Limited smoothelin expression within the muscularis mucosae

validation in bladder diverticula.

Donna E. Hansel, Gladell P. Paner, Nalan Nese, Mahul Amin

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Smoothelin, a marker of differentiated smooth muscle, is diffusely expressed by bladder muscularis propria and is negative to only weakly and focally expressed in muscularis mucosae. We used bladder diverticula, which lack muscularis propria and frequently demonstrate hyperplastic muscularis mucosae, to evaluate the use of smoothelin immunoreactivity in diagnostic pathology. Diverticula from 40 patients (21 with benign features, 19 with neoplastic features) were studied. Immunohistochemistry was performed using smoothelin antibody (clone R4A, 1:150 dilution; Abcam, Cambridge, MA); and tissue was scored as 0 (no expression), 1+ (moderate expression b10% of cells), 2+ expression (moderate expression N10% of cells), and 3+ (robust diffuse expression). All diverticula contained muscularis mucosae of varying caliber; staining in diverticular muscularis mucosae was compared with historic results in the muscularis mucosae of cystectomy specimens. Hyperplastic muscularis mucosae occurred in 31 (78%) of 40 cases. Smoothelin immunoreactivity in the diverticular muscularis mucosae included 0 (16/40, or 40%); 1+ (11/40, or 27.5%); 2+ (13/40, or 32.5%); and 3+ (0/40, or 0%), with a slightly higher 2+ expression level in hyperplastic versus nonhyperplastic muscularis mucosae (35% versus 22%). Adjacent normal muscularis propria, present in 12 specimens, demonstrated 3+ muscularis propria immunoreactivity. Comparison between diverticula with benign and neoplastic features showed no significant difference in smoothelin immunoreactivity. No correlation was evident with smoothelin immunohistochemistry and muscle caliber. Smoothelin immunoreactivity in bladder diverticula confirms the limited nature of smoothelin expression in the muscularis mucosae and represents a useful ancillary technique in the proper histopathologic evaluation of diverticular and nondiverticular bladder carcinomas. A strong and robust staining of smooth, rounded muscle with smoothelin remains a useful diagnostic adjunct in the reliable recognition of muscularis propria.

Original languageEnglish (US)
Pages (from-to)1770-1776
Number of pages7
JournalHuman pathology
Volume42
Issue number11
StatePublished - Jan 1 2011

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Mucous Membrane
Diverticulum
Smooth Muscle
Urinary Bladder
Immunohistochemistry
Staining and Labeling
Bladder Diverticulum
Cystectomy
Clone Cells
Pathology
Carcinoma
Muscles
Antibodies

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

Limited smoothelin expression within the muscularis mucosae : validation in bladder diverticula. / Hansel, Donna E.; Paner, Gladell P.; Nese, Nalan; Amin, Mahul.

In: Human pathology, Vol. 42, No. 11, 01.01.2011, p. 1770-1776.

Research output: Contribution to journalArticle

Hansel, Donna E. ; Paner, Gladell P. ; Nese, Nalan ; Amin, Mahul. / Limited smoothelin expression within the muscularis mucosae : validation in bladder diverticula. In: Human pathology. 2011 ; Vol. 42, No. 11. pp. 1770-1776.
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abstract = "Smoothelin, a marker of differentiated smooth muscle, is diffusely expressed by bladder muscularis propria and is negative to only weakly and focally expressed in muscularis mucosae. We used bladder diverticula, which lack muscularis propria and frequently demonstrate hyperplastic muscularis mucosae, to evaluate the use of smoothelin immunoreactivity in diagnostic pathology. Diverticula from 40 patients (21 with benign features, 19 with neoplastic features) were studied. Immunohistochemistry was performed using smoothelin antibody (clone R4A, 1:150 dilution; Abcam, Cambridge, MA); and tissue was scored as 0 (no expression), 1+ (moderate expression b10{\%} of cells), 2+ expression (moderate expression N10{\%} of cells), and 3+ (robust diffuse expression). All diverticula contained muscularis mucosae of varying caliber; staining in diverticular muscularis mucosae was compared with historic results in the muscularis mucosae of cystectomy specimens. Hyperplastic muscularis mucosae occurred in 31 (78{\%}) of 40 cases. Smoothelin immunoreactivity in the diverticular muscularis mucosae included 0 (16/40, or 40{\%}); 1+ (11/40, or 27.5{\%}); 2+ (13/40, or 32.5{\%}); and 3+ (0/40, or 0{\%}), with a slightly higher 2+ expression level in hyperplastic versus nonhyperplastic muscularis mucosae (35{\%} versus 22{\%}). Adjacent normal muscularis propria, present in 12 specimens, demonstrated 3+ muscularis propria immunoreactivity. Comparison between diverticula with benign and neoplastic features showed no significant difference in smoothelin immunoreactivity. No correlation was evident with smoothelin immunohistochemistry and muscle caliber. Smoothelin immunoreactivity in bladder diverticula confirms the limited nature of smoothelin expression in the muscularis mucosae and represents a useful ancillary technique in the proper histopathologic evaluation of diverticular and nondiverticular bladder carcinomas. A strong and robust staining of smooth, rounded muscle with smoothelin remains a useful diagnostic adjunct in the reliable recognition of muscularis propria.",
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