Ch. 1 - IHC Flashcards
What enzyme reaction forms the basis of IHC?
Diaminobenzidine method (DAB): Visualizes presence of enzyme-antibody-antigen complex fixed to tissue as a stable brown product. 3-amino-9-ethylcarbazole (AEC) can be used for red staining (does not archive as well).
CK polyclonal keratin (pankeratin)
Polyclonal cocktail that offers greater sensitivity than AE1/AE3.
p63
Expressed in basal and spinous cells of epidermis, germinative cells of sebaceous glands, and myoepithelial cells of sweat glands.
Useful in distinguishing cutaneous origin of spindle cell neoplasms.
CK7
In general, a marker of non-GI adenocarcinomas. Also marks Paget’s.
CK20
Marker of GI adenocarcinoma and merkel cell carcinoma (paranuclear dotting).
AE1/AE3
High and low weight keratins. Stains all epithelial tumors as well as epithelioid sarcoma, synovial sarcoma, and mesothelioma.
CAM5.2
Detects LWMK of glandular neoplasms but not epidermis. Marks Paget’s.
CDX2
Marker of intestinal adenocarcinoma (usually metastatic CRC)
EMA
Highlights normal sebaceous and sweat glands. Positive in sebaceous, squamous cell carcinomas and Paget’s. Negative in BCC.
CEA
Marks sweat glands. Positive in most adenocarcinomas…
Adipophilin
Expressed in lipid droplets of sebaceous and xanthomatous lesions.
Can distinguish sebaceous carcinoma from SqCC/BCC
Ber-EP4
Marks epithelia except those undergoing squamous differentiation.
Positive in BCC, not SqCC.
Desmin
SMA
Desmin: Stains skeletal and most smooth muscle (not vascular smooth muscle)
SMA: Stains smooth muscle, including vascular smooth muscle (and glomus cells)
CD34
Marker of vascular endothelium and hematopoietic progenitor cells.
Positive in DFSP but not DF. Positive in spindle cell, sclerotic fibroma, SFT, and many others.
Factor XIIIa
Highlights dermal dendritic cells.
Positive in DF but not DFSP. Positive in fibrous papule of the face.
CD31
More specific vascular marker than CD34
D2-40 (podoplanin)
Lymphatic endothelial marker.
For detecting LVI and mets (nonreactive vs primary)
UEA (Ulex europeus agglutinin)
Binds vascular endothelium
GLUT1 (glucose transporter)
Expressed in endothelial cells with blood-tissue barrier function.
Positive in infantile hemangiomas (but not AVMs), also stains perineural cells.
Vimentin
Stains almost everything but epithelium.
General marker of sarcomas and excludes most carcinomas (except synovial sarcoma and rare spindle cell carcinomas)
S100
Neural-crest and some mesenchymal lines. Melanocytes, langerhans cells, sweat glands, neural tissue, myoepithelial cells…
Useful in ddx of spindle cell neoplasms