Differential Diagnosis of Pleural Mesothelioma and Metastatic Adenocarcinoma by Immunohistochemistry.

Ko, Kyung Haeng; Park, Chang Min; Rim, Myung Soo; Kim, Yoo Il; Jang, Il Gweon; Hwang, Joon Hwa; Lim, Sung Chul; Kim, Young Chul; Park, Kyung Ok; Park, Chang Soo

doi:1999.47.4.478

Tuberc Respir Dis > Volume 47(4); 1999 > Article

Original Article

Tuberculosis and Respiratory Diseases 1999;47(4):478-487.
DOI: https://doi.org/10.4046/trd.1999.47.4.478 Published online October 1, 1999.

Differential Diagnosis of Pleural Mesothelioma and Metastatic Adenocarcinoma by Immunohistochemistry.

Kyung Haeng Ko, Chang Min Park, Myung Soo Rim, Yoo Il Kim, Il Gweon Jang, Joon Hwa Hwang, Sung Chul Lim, Young Chul Kim, Kyung Ok Park, Chang Soo Park

¹Department of Internal Medicine, Chonnam National University, Medical School, Kwangju, Korea.
²Department of Pathology, Chonnam National University, Medical School, Kwangju, Korea.

Abstract

BACKGROUND
Differential diagnosis of pleural malignant mesothelioma from secondary metastatic adenocarcinoma is often difficult. A variety of pathologic techniques have been developed to make a differential diagnosis of carcinoma from mesothelioma. Immunohistochemistry detecting diverse antigenic substances such as CEA, Leu-M1, B72-3, S-100 protein, vimentin, CK and EMA has been claimed to be of value as a panel in the differential diagnosis of adenocarcinoma from mesothelioma. The aim of this study was to investigate the suitable antibodies to distinguish mesothelioma from metastatic adenocarcinoma and establish candidate markers in a panel. METHODS: Complete, one-hour immunohistochemical staining using antibodies against cytokeratin (CK), epithelial membrane antigen(EMA), S-100 protein, vimentin, B72-3, Leu-M1, and carcino-embryonic antigen (CEA) was applied to cell blocks from 7 mesotheliomas and 7 adenocarcinomas which were confirmed by electron microscopic and histpathologic methods. RESULTS: All adenocarcinomas and 71.4% of mesotheliomas expressed the cytokeratin and EMA. S-100 protein and vimentin were expressed in 57.1% and 42.9% of mesotheliomas and 14.3% and 28.5% of adenocarcinomas, respectively. B72-3 was expressed in all adenocarcinomas, but in none of mesotheliomas. Leu-M1 was positive in 71.4% of the adenocarcinoma and 14.3% of the mesotheliomas. CEA was positive in all adenocarcinomas and 42.9% of mesotheliomas. Leu-M1 and B72-3 were coexpressed in 71.4% of adenocarcinomas but in none of mesothelioma. B72-3 and CEA were coexpressed in all adenocarcinomas, but in none of mesotheliomas. CONCLUSION: We concluded that B72-3 immunohistochemistry or panel staining of B72-3 and CEA could be recommanded for the differential diagnosis of pleural mesothelioma from metastatic adenocarcinoma.

Key Words: Malignant mesothelioma, Immunohistochemistry, B72-3