Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum

Attanoos, Richard; Webb, Richard C.; Dojcinov, Stefan; Gibbs, A R

doi:10.1046/j.1365-2559.2002.01352.x

Cited by 147 publications

(118 citation statements)

References 22 publications

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“…Although the utility of calretinin immunostaining in the diagnosis of mesothelioma was confirmed in subsequent studies, 3,7,9,10,35,36 only a few investigations on the expression of this marker in serous carcinomas have been published 1,2,20,34,37 (Table 3). In the present study, all of the mesotheliomas showed diffuse strong reactivity for calretinin, which confirms the findings of previous investigations, indicating that this marker is frequently expressed in these tumors.…”

Section: Discussionmentioning

confidence: 95%

“…Most studies have primarily focused on the utility of this marker in discriminating between mesotheliomas and lung adenocarcinomas, 9,26,34,35,[41][42][43] while only a few have investigated its value in differentiating peritoneal epithelioid mesotheliomas from serous carcinomas. 1,2,44 The reported percentages of thrombomodulin expression in serous carcinomas have ranged from 2 to 35%, and for peritoneal epithelioid mesotheliomas from 33 to 74% 1,2,44 (Table 5). In the present investigation, 73% of the mesotheliomas and 4% of the serous carcinomas were thrombomodulin positive.…”

Section: Discussionmentioning

confidence: 99%

“…It is generally accepted that immunohistochemical studies can be helpful in establishing the correct diagnosis, but, because a specific marker for either mesothelioma or serous carcinoma has not yet been identified, the differential diagnosis between these malignancies is based on the use of immunohistochemical panels that combine markers that are commonly expressed in epithelioid mesotheliomas, but not in serous carcinomas with markers that are often expressed in serous carcinomas but not in mesotheliomas. 1,2 In 1998, in the largest study on the role of immunohistochemistry in the diagnosis of peritoneal mesotheliomas, 16 markers that at that time were considered to have some potential utility in the diagnosis of this tumor were evaluated. 2 The conclusion of that investigation was that calretinin, thrombomodulin, and keratin 5/6 were the best positive mesothelioma markers and MOC-31, B72.3, Ber-EP4, CA19-9, and leu-M1 (CD15) were the best negative mesothelioma markers for differentiating peritoneal epithelioid malignant mesotheliomas from papillary serous carcinomas diffusely involving the peritoneum.…”

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confidence: 99%

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The diagnostic utility of immunohistochemistry and electron microscopy in distinguishing between peritoneal mesotheliomas and serous carcinomas: a comparative study

2006

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The histologic distinction between peritoneal epithelioid mesotheliomas and serous carcinomas diffusely involving the peritoneum may be difficult, but it can be facilitated by the use of immunohistochemistry and electron microscopy. D2-40 and podoplanin are two recently recognized lymphatic endothelial markers that can be expressed in normal mesothelial cells and mesotheliomas. The purpose of this study is to compare the value of these new mesothelial markers with those that are commonly used for discriminating between mesotheliomas and serous carcinomas, and also to determine the current role of electron microscopy in distinguishing between these malignancies. A total of 40 peritoneal epithelioid mesotheliomas and 45 serous carcinomas of the ovary (15 primary, 30 metastatic to the peritoneum) were investigated for the expression of the following markers: D2-40, podoplanin, calretinin, keratin 5/6, thrombomodulin, MOC-31, Ber-EP4, B72.3 (TAG-72), BG-8 (Lewis Y ), CA19-9, and leu-M1 (CD15). All 40 (100%) of the mesotheliomas reacted for calretinin, 93% for D2-40, 93% for podoplanin, 93% for keratin 5/6, 73% for thrombomodulin, 13% for Ber-EP4, 5% for MOC-31, 3% for BG-8, and none for B72.3, CA19-9, or leu-M1. All 45 (100%) serous carcinomas were positive for Ber-EP4, 98% for MOC-31, 73% for B72.3, 73% for BG-8, 67% for CA19-9, 58% for leu-M1, 31% for keratin 5/6, 31% for calretinin, 13% for D2-40, 13% for podoplanin, and 4% for thrombomodulin. After analyzing the results, it is concluded that Ber-EP4 and MOC-31 are the best negative mesothelioma markers for differentiating between epithelioid mesotheliomas and serous carcinomas. The best discriminators among the positive markers for mesotheliomas are D2-40, podoplanin, and calretinin. From a practical point of view, Ber-EP4 and MOC-31, in combination with calretinin, and/or D2-40 or podoplanin allow the differential diagnosis to be established between mesothelioma and serous carcinoma in nearly all instances. As a clear distinction could be made between these two malignancies in all of the cases in which electron microscopy was performed, this technique can be very useful in establishing the correct diagnosis when the immunohistochemical results are equivocal or further support of a diagnosis of either mesothelioma or serous carcinoma is needed.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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The diagnostic utility of immunohistochemistry and electron microscopy in distinguishing between peritoneal mesotheliomas and serous carcinomas: a comparative study

2006

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“…For example, except calretinin and Ber-EP4, markers such as podoplanin, thrombomodulin, cytokeratin 5/6, WT-1, B72.3, CD15, CEA, and CA19-9 are not helpful in the differential diagnosis of papillary serous carcinoma and malignant mesothelioma of the peritoneum due to the decreased sensitivity and/or specificity. 36,37 Recently, ER was reported to be positive in 93% of papillary serous carcinoma of the ovary and the peritoneum and PR was positive in 29% of these tumors. In contrast, ER and PR were reportedly negative in all malignant mesotheliomas of the peritoneum.…”

Section: Discussionmentioning

confidence: 99%

Expression of PAX2 in papillary serous carcinoma of the ovary: immunohistochemical evidence of fallopian tube or secondary Müllerian system origin?

et al. 2007

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PAX2 is a urogenital developmental transcription factor expressed in the Wolffian ducts, developing kidneys, and Mü llerian ducts during embryonic stage. Its function in renal development is well documented and its clinical application in the diagnosis of lesions of renal origin has been reported recently. However, information on its role in the Mü llerian-derived genital tract is sparse. In this study, we investigated the expression of PAX2 in human female genital tract using immunohistochemistry. We demonstrated that PAX2 was expressed specifically in the epithelial cells of fallopian tube, endometrial and endocervical glands, but not in the stromal tissues in these areas. PAX2 was detected in secondary Mü llerian structures in the ovary, such as endometriotic and endosalpingiotic glands and rete ovarii, but not in ovarian surface epithelium, surface epithelium-derived inclusion cysts, stroma, or sex-cord-derived structures such as follicles, oocytes, and corpus luteum. In addition, PAX2 was detected in 67% of ovarian papillary serous carcinomas (N ¼ 36) but rarely in peritoneal malignant mesotheliomas, with two exceptions (N ¼ 54). Interestingly, the two PAX2-positive 'peritoneal malignant mesotheliomas' were from female patients and were positive for estrogen receptor. The significance of expression of PAX2 and estrogen receptor in these cases is under investigation. Taken together, we suggest that PAX2 is a novel Mü llerian-specific epithelial marker when used in proper clinical settings. Identification of PAX2 in the majority of papillary serous carcinomas of the ovary but not in the ovarian surface epithelium or epithelium-derived inclusion cysts suggests that this malignant epithelial tumor may be directly derived from the primary or secondary Mü llerian epithelium in or surrounding the ovary, rather than from the surface epithelium or its derivatives.

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“…These include mesothelioma-related markers (calretinin, WT-1, thrombomodulin, CK 5/6), 11,43 adenocarcinoma-related markers (CEA, Leu M1, B72.3, Ber EP4), 43 Wolffian-derived structures-associated markers (CD10, calretinin), Mü llerian papillary serous neoplasm-associated markers (WT-1, CA125); a sex-cord tumor-associated marker (inhibin), and markers useful in characterizing metastasis of unknown origin (prostate-specific antigen, prostate-specific acid phosphatase, CDX-2, TTF-1 and CK7/CK20 coexpression pattern). [44][45][46][47][48] Obviously, a judicious selection from the above comprehensive list is required based on the most likely differential diagnoses. Selected panels are summarized in Table 6.…”

Section: Immunohistochemistry Of Testicular and Paratesticular Tumorsmentioning

confidence: 99%

Selected other problematic testicular and paratesticular lesions: rete testis neoplasms and pseudotumors, mesothelial lesions and secondary tumors

2005

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and, in some instances, communication between several structures in the testis and paratestis (rete testis, epididymis, mesothelium, vestigial epithelium and paratesticular soft tissue) result in a plethora of interesting tumors and tumor-like lesions that together pose a formidable diagnostic challenge both because of their morphologic overlap and rarity. The occasional spread of tumors primarily at other sites to this region adds to the potential problem encountered. This review provides an overview of the pathology of nonmesenchymal paratesticular neoplasms and pseudotumors with a focus on the approach to tubulopapillary neoplasms for which diagnostic considerations may include carcinoma of the rete testis, malignant mesothelioma, ovarian-type epithelial tumors, epididymal carcinoma and metastatic carcinomas. The cornerstone of accurate characterization of these lesions is still a comprehensive, traditional clinicopathologic approach, clinical history (of another primary), gross examination (location) and routine light microscopy, but judicious incorporation of contemporary immunohistochemical markers may aid or in some instances be crucial in resolving the problems encountered. Modern Pathology (2005) 18, S131-S145.

show abstract

Value of mesothelial and epithelial antibodies in distinguishing diffuse peritoneal mesothelioma in females from serous papillary carcinoma of the ovary and peritoneum

Cited by 147 publications

References 22 publications

The diagnostic utility of immunohistochemistry and electron microscopy in distinguishing between peritoneal mesotheliomas and serous carcinomas: a comparative study

The diagnostic utility of immunohistochemistry and electron microscopy in distinguishing between peritoneal mesotheliomas and serous carcinomas: a comparative study

Expression of PAX2 in papillary serous carcinoma of the ovary: immunohistochemical evidence of fallopian tube or secondary Müllerian system origin?

Selected other problematic testicular and paratesticular lesions: rete testis neoplasms and pseudotumors, mesothelial lesions and secondary tumors

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