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Immunostains > Antibodies > Flashcards

Antibodies Flashcards

1
Q

AAT-1

A

Cytoplasmic
Hepatocytes and histiocytes
Globules of AAT, HCC, histiocytic lesions

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2
Q

alpha-Actin

SMA

A

Cytoplasmic

smooth mm, myoeps, myofibroblasts

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3
Q

Muscle specific actin

MSA, Actin, HHF-35

A

Cytoplasmic

Smooth/skeletal/cardiac mm, myoeps

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4
Q

AFP

A

Cytoplasmic
Fetal liver
Yolk sac tumor, some embryonal CA, HCC, hepatoblastoma

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5
Q

ALK

anaplastic lymphoma kinase, p80

A

Nuclear, cytoplasmic, membranous (location depends on type of translocation)
Few neuronal cells
Inflammatory myofibroblastic tumor, ALCL, lung adenoCA with EML4-ALK rearrangement, rare DLBCL
t(2;5)/NMP-ALK rearrangement

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6
Q

Arginase-1

A

Cytoplasmic
Normal hepatocytes
Marker of hepatocellular differentiation

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7
Q

B72.3

A

Cytoplasmic, membranous
Secretory endometrium
AdenoCA (+) vs mesothelioma (-)
2nd line marker

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8
Q

beta-catenin

A

Only nuclear staining is significant
Normal: cytoplasm of most cells (binds APC), endothelial cells good + internal control
Colon CA, Pancreatic solid-pseudopapillary, Craniopharyngioma, Pancreatoblastoma, Hepatoblastoma, FAP-assoc tumors, Tubular adenoma

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9
Q

Bcl-2

b cell lymphoma 2

A 
Membranous and cytoplasmic
Inhibits apoptosis (normally OFF in GC)
Follicular lymphoma (t(14;18) retains bcl2 expression), CLL/SLL, MCL, MZL, synovial sarcoma, some CD34+ tumors (SFT, GIST)
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10
Q

Bcl-6

b cell lymphoma 6

A

Nuclear
Normal: GC cells
Lymphomas of follicular origin (FL, Burkitt, DLBCL, LP-HL), neoplastic T-lymphocytes in angioimmunoblastic T-cell lymphoma

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11
Q

Ber-EP4

A

Membranous
Epithelial cells
AdenoCA in general; lung adeno (+) vs mesothelioma (-)

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12
Q

BG8

A

Cytoplasmic
RBC
AdenoCA (+) vs mesothelioma (-), 2nd line marker

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13
Q

Brachyury

A

Nuclear
TF –> notochord dev’t; spermatogonia
Chordoma, hemangioblastoma

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14
Q

CAIX

carbonic anhydrase IX

A

Membranous
Ischemic tissues (expression related to HIF)
Clear cell RCC (sensitive and specific)

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15
Q

CA-125

A

Luminal
Many cell types
Serum marker for ovarian, not specific by IHC

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16
Q

CA 19-9

carbohydrate antigen 19-9

A

Cytoplasmic
Many cell types
Serum marker for pancreatic/GI cancers, not specific by IHC

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17
Q

Calcitonin

A

Cytoplasmic and extracellular
C cells of thyroid
Medullary carcinoma (can be positive in other NE tumors)

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18
Q

Caldesmon

h-Caldesmon

A

Cytoplasmic
Smooth mm, myoep cells (neg in myofibroblasts)
Leiomyosarcoma (+) vs myofibroblastic lesions such as fibromatosis (-)

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19
Q

Calponin

A

Cytoplasmic

Smooth mm, myoep cells, (variable in myofibroblasts)

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20
Q

Calretinin

A

Cytoplasmic and nuclear
Mesothelium, sex-cord stromal cells, some neural and epithelial cells
Adenomatoid tumor, sex-cord stromal tumors, adrenocortical tumors, cardiac myxoma
Epithelial mesothelioma (+) vs adenoCA (-)

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21
Q

Cathepsin-K

A

Cytoplasmic
Osteoclasts
Xp11 translocation RCC, PEComas, chordoma

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22
Q

CD1a

A

Membranous
Thymocytes (immature T cells), Langerhan’s cells
LCH, some T cell ALL, thymoma with admixed thymocytes

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23
Q

CD2

A

Membranous
pan-T cell marker, NK cells
T- and NK-cell lymphomas and leukemias

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24
Q

cCD3

flow cytometry only

A

Cytoplasmic
pan-T cell marker
most lineage-specific marker for T-cell differentiation

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25
Q

CD3

A

Membranous, cytoplasmic
pan-T cell marker
T-cell lymphomas and leukemias (best pan-T cell IHC); often lost in ALCL

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26
Q

CD4 and CD8

A

Membranous
CD4 - helper T cells
CD8 - cytotoxic and suppressor T cells, NK-like T cells
CD4/CD8 - thymus
T-cell L and L, CD4 is also + in monocytic/histiocytic lesions
Large number double (-) or double (+) usually indicates neoplasm

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27
Q

CD5

A

Membranous
T cells and subset of B cells
CD5+ low grade: CLL/SLL and MCL
CD5+ high grade: blastoid MCL, occasional DLBCL
T-cell L/L: aberrant loss of pan-T antigens, especially CD5 and CD7 common signature in peripheral T cell lymphomas (MF)
Thymic carcinoma (+ in epithelial cells) vs thymoma (-)

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28
Q

CD7

A

Membranous
T cells, NK cells
T-ALL (near 100%)
MF and other mature T-cell lymphomas (CD7-) vs reactive T-cell proliferation (+)
Aberrant expression in AML (CD7 on myeloid blasts can be seen in recovering marrow)

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29
Q

CD10

CALLA - Common acute leukemia antigen

A

Membranous
Precursor B & T cells, GC B cells, granulocytes, liver canaliculi, myoep cells, endometrial stroma
CD10(+) lymphomas: B-ALL, T-ALL, FL, Burkitt, some DLBCL, neoplastic cells in angioimmunoblastic T cell
HCC (+ canalicular) vs cholangiocarcinoma (-)
RCC
Pancreatic solid-pseudopapillary neoplasm
Sex cord-stromal tumors
Endometrial stromal sarcoma
Atypical fibroxanthoma (+) vs sarcoma, sarcomatoid carcinoma, and melanoma of the skin (-)

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30
Q

CD11b

a flow marker

A

Membranous
Monocytes, granulocytes, NK cells
Myeloid leukemias with differentiation and NK cell tumors

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31
Q

CD11c

a flow marker

A

Membranous
Myeloid and lymphoid cells
Hairy cell leukemia

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32
Q

CD13, CD14, CD33

flow markers

A

Membranous
Myeloid cells (CD13, CD33) and monocytes (CD14, CD33)
Myeloid leukemias

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33
Q

CD15

A

Membranous and Golgi (paranuclear dot-like)
Monocytes, myelocytes, granulocytes, endothelial cells, some carcinomas
RS in cHL, AML with differentiation (especially granulocytic), AdenoCA (+) vs mesothelioma (-)

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34
Q

CD19, CD20, CD22

A

Cytoplasmic and membranous
pan-B cell markers
B-cell lymphomas (plasmacytoma are negative), B-ALL (CD19+, CD20/22 variable),
CD20 reactivity is lost in DLBCL after Rx with Rituximab

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35
Q

CD21, CD35

A

Membranous
B cells, follicular dendritic cells, other
Follicular DC network in lymphomas
Follicular dendritic cell sarcoma (very rare)

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36
Q

CD23

A

Membranous
B cells, follicualr DCs, monocytes
SLL/CLL, follicular DC network in lymphomas

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37
Q

CD25

IL2 receptor

A

Membranous and cytoplasmic
Activated T and B cells
Hairy cell leukamia, adult T cell L/L, most ALCLs, neoplastic mast cells

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38
Q

CD30

Ki-1

A

Membranous and Golgi (paranuclear dot like)
Activated B and T cells, PCs, some non-heme cells
RS in cHL, ALCL (“target-like” membrane and Golgi pattern), MF (suggests transformation), embryonal carcinoma

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39
Q

CD31

A 
Cytoplasmic and membranous
Endothelial cells, megakaryocytes, macrophages
Endothelial differentiation (e.g. angiosarcoma, Kaposi), more sensitive and specific than CD34
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40
Q

CD34

A

Cytoplasmic and membranous
Endothelial cells, fibroblasts, hematopoietic blasts
Many soft tissue tumors: vascular tumors, DFSP (+) vs DF (-), GIST (+) vs fibromatosis and leiomyosarcoma (-), SFT (+) vs synovial sarcoma (always -), nerve sheath tumors, epithelioid sarcoma, adipocytic tumors
Other: primitive leukemias, HCC
CD34(-) tumors: carcinoma (except NUT midline tumor), melanoma, lymphoma (except ALL)

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41
Q

CD38

A

Membranous
Immature lymphocytes, plasma cells
Plasma cell diff, poor prognosis in CLL/SLL

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42
Q

CD41, CD42b, CD61

flow markers

A

Membranous
Megakaryocytes, platelets
AML with megakaryocyte differentiation

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43
Q

CD43

A

Membranous
T cells, myelocytes
Low grade B cell: aberrant expression in CLL/SLL, MCL, MZL, but not FL
Normal and malignant T cells, myeloid sarcoma (chloroma) - more sensitive than CD45

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44
Q

CD44

A 
Membranous
Normal urothelium (basal layer), also considered a cancer stem cell marker
Reactive urothelium (+ in basal layer) vs CIS (- or reduced), small cell carcinoma of the prostate
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45
Q

CD45

leukocyte common antigen

A

Cytoplasmic, membranous
Pan-leukocyte marker (absent on PCs and nucleated RBCs)
Most heme malignancies (not RS cells, lymphoblastic lymphomas, ALCL, myeloid sarcomas, follicular DC sarcoma)

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46
Q

CD56

NCAM - neural cell adhesion molecule

A

Membranous
NE cells, schwann cells, NK cells
NE neoplasms, nasal-type NK/T cell lymphoma, other T-cell lymphomas, Neoplastic plasma cells, aberrant expression in AML

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47
Q

CD57

A

Membranous
NE cells, schwann cells, NK-like T calls
NLPHL (CD57+ T cells forming rosettes) vs T-cell rich DLBCL or cHL (no rosette), T-cell large granular cell leukemia, NE neoplasms, some nerve sheath tumors, metanephric adenoma of kidney

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48
Q

CD68

A

Cytoplasmic, membranous
Lysosomal marked in histiocytes/macs/monos, granulocytes
Histiocytic differentiation, myeloid sarcoma

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49
Q

CD71

transferrin receptor, flow marker

A

Membranous
Erythroid cells (not specific)
AML with erythroid or megakaryocytic diff
Aggressive (+) vs indolent (-) CD10+ B-cell lymphomas (flow)

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50
Q

CD79a

A

Membranous
B-cells and plasma cells (broader than CD20)
B-cell neoplasms (B-all and myelomas), some cases of T-ALL

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51
Q

CD99

MIC2, O13

A

Membranous and cytoplasmic
Immature T cells, various epithelial cells, endothelial cells
PNET/Ewing sarcoma (not specific), other small round cell tumor of childhood (except neuroblastoma, always negative)
B- and T-ALL
Thymoma (CD99+, TdT+ immature T cells)
Sex cord-stromal cells

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52
Q

CD103

flow marker

A

Cytoplasmic
Intestinal epithelial T lymphocytes
Hairy cell leukemia, enteropathy associated T cell lymphoma

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53
Q

CD138

A

Membranous
Plasma cells, squamous epithelium
Plasma cell diff, many carcinomas

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54
Q

CD146

MelCAM

A

Membranous
Intermediate trophoblast, smooth mm, vascular endothelial cells
Mesothelioma (+) vs reactive mesothelial prolif (-)
Tumors of implantation site intermediate trophoblast
Choricarcinoma
Melanoma

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55
Q

CD163

A

Membranous
Member of scavenger receptor cysteine-rich superfamily restricted to mac/mono line
Histiocytic differentiation

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56
Q

CDX2

A

Nuclear
Intestine (duodenum to rectum)
Strong/diffuse expression in intestinal carcinomas
Variable in gastric and pancreaticobiliary CA, enteric phenotype CA
Appendicial carcinoid tumor
Yolk sac tumor (40%)

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57
Q

CEA

A 
Cytoplasmic
Fetal tissues and glandular epithelium
AdenoCA (mCEA+) vs mesothelioma (mCEA-)
HCC (canalicular pCEA) vs cholangioCA and metastatic adenoCA (cytoplasmic pCEA)
Adenocarinoma in general
Medullary thyroid CA
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58
Q

Chromogranin

CHR, chromogranin A

A

Cytoplasmic (granular)
Neurosecretory granules in NE tissues and neurons
NE diff (pheo, carcinoid, small cell, Merkel cell, panc NE tumor)

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59
Q

c-kit

CD117, stem cell factor receptor

A

Cytoplasmic and membranous
Interstitial cells of Cajal (origin of GIST), germ cells, HPCs, mast cells
GIST, seminoma, mast cell lesions, melanoma (30-40%), sclerosing mesenterisits, luminal epithelium in salivary gland tumors, PEComas, thymic carcinoma (not thymoma), renal oncocytoma, blasts in AML

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60
Q

Clusterin

A

Cytoplasmic
Follicular dendritic cells
Follicular DC tumors, tenosynovial giant cell tumors, pancreatic NE cell tumors, many others

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61
Q

CyclinD1

Bcl-1

A

Nuclear
Dividing cells, endothelial cells (internal control)
MCL and blastoid MCL (t(11;14)/CCND1-IgH)

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62
Q

AE1/AE3

pan-cytokeratin cocktail

A

Cytoplasmic
Most epithelial cells
Used with Cam5.2 to screen for CA
ID’s all CA except: HCC, RCC, adrenocortical CA, and some high grade NE CA

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63
Q

Cam5.2

A

Cytoplasmic
LMW keratins (8, 18) in simple (non-squamous) epithelium
Used with AE1/AE3 to screen for CA (negative in SqCC)
ID’s: HCC and some undiff CA
Paget’s disease (+) vs Bowen’s disease/SqCC in situ (-)

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64
Q

CK7 and CK20

A

Cytoplasmic
Specific LMW cytokeratin markers
CK7: Barrett’s mucosa (+) vs intestinal metaplasia in gastric cardia (-)
CK20: urothelial CIS (+ in all layers) vs reactive uro (+ in umbrella cells only)
CK7/CK20 used in combo to narrow differential
-CK7: above diaphragm, gyn
-CK20: below diaphragm, Merkel cell
-CK7/CK20: peridiaphragmatic organs, bladder
-both neg: simple visceral organs (liver, kidney, pancreas)

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65
Q

CK903

34betaE12, K903

A

Cytoplasmic
HMW keratin present in stratified epithelia (squam, resp, uro) plus myoep and basal cells
Urothelial (+) vs prostate (-) carcinoma
Prostatic basal cells (loss of staining –> CA)
UDH (+) vs DCIS (-)
Metaplastic breast cancer (+)

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66
Q

CK5/6

A

Cytoplasmic
Two specific HMW keratins
SqCC and mesothelioma (+) vs adenoCA (-)
Prostatic basal cells and metaplastic CA (similar to CK903)

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67
Q

Desmin

DEX

A

Cytoplasmic
Intermediate filament in mm
Smooth and skeletal mm diff in tumors
Reactive meso (+) vs mesothelioma (-), low specificity

68
Q

D2-40

Poloplanin

A

Membranous
Mesothelial cells, germ cells, lymphatic endothelial cells, FDCs
Mesothelioma (+) vs adenoCA (-)
DF (+) vs DFSP (-)
Hemangioblastoma (+) vs metastatic RCC (-)
Primary skin adnexal tumors (+) vs metastatic adenoCA (-)
Adrenocortical neoplasms (+) vs RCC (-)
Lymphatic channels
Seminoma (100%) and embryonal carcinoma (30%)
Nerve sheath tumors
Follicular DC tumors

69
Q

DPC-4, clone B8

Deleted in Pancreatic Carcinoma, SMAD4

A

Nuclear and cytoplasmic
Most normal tissues
Pancreatic CA: 55% invasive CA exhibit loss of expression (both nuclear and cytoplasmic staining must be negative), fairly specific to pancreas but also seen in subset colon CA

70
Q

DOG1

A

Membranous and cytoplasmic
Interstitial cells of Cajal
GIST, stains 1/3 of c-kit negative GISTs

71
Q

EBV stains

A

EBER (EBV encoded early RNA) - nuclear, most sensitive, all EBV related tumors, ISH
LMP-1 (late membrane protein) - membranous, less sensitive, ID’s PTLD and AIDS-related lymphomas, variable in NPC, BL, cHL
EBNA (ENV nuclear antigen) - nuclear, least sensitive, ID’s PTLD and AIDS related lymphomas only

72
Q

E-cadherin

CAD-E

A

Membranous
Breast - normal ductal and lobular cells (adhesion molecule)
Ductal (+) vs lobular (-) lesions
Loss of expression also seen in gastric signet-ring CA and undifferentiated pancreas carcinoma

73
Q

EGFR

epidermal growth factor receptor

A

Membranous and cytoplasmic
Many cell types
Membranous staining predicts response to Erbitux in advanced colon cancer

74
Q

EMA

epithelial membrane antigen, MUC1

A

Cytoplasmic or membranous
Epithelial, perineurial, meningothelial cells
Carcinomas, synovial sarcoma, epithelioid sarcoma, chordoma
EMA(+) CK(-): meningioma, perineurioma, plasma cell neoplasms, ALCL, RS cells in NLPHL
Mesothelioma (membranous) vs adenoCA (cytoplasmic )

75
Q

ER and PR

A

Nuclear
Breast, ovary, endometrium
ER/PR+ breast CA: favorable px, responsive to tamoxifen
Metastatic breast cancer, tumors of uterus and ovary (cervix is negative)
Non-mammary/gyn tumors: lung adenoCA, skin adnexal tumors, cystic neoplasms with ovarian-type stroma, meningioma (PR+), pancreatic SPP (PR+), pancreatic NE (PR+)

76
Q

Factor VIII

A 
Cytoplasmic
Endothelial cells, megakaryocytes, platelets
Endothelial diff (specific but not sensitive), AML with megakaryocytic diff
77
Q

Factor XIIIa

A

Cytoplasmic
Histiocytes, fibrohistiocytic cells, other
DF (+) vs DFSP (-)
Histiocytic differentiation
Sinonasal glomangiopericytoma (often with peculiar nuclear localization)

78
Q

Fascin

A

Cytoplasmic
Many cell types
RS in cHL, follicular DC tumors

79
Q

Fli-1

Friend leukemia integration 1

A

Nuclear
Endothelial cells, many other cell types
Endothelial diff, Ewing/PNET, not specific

80
Q

FMC-7

flow marker

A

Cytoplasmic
B cells
CD5+ lymphomas: MCL(+) vs CLL/SLL (-)
Expression opposite of CD23

81
Q

Gastrin

A

Cytoplasmic
G cells
G cell hyperplasia (autoimmune metaplastic atrophic gastritis), Gastric antrum (+) vs antralized body (-)

82
Q

GCDFP

Gross cystic disease fluid protein-15, BRST2

A

Cytoplasmic
Apocrine cells of breast and sweat glands
Metastatic breast cancer (~50%, notoriously focal, stains lobular best)
Other tumors with apocrine diff: tumors of salivary glands and skin adnexae

83
Q

GFAP

glial fibrillary astrocytic protein

A

Cytoplasmic
Glial, myoep, schwann cells
Gliomas (astrocytoma, ependymoma; oligo may be focal), myoepithelioma, some schwannomas

84
Q

GLUT1

glucose transporter 1

A

Membranous
RBCs and many tissues
Mesothelioma (+) vs reactive mesothelium (-)
Thymic CA (+) vs thymoma (-)
Juvenile hemangioma (+) vs other benign vascular lesions (-)

85
Q

Glycophorin

CD235a, flow marker

A

?

86
Q

Gypican-3

GPC3

A

Cytoplasmic, membranous, canalicular
Embryonic liver, placenta (syncytiotrophoblasts)
HCC, hepatoblastoma, yolk sac tumor, choriocarcinoma, placental site trophoblastic tumor
HCC (+) vs benign hepatic nodules (-)

87
Q

Granzyme B, Perform, TIA-1 (T-cell intracellular antigen)

A

Cytoplasmic
Cytotoxic proteins in CD8 T cells and NK cells
T- and NK-cell lymphomas

88
Q

HBME-1

A

Cytoplasmic and membranous
Epithelial and mesothelial cells
Mesothelioma (+) vs adenoCA
Thyroid CA (+/-) vs benign follicular lesions (-/+)

89
Q

Hemoglobin A (HbA)

A

Cytoplasmic
RBCs and precursors
Erythrocytic diff

90
Q

HepPar-1

Hepatocyte paraffin 1, OCH1E5

A

Granular cytoplasmic
Mitochondria in normal hepatocytes, small intestinal epithelium
Hepatocellular diff: HCC (90%), hepatoblastoma, carcinomas with hepatoid phenotype (ovary, testis, stomach)

91
Q

HER2

Her2Neu

A

Membranous and cytoplasmic
GF receptor which is only weakly expressed in normal epithelial cells
Breast CA: overexpression = poor px, can be treated with Herceptin (only membranous reactivity counts)
Increasing use in stomach and GE junction adenoCA
Overexpressed in several non-mammary CA (lung, GYN)

92
Q 
HLA-DR
(MHC class II)
A

Membranous
APCs
Most myeloid leukemias (+) vs APL (-)

93
Q

HMB45

human melanoma, black

A

Cytoplasmic
Immature melanocytes (negative in mature melanocytes)
Epithelioid (not desmoplastic) melanoma
Clear cell sarcoma/melanoma of soft parts, melanotic schwannoma, angiomyolipoma, other PEComas
Melanoma (+) vs nevus (-, progressive diminution as cells mature toward base)
Metastatic melanoma (+) vs benign nevus inclusion (-) in LN

94
Q

HNF-1beta

hepatocyte nuclear factor

A

Nuclear
Hepatocytes
Clear cell carcinoma of gyn tract

95
Q

HSD3B1

A

Cytoplasmic
IT and ST
All trophoblastic tumors

96
Q

hCG

A

Cytoplasmic
Syncytiotrophoblasts
Choriocarcinoma, syncytiotrophoblastic cells in seminoma, some carcinomas

97
Q

hPL

human placental lactogen

A

Cytoplasmic
Trophoblasts (ST and IT)
ST tumors (chorio), IT tumors (placental site tumors), moles

98
Q

IgG4

A

Cytoplasmic
Subset of plasma cells
Increased # in spectrum of inflammatory sclerosing diseases (autoimmune pancreatitis, chronic sclerosing sialadenitis, sclerosing mesenteritis)

99
Q

Ig Kappa and Lambda light chains

A

Surface (B cells), cytoplasmic (plasma cells)
Restricted staining –> monoclonal population
Double negative –> neoplastic (mediastinal DLBCL)

100
Q

Inhibin

INH

A

Cytoplasmic
Granulosa cells, Sertoli cells, adrenal cortical cells, trophoblasts
Adrenocortical neoplasms, sex cord stromal tumors, trophoblastic tumors, hemangioblastoma, granular cell tumor

101
Q

INI1

hsNF5/BAF47

A

Nuclear
Expressed in normal tissues (product of tumor suppressor gene on 22q11.2)
Loss of expression in AT/RT, rhaboid tumor of kidney, epithelioid sarcoma, medullary CA of kidney, epithelioid MPNST (50%), subset of myoepithelial carcinomas of soft tissue

102
Q

Ki67

MIB-1

A 
Nuclear
Any proliferating cell
To gauge mitotic activity for prognosis
Burkitt lymphoma (100% positivity)
Cytoplasmic reactivity in hyalinizing trabecular adenoma, sclerosing hemangioma of lung
103
Q

Langern

A

Membranous and cytoplasmic
Langerhans cells
LCH

104
Q

Lysozyme

muramidase

A

Cytoplasmic
Monocyte/macrophage/histiocyte, salivary gland
Histiocytic diff, myeloid sarcomas with monocytic diff

105
Q

Mammaglobin

A

Cytoplasmic
Breast epithelium, sweat glands
Tumors with apocrine diff (breast cancer, sweat gland tumors, salivary gland tumors), female genital tract
More sensitive but less specific to ID metastatic breast CA

106
Q

MART-1

melanoma antigen recognized by T cells, N2-7C10 clone

A

Cytoplasmic
Melanocytes
Melanoma (mainly epithelioid), more sensitive than HMB45, recognizes same protein as Melan-A ab

107
Q

Mast cell tryptase

MCT

A

Cytoplasmic

Mast cells

108
Q

Melan-A

A103 clone

A

Cytoplasmic
Melanocytes
Epithelioid (not desmoplastic melanoma) and other melanosome containing tumors (clear cell sarcoma/melanoma of soft parts, melanotic schwannoma, angiomyolipoma, PEComa)
Steroid cell tumors (adrenocortical, S/L and granulosa cell)

109
Q

Mesothelin

A

Membranous
Mesothelial cells
Serous ovarian carcinoma, mesothelioma, pancreatic CA

110
Q

MITF

microphthalmia transcription factor

A

Nuclear
Melanocytes
Melanoma and melanocytic tumors, angiomyolipoma
Can stain macrophages!

111
Q

MLH1, MSH2, MSH6, PMS2

mutL homolog 1, mutS homolog 2 and 6, postmeiotic segregation increased 2

A

Nuclear
DNA mismatch repair proteins (present in most cells)
Mutation and loss of expression –> MSI
Lynch syndrome: germline mutations (MSH2, MSH6, PMS2)
Sporadic: promoter hypermethylation (MLH1)
Tumors with defective MMR/MSI-high have distinctive histology and clinical behavior

112
Q

MOC31

A

Membranous
Most epithelial cells
Adenocarcinoma in general
Hepatic adenocarcinoma (primary or met) vs HCC

113
Q

MUC2

A

Cytoplasmic
Normal colon and stomach
Barrett’s mucosa (+) vs intestinal metaplasia of gastric cardia (-)
IPMN (+) vs PanIN (-)

114
Q

MUM1 (IRF4)

multiple myeloma 1; interferon regulatory factor 4

A

Nuclear and cytoplasmic
Various hematolymphoid cells (PCs) and melanocytes
Plasma cell neoplasms, subtyping DLBCL, epithelioid melanoma

115
Q

Myeloperoxidase

A

Cytoplasmic
Enzyme granules in myeloid cells
AML and myeloid sarcoma (chloroma)

116
Q

Myogenin (MGN) and MyoD1

A

Nuclear
TF in regenerating, but not normal, skeletal mm
Skeletal mm diff (rhabdomyoma, rhabdomyosarcoma)

117
Q

Napsin A

A

Cytoplasmic (granular)
Pneumocytes and renal tubular cells
Lung adenoCA, some RCC (papillary), small % thyroid CA

118
Q

NeuN

A

Nuclear
Neurons
Neuronal/ganglion cell tumors

119
Q

Neurofilament

Sm311 = pan-NF, Sm32 = cell body, Sm31 = axons

A

Cytoplasmic
Neurons
Neuronal/ganglion cell tumors, neuroblastic tumors, some NE tumors
Brain infiltration: SM31 may be used to highlight normal axons to help Id permeation of normal brain parenchyma by a glioma or meningioma

120
Q

Neuron Specific Enolase

NSE

A

Cytoplasmic
Neuroectodermal and NE cells
Neural and NE diff but not very specific
Sensitive for neuroblastoma

121
Q

NUT

nuclear protein in testis

A

Nuclear
Germ cells in testis and ovary
NUT midline CA

122
Q

OCT2/BOB.1

A

Nuclear
TF in B cells
RS cells in NLP(+) vs cHL (- or weak)
B cell lymphomas

123
Q

OCT4

OCT3/4

A

Nuclear
not expressed in normal, differentiated cells
Seminoma/dysgerminoma, intratubular germ cell neoplasia, embryonal CA

124
Q

p16

A

Nuclear and cytoplasmic
Cell with inactivated pRb
Cervix: HSIL (+) vs immature metaplasia (-)
Endocervical adenoCA (+) vs endometrial CA (-)
Metastatic SqCC of tonsil, cervix, anus (not specific)
Only strong, diffuse nuclear and cytoplasmic can be used as surrogate for HPV
Serous CA of GYN tract (robustly +) vs endometrioid CA (-)

125
Q

p53

A

Nuclear
TSG, not expressed at high levels in normal cells
Overexpression - negative px marker
Serous CA gyn (+) vs endometrioid CA (- or focal)
Dysplas-assoc lesion or mass (DALM)(+) vs sporadic TA (-)
Urothelial flat CIS (+) vs reactive urothelium(-)
Fallopian tube intraepithelial CA
High grade lymphomas

126
Q

p57

A

Nuclear
Trophoblasts
Complete mole (-) vs incomplete mole (+) and hydropic fetus (+).
Paternally imprinted and is normally transcribed entirely from a maternal allele (absent in complete mole)

127
Q

p63

4A4

A

Nuclear
TSG related to p53, marker of Sq epi, basal and myoep cells
Breast myoepithelial cells (endothelium and myofibroblasts are negative)
Prostate basal cells

128
Q

p120

p120 catenin

A

Membranous and cytoplasmic
E-cadherin-binding protein in breast epithelium
Lobular CA in cases with equivocal E-cad: ductal CA (membranous p120) vs lobular CA (strong cytoplasmic p120 –> no E-cad results in p120 cytoplasmic pool)

129
Q

Parafibromin

A

Nuclear
Protein product of TSG HRPT2, expressed in normal tissue
Loss of expression –> parathyroid CA and parathyroid adenomas of Hyperparathyroidism-Jaw Tumor Syndrome

130
Q

PAX2

paired box gene 2

A

Nuclear
Renal epithelium and tissue of Mullerian origin (not thyroid)
RCC (clear cell and papillary), oncocytoma, nephrogenic adenoma
Superior to CD10 and RCC in specificity and sensitivity
Minority (30%) Mullerian CA

131
Q

PAX5

BSAP, B-cell-specific activator protein, paired box gene 5

A

Nuclear
B-cell specific TF (PCs are negative)
B-cell diff including lymphoblasts (novel pan B-cell marker)
RS in NLPHL (+) vs cHL (weak)

132
Q

PAX8

paired box gene 8

A

Nuclear
Normal thyroid follicles, renal epithelial cells, tissue of Mullerian origin, lymphocytes
Pan-RCC (all types, broader than PAX2), thyroid CA (follicular origin i.e. not medullary), Pan-Mullerian CA, pancreatic NE tumors

133
Q

Placental Alkaline Phosphatase (PLAP)

A

Cytoplasmic
Placenta
Germ cell tumors (not spermatocytic seminoma), intratubular germ-cell neoplasia, trophoblastic tumors

134
Q

PNL2

A

Cytoplasmic
Melanocytes
Melanocytic lesions (new marker); reacitivity similar to HMB45

135
Q

ProExC

A

Nuclear
Cocktail against topoisomerase II alpha and minichromosome maintenance 2, proteins upregulated in cervical CA
New marker that is similar to Ki67 and used together with p16 and/orKi67 or in some combination for differentiating HPV-related lesions from mimickers in the GYN tract

136
Q

Prostein (P501S)

A

Cytoplasmic (perinuclear dots pattern)
Prostatic epithelium
Metastatic prostate cancer. Relatively new marker (similar sensitivity as PSA)

137
Q

PSA

Prostate specific antigen

A

Cytoplasmic
Prostatic epithelium but also salivary gland
Metastatic prostate cancer (80% sensitivity)
PSA reactivity also present in benign and neoplastic salivary gland duct epithelium (PA, mucoEp CA),
Periurethral glands of women, anal glands of men, and glandular urothelium (cystitis glandularis, urachal remnans, urothelial adenoCA)
PSA more specific but les sesnsitive that PSAP

138
Q

PSAP or PAP

Prostate acid phosphatase

A

Cytoplasmic
Prostatic epithelium
Metastatic prostate cancer
(+) in carcinoids and some bladder adenocarcinomas. Be careful not to mistake rectal carcinoid for prostate CA!

139
Q

PSMA

Prostate specific membrane antigen

A

Cytoplasmic, membranous
Prostatic epithelium, urothelium
Metastatic prostate cancer - in contrast to PSA and PSAP, expression does not decrease with tumor grade

140
Q

Racemase

P504S, AMACAR, alpha-methylacyl-CoA reductase

A

Cytoplasmic
Prostatic CA and PIN (normal prostate is negative)
Prostate cancer (+) vs adenosis, other benign mimics (-): - false positive (20%): adenosis, ephrogenic adenoma
- false neg: 20% adenoCA, 65% foamy CA, 65% atrophic CA, 75% pseudohyperplastic CA
Not specific for prostate; also (+) in other CA such as lung, breast, papillary RCC, clear cell adenoCA of bladder

141
Q

RCC

gp200/RTA

A

Cytoplasmic
Proximal renal tubules
RCC (poor sensitivity and specificity)
RCC (+) vs oncocytoma (-)

142
Q

SALL4

A

Nuclear
Embryonic stem cells
Germ cell tumors (pan-germ cell tumor marker)
Some leukemias

143
Q

S100

Solubility in 100% ammonium sulfate

A

Nuclear, cytoplasmic
Schwann cells/glia: schwannoma, NF, MPNST, granular cell tumor, gliomas
Melanocytes: melanoma (including desmoplastic), nevi
Soft tissue: clear cell sarcoma/melanoma of soft parts, synovial sarcoma, chordoma, lipomatous tumors
Histiocytes: benign histiocytosis, Rosai Dorfman, LCH, Langerhans cell sarcoma, some histiocytic sarcomas, interdigitating cell sarcoma, DCs
Myoepithelial cells: myoepithelioma
Other: sustentacular cells (pheo/paraganglioma), other mesenchymal cells
Negative in CA (except 30% breast CA)

144
Q

SF1

steroidogenic factor 1

A

Nuclear
Transcription factor
Sex cord stromal tumors

145
Q

Smooth muslces myosin heavy chain

SMMHC

A

Cytoplasmic
Myoepithelial cells, blood vessels, myofibroblasts
Myoepithelial layer in breast to rule out invasive breast cancer

146
Q

Smoothelin

A

Cytoplasmic
Terminally-diff smooth muscle
Bladder muscularis propria (strong) vs muscularis mucosae (negative or weak) in assessing depth of invasion in bladder CA

147
Q

SOX2

sex determining region of Y chromosome-related high mobility group box2

A

Nuclear
Fetal CNS tissue
Embryonal CA, PNET in teratoma

148
Q

SOX9

A

Nuclear
Normal cartilage - acts as master regulator of chondrogenesis
Cartilagenous differentiation, but not specific

149
Q

SOX10

A

Nuclear
Melanocytes, Schwann cells, myoepithelial cells
Melanoma, clear cell sarcoma, nerve sheath tumors, pheo/paraganglioma (sustentacular cells), carcinoid tumors (about 50%)

150
Q

SOX11

A

Nuclear
CNS (normal staining not well known yet)
New marker for mantel cell lymphoma

151
Q

Spectrin

A

Membranous
RBCs and precursors
AML with erythroid diff

152
Q

Surfactant protein A

PE10

A

Membranous, cytoplasmic
Pneumocytes
Complements TTF-1 in ID of lung carcinoma (but Napsin A is a much more sensitive marker for this role)

153
Q

Synaptophysin

SYN, secretogranin

A

Cytoplasmic
NE cells, neuronal cells, NMJ, Merkel cells
NE neoplasms, primitive neuroectodermal tumors (neuroblastoma, medulloblastoma, PNET/Ewing), neuronal tumors (ganglioglioma)
Adrenocortical tumors and pancreatic solid-pseudopapillary tumor

154
Q

Synuclein

A

Lewy bodies
Brain
Parkinson’s and Lewy body dementia

155
Q

Tau (AT8)

A

Cytoplasm
Brain
Neurofibrillary tangles in AD

156
Q

TdT

terminal deoxytransferase

A

Nuclear
Immature B and T lymphocytes
Precursor B and T L/L (+) vs lymphoma of mature cells, including Burkitt (-). Myeloid blasts are generally TdT negative but can occasionally be (+)
Thymoma (admixed immature T cells are TdT, CD1a, CD99+)

157
Q

TFE3

A

Nuclear
TF, reactivity in normal tissue extremely rare
Xp11-translocation RCC, alveolar soft part sarcoma, subset of renal angiomyolipomas

158
Q

TFEB

A

Nuclear
TF, reactivity in normal tissue extremely rare
(6;11)-translocation RCC

159
Q

Thyroglobulin

TGB

A

Cytoplasmic
Thyroid follicles
CA of thyroid follicular origin (papillary and follicular)

160
Q

Thrombomodulin

CD141

A

Cytoplasmic and membranous
Endothelial (cytoplasmic) and mesothelial (membranous) cells
Urothelial CA, mesothelioma (2nd line), some vascular tumors

161
Q

TLE1

A

Nuclear
TF whose gene was discovered to be upregulated in gene expression profiles of synovial sarcoma
Synovial sarcoma (can be focal in schwannoma, SFT)

162
Q

TTF-1

thyroid transcription factor 1

A

Nuclear
TF in lung and thyroid
Thyroid CA (follicular, papillary, medullary)
Lung adenoCA (80%+) vs extra-pulm adenoCA (-, with the exception of 20% of gyn CA of various types)
Poorly diff lung adenoCA (80%+) vs SqCC (-)
Lung adenoCA (+) vs mesothelioma (-)
Lung carcinoid (50%, usually weak) vs extra-pulm well-diff NE tumors
SCC: lung (90%), and extra-pulm (overall 44%: prostate 58%, bladder 34%, cervix 20%)
HCC (+) for cytoplasmic TTF-1

163
Q

Trypsin and chymotrypsin

A

Cytoplasmic
Pancreatic acinar cells
Pancreatic acinar cell CA (+) vs NE tumor and adenoCA (-)

164
Q

Uroplakin

A

Cytoplasmic
Urothelium
Urothelial CA - specific, but not very sensitive

165
Q

Villin

A

Cytoplasmic (“brush border” pattern)
Enterocytes
Intestinal diff in CA of unknown primary (any tumor with enteric diff).
Similar specificity but lesser sensitivity than CDX2

166
Q

Vimentin

A

Cytoplasmic
Most mesenchymal cells including fibroblasts, endothelium, smooth muscle
Sarcoma, lymphoma, and melanoma (+) vs CA and glioma (-)
Clear cell RCC (+) vs chromophobe RCC and oncocytoma (-)
Bladder muscularis mucosa (+) vs muscular propria (-): used in conjunction with smoothelin, which has the opposite pattern
Because of wide reactivity currently used mainly to confirm “immunoviability” of tissue

167
Q

WT1

Wilms Tumor 1

A

Nuclear
TSG in developing nephrons, nephrogenic rests and adult glomerular podocytes. Also stains normal and neoplastic meothelium.
Mesothelioma (+) vs adenoCA (-), Wilms tumor, desmoplastic small round cell tumor, ovarian serous CA (80%)

Immunostains (1 decks)

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