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AP CP initial decks from RD > Stains > Flashcards

Stains Flashcards

1
Q

Expression of CK 5/6

A

Expression of CK 5/6

  • Mesothelioma
  • Squamous/Basal Cell Carcinoma
  • Salivary Gland Tumor
  • Breast
  • Skin Adnexa
  • Urothelial Carcinoma
  • Thymoma
  • Endocervical Adenocarcinoma
  • Synovial Sarcoma (+/-)
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2
Q

TFE3

A

TFE3

  • Alveolar Soft Part Sarcoma (98%)
  • Renal Cell Carcinoma With Xp11.2 Translocation (97%)
  • Renal Cell Carcinoma t(X;1)(p11;q21) (76%)
  • Epithelioid Hemangioendothelioma (75%)
  • Granular Cell Tumor (68%)
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3
Q

EPITHELIAL TUMORS THAT COEXPRESS CYTOKERATIN AND VIMENTIN

A

EPITHELIAL TUMORS THAT COEXPRESS CYTOKERATIN AND VIMENTIN

  • Thyroid Carcinoma
  • Endometrial Carcinoma
  • Renal Cell Carcinoma
  • Mesothelioma
  • Myoepithelial Carcinoma
  • Metaplastic Breast Carcinoma
  • Sarcomatoid Carcinoma
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4
Q

MESENCHYMAL TUMORS THAT COEXPRESS CYTOKERATIN AND VIMENTIN

A

MESENCHYMAL TUMORS THAT COEXPRESS CYTOKERATIN AND VIMENTIN

  • Synovial Sarcoma
  • Epithelioid Sarcoma
  • Epithelioid Angiosarcoma
  • Desmoplastic Small Round Cell Tumor
  • Leiomyosarcoma
  • Malignant Rhabdoid Tumor
  • Chordoma
  • Adamantinoma
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5
Q

BREAST DIRECTED IMMUNOMARKERS

A

BREAST DIRECTED IMMUNOMARKERS

  • GROSS CYSTIC DISEASE FLUID PROTEIN 15 (GCDFP15)
  • MAMMAGLOBIN
  • NYBR 1
  • GATA 3
  • TFF 1
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6
Q

GATA3

A

GATA3 (nuclear)

  • Breast carcinoma
  • Urothelial carcinoma
  • Cutaneous Basal cell carcinoma
  • Cutaneous squamous carcinoma
  • Trophoblastic tumors
  • Endodermal sinus tumor
  • Chromophobe renal cell carcinoma
  • Pancreatic ductal adenocarcinoma
  • Salivary gland ductal carcinoma
  • Paraganglioma
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7
Q

ER Positive Tumors

A

ER Positive Tumors

  • Breast
  • Ovarian
  • Endometrial
  • Lung
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8
Q

PANEL OF IMMUNOMARKERS FOR THE DISTINCTION OF CK7+/ER+TUMORS

A

PANEL OF IMMUNOMARKERS FOR THE DISTINCTION OF CK7+/ER+TUMORS

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9
Q

GASTRO-INTESTINAL TRACT DIRECTED IMMUNOMARKERS

A

GASTRO-INTESTINAL TRACT DIRECTED IMMUNOMARKERS

  • CDX2
  • SATB2 (colon)
  • CDH17
  • CK17
  • Villin
  • EMERGING MARKER: LEF1
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10
Q

SATB2

A

SATB2

  • Nuclear matrix – associated transcription factor and epigenetic regulator
  • Positive in small bowel and colon adenocarcinoma
  • Positive in lower GI neuroendocrine
  • Expressed in majority of colorectal tumors including most poorly differentiated tumors
  • Negative in upper GI and pancreatic tumors
  • Ovarian, breast and lung adenocarinoma low
  • Sensitive marker of osteoblastic differentiation
  • Special AT-rich sequence binding protein 2
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11
Q

CADHERIN-17 (CDH 17) LIVER-INTESTINE CADHERIN

A

CADHERIN-17 (CDH 17) LIVER-INTESTINE CADHERIN

  • Calcium-dependent transmembrane glycoprotein
  • Mediates cell – cell adhesion and acts as intestinal peptide transporter
  • Expressed in normal glandular epithelium of GI tract and normal pancreatic ducts
  • Normal Colon/Small Intestine (100%)
  • Adenocarcinoma, Colon/Rectum (98%)
  • Lymphoepithelioma-like Carcinoma, Colon/Rectum (89%)
  • Adenoma, Metanephric (81%)
  • Adenocarcinoma, Bladder (70%)
  • Adenocarcinoma, Esophageal (67%)
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12
Q

LEF-1 EXPRESSION

A

LEF-1 EXPRESSION IN COLORECTAL TUMORS

  • LEF-1 is a TCF genes, activator (Lymphoid enhancer factor – 1/T cell factor)
  • LEF-1 is a DNA binding protein that interacts with β catenin and activates Wnt–responsive target genes
  • a/w KRAS mutation
  • Pancreatoblastoma (100%)
  • Solid Pseudo Papillary Tumor, Pancreas (100%)
  • CLL/SLL (89%)
  • Squamous Cell Carcinoma, Oropharynx (63%)
  • Adenocarcinoma, Colon/Rectum (37%)
  • DLBCL, Richter Transformation (21%)
  • DLBCL, NOS (16%)
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13
Q

IMMUNOMARKERS FOR GASTROINTESTINAL

TUMORS

A

IMMUNOMARKERS FOR GASTROINTESTINAL

TUMORS

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14
Q

PANCREATIC MARKERS

A

PANCREATIC MARKERS

  • CK17:
    • Low molecular weight Cytokeratin – myoepithelial cell and basal cells
    • Pancreatic DADC + 60%
  • S100P:
    • Belongs to the family S100 calcium binding protein
    • 95 amino acid protein purified from human placenta
    • Pancreatic DADC + 90%
  • Maspin :
    • (Serpin B5) Tumor supressor gene
    • Pancreatic DADC - +
  • pVHL (Von Hippel – Lindau)
    • Tumor Supervisor gene
    • Pancreatic DADC - +
  • IMP3:
    • Oncofetal RNA – binding protein
    • Pancreatic DADC - +
  • MUC5 AC:
    • High molecular weight Glycoprotein of mucin family
    • Pancreatic DADC +
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15
Q

DISTINCTION OF PANCREATIC DUCTAL

ADENOCARCINOMA FROM CHRONIC PANCREATITIS

A

DISTINCTION OF PANCREATIC DUCTAL

ADENOCARCINOMA FROM CHRONIC PANCREATITIS

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16
Q

LIVER DIRECTED IMMUNOMARKERS

A

LIVER DIRECTED IMMUNOMARKERS

  • Hep PAR1
  • GLYPICAN -3
  • ARGINASE 1
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17
Q

HEPATOCELLULAR CARCINOMA MARKERS

A

HEPATOCELLULAR CARCINOMA

  • Glypican - 3
  • HePAR 1
  • Arginase -1
  • Alpha feto protein
  • CDIO
  • pCEA
  • CD 34
  • Glutamine Synthetase
  • Heat shock protein 70
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18
Q

ANTIBODIES TO IDENTIFY

HEPATOCELLULAR DIFFERENTIATION

A

ANTIBODIES TO IDENTIFY

HEPATOCELLULAR DIFFERENTIATION

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19
Q

IMMUNOMARKERS FOR CONFIRMING

HEPATOCELLULAR DIFFERENTIATION

A

IMMUNOMARKERS FOR CONFIRMING

HEPATOCELLULAR DIFFERENTIATION

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20
Q

DISTINCTION OF CHOLANGIOCARCINOMA FROM METASTATIC TUMORS

A

DISTINCTION OF CHOLANGIOCARCINOMA FROM METASTATIC TUMORS

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21
Q

Metastatic Prostate Carcinoma Markers

A

Metastatic Prostate Carcinoma

  • PSA
  • PAP
  • Prostein
  • NKX.3
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22
Q

What do these stain in addition to prostate?

  • PSA
  • PAP
  • NKX3.1
A

What do these stain in addition to prostate?

  • PSA:
    • Salivary gland tumors
    • Bladder adenocarcinoma
    • Periurethral glands
    • Melanoma
    • Anal glands
    • Urachal remanants
  • PAP
    • NE Tumors
  • NKX3.1
    • Lobular Carcinoma Breast
23
Q

Urothelial Carcinoma Markers

A

Urothelial Carcinoma

  • Uroplakin III
  • Thrombomodulin
  • GATA-3
  • CK7+/CK20+, CK5/6, p63
  • Emerging markers: S100P, Uroplakin II
24
Q

KIDNEY – DIRECTED ANTIBODIES

A

KIDNEY – DIRECTED ANTIBODIES

  • PAX2/PAX8
  • RCC Ma
  • CD10
  • CA IX
  • AMACR
  • cKIT
  • CATHEPSIN
25
ADRENAL GLAND DIRECTED IMMUNOMARKERS
ADRENAL GLAND DIRECTED IMMUNOMARKERS * INHIBIN ALPHA * MELAN A (A103) * CALRETININ * Steroidogenic factor 1 (SF-1)
26
MESOTHELIUM – DIRECTED ANTIBODIES
MESOTHELIUM – DIRECTED ANTIBODIES * Calretinin * Cytokeratin 5 or 5/6 * Podoplanin (D2-40) * WT-1 (also serous carcinoma) * Thrombomodulin * Mesothelin
27
CALRETININ
CALRETININ - cytoplasm * Mesothelial cells/Mesothelioma * Sex cord-stromal neoplasms * Adrenocortical Cells * up to 38% of Adenocarcinoma
28
PODOPLANIN (D2-40)
PODOPLANIN (D2-40) - membranous Trans-membrane mucoprotein * Mesothelial cells/Mesothelioma * Lymphatic endothelium * Lymphangiomas * Kaposi sarcomas * Angiosarcoma (subset) * Seminomas * Epithelioid mesotheliomas
29
MESOTHELIN
MESOTHELIN * Mesothelial * Pancreatic Adenocarcinoma * Ovarian Serous Ca * Urothelial carcinoma * Lung Adenocarcinoma * Lung Squamous cell +/-
30
ANTIBODIES DIRECTED AGAINST CARCINOMA
ANTIBODIES DIRECTED AGAINST CARCINOMA * MOC 31 * Claudin -4 * BerEP4 * CEA * TAG – 72 (B72.3) * BG – 8 * CD - 15
31
DISTINCTION OF BENIGN MESOTHELIAL CELLS FROM MESOTHELIOMA
32
Neuroendocrine Markers
Neuroendocrine Markers * CD56 * Synaptophysin * Chromogranins * PAX5
33
METASTATIC MERKEL CELL CARCINOMA MERKEL CELL CARCINOMA
METASTATIC MERKEL CELL CARCINOMA MERKEL CELL CARCINOMA * CK20 * NF * Merkel cell polyoma virus (oncovirus)
34
MELANOMA MARKERS
MELANOMA MARKERS * S-100 * HMB45 * MART-1 * Tyrosinase * SOX10 * PNL2 DESMOPLASTIC MELANOMA * S100 * SOX10
35
CLEAR CELL RENAL CELL CARCINOMA
CLEAR CELL RENAL CELL CARCINOMA * POSITIVE MARKERS * AE1/AE3 * EMA * RCC m * PAX2/PAX8 * Vimentin * CD10 * Carbonic anhydrase IX * NEGATIVE MARKERS * CK7 * CD117 * Ksp-cadherin
36
PAPILLARY RENAL CELL CARCINOMA
PAPILLARY RENAL CELL CARCINOMA * Positive Markers: * Keratin * Vimentin * RCC Ma * Rasimase * CK7 * Pax2/Pax8 * CD10 (67-93%) * Negative Markers: * CA IX * Cathepsin K * TFE3/TFEB * CD117
37
CHROMOPHOBE RENAL CELL CARCINOMA
CHROMOPHOBE RENAL CELL CARCINOMA * POSITIVE MARKERS * CK7 * CD117 * PAX2/PAX8 * Ksp CADHERIN * NEGATIVE MARKERS * VIMENTIN * CD10 * RCC Ma * CA IX
38
RENAL ONCOCYTOMA
RENAL ONCOCYTOMA * POSITIVE MARKERS * CD117 * Ksp Cadherin * PAX8 * AE1/AE3 * NEGATIVE MARKERS * CK7 * Vimentin * CA IX * CD10 * RCCm
39
COLLECTING DUCT CARCINOMA
COLLECTING DUCT CARCINOMA * POSITIVE * CK7 * CEA * 34βE12 * Ulex Europeus * PAX8 * NEGATIVE * CK20 * CD10 * AMACR * CA IX * P63 * GATA 3
40
DIFFERENTIAL DIAGNOSIS OF RENAL TUMORS CLEAR CELLS
DIFFERENTIAL DIAGNOSIS OF RENAL TUMORS CLEAR CELLS
41
DIFFERENTIAL DIAGNOSIS OF RENAL TUMORS WITH A PAPILLARY COMPONENT
42
DIFFERENTIAL DIAGNOSIS OF RENAL TUMORS WITH ONCOCYTIC FEATURES
43
DIFFERENTIAL DIAGNOSIS OF DISTAL NEPHRON-LIKE CARCINOMAS
44
Vascular tumor markers
Vascular tumor markers * CD31 - good for dermal vascular stain BUT histiocytes will stain granular positive * **Erg** - better marker, nuclear marker
45
Spindle Cell DDx Markers
46
CK7/CK20 negative?
CK7/CK20 negative * Prostate * Kidney * Liver * Adrenal Gland Ca * Germ Cell: Seminoma & Yolk Sac * Squamous cell carcinoma
47
CK7/CK20 Positive?
CK7/CK20 Positive * **Ovary- Mucinous** carcinoma (90%) * **Bladder**- Urothelial carcinoma (65-89%) * **Pancreas**- Adenocarcinoma (65%) * **Bile Duct**- Cholangiocarcinoma (65%) * Stomach- Adenocarcinoma (38-40%) * Excludes: Carcinoid, Esophageal Squamous Ca, Head/Neck Squamous Ca, Liver Hepatocellular Ca, Lung Small Cell & Squamous Ca, Ovarian NonMucinous Ca, Kidney Renal Cell Ca
48
CK7+/CK20-
CK7+/CK20- * **Lung**- Adenocarcinoma (72-90%) * **Ovary- Non-Mucinous** Ca (100%) * **Thyroid**- all types (90%) * **Breast**- Ductal & Lobular Ca (80-90%) * **Uterus**- Endometrial carcinoma (80-85%) * **Germ Cell- Embryonal** Ca (80%) * **Pleura**- Mesothelioma (65-69%) * Bladder- Urothelial (35%) * Kidney- Renal cell carcinoma (24%) * Pancreas- Adenocarcinoma (26-30%) * Bile Duct- CholangioCa (30%) * Breast- Mucinous Carcinomas * Excludes: Colorectal Ca, Ovary Mucinous Ca, Seminoma, Yolk Sac Tumor
49
CK7-/CK20+
CK7-/CK20+ * **Colorectal** - Adenocarcinoma (75-80%) * **Skin- Merkel Cell** Carcinoma (70%) * **Stomach**- Gastric Adenocarcinoma (35%) * Colorectal- Mucinous Carcinomas * Excludes: Breast Ca, Carcinoid, CholangioCa, Esophageal Squamous, Germ cell, Lung (all types), Liver Hepatocellular Ca, Ovarian Ca, Pancreas Ca, Kidney Renal Ca, Bladder Urothelial Ca, Uterus Endometrioid
50
Mucinous Tumor Subsets - Staining Pattern * Breast * Colorectal * Ovary
Mucinous Tumor Subsets - Staining Pattern * Breast * CK 7 + CK20 - * Colorectal * CK7 - CK20 + * Ovary * CK7 + CK20 +
51
IMP3
IMP3 * Decidua (100%) * Normal Trophoblasts (100%) * Pancreas: Adenocarcinoma, Papillary (\>90%), PIN (57%) * Esophagus: Barrett's, Adenocarcinoma (\>90%) * Endocervical AIS (93%) * Uterine/Endometrial: Papillary serous adenocarcinoma (99%), Clear Cell Carcinoma (61%) * Ovarian Serous Cystadenocarcinoma (68%) * Melanoma (85-90%) * Cholangiocarcinoma, Intrahepatic (85%) * Adenoid Cystic Carcinoma (81%) * Mesothelioma (74%) * Lung Adenocarcinoma (55%)
52
Ovarian Serous Carcinoma
Ovarian Serous Carcinoma Mesothelin
53
GRANULOSA CELL TUMOR, stains
GRANULOSA CELL TUMOR * Inhibin * Calretinin * Vimentin * WT1 * CD 99 * S100 * CD56 * SF1 (steroidogenic factor) * FOXL2 gene abnormality on xsome 3
54
Breast Panel
Breast Panel Invasion? Myoepithelial (basal): + (HMW) CK5/6, CK14 (lg ducts only), CK17, p63, S100, actin, calponin, SMA, myosin heavy chain, CD10 Luminal: + (LMW) CK7,8,18,19 Basal lamina: type IV collagen, laminin UDH: + ER (heterogenous), + CK5/6 (mosaic pattern) ADH/low-grade DCIS: + ER (strong, uniform), - CK5/6 (Neg in neoplastic cells, only + in surrounging myoepithelial cells) High-grade DCIS: + HER2 (strong membranous), +p53 DCIS: p120 catenin (membranous) LCIS: + ER (strong, diffuse), - HER2 (+pleomorphic), - p53(+pleomorphic), - E-cadherin, + p120 catenin (cytoplasmic) Metaplastic/Spindle cell carcinoma: + HMW (variable), CK5/6, 34betaE12, +p63, +vimentin, +SMA, triple negative, +myoep/basal, "claudin low" Fibromatosis: +Beta-catenin (nuclear, can be seen in phyllodes stroma and metaplastic), +actin, +/-desmin, +/-S100 (minority of cells)

AP CP initial decks from RD (27 decks)

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