Template:Undifferentiated malignancy: Difference between revisions
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===Undifferentiated malignancy=== | ===Undifferentiated malignancy=== | ||
[[File:Histopathology of undifferentiated tumor cells.jpg|thumb|220px|Histopathology of a biopsy of a lymph node with cancer of unknown primary origin, showing undifferentiated high-grade tumor cells.]] | |||
An initial panel of '''cytokeratin''' (CK, such as by CK AE1/AE3 cocktail), '''S100''', '''vimentin''' and '''LCA (CD45)''' can be used (see source article for subsequent work-up).<ref name="pmid25427040">{{cite journal| author=Lin F, Liu H| title=Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. | journal=Arch Pathol Lab Med | year= 2014 | volume= 138 | issue= 12 | pages= 1583-610 | pmid=25427040 | doi=10.5858/arpa.2014-0061-RA | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25427040 }} </ref> | An initial panel of '''cytokeratin''' (CK, such as by CK AE1/AE3 cocktail), '''S100''', '''vimentin''' and '''LCA (CD45)''' can be used (see source article for subsequent work-up).<ref name="pmid25427040">{{cite journal| author=Lin F, Liu H| title=Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. | journal=Arch Pathol Lab Med | year= 2014 | volume= 138 | issue= 12 | pages= 1583-610 | pmid=25427040 | doi=10.5858/arpa.2014-0061-RA | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25427040 }} </ref> | ||
Alternatively, a more comprehensive panel can be performed upfront, with the most pertinent panel suggested below (with main associated primary origins in parentheses), but it should be tailored to additional clues from each individual case:<ref>Partly inspired by:<br>{{cite journal| author=Beauchamp K, Moran B, O'Brien T, Brennan D, Crown J, Sheahan K | display-authors=etal| title=Carcinoma of unknown primary (CUP): an update for histopathologists. | journal=Cancer Metastasis Rev | year= 2023 | volume= | issue= | pages= | pmid=37394540 | doi=10.1007/s10555-023-10101-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=37394540 }} </ref> | Alternatively, a more comprehensive panel can be performed upfront, with the most pertinent panel suggested below (with main associated primary origins in parentheses), but it should be tailored to additional clues from each individual case:<ref>Partly inspired by:<br>{{cite journal| author=Beauchamp K, Moran B, O'Brien T, Brennan D, Crown J, Sheahan K | display-authors=etal| title=Carcinoma of unknown primary (CUP): an update for histopathologists. | journal=Cancer Metastasis Rev | year= 2023 | volume= | issue= | pages= | pmid=37394540 | doi=10.1007/s10555-023-10101-6 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=37394540 }} </ref> | ||
[[File:Histopathology of signet ring cell carcinoma of urinary bladder on mucicarmine stain.jpg|thumb|220px|Mucicarmine stain showing signet ring cell carcinoma, with the mucin within tumor cells colored pink/red.]] | [[File:Histopathology of signet ring cell carcinoma of urinary bladder on mucicarmine stain.jpg|thumb|220px|Mucicarmine stain showing signet ring cell carcinoma, with the mucin within tumor cells colored pink/red.]] | ||
*'''Mucicarmine''' (adenocarcinoma) | *'''Mucicarmine''' or '''Cytokeratin CAM 5.2''' (adenocarcinoma) | ||
:*'''CK7 and CK20''' can give a broad indication of the primary site. Still use more specific immunohistochemistry stains instead or in addition where applicable. See table below for main patterns. | :*'''CK7 and CK20''' can give a broad indication of the primary site. Still use more specific immunohistochemistry stains instead or in addition where applicable. See table below for main patterns. | ||
:*'''NKX3.1''' in males ([[prostate adenocarcinoma]]) or '''estrogen and progesterone receptor''' in females ([[Female reproductive system|female reproductive tract]]). | :*'''NKX3.1''' in males ([[prostate adenocarcinoma]]) or '''estrogen and progesterone receptor''' in females ([[Female reproductive system|female reproductive tract]]). | ||
Revision as of 18:33, 8 December 2023
Undifferentiated malignancy
An initial panel of cytokeratin (CK, such as by CK AE1/AE3 cocktail), S100, vimentin and LCA (CD45) can be used (see source article for subsequent work-up).[1]
Alternatively, a more comprehensive panel can be performed upfront, with the most pertinent panel suggested below (with main associated primary origins in parentheses), but it should be tailored to additional clues from each individual case:[2]
- Mucicarmine or Cytokeratin CAM 5.2 (adenocarcinoma)
- CK7 and CK20 can give a broad indication of the primary site. Still use more specific immunohistochemistry stains instead or in addition where applicable. See table below for main patterns.
- NKX3.1 in males (prostate adenocarcinoma) or estrogen and progesterone receptor in females (female reproductive tract).
- TTF-1 (thyroid or lung tumor)
- GATA3 (urothelial carcinoma, breast tumor)
- CDX2 (gastrointestinal tumor)
- p63 (squamous cell carcinoma)
- S100 (neural, invasive melanoma)
- LCA (CD45) (hematopoietic)
- Synaptophysin (neuroendocrine)
| CK20 | |||
|---|---|---|---|
| Positive | Negative | ||
| CK7 | Positive |
|
|
| Negative |
|
| |
Notes
Main page
References
- ↑ Lin F, Liu H (2014). "Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. ". Arch Pathol Lab Med 138 (12): 1583-610. doi:. PMID 25427040. Archived from the original. .
- ↑ Partly inspired by:
Beauchamp K, Moran B, O'Brien T, Brennan D, Crown J, Sheahan K (2023). "Carcinoma of unknown primary (CUP): an update for histopathologists. ". Cancer Metastasis Rev. doi:. PMID 37394540. Archived from the original. . - ↑ Selves J, Long-Mira E, Mathieu MC, Rochaix P, Ilié M (2018). "Immunohistochemistry for Diagnosis of Metastatic Carcinomas of Unknown Primary Site. ". Cancers (Basel) 10 (4). doi:. PMID 29621151. PMC: 5923363. Archived from the original. .
- ↑ Elliot Weisenberg, M.D.. Esophagus - Carcinoma - Adenocarcinoma. Pathology Outlines. Last author update: 1 June 2013. Last staff update: 31 October 2022
Image sources