Elsevier

Human Pathology

Volume 18, Issue 1, January 1987, Pages 67-74
Human Pathology

The distinction of adenocarcinoma from malignant mesothelioma in cell blocks of effusions: The role of routine mucin histochemistry and immunohistochemical assessment of carcinoembryonic antigen, keratin proteins, epithelial membrane antigen, and milk fat globule-derived antigen

https://doi.org/10.1016/S0046-8177(87)80196-XGet rights and content

The immunohistochemical profile (i.e., carcinoembryonic antigen, keratin proteins, epithelial membrane antigen, human milk fat globule-derived antigen, and mucin) of paraffin-embedded cell blocks of 20 malignant effusions from patients with malignant mesothelioma was compared with that of 39 malignant effusions from patients with metastatic adenocarcinoma to determine whether these markers distinguished between these tumor types. Twenty-three adenocarcinomas (59 per cent) stained for mucin. Immunoreactivity for carcinoembryonic antigen (CEA) was observed in 28 adenocarcinomas (72 per cent). All were immunoreactive for keratin proteins, and 29 adenocarcinomas (74 per cent), including seven that were mucin and CEA negative and exhibited a “peripheral predominant” staining pattern for keratin proteins. By contrast, none of the mesotheliomas stained for mucin or for CEA, and although all were immunoreactive for keratin proteins, none demonstrated a peripheral predominant pattern of staining. Epithelial membrane antigen and milk fat globule-derived antigen were identified in the majority of both mesotheliomas and adenocarcinomas. Neither staining intensity nor pattern of reactivity of these markers clearly distinguished the tumors. This study of cell blocks of serous effusions suggests that staining for mucin, immunoreactivity for carcinoembryonic antigen, and a peripheral predominant pattern of reactivity for keratin proteins represent highly characteristic markers of adenocarcinomas, which identify the majority of these tumors (38 of 39) and allow their distinction from malignant mesotheliomas.

References (34)

  • CorsonJM et al.

    Mesothelioma: profile of keratin proteins and carcinoembyonic antigen—an immunoperoxidase study of 20 cases and comparison with pulmonary adenocarcinomas

    Am J Pathol

    (1982)
  • LoosliH et al.

    Immunohistological study of malignnant diffuse mesotheliomas of the pleura

    Histopathology

    (1984)
  • MarshallRJ et al.

    Use of antibodies to carcinoembryonic antigen and human milk fat globule to distinguish carcinoma, mesothelioma, and reactive mesothelium

    J Clin Pathol

    (1984)
  • BattiforaH et al.

    Distinction of mesothelioma from adenocarcinoma: an immunohistochemical approach

    Cancer

    (1985)
  • WarholMJ et al.

    Malignant mesothelioma: ultrastructural distinction from adenocarcinoma

    Am J Surg Pathol

    (1982)
  • CooperD et al.

    Biology of disease: classification of human epithelia and their neoplasms using monoclonal antibodies to keratins—strategies, applications and limitations

    Lab Invest

    (1985)
  • Cited by (0)

    *

    Received from the Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

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