Template:Undifferentiated malignancy

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Undifferentiated malignancy

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).[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]

File:Histopathology of signet ring cell carcinoma of urinary bladder on mucicarmine stain.jpg
Mucicarmine stain showing signet ring cell carcinoma, with the mucin within tumor cells colored pink/red.
  • S100 (neural, invasive melanoma)
  • LCA (CD45) (hematopoietic)
  • Synaptophysin (neuroendocrine)
Most common CK7 and CK20 patterns in carcinomas of unknown primary site (CUPs)[3]
CK20
Positive Negative
CK7 Positive
  • Urothelial carcinoma
  • Pancreatic adenocarcinoma
  • Ovarian mucinous carcinoma
  • Bladder adenocarcinoma
  • Gastric adenocarcinoma
  • Cholangiocarcinoma
  • Breast carcinoma
  • Lung adenocarcinoma
  • Endometrial adenocarcinoma
  • Endocervical adenocarcinoma
  • Ovarian (serous) carcinoma
  • Cholangiocarcinoma
  • Small cell lung carcinoma
  • Mesothelioma
  • Thyroid carcinoma
  • Salivary gland tumours
  • Kidney (papillary)
  • Urothelial carcinoma (subset)
  • Pancreatic adenocarcinoma
  • Gastric adenocarcinoma
  • Esophageal adenocarcinoma[4]
Negative
  • Colorectal adenocarcinoma
  • Merkel cell carcinoma
  • Gastric adenocarcinoma
  • Prostate adenocarcinoma
  • Renal (clear cells)
  • Hepatocellular carcinoma
  • Adrenocortical carcinoma
  • Non-seminoma germ cell tumours
  • Mesothelioma
  • Small cell lung carcinoma
  • Gastric adenocarcinoma

Notes


Main page

References

  1. ↑ Lin F, Liu H (2014). "Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. ". Arch Pathol Lab Med 138 (12): 1583-610. doi:10.5858/arpa.2014-0061-RA. PMID 25427040. Archived from the original. . 
  2. ↑ 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:10.1007/s10555-023-10101-6. PMID 37394540. Archived from the original. . 
  3. ↑ 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:10.3390/cancers10040108. PMID 29621151. PMC: 5923363. Archived from the original. . 
  4. ↑ Elliot Weisenberg, M.D.. Esophagus - Carcinoma - Adenocarcinoma. Pathology Outlines. Last author update: 1 June 2013. Last staff update: 31 October 2022

Image sources


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