title: The utility of villin and mammaglobin in the differential diagnosis between intrahepatic cholangiocarcinoma and breast cancer.
abstract: Liver metastasis is common for breast cancer. In breast cancer patients, differentiation between metastasis and intrahepatic cholangiocarcinoma (ICC) is crucial but not always possible, especially when estrogen receptor (ER) is negative. Villin and mammaglobin are gastrointestinal and breast markers, respectively, but were considered not useful in cholangiocarcinoma. The aim of this study was to reevaluate these 2 markers in the differential diagnosis between breast ductal carcinoma and ICC. Fifty-two cases of breast ductal carcinoma (including ER positive and negative, in situ, and invasive carcinomas), 27 cases of ICC, and 19 cases of extrahepatic bile duct adenocarcinoma were retrieved. Immunohistochemical staining for villin and mammaglobin was performed. The results showed that villin was negative in all breast cancers with a specificity of 100%, and positive in all ICCs with a sensitivity of 100%. Its sensitivity in extrahepatic bile duct adenocarcinoma was 63.2%. Mammaglobin was positive in a smaller percentage of breast cancers with no relationship to ER status. Discordant mammaglobin expression among matched invasive, in situ, and metastatic carcinomas of the same patient was common. Mammaglobin was negative in all ICCs with a specificity of 100%, when care was taken not to misinterpret patchy staining in adjacent normal hepatocytes as positive. In conclusion, the data showed that villin expression was highly accurate in the differential diagnosis between ICC and breast ductal carcinoma, which was particularly useful in ER-negative cases. Mammaglobin may be useful when it is positive.
authors.affiliation: Department of Pathology, Penn State Milton S. Hershey Medical Center, Hershey, PA.
authors.forename: Zhaohai
authors.initials: Z
authors.lastname: Yang
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000473:pathology; D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000473:pathology; D001653:Bile Ducts, Intrahepatic / Q000473:pathology; D014408:Biomarkers, Tumor / Q000378:metabolism; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000473:pathology; D044584:Carcinoma, Ductal / Q000175:diagnosis* / Q000473:pathology; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D060785:Mammaglobin A / Q000378:metabolism*; D008840:Microfilament Proteins / Q000378:metabolism*; D011960:Receptors, Estrogen / Q000378:metabolism; D012680:Sensitivity and Specificity
chemical_list: D014408:Biomarkers, Tumor; D060785:Mammaglobin A; D008840:Microfilament Proteins; D011960:Receptors, Estrogen; C026615:villin