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Warli SM, Kadar DD, Siregar GP, Husein A. The difference between cytokeratin 20 expression in high- and low-grade urothelial bladder carcinomas: A cross-sectional study. Urol Ann 2023; 15:383-387. [PMID: 38074175 PMCID: PMC10699178 DOI: 10.4103/ua.ua_138_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Abstract
Abstract
Background:
Bladder cancer is one of the most common cancers worldwide. Expression of cytokeratin 20 (CK 20) could be used as a biomarker in different epithelia to determine malignancy, especially in gastrointestinal, urinary tract, and Merkel cells. CK 20 could be detected in several urothelial carcinomas and was associated with bladder cancer recurrence. The study aimed to assess the utility of CK 20 expression for bladder cancer grading.
Materials and Methods:
This was a retrospective study assessing CK 20 expression in 73 bladder cancer patients who had transurethral resection of bladder tumor or cystectomy. The data were then collected and analyzed with SPSS Statistics version 20.0.
Results:
Fifty-six (76.7%) cases of high- and 17 (23.3%) cases of low-grade urothelial bladder cancer were examined for CK 20 expression. Positive expression was present in 57 (78.1%) samples. A significant difference (P = 0.034) in CK 20 expression was observed between low-grade and high-grade urothelial carcinomas. Positive expression was seen in 44 (77.2%) high-grade cases and only 13 (22.8%) low-grade cases.
Conclusion:
The difference in the CK 20 expression was found to be statistically significant among different grades of bladder cancer but not to metastatic bladder cancer. Further, studies are required to establish CK 20 as a diagnostic tool. We suggest a combination with several markers to compare which is superior.
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Affiliation(s)
- Syah Mirsya Warli
- Department of Surgery, Division of Urology, Faculty of Medicine, Universitas Sumatera Utara - Haji Adam Malik General Hospital, Medan, Indonesia
- Department of Urology, Universitas Sumatera Utara Hospital, Universitas Sumatera Utara, Medan, Indonesia
| | - Dhirajaya Dharma Kadar
- Department of Surgery, Division of Urology, Faculty of Medicine, Universitas Sumatera Utara - Haji Adam Malik General Hospital, Medan, Indonesia
| | - Ginanda Putra Siregar
- Department of Surgery, Division of Urology, Faculty of Medicine, Universitas Sumatera Utara - Haji Adam Malik General Hospital, Medan, Indonesia
| | - Ali Husein
- Department of Urology, Faculty of Medicine, Universitas Indonesia - Haji Adam Malik General Hospital, Medan, Indonesia
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Satoh F, Tsutusmi Y. Rare primary peritoneal mucinous adenocarcinoma in a 69-year-old man. Clin Case Rep 2021; 9:e04820. [PMID: 34532054 PMCID: PMC8436890 DOI: 10.1002/ccr3.4820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/14/2021] [Accepted: 08/30/2021] [Indexed: 11/20/2022] Open
Abstract
Primary peritoneal mucinous adenocarcinoma is rare in men. The low-grade tumor consisted of mucin-producing columnar cells with minimal nuclear atypia. Relationship to pseudomyxoma peritonei and disseminated peritoneal adenomucinosis is discussed.
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Affiliation(s)
- Fumiko Satoh
- Department of Legal MedicineSchool of MedicineKitasato UniversitySagamiharaJapan
- Tokyo Medical Examiner's OfficeTokyoJapan
| | - Yutaka Tsutusmi
- Diagnostic Pathology ClinicPathos TsutsumiInazawaJapan
- Yokkaichi Nursing and Medical Care UniversityYokkaichiJapan
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3
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Kim SH, Seung BJ, Cho SH, Lim HY, Bae MK, Eo KY, Yeo YG, Son JW, Sur JH. Ovarian adenocarcinoma with metastases in a white rhinoceros. J Vet Diagn Invest 2021; 33:366-369. [PMID: 33427119 DOI: 10.1177/1040638720986789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 36-y-old white rhinoceros (Ceratotherium simum) was presented with respiratory distress, sanguineous vaginal exudate, and anorexia. The clinical signs progressed over 40 d, and the rhinoceros died. Autopsy revealed significant ascites; a unilateral, 12.5-cm diameter, polypoid mass in the left ovary; a white, firm transmural mass in the right uterine horn; a white, friable mass in the lung; and white-to-tan, friable small nodules in the diaphragm. Histologic examination revealed similar neoplastic cells in the masses in all 4 locations, composed predominantly of epithelial cells proliferating in a tubulopapillary pattern with significant nuclear atypia and numerous atypical mitotic figures (18-42 per 2.37 mm2). Immunohistochemistry for CK7 (cytokeratin 7) and CK20 (cytokeratin 20) suggest that the ovarian, pulmonary, and diaphragmatic lesions were of ovarian origin and that the ovary was the primary tumor site.
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Affiliation(s)
- Soo-Hyeon Kim
- Department of Veterinary Pathology, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Byung-Joon Seung
- Department of Veterinary Pathology, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Seung-Hee Cho
- Department of Veterinary Pathology, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Ha-Young Lim
- Department of Veterinary Pathology, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Min-Kyung Bae
- Department of Veterinary Pathology, College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Kyung-Yeon Eo
- Conservation and Health Center, Seoul Zoo, Gwacheon-si, Gyeonggi-do, Korea
| | - Yong-Gu Yeo
- Conservation and Health Center, Seoul Zoo, Gwacheon-si, Gyeonggi-do, Korea
| | - Jang-Won Son
- Conservation and Health Center, Seoul Zoo, Gwacheon-si, Gyeonggi-do, Korea
| | - Jung-Hyang Sur
- Department of Veterinary Pathology, College of Veterinary Medicine, Konkuk University, Seoul, Korea
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4
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Kim SJ, Kim TG, Gu MJ, Kim S. Mucinous adenocarcinoma of the buttock associated with hidradenitis: A case report. World J Clin Cases 2020; 8:4200-4206. [PMID: 33024779 PMCID: PMC7520757 DOI: 10.12998/wjcc.v8.i18.4200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/02/2020] [Accepted: 08/25/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Mucinous adenocarcinomas of the buttock are rare and have an uncertain etiology and natural course. They are usually related to chronic anal fistulas, hidradenitis suppurativa, or Crohn's disease. Here, we report a case of mucinous adenocarcinoma associated with hidradenitis and contradictory immunochemistry results.
CASE SUMMARY A 62-year-old man complained of recurrent abscesses of the buttock for 3 years. He had several scars and nodules in bilateral buttocks, with purulent discharge. The skin lesions did not appear to originate from the anus. The patient was diagnosed with recurrent abscesses due to hidradenitis suppurativa at the first visit. He showed purulent and subsequent mucin discharge in the first operation and was diagnosed with mucinous adenocarcinoma. Several examinations were performed to determine disease origin and staging. There were no significant findings or evidence of anal fistulas. Hence, he underwent wide local excision and V-Y advancement flap in the second operation. The final diagnosis was mucinous adenocarcinoma without any evidence of anal fistulas. Additional immunochemistry test results were negative for cytokeratin (CK) 7 and positive for CK20 and CDX2, with a colorectal origin. A pathologist suggested that the disease originated from a chronic anal fistula. The patient has remained free of recurrence for 24 mo.
CONCLUSION Although the patient with mucinous adenocarcinoma showed an atypical course, immunochemistry helped detect the disease origin.
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Affiliation(s)
- Sung Jin Kim
- Department of Surgery, College of Medicine, Yeungnam University, Daegu 42415, South Korea
| | - Tae Gon Kim
- Department of Plastic and Reconstructive Surgery, College of Medicine, Yeungnam University, Daegu 42415, South Korea
| | - Mi Jin Gu
- Department of Pathology, College of Medicine, Yeungnam University, Daegu 42415, South Korea
| | - Sohyun Kim
- Department of Surgery, College of Medicine, Yeungnam University, Daegu 42415, South Korea
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5
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Strobel SL, Jenison EL, Van Kooten JM, Kitts AN, Britton AJ. Triple negative lobular breast carcinoma metastatic to an ovarian fibrothecoma. J Histotechnol 2020; 43:200-203. [PMID: 32508260 DOI: 10.1080/01478885.2020.1773638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
A postmenopausal woman with lobular breast carcinoma metastatic to a large ovarian fibrothecoma is presented. The two metastatic tumor nodules were grossly subtle and could have been overlooked in the background of the large ovarian stromal tumor. Thorough sampling of the tumor for histologic examination and supporting immunohistochemical stains were important in establishing the diagnosis. Differential diagnostic considerations are discussed.
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Affiliation(s)
- Stephen L Strobel
- Department of Pathology, Bon Secour Mercy St. Vincent Hospital , Toledo, OH, USA
| | - Eric L Jenison
- Department of Gynecologic Oncology, Bon Secour Mercy St. Vincent Hospital , Toledo, OH, USA
| | - Jessica M Van Kooten
- Department of Gynecologic Oncology, Bon Secour Mercy St. Vincent Hospital , Toledo, OH, USA
| | - Alyssa N Kitts
- Department of Gynecologic Oncology, Bon Secour Mercy St. Vincent Hospital , Toledo, OH, USA
| | - Andrew J Britton
- Department of Pathology, Bon Secour Mercy St. Vincent Hospital , Toledo, OH, USA
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Ribaut C, Voisin V, Malachovská V, Dubois V, Mégret P, Wattiez R, Caucheteur C. Small biomolecule immunosensing with plasmonic optical fiber grating sensor. Biosens Bioelectron 2016; 77:315-22. [DOI: 10.1016/j.bios.2015.09.019] [Citation(s) in RCA: 85] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 09/07/2015] [Accepted: 09/10/2015] [Indexed: 11/28/2022]
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7
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Saraiva AL, Payan-Carreira R, Gärtner F, Fortuna da Cunha MR, Rêma A, Faria F, Lourenço LM, Pires MDA. An immunohistochemical study on the expression of sex steroid receptors, Ki-67 and cytokeratins 7 and 20 in feline endometrial adenocarcinomas. BMC Vet Res 2015; 11:204. [PMID: 26268561 PMCID: PMC4535787 DOI: 10.1186/s12917-015-0530-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 08/04/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Endometrial adenocarcinomas are a rare type of tumour in cats. Though different morphologies have been reported, the most frequent histological type of feline endometrial adenocarcinoma (FEA) is the papillary serous. Characterization of molecular markers expression in FEA may contribute to clarify the pathogenesis of these tumours and to assess the differences between normal endometrium and FEA regarding the expression pattern of several proteins. Therefore, this study aimed to evaluate the immunohistochemical profile of a wide panel of antibodies (specific for ER-α, PR, Ki-67, CK7 and CK20) in twenty-four cases of FEA. Comparisons were made between FEA and feline normal cyclic endometrium in follicular (n = 13) and luteal (n = 10) stages. Except for Ki-67, all other molecular markers were assessed independently for the intensity of immunolabeling and for the percentage of cells expressing the protein. RESULTS This study showed that in FEA a loss of expression occurs for ER-α (P ≤ 0.0001) and less markedly also for PR. The lost in sex steroid receptors concerns a decrease in both the proportion of labelled cells and the intensity of immunolabelling (P = 0.002 and P = 0.024, respectively). Proliferative activity, estimated via Ki-67 immunoreaction, significantly increased in FEA as compared to normal endometrium (P ≤ 0.0001). Feline endometrial adenocarcinomas maintained the CK7+/CK20+ status of normal endometrium. However, FEA showed decreased CK7 intensity of labelling compared to normal endometria (P ≤ 0.0001) and loss of CK20 expression, both in intensity (P ≤ 0.0001) and in percentage of positive cells (P = 0.01), compared to normal tissues. CONCLUSIONS Data gathered in this study suggest that proliferation in FEA accompanies ER-α down-regulation, possibly following activation of pathways mediated by local growth factors. Moreover, FEA retains combined expression of CK7 and CK20, as evidenced in normal endometrial epithelia, although a decrease in CK7 expression was observed.
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Affiliation(s)
- Ana Laura Saraiva
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal. .,Escola Universitária Vasco da Gama (EUVG), Avenida José R. Sousa Fernandes, Campus Universitário, Bloco B, Lordemão, 3020-210, Coimbra, Portugal.
| | - Rita Payan-Carreira
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Fátima Gärtner
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira n.° 228, 4050-313, Porto, Portugal. .,Institute of Molecular Pathology and Immunology of the University of Porto (IPATIMUP), Rua Júlio Amaral de Carvalho, 45, 4200-135, Porto, Portugal.
| | - Marta R Fortuna da Cunha
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Alexandra Rêma
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira n.° 228, 4050-313, Porto, Portugal.
| | - Fátima Faria
- Abel Salazar Institute of Biomedical Sciences (ICBAS), University of Porto, Rua de Jorge Viterbo Ferreira n.° 228, 4050-313, Porto, Portugal.
| | - Lígia M Lourenço
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
| | - Maria Dos Anjos Pires
- CECAV, Centro de Ciência Animal e Veterinária, Universidade de Trás-os-Montes e Alto Douro, Quinta de Prados, 5000-801, Vila Real, Portugal.
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Cutaneous metastases from internal malignancies: a clinicopathologic and immunohistochemical review. Am J Dermatopathol 2012; 34:347-93. [PMID: 22617133 DOI: 10.1097/dad.0b013e31823069cf] [Citation(s) in RCA: 151] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Skin metastases occur in 0.6%-10.4% of all patients with cancer and represent 2% of all skin tumors. Skin metastases from visceral malignancies are important for dermatologists and dermatopathologists because of their variable clinical appearance and presentation, frequent delay and failure in their diagnosis, relative proportion of different internal malignancies metastasizing to the skin, and impact on morbidity, prognosis, and treatment. Another factor to take into account is that cutaneous metastasis may be the first sign of clinically silent visceral cancer. The relative frequencies of metastatic skin disease tend to correlate with the frequency of the different types of primary cancer in each sex. Thus, women with skin metastases have the following distribution in decreasing order of frequency of primary malignancies: breast, ovary, oral cavity, lung, and large intestine. In men, the distribution is as follows: lung, large intestine, oral cavity, kidney, breast, esophagus, pancreas, stomach, and liver. A wide morphologic spectrum of clinical appearances has been described in cutaneous metastases. This variable clinical morphology included nodules, papules, plaques, tumors, and ulcers. From a histopathologic point of view, there are 4 main morphologic patterns of cutaneous metastases involving the dermis, namely, nodular, infiltrative, diffuse, and intravascular. Generally, cutaneous metastases herald a poor prognosis. The average survival time of patients with skin metastases is a few months. In this article, we review the clinicopathologic and immunohistochemical characteristics of cutaneous metastases from internal malignancies, classify the most common cutaneous metastases, and identify studies that may assist in diagnosing the origin of a cutaneous metastasis.
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Bayrak R, Haltas H, Yenidunya S. The value of CDX2 and cytokeratins 7 and 20 expression in differentiating colorectal adenocarcinomas from extraintestinal gastrointestinal adenocarcinomas: cytokeratin 7-/20+ phenotype is more specific than CDX2 antibody. Diagn Pathol 2012; 7:9. [PMID: 22268990 PMCID: PMC3331835 DOI: 10.1186/1746-1596-7-9] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 01/23/2012] [Indexed: 12/12/2022] Open
Abstract
Background/Objective Metastatic adenocarcinoma from an unknown primary site is a common clinical problem. Determining the cytokeratin (CK) 7/CK20 pattern of tumors is one of the most helpful procedures for this purpose since the CK7-/CK20+ pattern is typical of colorectal adenocarcinomas. CDX2, a critical nuclear transcription factor for intestinal development, is expressed in intestinal epithelium and adenocarcinomas. In the present study, we compared the sensitivity and specificity of CDX2 expression and the CK7-/CK20+ phenotype in differentiating colorectal adenocarcinomas from pancreatic and gastric adenocarcinomas. Methods CK7/CK20 staining pattern and CDX2 expression were evaluated in 118 cases of colorectal, 59 cases of gastric, and 32 cases of pancreatic adenocarcinomas. The sensitivity, specificity, and positive and negative predictive values of the CK7-/CK20+ phenotype and of CDX2 expression were analyzed. Results The CK7-/CK20+ immunophenotype was expressed by 75 of 118 (64%) colorectal and 3 of 59 (5%) gastric tumors and was not observed in any pancreatic adenocarcinomas. The CK7+/CK20+ immunophenotype was expressed in 24/118 (20%) of colon, 28/59 (48%) of gastric and 7/32 (22%) of pancreatic adenocarcinomas. The CK7+/CK20- expression pattern was observed in only 2% (2 of 118) of colorectal carcinomas. CDX2 was expressed in 114 of 118 (97%) colorectal, 36 of 59 (61%) gastric, and 5 of 32(16%) pancreatic adenocarcinomas. There was no significant association between CDX2 expression and tumor differentiation in colorectal carcinomas. In gastric carcinomas, CDX2 expression was more common in intestinal type tumors than in diffuse type carcinomas. The CK7-/CK20+ phenotype showed a specificity of 96.7% in predicting colorectal adenocarcinomas, which was superior to that of CDX2 expression. CDX2 expression at both cut-off levels (> 5% and > 50%) had a higher sensitivity (96.6% and 78%) than the CK phenotype. Conclusions Both the CK7-/CK20+ phenotype and expression of the antibody CDX2 are highly specific and sensitive markers of colorectal origin. CDX2 expression should be a useful adjunct for the diagnosis of intestinal adenocarcinomas, particularly when better established markers such as CK7 and CK20 yield equivocal results. The CK7-/CK20+ phenotype is superior in its specificity and positive predictive value and might be preferred. Virtual slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4851011866354821
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Affiliation(s)
- Reyhan Bayrak
- Department of Pathology, Fatih University Hospital, Ankara, Turkey
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10
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Kim YI, Lee JJ, Paik JH, Kim YK, Kim SE. Detection of Thyroid Metastasis of Renal Transitional Cell Carcinoma Using FDG PET/CT. Nucl Med Mol Imaging 2011; 45:149-51. [PMID: 24899995 DOI: 10.1007/s13139-011-0079-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 01/20/2011] [Accepted: 02/20/2011] [Indexed: 11/30/2022] Open
Abstract
A 69-year-old man who was diagnosed with renal transitional cell carcinoma (TCC) underwent F-18 fluorodeoxyglucose (FDG) positron emission tomography with computed tomography (PET/CT) for detecting recurrence after chemotherapy. FDG PET/CT revealed multiple new hypermetabolic lesions in many places, including the right thyroid gland. Biopsy of the thyroid lesion was performed, and a diagnosis of metastatic TCC was made. We could detect thyroid metastasis of renal TCC by FDG PET/CT.
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Affiliation(s)
- Yong-Il Kim
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, Korea
| | - Jong Jin Lee
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, 86 Asanbyungwon-gil, Songpa-gu, Seoul, 138-736 Korea
| | - Jin Ho Paik
- Department of Pathology, Seoul National University Bundang Hospital, Seoul, Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, Korea
| | - Sang Eun Kim
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul, Korea
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12
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Baldwin L, Lee AHS, Al-Talib RK, Theaker JM. Transitional cell carcinoma of the bladder mimicking lobular carcinoma of the breast: a discohesive variant of urothelial carcinoma. Histopathology 2005; 46:50-6. [PMID: 15656886 DOI: 10.1111/j.1365-2559.2005.02051.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS To describe a series of 10 cases of transitional cell carcinoma which show morphological features which mimic lobular carcinoma of the breast and diffuse carcinoma of the stomach. METHODS AND RESULTS Ten cases were identified from the files at Southampton University Hospitals NHS Trust and from the authors' consultation files. Immunostains were performed and clinical information was obtained. Eight of the patients were male and two female. Ages ranged from 52 to 77 years at presentation. All of the tumours showed areas where the tumour was composed of uniform cells with a discohesive single-cell, diffusely invasive growth pattern. In areas the tumour cells were arranged in linear single-cell files and in separate areas solid sheets of discohesive cells. In all of the cases some tumour cells showed prominent intracytoplasmic vacuoles. In addition to this pattern, four cases showed typical transitional cell carcinoma or carcinoma in situ. The majority of the tumours expressed cytokeratin 20 but not oestrogen receptors. CONCLUSION This study highlights a pattern of diffusely invasive transitional cell carcinoma not previously described and one which is important to recognize in order to avoid misdiagnosis of metastatic lobular carcinoma of the breast, especially in small biopsies.
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Affiliation(s)
- L Baldwin
- Department of Cellular Pathology, Southampton University Hospitals NHS Trust, Southampton, UK
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Cid Mouteira P, Ortíz Rey JA, Antón Badiola I, San Miguel Fraile P, Alvarez Alvarez C, Zungri Telo E, de la Fuente Buceta A. [Coordinated expression of cytokeratin 7 and 20 in transitional carcinoma of the bladder: diagnostic usefulness]. Actas Urol Esp 2002; 26:279-84. [PMID: 12090187 DOI: 10.1016/s0210-4806(02)72774-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Cytokeratins are intermediate filament proteins which are part of the framework of eucariotic cells. A characteristic pattern of expression of cytokeratins has been described for each type of epithelium. This pattern is maintained during the process of malignancy and metastasis. Immunohistochemical analysis of cytokeratins 7 and 20 (Ck 7 and Ck 20) has been considered particularly useful for identifying the origin of carcinomas. METHODS A total of 122 cases of transitional cell carcinoma of urinary bladder were studied immunohistochemically with monoclonal antibodies against Ck 7 and Ck 20. The peroxidase labelled-streptavidin biotin technique was performed. Cases were considered positive when at least 1% of tumoral cells were stained. RESULTS All cases investigated expressed Ck 7 whereas Ck 20 was positive in 75% of them. Reactivity for Ck 20 was always focal. No tumor was negative for Ck 7. CONCLUSION Ck 7+/Ck 20+ immunophenotype is highly characteristic of transitional cell carcinoma of urinary bladder, whereas Ck 7+/Ck 20- is less frequent. Immunohistochemical determination of these cytokeratins is useful for the diagnosis when tumors are poorly differentiated and for identifying the primary site of metastatic carcinomas.
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Affiliation(s)
- P Cid Mouteira
- Servicio de Anatomía Patológica, Centro Médico POVISA, Vigo, Pontevedra
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Abstract
BACKGROUND Immunohistochemistry is a useful method in the differential diagnosis between pleural mesotheliomas and metastatic adenocarcinomas to the pleura. Cytokeratin (CK) 5-6 is one of the most specific mesothelioma-associated antibodies. Cytokeratin 20 and CK7 have been used successfully in studies determining primary location of adenocarcinomas from metastases. In the current study, the value of these CKs in differential diagnosis of malignant pleural lesions was examined. METHODS Ninety-three autopsy-verified cases (14 mesotheliomas and 79 adenocarcinomas including 42 primary lung tumors and 37 adenocarcinomas metastatic to the pleura) were stained on CK20, CK7, and CK5-6 with commercially available primary antibodies. The staining was conducted in an automated immunohistochemical system. The results were analyzed statistically at different positivity thresholds: 10% and 0%. RESULTS None of the mesotheliomas stained positively for CK20 at the 10% positivity level, but 3 cases showed focal positivity in < 10% of the tumor cells. Eighty-six percent (12 of 14) of these tumors were CK7+ and 64% (9 of 14) were CK5-6+. None of the mesotheliomas expressed the CK20+/7- pattern. Lung adenocarcinomas, both primary and metastatic, and breast carcinomas were very similar to mesotheliomas with regard to expression of CK20 and CK7 but differed significantly with regard to expression of CK5-6. Conversely, gastrointestinal adenocarcinomas and pancreaticobiliary tumors expressed CK20 positivity in a high proportion, 86% (13 of 15) and 77% (7 of 9), respectively. The gastrointestinal tumors stained positively for CK7 in only 20% (3 of 15) of cases and differed significantly from the other adenocarcinomas in this aspect. The CK20+/7- pattern was typical for gastrointestinal tumors. CONCLUSIONS Adding CK20 and CK7 to the panel of antibodies in the differential diagnosis of pleural mesothelioma versus metastatic adenocarcinomas is useful because diffuse CK20 positivity seems to be an indicator of metastasis. Furthermore, CK7 negativity most often is associated with metastases, and the CK20+/7- pattern, typical of colorectal adenocarcinomas, is absent in pleural mesotheliomas.
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Affiliation(s)
- T Tot
- Department of Pathology and Clinical Cytology, Central Hospital, Falun, Sweden.
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15
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Identifying the primary sites of metastatic carcinoma: the increasing role of immunohistochemistry. ACTA ACUST UNITED AC 2001. [DOI: 10.1054/cdip.2001.0079] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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