الفهرس 
Title: Histopathological and immunohistochemical study of D2-40 expression in malignant pleural mesothelioma and metastatic adenocarcinoma
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Abstract
To compare D2-40 immunostaining in pleural malignant epithelioid mesothelioma and metastatic adenocarcinoma and determining its sensitivity and specificity.Material and methods : 50 specimens of pleural decortication biopsy were viewed. Specimens were obtained from the department of Pathology in Hospital of Chest diseases, Abbassia, from January 2011 to January 2016. They were diagnosed as 40 cases of pleural malignant epithelioid mesothelioma and 10 cases of metastatic adenocarcinoma (unknown primary origin). This diagnosis based on H&E stained sections and other immunostaining markers such as calretinin, CK7, CEA, TTF-1. D2-40 staining result was considered positive or negative according to presence or absence of membranous staining. Positive results were evaluated according to intensity as strong, moderate, or weak (compared to the intensity of staining of the internal control). The percentage of immunostained malignant cells was scored as follows: 1+ (5{u2013}25%), 2+ (26{u2013}50%), and 3+ (>50%). A stain result involving <5% of cells was considered negative (score 0). Statistical analysis was done for assessment of D2-40 expression in both types of tumors.Results : All cases of malignant mesothelioma (M.M) epithelial type were positive for D2-40 while all cases of metastatic adenocarcinoma were negative for it (both sensitivity and specificity = 100%). All cases of M.M epithelial type were positive for calretinin while all cases of metastatic adenocarcinoma were negative (both sensitivity and specificity = 100% also). All cases of metastatic adenocarcinoma were positive for CEA(10/10) while in case of M.M epithelial type, all available cases stained by CEA were negative (0/23). All available cases of M.M epithelial type were negative for TTF-1(0/21) while 8/10 of metastatic adenocarcinoma cases were positive for it. For CK7, in M.M epithelial type, about half of available cases stained by CK7 were negative (11/21) while (10/21) were positive and all cases of metastatic adenocarcinoma (10/10) were positive for it. For membranous staining in positive D2-40 cases (M.M epithelial type) the strong intensity is the most prevalent (24/40) and score 3 is the most common