Diagnostic value of MUC4 immunostaining in distinguishing epithelial mesothelioma and lung adenocarcinoma

Karine Llinares, Fabienne Escande, Sébastien Aubert, Marie Pierre Buisine, Carme De Bolos, Surinder K. Batra, Bernard Gosselin, Jean Pierre Aubert, Nicole Porchet, Marie Christine Copin

Research output: Contribution to journalArticlepeer-review

56 Scopus citations


The distinction between pleural malignant mesothelioma and pleural infiltration by adenocarcinomas has complex therapeutic and medicolegal implications. Although the panel of adenocarcinoma-associated antibodies and one or two mesothelioma markers is useful in this purpose, most of these antibodies are not totally specific. We determined the diagnostic value of MUC4 immunostaining in this issue. MUC4 gene expression was also studied by in situ hybridization and RT-PCR. MUC4 is a membrane-bound mucin that has been suggested to be implicated in malignant progression in humans and rats. The MUC4 gene is expressed in various normal epithelial tissues of endodermic origin and carcinomas. In the respiratory tract, MUC4 transcripts have been detected in normal respiratory epithelium and lung carcinomas. MUC4 protein was expressed in 32 of 35 (91.4%) lung adenocarcinomas on paraffin-embedded tissue. None of the 41 malignant mesotheliomas nor the 32 cases of benign mesothelial cells expressed MUC4 at the protein and mRNA levels. We conclude that MUC4 is a very specific (100%) and sensitive (91.4%) marker of lung adenocarcinomas on paraffin-embedded tissue that could be useful in diagnostic practice in the distinction between malignant mesothelioma and adenocarcinoma.

Original languageEnglish (US)
Pages (from-to)150-157
Number of pages8
JournalModern Pathology
Issue number2
StatePublished - Feb 2004


  • Adenocarcinoma
  • Differential diagnosis
  • Immunohistochemistry
  • Malignant mesothelioma
  • Mucin

ASJC Scopus subject areas

  • General Medicine


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