Vimentin

Vimentin has a molecular weight of 57 kD and is considered the "primordial" of the intermediate filaments. It is the most widely distributed intermediate filament, being expressed in all mesenchymal cells and is coexpressed with cytokeratin by many epithelial cells and tumours.

Immunohistochemical expression

regenerating muscle fibres
Vimentin is coexpressed with cytokeratin by epithelial cells and tumours of:

lung

salivary glands

liver; hepatocytes and biliary tract

thyroid

renal tubules

gonads

endometrium

adrenal cortex
Vimentin coexpression has been reported in carcinomas of:

skin

breast

stomach

urothelium

prostate

uterine cervix

most spindle cell carcinomas

many exfoliated and metastatic carcinoma cells in body fluid

Breast, ductal carcinoma	7/11926, 9/10727
Breast, lobular carcinoma	2/1026
Pulmonary adenocarcinomas	5/3526
Gastric carcinomas	0/3926
Colonic carcinoma	0/2526, 2/9427
Pancreatic carcinoma	2/2626
Ovarian carcinoma	11/2926, 29/8627
Renal carcinomas	42/4526

Diagnostic utility

Vimentin is a useful "control marker". That is, if vimentin cannot be easily demonstrated in non-neoplastic endothelial cell, fibroblasts and other mesenchymal elements, there may be a problem with the state of preservation of the tissue with respect to immunoreactivity in general.7
The value of vimentin in tumour diagnosis is limited by its ubiquity. However, in malignant rhabdoid tumour, it usually assumes a characteristic globular cytoplasmic configuration, indenting the nucleus.7
Differentiation of mesothelioma from adenocarcinoma; vimentin is more commonly co-expressed with cytokeratins in epithelial cells in mesothelioma:

	adenocarcinoma	mesothelioma
Churg 19858	0/5(pulmonary adenocarcinomas)	5/8
Jasani 198510	11/24	33/44(all histological types)
Mullink 1986	4/8	11/12
Pfaltz 198711	3/22(pulmonary adenocarcinomas)	8/24(epithelioid mesotheliomas)
Ordonez 198912	3/23 , 0/23	5/19(epithelioid mesotheliomas)
Chenard-Neu 199013	2/20	8/14
Wick 199014	9/52	21/51(epithelioid mesotheliomas)
Wirth 199115	0/20(pulmonary adenocarcinomas)	29/36(epithelioid mesotheliomas)
Gaffey 199225	not studied	35/49(19/32 epithelioid and 16/17 biphasic)
Brown 199316	20/103(pulmonary adenocarcinomas)	22/34(epithelioid mesotheliomas)
Moch 199317	4/24(pulmonary adenocarcinomas)	26/27(all histological types)
Dejmek 199418	1/43(adenocarcinomas from various sites)	50/93
Dejmek 19975	1/43	60/110
Riera 199719	66/211(adenocarcinomas from various sites)	46/57(epithelioid mesotheliomas)
Chenard-Neu 199820	10/30(adenocarcinomas from various sites)	28/28(all histological types)
Garcia-Prats 199821	1/18	35/40
Brockstedt 20001	8/57	77/119
Dejmek 2000 (cytospin preparations of pleural fluids)22	25/49(adenocarcinomas from various sites)	26/33(epithelioid mesotheliomas)
Roberts 20012	3/18(adenocarcinomas from various sites)	30/108
Gonzalez-Lois 20013	6/15(adenocarcinomas from various sites)	42/42
Kayser 20014	68/146	98/118
Davidson 2001 (cell blocks of serous fluids)23	32/98(adenocarcinomas from various sites)	9/12(epithelioid mesotheliomas)
Ordonez 200324	19/50	33/60
Overall	28% (295/1036)	66% (667/1028)

A systematic review of seventeen studies (consisting of 773 epithelioid mesotheliomas and 815 pulmonary adenocarcinomas) reported sensitivities and specificities of vimentin for epithelioid mesothelioma of 62% and 75%28.

carcinoma of unknown primary: strong co-expression of vimentin and cytokeratin may indicate a renal, endometrial or thyroid primary6.
differentiation of endocervical from endometrial adenocarcinoma.

References

1 Brockstedt U, Gulyas M, Dobra K. An optimized batter of eight antibodies that can distingusih most cases of epithelial mesothelioma form adenocarcinoma. Am J Clin Pathol 2000;114:203-9.

2 Harper CM. Evaluation of a commercially available immunohistochemical diagnostic panel for malignant mesothelioma. J Pathol 2001:193(suppl):39A.

3 Gonzalez-Lois, C., Ballestin, C., Sotelo, M. T., Lopez-Rios, F., Garcia-Prats, M. D., Villena, V. Combined use of novel epithelial (MOC-31) and mesothelial (HBME-1) immunohistochemical markers for optimal first line diagnostic distinction between mesothelioma and metastatic carcinoma in pleura. Histopathology 2001;38:528-34.

4 K Kayser et al. Glyco- and immunohistochemical refinement of the differential diagnosis between mesothelioma and metastatic carcinoma and survival analysis of patients. J Pathol 2001;193:175-180.

5 Dejmek, A., Brockstedt, U., Hjerpe, A. Optimization of a battery using nine immunocytochemical variables for distinguishing between epithelial mesothelioma and adenocarcinoma. Apmis 1997;105:889-94.Dejmek, A., Brockstedt, U., Hjerpe, A. Optimization of a battery using nine immunocytochemical variables for distinguishing between epithelial mesothelioma and adenocarcinoma. Apmis 1997;105:889-94.

6 Azumi, N., Battifora, H. The distribution of vimentin and keratin in epithelial and nonepithelial neoplasms. A comprehensive immunohistochemical study on formalin- and alcohol-fixed tumors. Am J Clin Pathol 1987;88:286-96.

7 Diagnostic Immunohistochemistry edited by Professor D. J. Dabbs, page 63.

8 Churg, A. (1985). "Immunohistochemical staining for vimentin and keratin in malignant mesothelioma." Am J Surg Pathol 9(5): 360-5.

9 Jasani, B., R. E. Edwards, et al. (1985). "The use of vimentin antibodies in the diagnosis of malignant mesothelioma." Virchows Arch A Pathol Anat Histopathol 406(4): 441-8.

10 Mullink, H., S. C. Henzen-Logmans, et al. (1986). "Simultaneous immunoenzyme staining of vimentin and cytokeratins with monoclonal antibodies as an aid in the differential diagnosis of malignant mesothelioma from pulmonary adenocarcinoma." Virchows Arch B Cell Pathol Incl Mol Pathol 52(1): 55-65.

11 Pfaltz, M., B. Odermatt, et al. (1987). "Immunohistochemistry in the diagnosis of malignant mesothelioma." Virchows Arch A Pathol Anat Histopathol 411(4): 387-93.