Dr. Victor Roggli Presents on 10 Most Outrageous Misdiagnoses of Mesothelioma

On March 1st, Professor of Pathology Victor L. Roggli, MD, gave a Grand Rounds presentation titled “The 10 Most Outrageous Misdiagnoses of Mesothelioma That I Have Ever Encountered: What Can We Learn from These Cases?” Mesothelioma is a tumor of the tissue that lines the lungs, stomach, heart, and other organs.

Assistant Professor John M. Carney, MD, introduced the talk and was first author on a manuscript on which Roggli’s presentation was partly based, which will be printed later this year in the Annals of Diagnostic Pathology.

The manuscript, titled “The Over Diagnosis of Diffuse Mesothelioma: An Analysis of 311 Cases with Recommendations for the Avoidance of Pitfalls,” was co-authored by Duke colleagues Carolyn H. Glass, MD, PhD, Sergio Piña -Oviedo, MD, and Elizabeth N. Pavlisko, MD. In it, they conclude that there are various diagnostic pitfalls that can lead to the over-diagnosis of mesothelioma, and advise that paying careful attention to clinical and radiographic information can help to prevent such misdiagnoses, along with performing appropriate ancillary tests.

In order to draw these conclusions, they investigated a database containing more than 4,000 consultation cases of histologically confirmed mesothelioma to identify cases diagnosed by at least one pathologist when the available information pointed towards a different diagnosis.

Roggli is one of the world’s leading Pulmonary Pathologists with expertise in pneumoconiosis and mesothelioma. He specializes in the use of analytical scanning electron microscopy to identify and to quantify asbestos and other inorganic particulates in lung tissue samples.

He began his career at Duke in 1980 and was first appointed as a professor in 1994. In 2020, The Pulmonary Pathology Society (PPS) presented him with a PPS Lifetime Achievement Award in recognition of his outstanding clinical and academic contributions to the field of thoracic pathology and his service to the PPS over the years.