Reactive lesions of the pleura. Immunohistochemical characterization

Our plain-English summary of Reactive lesions of the pleura. Immunohistochemical characterization, by M. Brockmann, I. Brockmann, M. Fischer, et al (Pathology, Research and Practice, 1990).

The study

• Authors: M. Brockmann, I. Brockmann, M. Fischer, K.M. Müller
• Journal: Pathology, Research and Practice
• Published: 1990;186(2):238-46
• Cited by: 13 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

The visceral pleura of 8 lung tissue specimens with non-tumorous pleural lesions and of 10 specimens with secondary pleural infiltration of different primary tumours were tested by avidin-biotin-method with the following antibodies: anti-keratin KL1, anti-vimentin V9, anti-CEA (BMA 130c), HEA 125, Leu M1, HMFG 2 and anti-collagen type IV. In all cases anti-keratin positive subserosal cells could be proved. Activated mesothelial cells expressed vimentin additionally to keratin. The antibodies Leu M1, HEA 125 and BMA 130c (against CEA) showed no reaction in subserosal and mesothelial cells. With the antibody HMFG 2, however, a weak reaction could be observed. A distinction between reactive and neoplastic pleural lesions is not possible by using these antibodies. The antibodies LeuM1, HEA 125 and BMA 130c can be helpful for differential diagnosis in single cases with pleural carcinosis. The antibody against collagen type IV demonstrates newly developed basal membrane structures in areas with proliferating subserosal cells. Considering our results the entity of mesothelium and submesothelium is discussed with regard to the histogenetical aspect of mesothelioma.

In plain English

This German laboratory study tested how the lining of the lung (the pleura) reacts to seven antibody stains. The authors stained 18 surgically removed lung tissue samples. Eight had non-cancerous pleural changes (4 recurrent pneumothorax, 4 pleurisy). Ten had cancer from elsewhere that had spread to the pleura. No mesotheliomas were stained, and asbestos exposure was not studied. In all cases the keratin stain KL1 reacted strongly with the mesothelium (the surface layer), and activated cells beneath the surface (subserosal cells) were keratin-positive. Leu M1, HEA 125 and the CEA stain BMA 130c did not react with mesothelial or subserosal cells. HMFG 2 marked activated subserosal cells in 15 of 18 cases, but more weakly than pneumocytes (cells lining the lung's air sacs) in the same tissue section. The authors said these reactions of activated subserosal cells to the four stains were identical with those found in mesotheliomas. They concluded the stains could not separate reactive from cancerous pleural lesions, though three may help in some cases of spread carcinoma. They suggested that collagen type IV staining indicated a common origin of mesothelial and submesothelial cells.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Laboratory (immunohistochemical) study of archived surgical tissue samples
• Who was studied: 18 surgically resected lung tissue samples from the Institute of Pathology, Bergmannsheil Bochum, Germany: 4 recurrent pneumothorax and 4 pleurisy (reactive tissue); 7 pleural carcinosis (4 lung adenocarcinomas, 1 lung adenosquamous carcinoma, 1 breast carcinoma, 1 prostate carcinoma); 3 pleural sarcomatosis (osteosarcoma, melanoma, malignant fibrous histiocytoma). No mesotheliomas were included. Dates of the cases were not given.
• Exposure: No asbestos or other exposure was studied. The study tested a panel of antibody stains: anti-keratin KL1, anti-vimentin V9, anti-CEA (BMA 130c), HEA 125, Leu M1, HMFG 2 and anti-collagen type IV.
• Main results:
  • Keratin-positive subserosal cells were found in all cases, both in the non-tumorous lesions and in the cases of cancer spread to the pleura.
  • Activated mesothelium showed a weak positive reaction to the vimentin stain.
  • The CEA stain (BMA 130c) did not react with mesothelium or subserosal cells.
  • With BMA 130c, part of the tumour cells reacted in 2 of 4 adenocarcinomas and in the one adenosquamous carcinoma.
  • HEA 125 did not mark mesothelial or subserosal cells.
  • Leu M1 did not react with mesothelial or subserosal cells.
  • Leu M1 reacted with tumour cells in 3 of 4 adenocarcinomas, one prostate carcinoma, one breast carcinoma and one adenosquamous carcinoma.
  • HMFG 2 reacted with activated subserosal cells in 15 of 18 cases, but the reaction was distinctly weaker than in pneumocytes of the same section.
  • The authors stated two findings in activated subserosal cells: there was no reaction to Leu M1, HEA 125 and anti-CEA, and there was a weak reaction to HMFG 2. They said this result was identical with that found in mesotheliomas. No mesotheliomas were stained in this series.
  • Collagen type IV staining showed newly formed basement membrane structures below the surface in advanced non-cancerous lesions.
• The authors' conclusion: The authors concluded that these antibodies cannot distinguish reactive from cancerous pleural lesions. They said Leu M1, HEA 125 and anti-CEA can help in some cases of carcinoma spread to the pleura. They also said the collagen type IV findings indicate that mesothelial and submesothelial cells share the same origin.
• Limitations the authors state:
  • The authors said that judging the strength of a stain reaction is always difficult.
  • The authors said deformed macrophages were sometimes hard to tell apart from activated subserosal cells.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleura, Visceral Pleura, Collagen, Mesothelial Cells, Differential Diagnosis, Mesothelium, Mesothelioma.

Related studies

• Immunohistological staining of reactive mesothelium, mesothelioma, and lung carcinoma with a panel of monoclonal antibodies — A.K. Ghosh, K.C. Gatter, et al. (1987)
• Immunohistochemical staining for vimentin and keratin in malignant mesothelioma — A. Churg (1985)
• Immunohistochemical analysis still has a limited role in the diagnosis of malignant mesothelioma. A study of thirteen antibodies — F. Roberts, C.M. Harper, et al. (2001)
• Calretinin, thrombomodulin, CEA, and CD15: a useful combination of immunohistochemical markers for differentiating pleural epithelial mesothelioma from peripheral pulmonary adenocarcinoma — C.E. Comin, L. Novelli, et al. (2001)
• Expression of calretinin, thrombomodulin, keratin 5, and mesothelin in lung carcinomas of different types: an immunohistochemical analysis of 596 tumors in comparison with epithelioid mesotheliomas of the pleura — M. Miettinen, M. Sarlomo-Rikala (2003)
• Combined use of novel epithelial (MOC-31) and mesothelial (HBME-1) immunohistochemical markers for optimal first line diagnostic distinction between mesothelioma and metastatic carcinoma in pleura — C. González-Lois, C. Ballestín, et al. (2001)

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