Value of immunohistochemistry in the differential diagnosis of pleural sarcomatoid mesothelioma from lung sarcomatoid carcinoma
Version of Record online: 24 APR 2009
© 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Limited
Volume 54, Issue 6, pages 667–676, May 2009
How to Cite
Takeshima, Y., Amatya, V. J., Kushitani, K., Kaneko, M. and Inai, K. (2009), Value of immunohistochemistry in the differential diagnosis of pleural sarcomatoid mesothelioma from lung sarcomatoid carcinoma. Histopathology, 54: 667–676. doi: 10.1111/j.1365-2559.2009.03298.x
- Issue online: 24 APR 2009
- Version of Record online: 24 APR 2009
- Date of submission 28 June 2008 Accepted for publication 11 November 2008
- differential diagnosis;
- sarcomatoid carcinoma;
- sarcomatoid mesothelioma
Aims: The differential diagnosis of pleural sarcomatoid mesothelioma (SM) from lung sarcomatoid carcinoma (LSC) invading parietal pleura and chest wall is a challenging issue. The aim of this study was to identify useful antibodies that can be used for the differential diagnosis of pleural SM from LSC.
Methods and results: Forty-five cases of pleural SM and 27 cases of LSC were immunohistochemically analysed by using 15 commercially available antibodies, including D2-40 and antibodies to calretinin, thrombomodulin, Wilms’ Tumour 1, carcinoembryonic antigen (CEA), Napsin A, thyroid transcription factor (TTF)-1, pan-cytokeratin, CAM5.2, epithelial membrane antigen, Ber-EP4, MOC-31, α-smooth muscle actin, h-caldesmon and desmin. The results revealed that D2-40 positivity was significantly higher in pleural SM (86.7%) than in LSC (25.9%). The positivity of the adenocarcinoma markers, including CEA, Napsin A, and TTF-1, was low even in LSC.
Conclusions: Evaluating the positivity and degree of staining of the well-known mesothelial marker D2-40 could be applied to differentiate pleural SM from the sarcomatoid component of LSC, in addition to assessing clinical and radiological information.