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QIHC maryjw79 @ gmail email 4 access > IHC > Flashcards

IHC Flashcards

(135 cards)

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1
Q

GFAP

A

Cytoplasmic and cell processes of astrocytes

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2
Q

Nestin

A

intermediate filament in embryonic nerve cells and hair follicle stem cells (can differentiate into multiple types of cells), proliferating new endothelial cells. Cytoplasm.

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3
Q

Synaptophysin

A

Neuroendocrine: Adrenal medulla, neuronal cells, neuroendocrine cells, pineal gland. Membrane and cytoplasm (integral membrane protein and pre-synaptic vesicles)

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4
Q

Vimentin

A

intermediate filament of mesenchymal cells; cytoplasm

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5
Q

Neurofilament

A

Neurons; cytoskeletal component of axons and dendrites

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6
Q

SOX-10

A

Transcription factor; neural crest derived tissues; expressed by melanocytes, mammary myoepithelial cells and Schwann cells. Melanoma & neural crest marker!

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7
Q

TTF-1

A

Thyroid Transcription Factor 1; found in the nucleus only! Thyroid, lung and diencephalic brain (thalamus/hypothalamus/pineal/pituitary) structures.

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8
Q

Chromogranin

A

secretory vesicles of neuroendocrine cells; Adrenal medulla (chromaffin cells), heart AV node, pancreas (islets), parathyroid (chief cells), thyroid (C cells)

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9
Q

Desmin

A

Intermediate filament in cardiac, smooth and skeletal muscle (GISTs are negative)

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10
Q

CD31/PECAM

A

PECAM; Membranous expression! Endothelial cells at cell junctions, megakaryocytes, pericytes, platelets, brown fat, trophoblasts, fibroblasts, spermatozoa, surface of platelets, monocytes, neutrophils and some types of T cells. key role in leukocyte trafficking across endothelium

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11
Q

Calponin

A

Actin-filament associated protein; Smooth muscle, myoepithelial cells, myofibroblasts, keratinocytes and nerve fibers

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12
Q

Alkaline Phosphatase

A

sarcoplasm of regenerating myofibers and cytoplasm of arteriole endothelial cells (not capillaries)

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13
Q

CD79a

A

B cells / B cell origin (with CD20) including plasma cells. May be positive when CD20 is negative.

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14
Q

CD20

A

B cells (not plasma cells)

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15
Q

CD45

A

also called leukocyte common antigen; NUCLEATED HEMATOPOIETIC CELLS (so not RBC’s, megakaryocytes or PLT’s).

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16
Q

CD18

A

leukocyte adhesion protein (deficiency leads to LAD); Neutrophils, macrophages, monocytes, NK cells and basophils

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17
Q

CD3

A

Thymocytes, peripheral T cells, NK cells (early cytoplasmic staining, then membranous)

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18
Q

c-KIT

A

AKA CD 117; proto-oncogene activated in GISTs and Mast Cell Tumors; cytoplasmic expression. Also found in interstitial cells of Cajal, hematopoietic progenitor cells, melanocytes, embryonic/fetal brain, endothelium, gonads, breast epithelium, germ cells.

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19
Q

S-100

A

show nerve sheath involvement (i.e Schwann cell) or melanocytic origin; neurons, myoepithelial cells, adipocytes, langerhans/ tissue and interdigitating dendritic cells, chondrocytes and notochord

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20
Q

PNL-2

A

melanocytes; cytoplasm

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21
Q

Melan-A

A

AKA MART1; cytoplasm. Anything that forms melanosomes.

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22
Q

DOG-1

A

GISTs only. Discovered On Gists 1. Membrane & cytoplasm.

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23
Q

Ki67

A

proliferation index during G1, S, G2 and M phases of cell cycle. Not found in G0 and early G1. Nuclear stain is the only one that “counts”.

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24
Q

CK AE1/AE3

A

Epithelial cells and trophoblasts; Detects CK1-8, 10, 14-16 and 19

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25
CK 34BE12
Squamous, transitional and some ductal epithelium
26
CK5/6
Mammary myoepithelial cells, cornea, mesothelium, basal epithelium
27
CK 7
Glandular and transitional epithelium
28
CK 8/18
Carcinomas of epithelial origin and mesotheliomas
29
CK 20
Gastric, intestinal, urothelial epithelium and Merkel cells
30
Doublecortin
neurons
31
E-cadherin
decreased in carcinoma
32
Argyrophilic Nucleolar Organizer Region (AgNOR)
Proliferation marker; increased nucleolar silver stained dots increases the potential for malignancy
33
Calretinin
Adipocytes, mesothelial cells, endometrial stroma, Leydig cells, mast cells, nerves, ovarian theca cells, Sertoli cells
34
HMB-45
Melanocytes
35
Iba-1
Macrophages/histiocytes/microglia
36
Inhibin
Sertoli cells, granulosa cells, prostate, brain, adrenal gland
37
Laminin
Basement membrane
38
Tyrosinase-related protein-1 (TRP1) and 2 (TRP2)
melanocytes
39
Uroplakin I, II, III
urothelium
40
WT-1 (Wilms tumor)
Nephroblastoma
41
Luminal A
ER (+) PR (+) HER2 (-)
42
Luminal B
ER (+) PR (+) HER2 (+)
43
HER2
ER (-) PR (-) HER2 (+)
44
Basal-like
ER (-) PR (-) HER2 (-) Perform CK5/6 and EGFR to define more precisely tumors in basal-like group
45
Luminal
Molecular category of Breast cancer with high expression of hormone receptors and associated genes (luminal A > luminal B)
46
HER2
Molecular category of breast cancer with high expression of HER2 and other genes in amplicon. Low expression of ER and associated genes.
47
Basal-like
Molecular category of breast cancer with high expression of basal epithelial genes, basal cytokeratins; low expression of ER and associated genes; low expression of HER2. BRCA1-associated cancers
48
Carcinoma
PanCK (+) LCA (-) S100/HMB45/MART-1 tyrosinase (-) Desmin (-) Vimentin (-)
49
Lymphoma
PanCK (-) LCA (+) S100/HMB45/MART-1 tyrosinase (-) Desmin (-) Vimentin (-)
50
Melanoma
PanCK (-) LCA (-) S100/HMB45/MART-1 tyrosinase (+) Desmin (-) Vimentin (+)
51
Sarcoma
PanCK (-) LCA (-) S100/HMB45/MART-1 tyrosinase (-) Desmin (+) Vimentin (+)
52
Desmin, HHF35, SmActin
Smooth muscle
53
Myoglobin
Skeletal muscle
54
CD68, Factor XIIIa
Fibrohistiocyte
55
Leu7, GFAP
Nerve sheath
56
Factor VIII, CD34, CD31
Endothelial, perivascular
57
LCA, CD3, CD20
Hematopoietic
58
NSE, Chromogranin
Neuroendocrine
59
MIC-2(O-13), CD99
Ewing’s sarcoma/PNET
60
Lung lesion showing mostly isolated small cells with pyknotic nuclei. What is the diagnosis?
Lymphoma: CK(-) LCA (+) Small cell cancer: CK(+) LCA(-)
61
What is the diagnostic approach to Metastatic Carcinoma of Unknown Primary?
1. Find the cell line of differentiation using major lineage markers 2. Find the CK type distribution in tumor cells 3. Find if there is co-expression of vimentin 4. Find if there is expression of supplemental antigen of epithelial or germ cell derivation (CEA, EMA, PLAP) 5. Find if there is expression of cell-specific products, cell-specific structures or receptors that are unique identifiers of cell types (GCDFP, PSA, TTF-1)
62
CK7+/CK20+
Transitional cell carcinoma Pancreatic carcinoma Ovarian mucinous carcinoma 50% of gastric CA
63
CL7-/CK20+
Colorectal adenocarcinoma Merkel cell carcinoma
64
CK7+/CK20-
Non-small cell cancer of the lung Small cell cancer of the lung Breast cancer, ductal and lobular Nonmucinous ovarian cancer Endometrial adenocancer Mesothelioma Squamous cell cancer of the cervix
65
CK7-/CK20-
Squamous cell cancer of the lung Prostate adenocancer Renal cell cancer Hepatoma Thymus
66
Prostate (MCUP)
PSA Se 100 Sp 99
67
Lung (MCUP)
TTF-1 Se 91 Sp 98
68
Colon
CDX-2 Se 83 Sp 96 CK20 Se 68 Sp 91
69
Colon and stomach
CDX-2 Se 56 Sp 98
70
Colon, stomach, pancreas
CK20 Se 36 Sp 97
71
Breast
GCDFP-15 Se 54 Sp 96
72
Breast and ovary
ER Se 74 Sp 95
73
Ovary and pancreas
CA 125 Se 88 Sp 88 Mesothelin Se 85 Sp 85
74
Stomach and pancreas
Lysozyme Se 65 Sp 69 CK 7 Se 72 Sp 96
75
Work-up lineage for lymphoma
CD20+: B cell lymphoma CD3+: T cell or NK cell lymphoma CD20-/CD3-: nonhematolymphoid, plasmacytoma, anaplastic lymphoma, t cell lymphoma, lymphoblastic lymphoma
76
TdT
Important markers for classifying lymphomas: Precursor lymphoblastic lymphoma
77
CD5, CD23
Important markers for classifying lymphomas: Chronic lymphocytic lymphoma
78
Cyclin D1 (aka BCL-1 and PRAD): nuclear positivity
Important markers for classifying lymphomas: Mantle cell lymphoma
79
CD10 (or BCL-6)
Important markers for classifying lymphomas: Follicular lymphoma
80
Ki67 (~100% proliferation index)
Important markers for classifying lymphomas: Burkitt lymphoma
81
CD10, follicular dendritic cell markers (extrafollicular meshworks)
Important markers for classifying lymphomas: Angioimmunoblastic T cell lymphoma
82
CD30, ALK
Important markers for classifying lymphomas: Anaplastic large cell lymphoma
83
Biomarkers in prostate CA
PSA - cytoplasmic expression in glandular epithelium Basal cell markers - p63, HMW-CK Alpha-methyl-CoA racemase (AMACR) - recently identified as being overexpressed in prostatic adenocarcinoma (80%)
84
GCDFP-15
Gross cystic disease fluid protein - 15
85
IHC panel of small round cell tumors in children
CK - carcinoma LCA - lymphoma Desmin - rhabdomyosarcoma CD99 - Ewings sarcoma/PNET
86
IHC panel of small round cell tumors in adults
CK - carcinoma LCA - lymphoma Vimentin, S100 - sarcoma Chromogranin/Synaptophysin - PNET
87
IHC panel of endometrial and endocervical, primary
Both: CK7(-)/CK20(+) Endocervical: p16, CEA Endometrial: vimentin, ER
88
IHC panel in subclassification of the most common lung cancers
SCCA: p63, CK5/6, CK7(-) AdenoCA: TTF-1, CK7(+) Small cell: chromogranin/synaptophysin, variable CK positivity
89
IHC panel of atypical small acinar proliferation in prostate biopsy cases.
AMACR Myoepithelial markers: p63, 34BA12 or HMWCK, SMA
90
IHC panel of DCIS vs Invasive Ductal Carcinoma breast biopsy cases
Myoepithelial markers: p63, actin, SMA CK5/6: (+)ADH with low grade DCIS
91
IHC panel of mature B cell neoplasm
Follicular lymphoma: Bcl-2 MALT: cytokeratin 3 4 5
92
IHC panel in differentiating HL from NHL
LCA CD30: golgi and cytoplastmic membrane CD15: golgi and cytoplasmic membrane CD20 CD3 Fascin (cytoplasmic expression in HL)
93
IHC panel in differentiating lung, thyroid, hepatocellular, primary.
Thyroid: CK7+/CK20- TTF-1(+): nuclear TGB(+): cytoplasmic Lung: CK7+/CK20- TTF-1(+): nuclear TGB(-): cytoplasmic Liver: CK7-/CK20- AFP: poorly diff hepatocellular CA Hepar-1: well to mod diff hepatocellular CA
94
Pattern of bcl-2 expression in reactive lymphadenopath
Interfollicular and paracortical
95
Pattern of bcl-2 expression in follicular lymphoma
Within the follicles
96
CD56 (NCAM) NSE
Olfactory neuroblastoma
97
Medium-sized lymphoma
Lymphoblastic lymphoma: TdT Follicular lymphoma
98
Positive for HMB-45
Epitheloid angiomyolipoma Melanoma
99
RCC, CD10
Renal cell CA
100
CD19
The earliest IHC marker for B-lineage differentiation.
101
CD20
Acquired late in pre-B-cell stage of maturation; lost at the plasma cell stage.
102
CD20: cytoplasmic staining
Strongly positive: half of lymphoblastic lymphoma/leukemia; all mature B-cell lymphomas; Reedsternberg cells in 1/4 cases of HL
103
CD21
IHC marker found in follicular dendritic cells and some B lymphocytes; helps identify the hyperplastic islands of dendritic cells in angioimmunoblastic T-cell lymphoma.
104
CD22
IHC marker strongly expressed in hairy cell leukemia.
105
CD23
IHC marker that is most useful in distinguishing B-cell CLL/SLL from other entities and remains present in CLL/SLL that has undergone large cell transformation.
106
CD79a
Expressed in nearly all of the assayed precursor B-cell lymphoblastic lymphoma/leukemias, with no T-cell staining. Also positive in mature B-cell lymphomas.
107
DBA.44
Strongly stains the cytoplasm of most hairy cell leukemias, marginal zone lymphomas, and large cell lymphomas
108
CD2
IHC marker for early T-cell antigen in a normal lymph node.
109
CD3 (cell membrane
Positive with most T-cell lymphomas except anaplastic large cell lymphomas and NK leukemias/lymphomas. Very specific for T-cell derivation.
110
CD4
It interacts with HLA class II during antigen recognition, and defines a helper-inducer subset of T cells. Expressed in most mature T-cell lymphomas.
111
CD5
Detectable on the surface of most thymocytes and immature peripheral T cells and in a small subset of circulating B cells. Primarily used in the detection of B cell CLL/SLL and mantle cell lymphoma.
112
CD7
It has the distinction of being the most frequently lost T-subset marker in malignancies, particularly on mycosis fungiodes. Also present on non-T-cell malignancies, including NK tumors and AML
113
CD8
This antigen defines the suppressor/cytotoxic T-cell subset
114
t(2;5)
Anaplastic large cell lymphoma
115
t(11;14)
Mantle cell lymphoma
116
Cyclin D1 (aka BCL-1 and PRAD 1): nuclea
Hallmark of mantle cell lymphomas. Weaker signal in hairy cell leukemia and plasmacytoma.
117
t(14;18)
Follicular lymphoma
118
Found in app 3/4 of cases of follicular lymphoma.
BCL-2: stains malignant follicles Reversed pattern in lymph nodes exhibiting follicular hyperplasia
119
BCL-2
Normally present in the cytoplasm of follicular mantle B lymphocytes, occasional germinal center cells, and many T lymphocytes
120
BCL-6
Expressed normally in germinal center lymphocytes. Expressed in a variety of B-cell neoplasms. Also detected in L&H variants of nodular lymphocyte predominant Hodgkin disease.
121
CD1a
Ag associated with beta 2 macroglobulin. Found in a subset of precursor T-lymphoblastic lymphoma/leukemia.
122
CD10 (CALLA)
Almost always present on the surface of precursor B lymphoblastic and Burkitt’s lymphomas, many FL and some DLBCL along with MM
123
CD15
X hapten or Lewis X antigen
124
CD15: membranous with a paranuclear dot-like Golgi localization
Marker for RS cells of classical HL. Also used to stain adenocarcinomas.
125
CD25
IL-2 receptor. Expressed on hairy cell leukemia and adult T-cell leukemia/lymphoma.
126
Burkitt’s lymphoma
Ki-67 index (nuclear staining)
127
Follicular lymphoma
BCL-2 positivity in enlarged follicles
128
Reactive hyperplasia
BCL-2 positivity around follicles
129
TdT
Almost always present in the nucleus of lymphoblastic lymphoma cells
130
CD20+ BCL-2+
Mantle cell lymphoma Follicular lymphoma Some marginal zone lymphoma
131
B-CLL/SLL vs Mantle cell lymphoma
B-CLL/SLL: CD23 (+) Cyclin D1 (-) Mantle cell lymphoma: CD23 (-) Cyclin D1 (+)
132
B-CLL/SLL vs Follicular lymphoma
B-CLL/SLL: CD10 (-) CD5/CD43 (+)
133
ZAP-70
Predicts poor outcome in B-CLL
134
Mature B lymphocytes vs plasma cells
Mature B lymphocytes: CD45RB (+) CD20 (+)
135
BCL-2
Sensitive for follicular lymphoma but not specific

QIHC maryjw79 @ gmail email 4 access (16 decks)

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