CD56 (Neural cell adhesion molecules, NCAM, Leu19)

NCAM is a cell adhesion molecule originally isolated on the basis of its role in neural cell adhesion. Antibodies are effective on paraffin-embedded tissue. There have ben reports that NCAM positive carcinomas are more aggressive than NCAM negative carcinomas⁶.

Antibodies are effective on paraffin-embedded tissue⁷.

Immunohistochemical expression

• see comparison of neuroendocrine markers

• pulmonary small cell carcinoma

• mesothelioma:²

	epithelial cells	spindle cells
epithelial mesothelioma	6/122	5/12 in stromal fibroblasts
biphasic mesothelioma	4/112	11/112
sarcomatoid mesothelioma	-	2/32
mesothelioma overall	73% (19/26)2
squamous cell carcinoma	4/521,0/252	-
adenocarcinoma	1/381,0/252	-

• carcinoid

foregut	13/173
midgut	7/123
hindgut	2/103

• rarely positive in pulmonary and laryngeal squamous cell carcinoma

• pancreatic islet cell tumour

• Pancreatic tumours with neuroendocrine differentiation

• Merkel cell carcinoma

• hepatocellular carcinoma

• some renal cell carcinoma¹

• some ovarian carcinoma¹

• some endometrial carcinoma¹

• follicular and papillary thyroid carcinoma

• neuroblastoma

• ganglioglioma

• oligodendroglioma

• glioblastoma multiforme

• phaeochromocytoma

• retinoblastoma

• large granular lymphocyte leukaemia of NK type

• myeloma

• natural killer cells and a subset of T-lymphocytes

• osteoblasts⁹

• Using a polyclonal antibody, there is immunoreactivity in the fetal myocardium, the conduction system of the adult heart, and upregulation in Chagas' disease, where staining of intercalated disks and amastigote nests is seen⁴.

• Perisinusoidal stellate cells of the liver⁵.

The following are negative for CD 56:

• nasopharyngeal carcinoma

• colonic carcinoma

• melanoma

• meningioma

• follicle centre cell lymphoma

• hairy cell leukaemia

• Ewing's sarcoma

Diagnostic utility

• identification of pulmonary small cell carcinomas

• CD56 may be useful in differentiating myeloma from MGUS and polyclonal plasmacytosis

References

¹Kaufmann, O. Georgi, T. Dietel, M. Utility of 123C3 monoclonal antibody against CD56 (NCAM) for the diagnosis of small cell carcinomas on paraffin sections. Hum Pathol 1997;28:1373-8.

²Lantuejoul S. Laverriere MH. Sturm N. Moro D. Frey G. Brambilla C. Brambilla E. NCAM (neural cell adhesion molecules) expression in malignant mesotheliomas. Human Pathology 2000;31(4):415-21.

³Al-Khafaji et al. Immunohistologic analysis of gastrointestinal and pulmonary carcinoid tumours. Human Pathol 1998;29:992-999.

⁴Soler, A. P., Gilliard, G., Xiong, Y., Knudsen, K. A., Martin, J. L., De Suarez, C. B., Mota Gamboa, J. D., Mosca, W., Zoppi, L. B. Overexpression of neural cell adhesion molecule in Chagas' myocarditis. Human Pathol 2001;32:149-155.

⁵Nakatani, K., Seki, S., Kawada, N., Kobayashi, K., Kaneda, K. Expression of neural cell adhesion molecule (N-CAM) in perisinusoidal stellate cells of the human liver. Cell Tissue Res 1996;283:159-165.

⁶Naka, T., Oda, Y., Iwamoto, Y. Immunohistochemical analysis of E-cadherin, alpha-catenin, beta- catenin, gamma-catenin, and neural cell adhesion molecule (NCAM) in chordoma. J Clin Pathol 2001;54:945-950

⁷Leong A S-Y, Cooper K and Leong FJ W-M. Manual of diagnostic antibodies for immunohistology. 2nd edition, 2003

⁸Martin, P., A. Santon, et al. (2004). "Neural cell adhesion molecule expression in plasma cells in bone marrow biopsies and aspirates allows discrimination between multiple myeloma, monoclonal gammopathy of uncertain significance and polyclonal plasmacytosis." Histopathology 44(4): 375-80.

⁹Ely, S. A. and D. M. Knowles (2002). "Expression of CD56/neural cell adhesion molecule correlates with the presence of lytic bone lesions in multiple myeloma and distinguishes myeloma from monoclonal gammopathy of undetermined significance and lymphomas with plasmacytoid differentiation." Am J Pathol 160(4): 1293-9.

This page last revised 20.12.2004.

©SMUHT/PW Bishop