Renal cell carcinoma vs mesothelioma
Renal cell carcinoma may present
with pleural metastases, even in the absence of urological symptoms.
Differentiation on morphological grounds may not be possible: a clear
cell variant of mesothelioma has been described10,11.
Immunohistochemistry
| |
|
mesothelioma |
renal cell carcinoma |
all other adenocarcinomas |
|
|
Calretinin |
86% (158/184: 36/371, 38/382,
12/315, 44/446,
47/517, 20/20
(three cases stained only weakly)9) |
7% (4/58: 4/401, 0/82,
0/15, 0/46,
0/47, 0/19) |
9% (43/501: 14/1472,
0/35, 28/2766,
1/557, 1/20
(weak staining in one case)9) |
|
CK5/6 |
79% (134/169: 29/371, 40/403,
9/315, 56/617) |
5% (3/55: 2/401, 0/103,
0/15, 1/47) |
13% (22/175: 14/1133, 0/35,
8/597) |
|
Thrombomodulin |
76% (156/206: 32/371, 11/204,
9/315, 55/617,
49/578) |
20% (17/85: 13/401, 1/204,
0/15, 2/47,
1/208) |
16% (17/105: 0/35, 10/597,
7/438) |
|
CEA |
0/371, |
0/401, |
|
|
BerEP4 |
6/37 (membrane
staining, always focal and generally weak)1, |
20/401, |
|
|
CD10 |
578/145
(staining was seen in both epithelioid and sarcomatoid components) 12 |
20/2012 |
|
|
Erythropoietin |
100/100
(staining was equally strong in epithelioid and sarcomatoid components)12 |
20/2012 |
|
|
Renal cell carcinoma marker |
38/145
(staining was largely restricted to the epithelioid coponent)12
|
11/2012 |
|
|
BCA225 |
30/361, |
35/401, |
|
Conclusion
While
calretinin and CK5/6 are diagnostically useful,
thrombomodulin shows variable specificity for mesothelioma. CEA and
BCA225 are uninformative in this
context. The sensitivity of BerEP4 for renal cell carcinoma is poor.
References
1
Osborn, M., N. Pelling, et al. (2002). "The value of
'mesothelium-associated' antibodies in distinguishing between
metastatic renal cell carcinomas and mesotheliomas."
Histopathology 41(4): 301-7.
2
Ordonez, N. G. (1998). "Value of calretinin immunostaining in
differentiating epithelial mesothelioma from lung
adenocarcinoma." Mod Pathol 11(10): 929-33.
3
Ordonez, N. G. (1998). "Value of cytokeratin 5/6 immunostaining
in distinguishing epithelial mesothelioma of the pleura from lung
adenocarcinoma." Am J Surg Pathol 22(10): 1215-21.
4
Attanoos, R. L., H. Goddard, et al. (1995). "A comparative
immunohistochemical study of malignant mesothelioma and renal cell
carcinoma: the diagnostic utility of Leu-M1, Ber EP4, Tamm- Horsfall
protein and thrombomodulin." Histopathology 27(4): 361-6.
5
Attanoos, R. L., S. D. Dojcinov, et al. (2000). "Anti-mesothelial
markers in sarcomatoid mesothelioma and other spindle cell
neoplasms." Histopathology 37(3): 224-31.
6
Doglioni, C., A. P. Tos, et al. (1996). "Calretinin: a novel
immunocytochemical marker for mesothelioma." Am J Surg Pathol
20(9): 1037-46.
7
Cury, P. M., D. N. Butcher, et al. (2000). "Value of the
mesothelium-associated antibodies thrombomodulin, cytokeratin 5/6,
calretinin, and CD44H in distinguishing epithelioid pleural
mesothelioma from adenocarcinoma metastatic to the pleura." Mod
Pathol 13(2): 107-12.
8
Kennedy, A. D., G. King, et al. (1997). "HBME-1 and
antithrombomodulin in the differential diagnosis of malignant
mesothelioma of pleura." J Clin Pathol 50(10): 859-62.
9
Leers, M. P., M. M. Aarts, et al. (1998). "E-cadherin and
calretinin: a useful combination of immunochemical markers for
differentiation between mesothelioma and metastatic
adenocarcinoma." Histopathology 32(3): 209-16.
10 Ordonez,
N. G., M. Myhre, et al. (1996). "Clear cell mesothelioma."
Ultrastruct Pathol 20(4): 331-6.
11
Dessy, E., M. Falleni, et al. (2001). "Unusual clear cell
variant of epithelioid mesothelioma." Arch Pathol Lab Med
125(12): 1588-90.
12 Butnor
KJ, Nicholson AG, Allred DC, et al. Expression of renal cell
carcinoma-associated markers erythropoietin, CD10, and renal cell
carcinoma marker in diffuse malignant mesothelioma and metastatic
renal cell carcinoma. Arch Pathol Lab Med 2006; 130:823-7 FULL
TEXT
This page last
revised 12.7.2008.
©SMUHT/PW Bishop