title: Expression of thrombomodulin, calretinin, cytokeratin 5/6, D2-40 and WT-1 in a series of primary carcinomas of the lung: an immunohistochemical study in comparison with epithelioid pleural mesothelioma.
abstract: OBJECTIVE
  A number of immunohistochemical markers have been suggested as useful in the positive diagnosis of epithelioid mesothelioma. The most widely used mesothelioma markers are thrombomodulin, calretinin, cytokeratin 5/6, D2-40 and WT-1. Numerous investigations have demonstrated their variable sensitivity and specificity in differentiating epithelioid mesothelioma from lung adenocarcinoma. However, data on the expression of these markers in other types of lung carcinomas are very limited. We evaluated the expression of these markers in a series of 172 primary carcinomas of the lung and in 75 epithelioid pleural mesotheliomas.
  
  
  RESULTS
  Thrombomodulin expression was found in squamous cell carcinomas (71%), small cell lung carcinomas (11%), adenocarcinomas (4%), large cell carcinomas (50%), large cell neuroendocrine carcinomas (25%) and in sarcomatoid carcinomas (10%). Calretinin expression was common in small cell lung carcinomas (44%) and large cell neuroendocrine carcinomas (25%), less common in squamous cell carcinomas (20%), rare and focal in adenocarcinomas (4%) and sarcomatoid carcinomas (10%). Cytokeratin 5/6 was expressed in most of the squamous cell carcinomas (94.5%). Immunoreactivity was also found in large cell carcinomas (50%), sarcomatoid carcinomas (30%) and rarely in adenocarcinomas (4%). D2-40 was consistently expressed in squamous cell carcinomas (42%). Focal immunoreactivity was found in adenocarcinomas (3%). WT-1 was focally present in one (2%) squamous cell carcinoma.
  
  
  CONCLUSIONS
  These results indicate that some of the most commonly used mesothelioma markers may react with different types of primary lung carcinomas. These data should be taken into consideration especially when dealing with small biopsy fragments and poorly differentiated tumors.
authors.forename: Camilla E
authors.initials: CE
authors.lastname: Comin
authors.forename: Luca
authors.initials: L
authors.lastname: Novelli
authors.forename: Alberto
authors.initials: A
authors.lastname: Cavazza
authors.forename: Matteo
authors.initials: M
authors.lastname: Rotellini
authors.forename: Fabio
authors.initials: F
authors.lastname: Cianchi
authors.forename: Luca
authors.initials: L
authors.lastname: Messerini
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism*; D058846:Antibodies, Monoclonal, Murine-Derived / Q000737:chemistry; D014408:Biomarkers, Tumor / Q000378:metabolism*; D064032:Calbindin 2 / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000378:metabolism*; D003937:Diagnosis, Differential; D006801:Humans; D007150:Immunohistochemistry; D053555:Keratin-5 / Q000378:metabolism; D053553:Keratin-6 / Q000378:metabolism; D008175:Lung Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D008562:Membrane Glycoproteins / Q000276:immunology / Q000378:metabolism; D008654:Mesothelioma / Q000175:diagnosis / Q000378:metabolism*; D009375:Neoplasms, Glandular and Epithelial / Q000175:diagnosis / Q000378:metabolism*; D010997:Pleural Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D018180:Thrombomodulin / Q000378:metabolism; D025721:WT1 Proteins / Q000378:metabolism; D000098853:Podoplanin
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D064032:Calbindin 2; D053555:Keratin-5; D053553:Keratin-6; D008562:Membrane Glycoproteins; D018180:Thrombomodulin; D025721:WT1 Proteins; C576764:CALB2 protein, human; C117468:PDPN protein, human; D000098853:Podoplanin; C546931:THBD protein, human; C583751:WT1 protein, human; C500987:monoclonal antibody D2-40