Thrombomodulin (CD141)

Author: Nat Pernick, M.D. (see Authors page)

Revised: 7 December 2015, last major update June 2005

Copyright: (c) 2003-2015,, Inc.

PubMed Search: Thrombomodulin[title]

Cite this page: Thrombomodulin. website. Accessed October 24th, 2016.
Definition / General
  • Also called CD141
  • 75kD transmembrane glycoprotein and cofactor for the thrombin-mediated activation of protein C
  • Marker of mesotheliomas, endothelial cells and coagulation factor
  • Important fibrinolytic inhibitor, as it decreases the activation of plasminogen to plasmin
  • Critical for activation of protein C and initiation of the protein C anticoagulant pathway
  • Plasma CD141 levels are associated with endothelial damage
  • Membranous staining pattern, often focal (cytoplasmic staining may be artifactual)
Uses by Pathologists
  • Mesothelioma vs. lung adenocarcinoma: 64% sensitive, 95% specific for mesotheliomas, but must exclude vasculature; often membranous staining of periphery with isolated papilla; negative staining in sarcomatoid mesotheliomas; considered to have a "secondary" role as other markers are better (Hum Pathol 2002;33:953)
  • Urothelial carcinomas (positive) vs. renal cell, prostate, endometrial or colonic carcinomas (Am J Surg Pathol 2001;25:1380)
  • Squamous cell carcinomas (positive) (Am J Clin Pathol 1998;110:385, Am J Surg Pathol 2003;27:150)
Positive Staining - Normal
  • Endothelial cells, megakaryocytes, keratinocytes, mesothelial cells, monocytes, neutrophils, platelets, smooth muscle cells, syncytiotrophoblasts, synovial lining cells, urothelium
Positive staining - Tumors
  • Mesothelioma (epithelioid), squamous cell carcinomas, trophoblastic tumors, urothelial carcinomas, vascular tumors (including angiosarcoma), synovial sarcoma (diffusely positive in 10%, Am J Surg Pathol 2001;25:610)
Negative Staining
  • Adenocarcinoma of colon, endometrium, kidney, lung (usually), prostate; sarcomatoid mesothelioma