The Journal of Thoracic and Cardiovascular Surgery, Vol 100, 860-866, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Diagnostic significance of carcinoembryonic antigen in the differential diagnosis of malignant mesothelioma
J Mezger, R Lamerz and W Permanetter
Department of Internal Medicine III, Klinikum Grosshadern, Munich, Federal Republic of Germany.
The histologic and cytologic distinction of malignant mesothelioma from
carcinomas metastatic to the pleura or peritoneum is often problematic. For
this reason immunologic methods are being increasingly used as diagnostic
adjuncts. This review summarizes 40 studies on the expression of
carcinoembryonic antigen in mesotheliomas and in lung and other carcinomas
involving the pleura or peritoneum. Carcinoembryonic antigen was identified
immunohistochemically in 11% of mesotheliomas and in 84% of carcinomas
examined and immunocytochemically (in serous effusions) in 4% and 58%,
respectively. In serum and in pleural or ascitic fluid, significantly
elevated levels of carcinoembryonic antigen are commonly associated with
(lung) carcinomas but rarely with mesotheliomas. Thus, together with
identification of the antigen in serum, pleural fluid, or ascitic fluid,
immunohistochemical and immunocytochemical techniques for detecting
carcinoembryonic antigen provide a valuable aid for distinguishing
malignant mesothelioma from metastatic carcinomas.