Table of Contents
Definition / general | Essential features | Interpretation | Uses by pathologists | Prognostic factors | Microscopic (histologic) description | Microscopic (histologic) images | Positive staining - normal | Positive staining - disease | Negative staining | Board review style question #1 | Board review style answer #1Cite this page: Gomaa W. Villin. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainsvillin.html. Accessed January 22nd, 2021.
Definition / general
- One of the gelsolin family of calcium regulated actin binding proteins
- First isolated and characterized in the microvilli of intestinal epithelium and later found in the brush of many absorptive epithelia
- Intestinal microvilli in the apical membrane (brush border) are maintained by bundles of parallel actin filaments that are organized by multiple actin binding proteins including villin (Am J Pathol 2012;180:1509)
- Expressed in tumors with enteric differentiation
Essential features
- Normally expressed in the brush border of epithelial cells lining the gastrointestinal tract, hepatobiliary tract and renal proximal convoluted tubules
- In colorectal carcinoma, villin is highly expressed
- In practice, villin can be included in the panel used for metastatic carcinoma to detect colorectal origin
Interpretation
- Apical membranous (brush border) immunostaining in normal epithelium and tumors
- Cytoplasmic immunostaining in tumors
Uses by pathologists
- Main use is confirming the site of origin of metastatic carcinoma (Dabbs: Diagnostic Immunohistochemistry: Theranostic and Genomic Applications, 5th Edition, 2018)
- The following tumors are villin positive in varying percentage:
- Colorectal, gastric, duodenal and esophageal carcinoma (sensitive and relatively specific pan-GI tract marker)
- Gastrointestinal neuroendocrine marker
- Endometrial carcinoma
- Hepatocellular carcinoma
- Pulmonary adenocarcinoma, enteric type
Prognostic factors
- Loss of villin immunostaining in colorectal carcinoma is associated with poor differentiation and survival (ISRN Gastroenterol 2013;2013:679724)
Microscopic (histologic) description
- In normal colonic crypts, shows a well organized brush border pattern together with small cytoplasmic dots in all crypts (ISRN Gastroenterol 2013;2013:679724)
- Can highlight brush border or cytoplasm in positive tumors
Microscopic (histologic) images
Positive staining - normal
- Normal colonic mucosa (ISRN Gastroenterol 2013;2013:679724)
- Normal small bowel (Ann Hepatol 2011;10:508, Lin: Handbook of Practical Immunohistochemistry, 2011)
- Brush border of bronchial glandular cells (Lin: Handbook of Practical Immunohistochemistry, 2011)
- Gastric pylorus (Dev Dyn 2002;224:90)
- Proximal renal tubules (Lin: Handbook of Practical Immunohistochemistry, 2011)
Positive staining - disease
- Colorectal carcinoma (82 - 84.9%) (ISRN Gastroenterol 2013;2013:679724, Lin: Handbook of Practical Immunohistochemistry, 2011)
- Gastrointestinal neuroendocrine tumors (72%) (Arch Pathol Lab Med 1999;123:812)
- Endocervical adenocarcinoma (93.3%) (Turk Patoloji Derg 2017;1:29)
Negative staining
- Bronchial and bronchiolar basal (reserve cells), bronchial epithelium in conducting airway, bronchiolar epithelium, Clara cells and type I and II pneumocytes (Hum Pathol 1998;29:390, Chu: Modern Immunohistochemistry, 1st Edition, 2009)
- Normal endometrium (EJGO 2017;38:560)
- Distal renal tubules (Lin: Handbook of Practical Immunohistochemistry, 2011)
- Renal glomeruli (Lin: Handbook of Practical Immunohistochemistry, 2011)
- Gastric mucosa (body) (Lin: Handbook of Practical Immunohistochemistry, 2011)
- Urothelial carcinoma (Lin: Handbook of Practical Immunohistochemistry, 2011, Arch Pathol Lab Med 2002;126:1057)
- Prostatic adenocarcinoma (Am J Surg Pathol 2003;27:303, Medicine (Baltimore) 2018;97:e13697)
- Breast carcinoma (Am J Surg Pathol 2003;27:303)
- Hepatocellular carcinoma (canalicular) (9% and 31%) (Ann Hepatol 2011;10:508, Hum Pathol 2002;33:1175)
- Lung adenocarcinoma (6% and 31.6%) (Chu: Modern Immunohistochemistry, 1st Edition, 2009, Hum Pathol 1998;29:390, Mol Carcinog 1998;23:234)
- Cholangiocarcinoma (20% and 22%) (Ann Hepatol 2011;10:508, Hum Pathol 2002;33:1175)
- Esophageal adenocarcinoma (17%) (Lin: Handbook of Practical Immunohistochemistry, 2011)
- Endometrial carcinoma (12.3% and 20%) (EJGO 2017;38:560, Turk Patoloji Derg 2017;1:29)
Board review style question #1
Board review style answer #1
E. Villin. The patient has metastasis to the liver. Positivity to CDX2 and CK20 suggests colorectal origin. Villin is the most relevant of the provided markers to confirm colorectal origin.
Reference: Villin
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Reference: Villin
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