandable?

A: Very good

Further comments on the paper

Comments: This study presents eight cases of patients who underwent autopsy over a 3-year period (2017-2019) and are clinically and macroscopically highly suspicious for pleural mesothelioma. This study holds significance as it shows that differentiating between pleural mesothelioma and pseudo-mesotheliomatous neoplasms is still a diagnostic challenge and requires extensive knowledge about differential diagnoses and immunohistochemical markers. This study also adds up well to previous investigations and shows that in some instances, positive expression of immunohistochemistry (IHC) markers was only focally present and thus can easily be missed by targeted small-sample biopsies. Therefore, due to striking morphological similarities, the exact final diagnosis is only possible after extended immunohistochemical analysis of the tissues.

Q: Would you recommend this manuscript for further publication?

A: Yes - Suitable to be published

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Science Repository Team