Skip Navigation LinksHome > May 2005 - Volume 29 - Issue 5 > Pulmonary Adenocarcinomas With Enteric Differentiation: Hist...
American Journal of Surgical Pathology:
Original Article

Pulmonary Adenocarcinomas With Enteric Differentiation: Histologic and Immunohistochemical Characteristics Compared With Metastatic Colorectal Cancers and Usual Pulmonary Adenocarcinomas

Inamura, Kentaro MD*†; Satoh, Yukitoshi MD, PhD*‡; Okumura, Sakae MD‡; Nakagawa, Ken MD‡; Tsuchiya, Eiju MD, PhD§; Fukayama, Masashi MD, PhD†; Ishikawa, Yuichi MD, PhD*

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Abstract

Primary pulmonary adenocarcinomas with enteric differentiation (PAED) are mainly composed of tall-columnar cells that show similarity to intestinal epithelia and colorectal carcinomas. In this study, we analyzed the immunostaining profiles of 7 PAEDs in comparison with 14 metastatic colorectal carcinomas (MCRs) and 30 usual pulmonary adenocarcinomas (PACs), using antibodies against CDX-2, cytokeratin 7 (CK7), cytokeratin 20 (CK20), TTF-1, surfactant apoprotein-A (SP-A), Napsin A, and MUC2. The positive rates for CDX-2, CK7, CK20, TTF-1, SP-A, Napsin A, and MUC2 were 71%, 100%, 43%, 43%, 14%, 0%, and 43%, respectively, in the PAEDs; 100%, 0%, 86%, 0%, 0%, 0%, and 57% in the MCRs; 3%, 100%, 0%, 93%, 73%, 90%, and 0% in PACs. As expected, immunoreactivity of CDX-2, CK20, and MUC2 was detected in PAEDs. The observed decrease or loss of immunoreactivity for TTF-1, SP-A, and Napsin A indicates that these lesions demonstrate a shift away from their pulmonary phenotype, although CK7 expression was retained. The results indicate that CK7 and CK20 may be useful markers for distinction of PAEDs from MCRs.

© 2005 Lippincott Williams & Wilkins, Inc.

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