Molecular characterization of diffuse malignant peritoneal mesothelioma


Malignant peritoneal mesothelioma is a rare aggressive tumor that arises from the peritoneal lining. While recurrent BAP1 mutations have been identified in a subset of mesotheliomas, molecular characteristics of peritoneal mesotheliomas, including those lacking BAP1 alterations, remain poorly understood. Using targeted next-generation sequencing, we examined the molecular features of 26 diffuse malignant peritoneal mesotheliomas. As part of an exploratory analysis, we analyzed an additional localized peritoneal mesothelioma and one well-differentiated papillary mesothelioma with invasive foci. Genomic characterization identified categories of diffuse malignant peritoneal mesotheliomas: The first group included 18 (69%) tumors with recurrent BAP1 alterations, with eight (31%) having more than one BAP1 alterations, and concomitant alterations in PBRM1 (46%) and SETD2 (35%). All tumors with complete loss of BAP1 expression by immunohistochemistry harbored BAP1 molecular alterations. PBRM1 alterations were significantly enriched in the BAP1-altered cohort. Frequent copy number loss of BAP1, ARID1B, PRDM1, PBRM1, SETD2, NF2, and CDKN2A was noted. The second group included eight (31%) BAP1-wild-type tumors: two with TP53 mutations, one with a TRAF7 activating mutation, one with a SUZ12 inactivating mutation, and three with ALK rearrangements that we previously published. One TP53-mutant biphasic mesothelioma showed evidence of genomic near-haploidization showing loss of heterozygosity of all chromosomes except 5, 7, 16, and 20. The localized peritoneal mesothelioma harbored a nonsense CHEK2 mutation, and the well-differentiated papillary mesothelioma with invasive foci harbored no reportable variants. In conclusion, we described the genetic categories of diffuse malignant peritoneal mesotheliomas, with BAP1-mutant and BAP1-wild-type groups. Our findings implicated DNA repair, epigenetics, and cell cycle regulation in the pathogenesis of peritoneal mesotheliomas, with identification of potential therapeutic targets.

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Fig. 1: Landscape of clinicopathologic and molecular features of peritoneal mesotheliomas in this study.
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  1. 1.

    Galateau-Salle F, Churg A, Roggli V, Chirieac LR, Attanoos R, Borczuk A, et al. Tumours of the pleura. Mesothelial tumours. In: Travis WD, Brambilla E, Burke A, Marx A, Nicholson AG, editors. World Health Organization classification of tumors. Pathology and genetics of tumors of the lung, pleura, thymus, and heart, Vol., 4th edn. IARC Press: Lyon, France, 2015. p156.

  2. 2.

    Moolgavkar SH, Meza R, Turim J. Pleural and peritoneal mesotheliomas in SEER: age effects and temporal trends, 1973–2005. Cancer Causes Control. 2009;20:935–44.

    PubMed  Google Scholar 

  3. 3.

    Mazurek JM, Syamlal G, Wood JM, Hendricks SA, Weston A. Malignant Mesothelioma Mortality—United States, 1999–2015. MMWR Morb Mortal Wkly Rep. 2017;66:214–8.

    PubMed  PubMed Central  Google Scholar 

  4. 4.

    Geary WA, Mills SE, Frierson HF Jr., Pope TL. Malignant peritoneal mesothelioma in childhood with long-term survival. Am J Clin Pathol. 1991;95:493–8.

    CAS  PubMed  Google Scholar 

  5. 5.

    Kerrigan SA, Turnnir RT, Clement PB, Young RH, Churg A. Diffuse malignant epithelial mesotheliomas of the peritoneum in women: a clinicopathologic study of 25 patients. Cancer. 2002;94:378–85.

    PubMed  Google Scholar 

  6. 6.

    Moran CA, Albores-Saavedra J, Suster S. Primary peritoneal mesotheliomas in children: a clinicopathological and immunohistochemical study of eight cases. Histopathology. 2008;52:824–30.

    CAS  PubMed  Google Scholar 

  7. 7.

    Thomas A, Chen Y, Yu T, Gill A, Prasad V. Distinctive clinical characteristics of malignant mesothelioma in young patients. Oncotarget. 2015;6:16766–73.

    PubMed  PubMed Central  Google Scholar 

  8. 8.

    Boffetta P. Epidemiology of peritoneal mesothelioma: a review. Ann Oncol. 2007;18:985–90.

    CAS  PubMed  Google Scholar 

  9. 9.

    Allen TC, Cagle PT, Churg AM, Colby TV, Gibbs AR, Hammar SP, et al. Localized malignant mesothelioma. Am J Surg Pathol. 2005;29:866–73.

    PubMed  Google Scholar 

  10. 10.

    Borczuk AC, Taub RN, Hesdorffer M, Hibshoosh H, Chabot JA, Keohan ML, et al. P16 loss and mitotic activity predict poor survival in patients with peritoneal malignant mesothelioma. Clin Cancer Res. 2005;11:3303–8.

    CAS  PubMed  Google Scholar 

  11. 11.

    Nelson DB, Rice DC, Niu J, Atay S, Vaporciyan AA, Antonoff M, et al. Long-term survival outcomes of cancer-directed surgery for malignant pleural mesothelioma: propensity score matching analysis. J Clin Oncol. 2017;35:3354–62.

    PubMed  Google Scholar 

  12. 12.

    Chirac P, Maillet D, Lepretre F, Isaac S, Glehen O, Figeac M, et al. Genomic copy number alterations in 33 malignant peritoneal mesothelioma analyzed by comparative genomic hybridization array. Hum Pathol. 2016;55:72–82.

    CAS  PubMed  Google Scholar 

  13. 13.

    Carbone M, Yang H, Pass HI, Krausz T, Testa JR, Gaudino G. BAP1 and cancer. Nat Rev Cancer. 2013;13:153–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  14. 14.

    Attanoos RL, Churg A, Galateau-Salle F, Gibbs AR, Roggli VL. Malignant mesothelioma and its non-asbestos causes. Arch Pathol Lab Med. 2018;142:753–60.

    CAS  PubMed  Google Scholar 

  15. 15.

    Hillerdal G, Berg J. Malignant mesothelioma secondary to chronic inflammation and old scars. Two new cases and review of the literature. Cancer. 1985;55:1968–72.

    CAS  PubMed  Google Scholar 

  16. 16.

    Butnor KJ, Rueckert J, Pavlisko EN, Sporn TA, Roggli VL. Malignant peritoneal mesothelioma in patients with endometriosis. J Clin Pathol. 2018;71:971–4.

    PubMed  Google Scholar 

  17. 17.

    Antman KH, Corson JM, Li FP, Greenberger J, Sytkowski A, Henson DE, et al. Malignant mesothelioma following radiation exposure. J Clin Oncol. 1983;1:695–700.

    CAS  PubMed  Google Scholar 

  18. 18.

    Carbone M, Emri S, Dogan AU, Steele I, Tuncer M, Pass HI, et al. A mesothelioma epidemic in Cappadocia: scientific developments and unexpected social outcomes. Nat Rev Cancer. 2007;7:147–54.

    CAS  PubMed  Google Scholar 

  19. 19.

    Taylor S, Carpentieri D, Williams J, Acosta J, Southard R. Malignant peritoneal mesothelioma in an adolescent male with BAP1 deletion. J Pediatr Hematol Oncol. 2015;37:e323–7.

    CAS  PubMed  Google Scholar 

  20. 20.

    Panou V, Gadiraju M, Wolin A, Weipert CM, Skarda E, Husain AN, et al. Frequency of germline mutations in cancer susceptibility genes in malignant mesothelioma. J Clin Oncol. 2018;36:2863–71.

    CAS  PubMed  PubMed Central  Google Scholar 

  21. 21.

    Guo G, Chmielecki J, Goparaju C, Heguy A, Dolgalev I, Carbone M, et al. Whole-exome sequencing reveals frequent genetic alterations in BAP1, NF2, CDKN2A, and CUL1 in malignant pleural mesothelioma. Cancer Res. 2015;75:264–9.

    CAS  PubMed  Google Scholar 

  22. 22.

    Lo Iacono M, Monica V, Righi L, Grosso F, Libener R, Vatrano S, et al. Targeted next-generation sequencing of cancer genes in advanced stage malignant pleural mesothelioma: a retrospective study. J Thorac Oncol. 2015;10:492–9.

    CAS  PubMed  Google Scholar 

  23. 23.

    Bueno R, Stawiski EW, Goldstein LD, Durinck S, De Rienzo A, Modrusan Z, et al. Comprehensive genomic analysis of malignant pleural mesothelioma identifies recurrent mutations, gene fusions and splicing alterations. Nat Genet. 2016;48:407–16.

    CAS  PubMed  Google Scholar 

  24. 24.

    Kato S, Tomson BN, Buys TP, Elkin SK, Carter JL, Kurzrock R. Genomic landscape of malignant mesotheliomas. Mol Cancer Ther. 2016;15:2498–507.

    CAS  PubMed  Google Scholar 

  25. 25.

    Zehir A, Benayed R, Shah RH, Syed A, Middha S, Kim HR, et al. Mutational landscape of metastatic cancer revealed from prospective clinical sequencing of 10,000 patients. Nat Med. 2017;23:703–13.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Hmeljak J, Sanchez-Vega F, Hoadley KA, Shih J, Stewart C, Heiman D, et al. Integrative molecular characterization of malignant pleural mesothelioma. Cancer Discov. 2018;8:1548–65.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. 27.

    Blum Y, Meiller C, Quetel L, Elarouci N, Ayadi M, Tashtanbaeva D, et al. Dissecting heterogeneity in malignant pleural mesothelioma through histo-molecular gradients for clinical applications. Nat Commun. 2019;10:1333.

    PubMed  PubMed Central  Google Scholar 

  28. 28.

    Quetel L, Meiller C, Assie JB, Blum Y, Imbeaud S, Montagne F, et al. Genetic alterations of malignant pleural mesothelioma: association with tumor heterogeneity and overall survival. Mol Oncol. 2020.

  29. 29.

    Alakus H, Yost SE, Woo B, French R, Lin GY, Jepsen K, et al. BAP1 mutation is a frequent somatic event in peritoneal malignant mesothelioma. J Transl Med. 2015;13:122.

    PubMed  PubMed Central  Google Scholar 

  30. 30.

    Chao A, Lai CH, Lee YS, Ueng SH, Lin CY, Wang TH. Molecular characteristics of endometrial cancer coexisting with peritoneal malignant mesothelioma in Li-Fraumeni-like syndrome. BMC Cancer. 2015;15:8.

    PubMed  PubMed Central  Google Scholar 

  31. 31.

    Sheffield BS, Tinker AV, Shen Y, Hwang H, Li-Chang HH, Pleasance E, et al. Personalized oncogenomics: clinical experience with malignant peritoneal mesothelioma using whole genome sequencing. PLoS One. 2015;10:e0119689.

    PubMed  PubMed Central  Google Scholar 

  32. 32.

    Lai J, Zhou Z, Tang XJ, Gao ZB, Zhou J, Chen SQ. A tumor-specific neo-antigen caused by a frameshift mutation in BAP1 is a potential personalized biomarker in malignant peritoneal mesothelioma. Int J Mol Sci. 2016;17:E739.

    PubMed  Google Scholar 

  33. 33.

    Maki-Nevala S, Sarhadi VK, Knuuttila A, Scheinin I, Ellonen P, Lagstrom S, et al. Driver gene and novel mutations in asbestos-exposed lung adenocarcinoma and malignant mesothelioma detected by exome sequencing. Lung. 2016;194:125–35.

    CAS  PubMed  Google Scholar 

  34. 34.

    Ugurluer G, Chang K, Gamez ME, Arnett AL, Jayakrishnan R, Miller RC, et al. Genome-based mutational analysis by next generation sequencing in patients with malignant pleural and peritoneal mesothelioma. Anticancer Res. 2016;36:2331–8.

    CAS  PubMed  Google Scholar 

  35. 35.

    Vanni I, Coco S, Bonfiglio S, Cittaro D, Genova C, Biello F, et al. Whole exome sequencing of independent lung adenocarcinoma, lung squamous cell carcinoma, and malignant peritoneal mesothelioma: A case report. Med (Baltim). 2016;95:e5447.

    Google Scholar 

  36. 36.

    Desmeules P, Joubert P, Zhang L, Al-Ahmadie HA, Fletcher CD, Vakiani E, et al. A subset of malignant mesotheliomas in young adults are associated with recurrent EWSR1/FUS-ATF1 fusions. Am J Surg Pathol. 2017;41:980–8.

    PubMed  PubMed Central  Google Scholar 

  37. 37.

    Joseph NM, Chen YY, Nasr A, Yeh I, Talevich E, Onodera C, et al. Genomic profiling of malignant peritoneal mesothelioma reveals recurrent alterations in epigenetic regulatory genes BAP1, SETD2, and DDX3X. Mod Pathol. 2017;30:246–54.

    CAS  PubMed  Google Scholar 

  38. 38.

    Ross JS, Ali SM, Fasan O, Block J, Pal S, Elvin JA, et al. ALK fusions in a wide variety of tumor types respond to Anti-ALK targeted therapy. Oncologist. 2017;22:1444–50.

    CAS  PubMed  PubMed Central  Google Scholar 

  39. 39.

    Bochtler T, Endris V, Reiling A, Leichsenring J, Schweiger MR, Klein S, et al. Integrated histogenetic analysis reveals BAP1-mutated epithelioid mesothelioma in a patient with cancer of unknown primary. J Natl Compr Canc Netw. 2018;16:677–82.

    PubMed  Google Scholar 

  40. 40.

    Hung YP, Dong F, Watkins JC, Nardi V, Bueno R, Dal Cin P, et al. Identification of ALK rearrangements in malignant peritoneal mesothelioma. JAMA Oncol. 2018;4:235–8.

    PubMed  Google Scholar 

  41. 41.

    Loffler MW, Steinhilber J, Hilke FJ, Haen SP, Bosmuller H, Montes-Mojarro IA, et al. First case report of malignant peritoneal mesothelioma and oral verrucous carcinoma in a patient with a germline PTEN mutation: a combination of extremely rare diseases with probable further implications. BMC Med Genet. 2018;19:144.

    PubMed  PubMed Central  Google Scholar 

  42. 42.

    Belfiore A, Busico A, Bozzi F, Brich S, Dallera E, Conca E, et al. Molecular signatures for combined targeted treatments in diffuse malignant peritoneal mesothelioma. Int J Mol Sci. 2019;20:E5817.

    PubMed  Google Scholar 

  43. 43.

    Lund-Andersen C, Nakken S, Nygard S, Fromm B, Aasheim LB, Davidson B, et al. Integrative genomic analysis of peritoneal malignant mesothelioma: understanding a case with extraordinary chemotherapy response. Cold Spring Harb Mol Case Stud. 2019;5:a003566.

    CAS  PubMed  PubMed Central  Google Scholar 

  44. 44.

    Ruschoff JH, Gradhand E, Kahraman A, Rees H, Ferguson JL, Curioni-Fontecedro A, et al. STRN-ALK rearranged malignant peritoneal mesothelioma with dramatic response following ceritinib treatment. JCO Precis Oncol. 2019;3:1–6.

    Google Scholar 

  45. 45.

    Shrestha R, Nabavi N, Lin YY, Mo F, Anderson S, Volik S, et al. BAP1 haploinsufficiency predicts a distinct immunogenic class of malignant peritoneal mesothelioma. Genome Med. 2019;11:8.

    PubMed  PubMed Central  Google Scholar 

  46. 46.

    Smith-Hannah A, Naous R. Primary peritoneal epithelioid mesothelioma of clear cell type with a novel VHL gene mutation: a case report. Hum Pathol. 2019;83:199–203.

    PubMed  Google Scholar 

  47. 47.

    Glass C, Sholl LM, Landgraf JR, Chirieac L, Roggli VL. Molecular analysis of a patient with neurofibromatosis 2 (NF2) and peritoneal malignant mesothelioma. Am J Surg Pathol. 2020;44:288–92.

    PubMed  Google Scholar 

  48. 48.

    Bott M, Brevet M, Taylor BS, Shimizu S, Ito T, Wang L, et al. The nuclear deubiquitinase BAP1 is commonly inactivated by somatic mutations and 3p21.1 losses in malignant pleural mesothelioma. Nat Genet. 2011;43:668–72.

    CAS  PubMed  PubMed Central  Google Scholar 

  49. 49.

    Testa JR, Cheung M, Pei J, Below JE, Tan Y, Sementino E, et al. Germline BAP1 mutations predispose to malignant mesothelioma. Nat Genet. 2011;43:1022–5.

    CAS  PubMed  PubMed Central  Google Scholar 

  50. 50.

    Cigognetti M, Lonardi S, Fisogni S, Balzarini P, Pellegrini V, Tironi A, et al. BAP1 (BRCA1-associated protein 1) is a highly specific marker for differentiating mesothelioma from reactive mesothelial proliferations. Mod Pathol. 2015;28:1043–57.

    CAS  PubMed  Google Scholar 

  51. 51.

    Nasu M, Emi M, Pastorino S, Tanji M, Powers A, Luk H, et al. High Incidence of Somatic BAP1 alterations in sporadic malignant mesothelioma. J Thorac Oncol. 2015;10:565–76.

    CAS  PubMed  PubMed Central  Google Scholar 

  52. 52.

    Sheffield BS, Hwang HC, Lee AF, Thompson K, Rodriguez S, Tse CH, et al. BAP1 immunohistochemistry and p16 FISH to separate benign from malignant mesothelial proliferations. Am J Surg Pathol. 2015;39:977–82.

    PubMed  Google Scholar 

  53. 53.

    Singhi AD, Krasinskas AM, Choudry HA, Bartlett DL, Pingpank JF, Zeh HJ, et al. The prognostic significance of BAP1, NF2, and CDKN2A in malignant peritoneal mesothelioma. Mod Pathol. 2015;29:14–24.

    PubMed  Google Scholar 

  54. 54.

    Leblay N, Lepretre F, Le Stang N, Gautier-Stein A, Villeneuve L, Isaac S, et al. BAP1 is altered by copy number loss, mutation, and/or loss of protein expression in more than 70% of malignant peritoneal mesotheliomas. J Thorac Oncol. 2017;12:724–33.

    PubMed  Google Scholar 

  55. 55.

    Panagopoulos I, Thorsen J, Gorunova L, Micci F, Haugom L, Davidson B, et al. RNA sequencing identifies fusion of the EWSR1 and YY1 genes in mesothelioma with t(14;22)(q32;q12). Genes Chromosomes Cancer. 2013;52:733–40.

    CAS  PubMed  Google Scholar 

  56. 56.

    Loharamtaweethong K, Puripat N, Aoonjai N, Sutepvarnon A, Bandidwattanawong C. Anaplastic lymphoma kinase (ALK) translocation in paediatric malignant peritoneal mesothelioma: a case report of novel ALK-related tumour spectrum. Histopathology. 2016;68:603–7.

    PubMed  Google Scholar 

  57. 57.

    Mian I, Abdullaev Z, Morrow B, Kaplan RN, Gao S, Miettinen M, et al. Anaplastic lymphoma kinase gene rearrangement in children and young adults with mesothelioma. J Thorac Oncol. 2020;15:457–61.

    CAS  PubMed  Google Scholar 

  58. 58.

    Warhol MJ, Hickey WF, Corson JM. Malignant mesothelioma: ultrastructural distinction from adenocarcinoma. Am J Surg Pathol. 1982;6:307–14.

    CAS  PubMed  Google Scholar 

  59. 59.

    De Rienzo A, Archer MA, Yeap BY, Dao N, Sciaranghella D, Sideris AC, et al. Gender-specific molecular and clinical features underlie malignant pleural mesothelioma. Cancer Res. 2016;76:319–28.

    PubMed  Google Scholar 

  60. 60.

    Sholl LM, Do K, Shivdasani P, Cerami E, Dubuc AM, Kuo FC, et al. Institutional implementation of clinical tumor profiling on an unselected cancer population. JCI Insight. 2016;1:e87062.

    PubMed  PubMed Central  Google Scholar 

  61. 61.

    Kolin DL, Dong F, Baltay M, Lindeman N, MacConaill L, Nucci MR, et al. SMARCA4-deficient undifferentiated uterine sarcoma (malignant rhabdoid tumor of the uterus): a clinicopathologic entity distinct from undifferentiated carcinoma. Mod Pathol. 2018;31:1442–56.

    PubMed  Google Scholar 

  62. 62.

    Churg A, Allen T, Borczuk AC, Cagle PT, Galateau-Salle F, Hwang H, et al. Well-differentiated papillary mesothelioma with invasive foci. Am J Surg Pathol. 2014;38:990–8.

    PubMed  Google Scholar 

  63. 63.

    Brich S, Bozzi F, Perrone F, Tamborini E, Cabras AD, Deraco M, et al. Fluorescence in situ hybridization (FISH) provides estimates of minute and interstitial BAP1, CDKN2A, and NF2 gene deletions in peritoneal mesothelioma. Mod Pathol. 2020;33:217–27.

    CAS  PubMed  Google Scholar 

  64. 64.

    Chiosea S, Krasinskas A, Cagle PT, Mitchell KA, Zander DS, Dacic S. Diagnostic importance of 9p21 homozygous deletion in malignant mesotheliomas. Mod Pathol. 2008;21:742–7.

    CAS  PubMed  Google Scholar 

  65. 65.

    Krasinskas AM, Bartlett DL, Cieply K, Dacic S. CDKN2A and MTAP deletions in peritoneal mesotheliomas are correlated with loss of p16 protein expression and poor survival. Mod Pathol. 2010;23:531–8.

    CAS  PubMed  Google Scholar 

  66. 66.

    Borczuk AC, Pei J, Taub RN, Levy B, Nahum O, Chen J, et al. Genome-wide analysis of abdominal and pleural malignant mesothelioma with DNA arrays reveals both common and distinct regions of copy number alteration. Cancer Biol Ther. 2016;17:328–35.

    CAS  PubMed  PubMed Central  Google Scholar 

  67. 67.

    Pavlisko EN, Roggli VL. Sarcomatoid peritoneal mesothelioma: clinicopathologic correlation of 13 cases. Am J Surg Pathol. 2015;39:1568–75.

    PubMed  Google Scholar 

  68. 68.

    Pastorino S, Yoshikawa Y, Pass HI, Emi M, Nasu M, Pagano I, et al. A subset of mesotheliomas with improved survival occurring in carriers of BAP1 and other germline mutations. J Clin Oncol. 2018;36:3485–94.

    CAS  PubMed Central  Google Scholar 

  69. 69.

    Mijalovsky A, Halperin D, Perez Y, Zafarov B, Shaco-Levy R, Kapelushnik J, et al. Malignant peritoneal mesothelioma in an infant with familial ATM mutations. J Pediatr Hematol Oncol. 2018;40:e511–e5.

    CAS  PubMed  Google Scholar 

  70. 70.

    Lee W, Teckie S, Wiesner T, Ran L, Prieto Granada CN, Lin M, et al. PRC2 is recurrently inactivated through EED or SUZ12 loss in malignant peripheral nerve sheath tumors. Nat Genet. 2014;46:1227–32.

    CAS  PubMed  PubMed Central  Google Scholar 

  71. 71.

    Kemp CD, Rao M, Xi S, Inchauste S, Mani H, Fetsch P, et al. Polycomb repressor complex-2 is a novel target for mesothelioma therapy. Clin Cancer Res. 2012;18:77–90.

    CAS  PubMed  Google Scholar 

  72. 72.

    Shinozaki-Ushiku A, Ushiku T, Morita S, Anraku M, Nakajima J, Fukayama M. Diagnostic utility of BAP1 and EZH2 expression in malignant mesothelioma. Histopathology. 2017;70:722–33.

    PubMed  Google Scholar 

  73. 73.

    LaFave LM, Beguelin W, Koche R, Teater M, Spitzer B, Chramiec A, et al. Loss of BAP1 function leads to EZH2-dependent transformation. Nat Med. 2015;21:1344–9.

    CAS  PubMed  PubMed Central  Google Scholar 

  74. 74.

    Laugesen A, Hojfeldt JW, Helin K. Role of the polycomb repressive complex 2 (PRC2) in transcriptional regulation and cancer. Cold Spring Harb Perspect Med. 2016;6:a026575.

    PubMed  PubMed Central  Google Scholar 

  75. 75.

    Goode B, Joseph NM, Stevers M, Van Ziffle J, Onodera C, Talevich E, et al. Adenomatoid tumors of the male and female genital tract are defined by TRAF7 mutations that drive aberrant NF-kB pathway activation. Mod Pathol. 2018;31:660–73.

    CAS  PubMed  Google Scholar 

  76. 76.

    Tamura D, Maeda D, Halimi SA, Okimura M, Kudo-Asabe Y, Ito S, et al. Adenomatoid tumour of the uterus is frequently associated with iatrogenic immunosuppression. Histopathology. 2018;73:1013–22.

    PubMed  Google Scholar 

  77. 77.

    Stevers M, Rabban JT, Garg K, Van Ziffle J, Onodera C, Grenert JP, et al. Well-differentiated papillary mesothelioma of the peritoneum is genetically defined by mutually exclusive mutations in TRAF7 and CDC42. Mod Pathol. 2019;32:88–99.

    CAS  PubMed  Google Scholar 

  78. 78.

    Hung YP, Dong F, Dubuc AM, Dal Cin P, Bueno R, Chirieac LR. Molecular characterization of localized pleural mesothelioma. Mod Pathol. 2020;33:271–80.

    CAS  PubMed  Google Scholar 

  79. 79.

    Sukov WR, Ketterling RP, Wei S, Monaghan K, Blunden P, Mazzara P, et al. Nearly identical near-haploid karyotype in a peritoneal mesothelioma and a retroperitoneal malignant peripheral nerve sheath tumor. Cancer Genet Cytogenet. 2010;202:123–8.

    CAS  PubMed  Google Scholar 

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We thank Ms. Mei Zheng and the immunohistochemistry laboratory; Ms. Michele Baltay at the Center for Advanced Molecular Diagnostics, Brigham and Women’s Hospital, for technical support.

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Correspondence to Yin P. Hung or Lucian R. Chirieac.

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There is no disclosure from YPH, FD, MT, and CPC. RB has served on the Advisory boards for Myriad, Exosome Diagnostics, and CollaboRx and received support from the National Cancer Institute and investigator-initiated industry grants from Castle Biosciences, Exosome Diagnostics, Genentech-Roche, Gritstone, HTG, Merck, Myriad, Novartis, PamGene, Siemens, Verastem, MedGenome, and Epizyme. LRC undertakes medicolegal work related to mesothelioma. All financial disclosures listed above do not apply to the current study, which is not associated with a specific source of funding.

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Hung, Y.P., Dong, F., Torre, M. et al. Molecular characterization of diffuse malignant peritoneal mesothelioma. Mod Pathol 33, 2269–2279 (2020).

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