Virchows Archiv

, Volume 472, Issue 3, pp 425–432 | Cite as

The diagnostic role of PTEN and ARID1A in serous effusions

  • Ben DavidsonEmail author
  • Maurizio Pinamonti
  • Dolors Cuevas
  • Arild Holth
  • Pio Zeppa
  • Thomas Hager
  • Jeremias Wohlschlaeger
  • Martin Tötsch
Original Article


The aim of this study was to analyze the diagnostic role of PTEN and ARID1A in effusion cytology. Effusions (n = 279), consisting of 226 carcinomas (70 ovarian, 64 breast, 36 lung, and 15 uterine corpus carcinomas; 41 carcinomas of other origin) and 53 malignant mesotheliomas, were analyzed for PTEN and ARID1A expression using immunohistochemistry. PTEN was preserved in 166 (59%) tumors, partially lost in 38 (14%), and absent in 75 (27%), with lower expression in malignant mesotheliomas compared to carcinomas, though not significantly (p = 0.084). ARID1A was preserved in 243 (88%) tumors, partially lost in 18 (6%), and absent in 18 (6%). The majority of tumors with absent ARID1A were ovarian carcinomas, predominantly of clear cell or low-grade serous type. Reactive mesothelial cells in carcinoma specimens were uniformly positive for both proteins. ARID1A mutation analysis showed no mutations in eight analyzed specimens negative by immunohistochemistry. Loss of PTEN and ARID1A expression is highly specific for malignancy in effusion pathology. Loss of PTEN is not informative of organ of origin, whereas absence of ARID1A should raise suspicion of an ovarian primary.


PTEN ARID1A Effusions Immunohistochemistry Diagnosis 


Funding information

This work was supported by The Research Foundation at the Norwegian Radium Hospital.

Compliance with ethical standards

The study was approved by the Regional Committee for Medical Research Ethics in Norway. Permission from the local ethics committee and patient consent were obtained at all locations according to national guidelines.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  1. 1.Department of Pathology, Norwegian Radium HospitalOslo University HospitalOsloNorway
  2. 2.Faculty of Medicine, Institute of Clinical MedicineUniversity of OsloOsloNorway
  3. 3.Unit of Pathology, Department of Medical, Surgical and Health SciencesUniversity of TriesteTriesteItaly
  4. 4.Hospital Universitari Arnau de Vilanova de LleidaIRB LleidaLleidaSpain
  5. 5.Department of PathologyUniversity of SalernoSalernoItaly
  6. 6.Department of PathologyUniversity Hospital EssenEssenGermany
  7. 7.Institute of CytologyMedical University of GrazGrazAustria

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