title: Pancreatic metastases of renal clear cell carcinoma: a clinicopathological study of 11 cases with special emphasis on the usefulness of PAX2 and mesothelin for the distinction from primary ductal adenocarcinoma of the pancreas.
abstract: OBJECTIVE
  To determine whether PAX2 and mesothelin immunohistochemistry add additional diagnostic value in discriminating between pancreatic metastasis of renal clear cell carcinoma (PMRCC) and primary ductal adenocarcinoma of the pancreas (PDAC).
  
  
  METHODS
  We retrospectively collected tissue from PMRCC and PDAC. Eleven cases of PMRCC registered at Lille University Hospitals from 2001 to 2010 were included. Eleven cases of PDAC were randomly selected from our files. A comparative immunohistochemical study with anti-PAX2, anti-mesothelin, and the classical renal antibodies anti-CD10 and anti-vimentin was performed on PMRCC and PDAC.
  
  
  RESULTS
  We found that PMRCC displays a clinical presentation that might mimic primary pancreatic tumor, as PMRCC presented as a solitary mass in 8 cases and appeared a long time after diagnosis of a renal tumor (12.8 years, mean for metachronous metastasis). By immunohistochemistry we observed that PAX2, mesothelin, CD10 and vimentin stainings were noted in 10/11 (91%), 0/11 (0%), 11/11 (100%) and 7/11 cases (64%), respectively, among 11 PMRCC cases. All PDACs displayed diffuse mesothelin (100%) expression without PAX2 and vimentin (0%) staining, whereas CD10 was noted in 4/11 cases (36%).
  
  
  CONCLUSIONS
  These data suggest that in difficult diagnostic cases both PAX2 and mesothelin immunohistochemical study may be useful in discriminating between PMRCC and primary pancreatic carcinoma.
authors.affiliation: Department of Pathology, Lille University Hospital and Faculty of Medicine, Lille, France. gnemmiviv@yahoo.fr
authors.forename: Viviane
authors.initials: V
authors.lastname: Gnemmi
authors.affiliation: Department of Pathology, Lille University Hospital and Faculty of Medicine, Lille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Leroy
authors.affiliation: Department of Digestive Surgery, Lille University Hospital and Faculty of Medicine, Lille, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Triboulet
authors.affiliation: Department of Digestive and Transplantation Surgery, Lille University Hospital and Faculty of Medicine, Lille, France.
authors.forename: François-René
authors.initials: FR
authors.lastname: Pruvot
authors.affiliation: Department of Urology, Lille University Hospital and Faculty of Medicine, Lille, France.
authors.forename: Arnauld
authors.initials: A
authors.lastname: Villers
authors.affiliation: Department of Pathology, Lille University Hospital and Faculty of Medicine, Lille, France.
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Leteurtre
authors.affiliation: Department of Pathology, Lille University Hospital and Faculty of Medicine, Lille, France.
authors.forename: David
authors.initials: D
authors.lastname: Buob
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000473:pathology / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000378:metabolism* / Q000473:pathology; D005260:Female; D058851:GPI-Linked Proteins / Q000235:genetics*; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D000090204:Mesothelin; D008875:Middle Aged; D051762:PAX2 Transcription Factor / Q000235:genetics*; D010190:Pancreatic Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000556:secondary
chemical_list: D014408:Biomarkers, Tumor; D058851:GPI-Linked Proteins; D051762:PAX2 Transcription Factor; C497318:PAX2 protein, human; D000090204:Mesothelin