Expression of OPG receptors in LAM lung nodules demonstrated by confocal microscopy. Tissue sections were immunoreacted with anti–α-SMA antibody (FITC, green) and anti-RANKL, anti-TRAIL, anti–syndecan-1, or anti–syndecan-2 antibodies (Texas Red, red). The four receptors are expressed in areas of cellular proliferation (A–D). A: Cells positive for RANKL are seen adjacent to anti–α-SMA antibody–reactive cells. Some cells within the nodule express reactivity to both anti–α-SMA antibody and anti-TRAIL (B), anti–syndecan-1 (C), or anti–syndecan-2 (D) antibodies. E and F: The nuclei of cells were counterstained with DAPI. Control sections (deletion of primary antibody) were negative. Scale bar = 10 μm (A–F). Frozen lung sections from three patients with LAM showed comparable results.