Expression of epithelial membrane antigen on malignant mesothelioma cells. An immunocytochemical and immunoelectron microscopic study.

The presence of epithelial membrane antigen (EMA) on malignant mesothelial cells found in pleural and ascitic fluids was demonstrated immunocytochemically using a monoclonal anti-EMA antibody. Serous fluids of 25 patients with malignant mesotheliomas were investigated. In 23 cases, varying numbers of EMA-positive tumor cells were present; in 2 cases, no such cells were found. Immunoelectron microscopy was performed both on Lowicryl-embedded sediments of serous fluids and by application of preembedding techniques using the immunogold method. Expression of EMA by the immunogold method was found selectively on the villi of the malignant mesothelioma cells whereas the nonvillous, flat surfaces were largely EMA-negative. The results indicate that immunoelectron microscopy may offer a useful adjunct in the diagnosis of malignant mesothelioma in serous fluids.