Vimentin

Vimentin has a molecular weight of 57 kD and is considered the "primordial" of the intermediate filaments. It is the most widely distributed intermediate filament, being expressed in all mesenchymal cells and is coexpressed with cytokeratin by many epithelial cells and tumours.

Immunohistochemical expression

regenerating muscle fibres

Vimentin is coexpressed with cytokeratin by epithelial cells and tumours of:

lung


salivary glands


liver; hepatocytes and biliary tract


thyroid


renal tubules


gonads


endometrium


adrenal cortex

• Vimentin coexpression has been reported in carcinomas of:

  skin
  

  breast
  

  stomach
  

  urothelium
  

  prostate
  

  uterine cervix
  

  most spindle cell carcinomas
  

  many exfoliated and metastatic carcinoma cells in body fluid

Breast, ductal carcinoma	7/11926, 9/10727
Breast, lobular carcinoma	2/1026
Pulmonary adenocarcinomas	5/3526
Gastric carcinomas	0/3926
Colonic carcinoma	0/2526, 2/9427
Pancreatic carcinoma	2/2626
Ovarian carcinoma	11/2926, 29/8627
Renal carcinomas	42/4526

Diagnostic utility

• Vimentin is a useful "control marker". That is, if vimentin cannot be easily demonstrated in non-neoplastic endothelial cell, fibroblasts and other mesenchymal elements, there may be a problem with the state of preservation of the tissue with respect to immunoreactivity in general.⁷

• The value of vimentin in tumour diagnosis is limited by its ubiquity. However, in malignant rhabdoid tumour, it usually assumes a characteristic globular cytoplasmic configuration, indenting the nucleus.⁷

• Differentiation of mesothelioma from adenocarcinoma; vimentin is more commonly co-expressed with cytokeratins in epithelial cells in mesothelioma:

	adenocarcinoma	mesothelioma
Churg 19858	0/5 (pulmonary adenocarcinomas)	5/8 (epithelioid and biphasic mesotheliomas: alcohol fixation required for strong staining)
Jasani 198510	11/24 (pulmonary adenocarcinomas: staining was less intense than in the mesothleiomas)	33/44 (all histological types)
Mullink 1986	4/8 (pulmonary adenocarcinomas; only a few cells stained)	11/12 (6 epithelioid and 6 biphasic mesotheliomas)
Pfaltz 198711	3/22 (pulmonary adenocarcinomas)	8/24 (epithelioid mesotheliomas)
Ordonez 198912	3/23 (pulmonary adenocarcinomas, Dako clone V9), 0/23 (pulmonary adenocarcinomas, Labsystems monoclonal)	5/19 (epithelioid mesotheliomas)
Chenard-Neu 199013	2/20	8/14
Wick 199014	9/52 (peripheral adenocarcinoma of the lung with pleural invasion)	21/51 (epithelioid mesotheliomas)
Wirth 199115	0/20 (pulmonary adenocarcinomas)	29/36 (epithelioid mesotheliomas)
Gaffey 199225	not studied	35/49 (19/32 epithelioid and 16/17 biphasic)
Brown 199316	20/103 (pulmonary adenocarcinomas)	22/34 (epithelioid mesotheliomas)
Moch 199317	4/24 (pulmonary adenocarcinomas)	26/27 (all histological types)
Dejmek 199418	1/43 (adenocarcinomas from various sites)	50/93 (epithelioid and biphasic mesotheliomas)
Dejmek 19975	1/43	60/110
Riera 199719	66/211 (adenocarcinomas from various sites)	46/57 (epithelioid mesotheliomas)
Chenard-Neu 199820	10/30 (adenocarcinomas from various sites)	28/28 (all histological types)
Garcia-Prats 199821	1/18 (1/15 pulmonary primaries and 0/3 extrapulmonary primaries)	35/40 (23/26 epithelioid, 8/10 sarcomatoid, 4/4 biphasic mesotheliomas)
Brockstedt 20001	8/57 (adenocarcinomas of various sites, metastatic to pleura: reactivity in epithelial cells)	77/119 (epithelioid and biphasic mesotheliomas: reactivity in epithelioid cells)
Dejmek 2000 (cytospin preparations of pleural fluids)22	25/49 (adenocarcinomas from various sites)	26/33 (epithelioid mesotheliomas)
Roberts 20012	3/18 (adenocarcinomas from various sites)	30/108 (17/79 epithelioid, 5/11 sarcomatoid, 4/11 biphasic and 4/7 desmoplastic)
Gonzalez-Lois 20013	6/15 (adenocarcinomas from various sites)	42/42 (33/33 epithelioid, 7/7 sarcomatoid, 1/1 mixed and 1/1 lymphohistiocytoid mesotheliomas)
Kayser 20014	68/146 (40/82 lung, 15/47 breast, 3/3 colon, 1/2 kidney, 9/12 site not known)	98/118 (79/99 epithelioid, 12/12 mixed and 7/7 sarcomatoid)
Davidson 2001 (cell blocks of serous fluids)23	32/98 (adenocarcinomas from various sites)	9/12 (epithelioid mesotheliomas)
Ordonez 200324	19/50(lung adenocarcinomas: in 2 cases 26-50% of cells stained, in 16 cases, 1-25% of cells stained and in 1 cases <1% of cells stained)	33/60 (epithelioid mesotheliomas: in 4 cases 26-50% of cells stained,in 28 cases, 1-25% of cells stained and in 1 cases <1% of cells stained)
Overall	28% (295/1036)	66% (667/1028)

A systematic review of seventeen studies (consisting of 773 epithelioid mesotheliomas and 815 pulmonary adenocarcinomas) reported sensitivities and specificities of vimentin for epithelioid mesothelioma of 62% and 75%²⁸.

• carcinoma of unknown primary: strong co-expression of vimentin and cytokeratin may indicate a renal, endometrial or thyroid primary⁶.

• differentiation of endocervical from endometrial adenocarcinoma.

References

¹ Brockstedt U, Gulyas M, Dobra K. An optimized batter of eight antibodies that can distingusih most cases of epithelial mesothelioma form adenocarcinoma. Am J Clin Pathol 2000;114:203-9.

² Harper CM. Evaluation of a commercially available immunohistochemical diagnostic panel for malignant mesothelioma. J Pathol 2001:193(suppl):39^A.

³ Gonzalez-Lois, C., Ballestin, C., Sotelo, M. T., Lopez-Rios, F., Garcia-Prats, M. D., Villena, V. Combined use of novel epithelial (MOC-31) and mesothelial (HBME-1) immunohistochemical markers for optimal first line diagnostic distinction between mesothelioma and metastatic carcinoma in pleura. Histopathology 2001;38:528-34.

⁴ K Kayser et al. Glyco- and immunohistochemical refinement of the differential diagnosis between mesothelioma and metastatic carcinoma and survival analysis of patients. J Pathol 2001;193:175-180.

⁵ Dejmek, A., Brockstedt, U., Hjerpe, A. Optimization of a battery using nine immunocytochemical variables for distinguishing between epithelial mesothelioma and adenocarcinoma. Apmis 1997;105:889-94.Dejmek, A., Brockstedt, U., Hjerpe, A. Optimization of a battery using nine immunocytochemical variables for distinguishing between epithelial mesothelioma and adenocarcinoma. Apmis 1997;105:889-94.

⁶ Azumi, N., Battifora, H. The distribution of vimentin and keratin in epithelial and nonepithelial neoplasms. A comprehensive immunohistochemical study on formalin- and alcohol-fixed tumors. Am J Clin Pathol 1987;88:286-96.

⁷ Diagnostic Immunohistochemistry edited by Professor D. J. Dabbs, page 63.

⁸ Churg, A. (1985). "Immunohistochemical staining for vimentin and keratin in malignant mesothelioma." Am J Surg Pathol 9(5): 360-5.

⁹ Jasani, B., R. E. Edwards, et al. (1985). "The use of vimentin antibodies in the diagnosis of malignant mesothelioma." Virchows Arch A Pathol Anat Histopathol 406(4): 441-8.

¹⁰ Mullink, H., S. C. Henzen-Logmans, et al. (1986). "Simultaneous immunoenzyme staining of vimentin and cytokeratins with monoclonal antibodies as an aid in the differential diagnosis of malignant mesothelioma from pulmonary adenocarcinoma." Virchows Arch B Cell Pathol Incl Mol Pathol 52(1): 55-65.

¹¹ Pfaltz, M., B. Odermatt, et al. (1987). "Immunohistochemistry in the diagnosis of malignant mesothelioma." Virchows Arch A Pathol Anat Histopathol 411(4): 387-93.

¹² Ordonez, N. G. (1989). "The immunohistochemical diagnosis of mesothelioma. Differentiation of mesothelioma and lung adenocarcinoma." Am J Surg Pathol 13(4): 276-91.

¹³ Chenard-Neu, M. P., J. P. Bellocq, et al. (1990). "[Malignant mesothelioma of the pleura. Analysis of its immunohistochemical aspects]." Ann Pathol 10(1): 20-7.

¹⁴ Wick, M. R., T. Loy, et al. (1990). "Malignant epithelioid pleural mesothelioma versus peripheral pulmonary adenocarcinoma: a histochemical, ultrastructural, and immunohistologic study of 103 cases." Hum Pathol 21(7): 759-66.

¹⁵ Wirth, P. R., J. Legier, et al. (1991). "Immunohistochemical evaluation of seven monoclonal antibodies for differentiation of pleural mesothelioma from lung adenocarcinoma." Cancer 67(3): 655-62.

¹⁶ Brown, R. W., G. M. Clark, et al. (1993). "Multiple-marker immunohistochemical phenotypes distinguishing malignant pleural mesothelioma from pulmonary adenocarcinoma [see comments]." Hum Pathol 24(4): 347-54.

¹⁷ Moch, H., M. Oberholzer, et al. (1993). "Diagnostic tools for differentiating between pleural mesothelioma and lung adenocarcinoma in paraffin embedded tissue. Part I: Immunohistochemical findings." Virchows Arch A Pathol Anat Histopathol 423(1): 19-27.

¹⁸ Dejmek, A. and A. Hjerpe (1994). "Immunohistochemical reactivity in mesothelioma and adenocarcinoma: a stepwise logistic regression analysis." Apmis 102(4): 255-64.

¹⁹ Riera, J. R., C. Astengo-Osuna, et al. (1997). "The immunohistochemical diagnostic panel for epithelial mesothelioma: a reevaluation after heat-induced epitope retrieval [see comments]." Am J Surg Pathol 21(12): 1409-19.

²⁰ Chenard-Neu, M. P., A. Kabou, et al. (1998). "[Immunohistochemistry in the differential diagnosis of mesothelioma and adenocarcinoma. Evaluation of 5 new antibodies and 6 traditional antibodies]." Ann Pathol 18(6): 460-5.

²¹ Garcia-Prats, M. D., C. Ballestin, et al. (1998). "A comparative evaluation of immunohistochemical markers for the differential diagnosis of malignant pleural tumours." Histopathology 32(5): 462-72.

²² Dejmek, A. and A. Hjerpe (2000). "Reactivity of six antibodies in effusions of mesothelioma, adenocarcinoma and mesotheliosis: stepwise logistic regression analysis." Cytopathology 11(1): 8-17.

²³ Davidson, B., S. Nielsen, et al. (2001). "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 25(11): 1405-12.

²⁴ Ordonez, N. G. (2003). "The immunohistochemical diagnosis of mesothelioma: a comparative study of epithelioid mesothelioma and lung adenocarcinoma." Am J Surg Pathol 27(8): 1031-51.

²⁵ Gaffey, M. J., S. E. Mills, et al. (1992). "Immunoreactivity for BER-EP4 in adenocarcinomas, adenomatoid tumors, and malignant mesotheliomas." Am J Surg Pathol 16(6): 593-9.

²⁶ Kaufmann, O., T. Deidesheimer, et al. (1996). "Immunohistochemical differentiation of metastatic breast carcinomas from metastatic adenocarcinomas of other common primary sites." Histopathology 29(3): 233-40.

²⁷Lagendijk, J. H., H. Mullink, et al. (1999). "Immunohistochemical differentiation between primary adenocarcinomas of the ovary and ovarian metastases of colonic and breast origin. Comparison between a statistical and an intuitive approach." J Clin Pathol 52(4): 283-90.

²⁸ King JE, Thatcher N, Pickering CA, et al. Sensitivity and specificity of immunohistochemical markers used in the diagnosis of epithelioid mesothelioma: a detailed systematic analysis using published data. Histopathology 2006; 48:223-32

This page last revised 16.2.2006.

©SMUHT/PW Bishop