Biphasic mesothelioma

Moll R, Franke WW, Vole Platzer B, Krepler R (1982b) Different keratin polypeptides in epider mis and other epithelia of human skin a specific cytokeratin of molecular weight 46,000 in epithelia of the pilosebaceous tract and basal cell epitheliomas. J Cell Biol 95(1) 285 295 Moll R, Krepler R, Franke WW (1983) Complex cytokeratin polypeptide patterns observed in certain human carcinomas. Differentiation 23(3) 256 269 Moll R, Dhouailly D, Sun TT (1989) Expression of keratin 5 as a distinctive feature of epithelial and biphasic mesotheliomas. An immunohistochemical study using monoclonal antibody AE14. Virchows Arch B Cell Pathol Incl Mol Pathol 58(2) 129 145 Moll R, Schiller DL, Franke WW (1990) Identification of protein IT of the intestinal cytoskeleton as a novel type I cytokeratin with unusual properties and expression patterns. J Cell Biol 111(2) 567 580... 

FIGURE 1.6. The reactivity of vascular endothelial growth factor in the cytoplasm of tumor cells in an epithelial nest of biphasic mesothelioma. This reactivity is one of the most potent angiogenic cytokines. Courtesy of Eric van Marck and Samir Kumar-Singh. 

Moll R, Dhovailly D, Sun TT. Expression of keratin 5 as a distinctive feature of epithelial and biphasic mesotheliomas An immunohistochemical study using monoclonal antibody AE14. Virchows Archiv B Cell Pathol. 1989 58 129-145. 

Reale, F. R Griffin, T. W., Compton, J. M., Graham, S., Townes, P. L and Bogden, A. (1987) Characterization of a human malignant mesothelioma cell line (H-MESO-1) A biphasic solid and ascitic tumormodel. Cancer Res. 47,3199-3205. 

Pleural mesotheliomas show a wide range of histologic differentiation, although they can be divided into four major subtypes 1) epithelial 2) sarcomatoid [fibrous, sarcomatous] 3) biphasic and 4) desmoplastic [a variant of a sarcomatoid mesothelioma]. 

Lucas and colleagues immunostained 20 mesotheliomas with sarcomatoid components (10 biphasic and 10 sarcomatoid) for pan cytokeratin, CK5/6, cal-retinin, WTl, thrombomodulin, and smooth muscle actin. They compared the immunophenotypic profile of these tumors with 24 high-grade sarcomas, 10 pulmonary sarcomatoid carcinomas, and 16 epithelioid mesotheliomas. The 10 pulmonary sarcomatoid carcinomas were also immunostained for TTF-1. Their results are shown in Table 12.24. They concluded that 1) there was a decrease in epithelial and mesothelial epitopes in sarcomatoid mesothelioma 2) there was a wide immunophenotypic overlap among sarcomatoid... 

Using formalin-hxed paraffin-embedded tissue sections, Hurlimann reported immunohistochemical desmin expression in 9 of 16 (56.3%) mesotheliomas (8 epithelial and 1 biphasic). Staining was described as focal or was found only in rare tumor cells. Cases showed positive reactivity more frequently with heat-induced epitope retrieval. Four of 16 (25%) mesotheliomas (3 epithelial and 1 biphasic) expressed neuron-specific eno-lase, 5 of 16 (31.3%) immunostained for chromogranin (4 epithelial, 1 biphasic) and 5 of 16 (31.3%) mesotheliomas (all epithelial) were positive for S-100 protein. Only rare tumor cells expressed these neuroepithelial markers. 

Azumi and associates used immunohistochemistry to study 33 mesotheliomas (32 pleural, 1 peritoneal, 18 epithelial, 10 biphasic, 4 sarcomatoid, 1 desmoplastic) and 37 adenocarcinomas for hyaluronate. Three of 37 (8.1%) adenocarcinomas and all mesotheliomas immunostained for hyaluronate. The location of the staining reaction in the mesotheliomas was membranous in 30 cases, cytoplasmic in 21 cases, and membranous and cytoplasmic in 19 cases. The staining reaction in mesotheliomas was classified as moderate or greater in 27 of 33 (81.8%) cases. The authors concluded that the demonstration of hyaluronate should be considered an important adjunct to other immunohistochemical tests and electron microscopy in diagnosing epithelial mesotheliomas. 

S-100 protein immunoperoxidase staining may be of use when epithehal and biphasic malignant mesothelioma vs. poorly differentiated carcinoma is a diagnostic problem (Rasmussen and Larsen... 

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