The Value of Immunohistochemistry of Pleural Biopsy Specimens in the Differential Diagnosis between Malignant Mesothelioma and Metastatic Carcinoma

Applications and Limitations of Immunohistochemistry in the Diagnosis of Malignant Mesothelioma

“…85,87,98,99 The reported percentages of Leu M-1 positivity for adenocarcinoma has ranged from 28% to 100% of cases, 4,41,[65][66][67]75,81,83,85 and for malignant mesothelioma from 0% to 33% of cases. 4,41,46,81,[83][84][85]94,98,100 The reported percentages of positivity for Ber-EP4 for adenocarcinoma have ranged from 32% to 100% of cases, 4,20,22,65,75,89,98,[101][102][103] and for malignant mesothelioma from 0% to 88%. 4,20,22,44,61,65,66,75,88,89,94,98,102,103 The wide range and variability of these results in the various reported studies have been explained on the basis of the use of different commercial antibodies, variable conditions in the immunostaining process, variability in the quality and preservati...…”

“…4,41,46,81,[83][84][85]94,98,100 The reported percentages of positivity for Ber-EP4 for adenocarcinoma have ranged from 32% to 100% of cases, 4,20,22,65,75,89,98,[101][102][103] and for malignant mesothelioma from 0% to 88%. 4,20,22,44,61,65,66,75,88,89,94,98,102,103 The wide range and variability of these results in the various reported studies have been explained on the basis of the use of different commercial antibodies, variable conditions in the immunostaining process, variability in the quality and preservation of the tissues, or the possible inclusion of incorrectly diagnosed cases in the study thus accounting for apparently paradoxical results. The fact remains that whatever the reason for the discrepancies reported in the literature, there seems to be great overlap in the results of immunostaining with these markers between adenocarcinoma and malignant mesothelioma.…”

Morphological and immunohistochemical characterization of isolated tumor cells by p53 status in gastrointestinal tumors

“…However, there is evidence from the literature that Ber-EP4 may indeed stain benign cells originating from hematopoetic or lymphoid tissue [18][19][20][21][22][23][24][25][26][27][28]42], leading others to question the value of Ber-EP4 in specifically displaying ITCs [43]. To the authors' knowledge, phenotyping of Ber-Ep4-immunoreactive cells has not been used widely in audits addressing the incidence and prognostic effect of lymphatic ITCs in solid tumors [4,6,15,44]; thus, it was investigated in the study reported here.…”

“…It has been claimed that Ber-Ep4 does not cross-react with mesenchymal tissue or reticulum cells [16,17], thus leading to a sensitivity of more than 90% and a specificity of nearly 100% to display ITCs [15,18]. However, there is evidence that the specificity of Ber-EP4 may in fact be lower than reported [18][19][20][21][22][23][24][25][26][27][28], questioning the value of Ber-EP4 to display ITCs.…”

Characterizing Subpopulations of Neoplastic Cells in Serous Effusions

“…A positive reaction for CEA and/or CD15 has been shown to be the best immunocytochemical combination for adenocarcinoma, and a negative reaction for both would be the best indicator of mesothelioma. 24 A panel made up of CEA, Ber-EP4 and LeuM1 is highly sensitive and extremely specific in detecting adenocarcinoma cells in cell blocks from serous effusions, resulting in a more accurate diagnosis. The failure of cytologically positive cases to react with one or more of these markers (one case for CEA, six for Ber-EP4 and seven for LeuM1) was probably due more to the absence of expression of the detectable molecules by these antibodies rather than to genetic abnormalities occurring in clones of metastatic cells.…”