Immunohistochemistry of pulmonary and pleural neoplasia
Wednesday, July 9th, 2008.
Archives of Pathology and Laboratory Medicine. 2008 Jul;132(7):1062-72. [Link]
Beasley MB.
Department of Pathology, Mount Sinai Medical Center, New York, NY 10029, USA. mbbeasleymd@yahoo.com
Abstract
Context: The use of immunohistochemical stains has several applications in the evaluation of pulmonary and pleural neoplasms. The number of available immunohistochemical stains is continually expanding and, although these stains are an important diagnostic adjunct, their use is not without limitations and pitfalls.
Objective: To review and summarize the primary immunohistochemical applications with regard to the most common pulmonary and pleural neoplasms and discuss newly developed markers and common pitfalls.
Data Sources: Pertinent peer-reviewed literature emphasizing immunohistochemical applications in common lung and pleural tumors, unusual and problematic staining patterns in frequently encountered subtypes/histologic variants, and recently developed immunohistochemical stains of potential promise.
Conclusions: Immunohistochemical stains provide the greatest aid in establishing the site of origin of adenocarcinomas encountered in the lung and in separating epithelioid mesothelioma from adenocarcinoma. Certain subtypes of pulmonary adenocarcinomas may exhibit unusual staining patterns that may be potentially problematic. Immunohistochemistry has a more limited role in separating small cell carcinoma from non–small cell carcinoma, and extreme caution must be used in the situation of crushed biopsy specimens.
Glossary
- adenocarcinoma
- (add-en-o car-sin-o-muh). Cancer that starts in the glandular tissue, such as in the ducts or lobules of the breast.
- cell
- the basic unit of which all living things are made. Cells replace themselves by splitting and forming new cells (mitosis). The processes that control the formation of new cells and the death of old cells are disrupted in cancer.
- carcinoma
- (car-sin-o-ma) a malignant tumor that begins in the lining layer (epithelial cells) of organs. At least 80% of all cancers are carcinomas.
- biopsy
- (buy-op-see) the removal of a sample of tissue to see whether cancer cells are present. There are several kinds of biopsies. In some, a very thin needle is used to draw fluid and cells from a lump. In a core biopsy, a larger needle is used to remove more tissue.
- mesothelioma
- a tumor derived from mesothelial tissue, such as the peritoneum (lining the abdomen) or pleura (lining the lungs). More on mesothelioma.
