categorised semiquantitatively into four

proliferative grades, a classification that

can be performed rapidly and reproducibly by

the pathologist. In keeping with previous

cell kinetic studies all small cell car-

cinomas had high proliferation rates,

whereas the carcinoid tumours were in the

lowest grade. In contrast, the adenocar-

cinomas (27 cases) and s~Lqmous cell car-

cinomas (63 cases) varied widely in their

proliferative state, in keeping with their

heterogeneous, morphological, and clinical

behaviour. In~m/nocytochemical labelling of

lung tumour biopsy specimens with antibody

Ki67 is a sidle technique within the scope

of routine surgical pathology laboratories,

which might enable these tumours to be

classified according to their proliferative

status and treatment to be selected accord-

ingly.

Neuron-Specific Enolase (NSE) in Lung

Cancer: An Immunohistochemical and Inn~unoen-

zymatic Study.

Leonardo, E., Dogliotti, C., Oliaro, A. Cat-

tedra di Tecnica e Diagn. Citopat., Dipar-

timento di Scienze Biomediche ed Oncologia

Umana, Univ. Torino, Torino, Italy. Minerva

Med. 77: 977-980, 1986.

Serum level of neuro-specific enolase

(NSE) was determined in 20 lung cancer

patients. NSE concentration was detected

also in neoplastic tissue and NSE-positive

neoplastic cells on histological sections

were observed immunohistochemically. The

presence of a high level of NSE was showed

in small cell lung cancer.

Somatostatin and Adrenocorticotrophic Hor-

mone Like Immunoreactivity in Small Cell

Carcinoma of the Lung.

Chretien, M.F., Pouplard-Barthelaix, A.,

Dubois, M.P. et al. Laboratoire

d'Histologie-Embryologie-Cytologie, Centre

Hospitalier Universitaire, 49045-Angers

Cedex, France. J. Clin. Pathol. 39: 418-422,

1986. The inmmnocytological detection of

adrenocorticotrophic hormone (ACT}{) and

somatostatin release inhibitor factor (SRIF)

like inmnlnoreactivity was carried out on

tumour cells from bronchial brush smears in

39 cases of lung tumors. Results obtained

were compared with the cytological and his-

tological diagnosis and confirmed the high

incidence of ACTH synthesis by malignant

bronchial carcinoma cells: the same

35

phenomenon also seems to occur for somatos-

tatin. The concomitant detection of ACTH and

SRIF like immunoreactivity seems to be

highly suggestive of small cell carcionma

and indicates that the inmnmocytological

detection of hormones carried out at the

same time as cytological examination can im-

prove the accuracy of the diagnosis.

Expression of Vimentin in Surgically

Resected Adenocarcinomas and Large Cell Car-

cinomas of the Lung.

Upton, M.P., Hirohashi, S., Tome, Y. et al.

Pathology Division, National Cancer Center

Research Institute, 5-1-1 Tsukiji, Chuo-ku,

Tokyo 104, Japan. Am. J. Surg. Pathol. I0:

560-567, 1986.

The expression of vimentin in pulmonary

carcinomas was studied in 285 cases of sur-

gically resected lung cancer from our hospi-

tal files. Formalin fixed, paraffin-embedded

sections were studied by inm~anoreactive

staining techniques using two monoclonal an-

tibodies against vimentin. Cases demonstrat-

ing vimentin positivity by the avidin-

biotin-peroxidase method included ii of 129

adenocarcinomas studied (8.5%), and 15 of 61

large cell carcinomas studied (24.6%).

Vimentin expression was not seen in any of

the 51 squamous cell carcinomas or 35 small

cell carcinomas in our series. The positive

cases of adenocarcinoma were in moderately

and poorly differentiated cancers. Four of

the eight giant cell carcinomas (50%)

demonstrated vimentin expression. All cases

that exhibited vimentin positivity were

studied for cytokeratin expression.

Coexpression of vimentin and cytokeratin was

demonstrated not only within the same tumor

but also within the same cells in some cases

stained by double antibody technique, in-

cluding both adenocarcinomas and large cell

carcinomas. Similar i~inunoreactive methods

were also applied to sections from h,-,an

lung cancer transplants grown in the nude

mouse. Of 28 tumours studied, four of ii

adenocarcinomas (36%) and all 4 large cell

carcinomas demonstrated coexpression of

vimentin and cytokeratin, while none of the

five squamous cell carcinomas or eight small

cell carcinomas expressed vimentin.

Immunohistochemical Localization of Placen-

tal Alkaline Phosphatase, Carcinoembryonic

Antigen, and Cancer Antigen 125 in Normal

and Neoplastic H,-,anLung.

Nouwen, E.J., Poller, D.E., Eerdekens, M.W.

36

et al. Department of Nephrology and Hyper-

tension, University Hospital, B-2520 Edegem,

Belgium. Camcer Res. 46: 866-876, 1986.

Human placental alkaline phosphatase

(HPLAP), carcinoembryonic antigen (CEA), and

cancer antigen 125 (CA 125) were localized

i,m~nohistochemically in paraffin sections

of normal lung tissue from 16 patients,

using monoclonal antibodies and an indirect

avidin-biotin-peroxidase staining procedure.

HPLAP and CEA were present in epithelial

cells of respiratory bronchioli and alveolar

type I pneumocytes. CEA was also observed in

the tracheal, bronchial, and bronchiolar

epithelium. CA 125 was present in the

tracheal, bronchial, bronchiolar, and ter-

minal bronchiolar epithelium; in the

tracheal and bronchial glands; and in the

pleural mesothelium. Normal and hyperplastic

type II pneumocytes were negative for HPLAP,

CFA, and CA 125 but were histochemically

positive for nonspecific alkaline phos-

phatase. Fetal lung tissue between ii and 15

weeks of gestation was negative for HPLAP,

CEA, and CA 125. The fetal tracheal and

bronchial epithelium, tracheal glands, and

pleural mesothelium were positive for CA

125. For ten malignant pulmonary tumors in-

vestigated, HPLAP staining was observed in

five, CEA in nine, and CA 125 in seven. The

localization of HPLAP, CEA, and CA 125 in

apparently normal constituents of all pulmo-

nary specimens is in disagreement with the

concept that the expression of these sub-

stances in the lung is indicative of abnor-

mal cellular activity.

The Diagnostic Distinction Between Malignant

Mesothelioma of the Pleura and Adenocar-

cinoma of the Lung as Defined by a

Monoclonal Antibody (B72.3).

Szpak, C.A., Johnston, W.W., Roggli, V. et

al. Department of Pathology, Duke University

Medical Center, Durham, NC 27710, U.S.A. ~.

J. Pathol. 122: 252-260, 1986.

The correct distinction between malig-

nant mesothelioma of the pleura and

adenocarcinoma of the lung has become in-

creasingly complex, with a variety of his-

tochemical, im~/nohistochemical, and

ultrastructural studies to be performed on

biopsy material. The reliability of im-

munohistochemical studies has been hampered

by the use of polyclonal antisera to

'carcinoembryonic antigen (CEA)' and

keratin. Hybridoma technology now offers

monoclonal antibodies (MAbs) in unlimited

quantity and standardized quality to selec-

tive ranges of specific antigenic deter-

minants. MAb B72.3, generated against a

membrane-enriched fraction of ~,,an metas-

tatic breast carcinoma, was used to distin-

guish malignant mesothelioma of the pleura

from adenocarcinoma of the lung in tissue

sections and was compared in terms of diag-

nostic utility with polyclonal anti-keratin

and anti-CEA to make the same distinction.

Reactivity with MAb B72.3 in at least 10% of

tumor cells or more was noted in 19 of 22

adenocarcinomas of the lung (P>O.O001),

whereas none of the 20 cases of malignant

mesothelioma demonstrated comparable reac-

tivity. Furthermore, MAb B72.3 showed no

reactivity with benign mesothelial

proliferations. MAb B72.3 thus appears to be

an appropriate diagnostic adjunct capable of

discriminating between these malignancies.

Antigenic Phenotype of Malignamt

Mesothelio,~s and Pulmonary Adenocarcinomas.

An Immunohistologic Analysis Demonstrating

the Value of Leu MI Antigen.

Sheibani, K., Battifora, H., Burke, J.S.

Division of Anatomic Pathology, City of Hope

National Medical Center, Duarte, CA 91010,

U.S.A. Am. J. Pathol. 123: 212-219, 1986.

To evaluate the usefulness of an im-

munohistologic approach to the differential

diagnosis of mesothelioma and pulmonary

adenocarcinoma, the authors studies

paraffin-embedded, fixed tissue sections

from 50 primary adenocarcinomas of the lung

and 28 mesotheliomas of the pleura by using

a panel of monoclonal antikeratin, antihuman

milk fat globule (HMFG-2), anti-Leu MI, and

monoclonal anticarcinoembryonic antigen

(CEA) antibody; we also used a conventional

heterologous anti-CEA antiserum with and

without prior absorption with spleen powder

to remove antibodies to nonspecific cross-

reacting antigen (NCA). Keratin was present

in both mesotheliomas and adenocarcinomas

and did not help in distinguishing between

these two neoplasms. HMFG-2 was detected in

48 (96%), and Leu M1 was positive in 47

(94%) of the adenocarcinomas, but not in any

of the mesotheliomas. By using conventional

rabbit antiserum, the authors detected CEA

in the majority of adenocarcinomas (96%),

but also in 2 cases of mesothelioma. When

the anti-CEA antiserum was absorbed with

NCA, the number of positively reacting

adenocarcinomas decreased considerably to

76%; however, after this treatment, none of