The role of immunohistochemistry in the differential diagnosis of serous effusions.

Anatomia Patologica. Ospedale S. Martino di Belluno.
Advances in clinical pathology: the official journal of Adriatic Society of Pathology 11/2000; 4(4):183-5.
Source: PubMed
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    ABSTRACT: Morphologic distinction of Müllerian carcinomas from non-Müllerian carcinomas in effusion specimens by cytomorphology alone can be diagnostically challenging. Therefore, immunohistochemical adjuncts can be useful in differentiating Müllerian from non-Müllerian metastases. In this study, we evaluated the expression of PAX8 and PAX2 in malignant effusions collected from patients with known Müllerian and non-Müllerian carcinomas. Sections from cell blocks prepared from 152 effusion specimens (54 and 98 cases representing metastases from Müllerian and non-Müllerian primaries, respectively) were immunostained with rabbit polyclonal antibodies against PAX8 and PAX2. Immunopositivity was defined as the presence of strong nuclear staining in at least 25% of the tumor cells. Fifty-two (96%) and 13 (24%) of the 54 Müllerian carcinomas were positive for PAX8 and PAX2, respectively. PAX8 positivity was seen in only four (4%) of 98 non-Müllerian carcinomas; these represented metastasis from a large cell neuroendocrine lung carcinoma, papillary thyroid carcinoma, renal cell carcinoma, and acinic cell carcinoma of the parotid gland. PAX2 positivity was not seen in any of the non-Müllerian carcinomas. The results demonstrate that both PAX8 and PAX2 are highly specific markers for metastatic Müllerian carcinomas in cell block preparations from effusion specimens (96% and 100%, respectively). PAX8, however, is more sensitive than PAX2 in identifying Müllerian carcinomas in fluids (96% versus 24%). Overall, immunohistochemistry for PAX8 and PAX2 represent diagnostically useful adjuncts in identifying a Müllerian carcinoma as a source of a malignant effusion.
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    ABSTRACT: A previously tested antibody panel identified three criteria of major importance for distinguishing between mesothelioma and adenocarcinoma (ACA): carcinoembryonic antigen (CEA), BerEp4, and epithelial membrane antigen (EMA) accentuated at the cell membrane. An extended panel, consisting of CEA, BerEp4, EMA, vimentin, mesothelioma antibody (HBME-1), thrombomodulin, Ca125, and sialyl-Tn was applied to effusions from 86 ACAs and 21 mesotheliomas. The specificities and sensitivities of the previously identified reactivity patterns were tested on the new material and the effect of the added antibodies was evaluated. Further, hyaluronan analysis was added as a parameter.The previously selected criteria remained fully predictive for mesothelioma and ACA, respectively, also in the extended material (in all, 139 ACAs and 57 mesotheliomas). With the addition of the hyaluronan value, 79% of the cases was identified with 100% specificity. Among the new antibodies sialyl-Tn seemed the most promising because it specifically identified ACAs not expressing CEA. Diagn. Cytopathol. 2005;32:160–166. © 2005 Wiley-Liss, Inc.
    Diagnostic Cytopathology 03/2005; 32(3):160 - 166. DOI:10.1002/dc.20202 · 1.52 Impact Factor