Lung adenocarcinomas metastatic to the brain with and without ultrastructural evidence of rootlets: An electron microscopic and immunohistochemical study using cytokeratins 7 and 20 and villin

Suash Sharma, Jianyou Tan, Gurdip Sidhu, Rosemary Wieczorek, Douglas C. Miller, Nicholas D. Cassai

Research output: Contribution to journalArticle

9 Scopus citations


Adenocarcinomas metastatic to brain from lung or colon may pose differentiation difficulties. Ultrastructurally, both may have brush borders with rootlets. This study examines the ultrastructural morphology and immunohistochemical expression of villin (associated with rootlets), cytokeratin 7 (present in lung adenocarcinomas), and cytokeratin 20 (present in colon adenocarcinomas) in 19 formalin-fixed sequential surgical biopsies of lung adenocarcinomas metastatic to brain as compared to 13 colonic adenocarcinoma metastases. Of lung tumor metastases, mucinous differentiation with rootlets was most common [6/19(32%)-]. All colon tumor metastases were cytokeratin 7(-), 20(+), and profusely villin(+). Well-formed rootlets were seen. All lung metastases were cytokeratin 7(+) and 20(-). 5/6(83%) lung metastases with rootlets were focally villin(+). 12/13(95%) without rootlets were villin(-). Rootlets are extremely common in lung adenocarcinoma metastatic to brain. Villin immunoreactivity closely correlates with rootlets. Its distribution is a useful adjunct to cytokeratin 7 and 20 in differentiation of lung versus colon adenocarcinomas metastatic to the brain.

Original languageEnglish (US)
Pages (from-to)385-391
Number of pages7
JournalUltrastructural Pathology
Issue number5
StatePublished - Jan 1 1998
Externally publishedYes



  • Brain metastases
  • Cytokeratin (CK) 7 and 20
  • Immunohistochemistry
  • Lung adenocarcinoma
  • Ultrastructure
  • Villin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Structural Biology

Cite this