Differentiation of carcinoma from mesothelial cells in effusions

Immunohistochemistry on cell blocks prepared from effusion specimens:

 

carcinoma

mesothelioma

reactive mesothelial cells

 

Desmin

2/98, 1/222, 0/565

1/121, 0/145

 47/561, 25/252, 19/203, 22/245

Calretinin

3/98, 3/676

11/121

52/561, 37/526

CEA

40/981

0/121

0/561

Ber-EP4

94/981

4/121

4/561

p53

66/981

10/121

8/561

N-cadherin

47/981

12/121

48/561

E-cadherin

90/981

10/121

28/561

CA 125

70/981

12/121

47/561

vimentin

32/981

9/121

50/561

EMA

94/981

12/121

39/561, 4/124

 

Desmin and calretinin appear to be useful mesothelial markers. CEA has a high specificity for carcinoma but a low sensitivity. Ber-EP4 also appears useful, but stains some mesotheliomas as well as carcinomas. p53 has potential in the differentiation of malignant (carcinoma or mesothelioma) from benign mesothelial cells.

See also the use of Immunohistochemistry in histological specimens.

References

1Davidson, B., Nielsen, S., Christensen, J., Asschenfeldt, P., Berner, A., Risberg, B., Johansen, P. The role of desmin and N-cadherin in effusion cytology: a comparative study using established markers of mesothelial and epithelial cells. Am J Surg Pathol 2001;25:1405-1412.

2Gill, S. A., Meier, P. A., Kendall, B. S. Use of desmin immunohistochemistry to distinguish between mesothelial cells and carcinoma in serous fluid cell block preparations. Acta Cytol 2000;44:976-80.

3Hurlimann, J. Desmin and neural marker expression in mesothelial cells and mesotheliomas. Hum Pathol 1994;25:753-7.

4Walts, A. E., Said, J. W., Shintaku, I. P. Epithelial membrane antigen in the cytodiagnosis of effusions and aspirates: immunocytochemical and ultrastructural localization in benign and malignant cells. Diagn Cytopathol 1987;3:41-9.

5Afify, A.M., Al-Khafaji, B.M., Paulino, A.F. and Davila, R.M. Diagnostic use of muscle markers in the cytologic evaluation of serous fluids. Appl Immunohistochem Mol Morphol 2002;10:178-82.

6B Davidson et al. E-cadherin and alpha-, beta-, and gamma-catenin protein expression is up-regulated in ovarian carcinoma cells in serous effusions. J Pathol 2000;192:46-469.

 

This page last revised 16.12.2002.

©SMUHT/PW Bishop