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QIHC maryjw79 @ gmail email 4 access > IHC > Flashcards

IHC Flashcards

1
Q

GFAP

A

Cytoplasmic and cell processes of astrocytes

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2
Q

Nestin

A

intermediate filament in embryonic nerve cells and hair follicle stem cells (can differentiate into multiple types of cells), proliferating new endothelial cells. Cytoplasm.

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3
Q

Synaptophysin

A

Neuroendocrine: Adrenal medulla, neuronal cells, neuroendocrine cells, pineal gland. Membrane and cytoplasm (integral membrane protein and pre-synaptic vesicles)

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4
Q

Vimentin

A

intermediate filament of mesenchymal cells; cytoplasm

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5
Q

Neurofilament

A

Neurons; cytoskeletal component of axons and dendrites

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6
Q

SOX-10

A

Transcription factor; neural crest derived tissues; expressed by melanocytes, mammary myoepithelial cells and Schwann cells. Melanoma & neural crest marker!

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7
Q

TTF-1

A

Thyroid Transcription Factor 1; found in the nucleus only! Thyroid, lung and diencephalic brain (thalamus/hypothalamus/pineal/pituitary) structures.

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8
Q

Chromogranin

A

secretory vesicles of neuroendocrine cells; Adrenal medulla (chromaffin cells), heart AV node, pancreas (islets), parathyroid (chief cells), thyroid (C cells)

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9
Q

Desmin

A

Intermediate filament in cardiac, smooth and skeletal muscle (GISTs are negative)

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10
Q

CD31/PECAM

A

PECAM; Membranous expression! Endothelial cells at cell junctions, megakaryocytes, pericytes, platelets, brown fat, trophoblasts, fibroblasts, spermatozoa, surface of platelets, monocytes, neutrophils and some types of T cells. key role in leukocyte trafficking across endothelium

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11
Q

Calponin

A

Actin-filament associated protein; Smooth muscle, myoepithelial cells, myofibroblasts, keratinocytes and nerve fibers

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12
Q

Alkaline Phosphatase

A

sarcoplasm of regenerating myofibers and cytoplasm of arteriole endothelial cells (not capillaries)

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13
Q

CD79a

A

B cells / B cell origin (with CD20) including plasma cells. May be positive when CD20 is negative.

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14
Q

CD20

A

B cells (not plasma cells)

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15
Q

CD45

A

also called leukocyte common antigen; NUCLEATED HEMATOPOIETIC CELLS (so not RBC’s, megakaryocytes or PLT’s).

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16
Q

CD18

A

leukocyte adhesion protein (deficiency leads to LAD); Neutrophils, macrophages, monocytes, NK cells and basophils

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17
Q

CD3

A

Thymocytes, peripheral T cells, NK cells (early cytoplasmic staining, then membranous)

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18
Q

c-KIT

A

AKA CD 117; proto-oncogene activated in GISTs and Mast Cell Tumors; cytoplasmic expression. Also found in interstitial cells of Cajal, hematopoietic progenitor cells, melanocytes, embryonic/fetal brain, endothelium, gonads, breast epithelium, germ cells.

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19
Q

S-100

A

show nerve sheath involvement (i.e Schwann cell) or melanocytic origin; neurons, myoepithelial cells, adipocytes, langerhans/ tissue and interdigitating dendritic cells, chondrocytes and notochord

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20
Q

PNL-2

A

melanocytes; cytoplasm

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21
Q

Melan-A

A

AKA MART1; cytoplasm. Anything that forms melanosomes.

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22
Q

DOG-1

A

GISTs only. Discovered On Gists 1. Membrane & cytoplasm.

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23
Q

Ki67

A

proliferation index during G1, S, G2 and M phases of cell cycle. Not found in G0 and early G1. Nuclear stain is the only one that “counts”.

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24
Q

CK AE1/AE3

A

Epithelial cells and trophoblasts; Detects CK1-8, 10, 14-16 and 19

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25
Q

CK 34BE12

A

Squamous, transitional and some ductal epithelium

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26
Q

CK5/6

A

Mammary myoepithelial cells, cornea, mesothelium, basal epithelium

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27
Q

CK 7

A

Glandular and transitional epithelium

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28
Q

CK 8/18

A

Carcinomas of epithelial origin and mesotheliomas

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29
Q

CK 20

A

Gastric, intestinal, urothelial epithelium and Merkel cells

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30
Q

Doublecortin

A

neurons

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31
Q

E-cadherin

A

decreased in carcinoma

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32
Q

Argyrophilic Nucleolar Organizer Region (AgNOR)

A

Proliferation marker; increased nucleolar silver stained dots increases the potential for malignancy

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33
Q

Calretinin

A

Adipocytes, mesothelial cells, endometrial stroma, Leydig cells, mast cells, nerves, ovarian theca cells, Sertoli cells

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34
Q

HMB-45

A

Melanocytes

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35
Q

Iba-1

A

Macrophages/histiocytes/microglia

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36
Q

Inhibin

A

Sertoli cells, granulosa cells, prostate, brain, adrenal gland

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37
Q

Laminin

A

Basement membrane

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38
Q

Tyrosinase-related protein-1 (TRP1) and 2 (TRP2)

A

melanocytes

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39
Q

Uroplakin I, II, III

A

urothelium

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40
Q

WT-1 (Wilms tumor)

A

Nephroblastoma

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41
Q

Luminal A

A

ER (+)
PR (+)
HER2 (-)

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42
Q

Luminal B

A

ER (+)
PR (+)
HER2 (+)

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43
Q

HER2

A

ER (-)
PR (-)
HER2 (+)

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44
Q

Basal-like

A

ER (-)
PR (-)
HER2 (-)

Perform CK5/6 and EGFR to define more precisely tumors in basal-like group

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45
Q

Luminal

A

Molecular category of Breast cancer with high expression of hormone receptors and associated genes (luminal A > luminal B)

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46
Q

HER2

A

Molecular category of breast cancer with high expression of HER2 and other genes in amplicon. Low expression of ER and associated genes.

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47
Q

Basal-like

A

Molecular category of breast cancer with high expression of basal epithelial genes, basal cytokeratins; low expression of ER and associated genes; low expression of HER2.

BRCA1-associated cancers

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48
Q

Carcinoma

A

PanCK (+)
LCA (-)
S100/HMB45/MART-1 tyrosinase (-)
Desmin (-)
Vimentin (-)

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49
Q

Lymphoma

A

PanCK (-)
LCA (+)
S100/HMB45/MART-1 tyrosinase (-)
Desmin (-)
Vimentin (-)

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50
Q

Melanoma

A

PanCK (-)
LCA (-)
S100/HMB45/MART-1 tyrosinase (+)
Desmin (-)
Vimentin (+)

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51
Q

Sarcoma

A

PanCK (-)
LCA (-)
S100/HMB45/MART-1 tyrosinase (-)
Desmin (+)
Vimentin (+)

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52
Q

Desmin, HHF35, SmActin

A

Smooth muscle

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53
Q

Myoglobin

A

Skeletal muscle

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54
Q

CD68, Factor XIIIa

A

Fibrohistiocyte

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55
Q

Leu7, GFAP

A

Nerve sheath

56
Q

Factor VIII, CD34, CD31

A

Endothelial, perivascular

57
Q

LCA, CD3, CD20

A

Hematopoietic

58
Q

NSE, Chromogranin

A

Neuroendocrine

59
Q

MIC-2(O-13), CD99

A

Ewing’s sarcoma/PNET

60
Q

Lung lesion showing mostly isolated small cells with pyknotic nuclei. What is the diagnosis?

A

Lymphoma: CK(-) LCA (+)

Small cell cancer: CK(+) LCA(-)

61
Q

What is the diagnostic approach to Metastatic Carcinoma of Unknown Primary?

A
  1. Find the cell line of differentiation using major lineage markers
  2. Find the CK type distribution in tumor cells
  3. Find if there is co-expression of vimentin
  4. Find if there is expression of supplemental antigen of epithelial or germ cell derivation (CEA, EMA, PLAP)
  5. Find if there is expression of cell-specific products, cell-specific structures or receptors that are unique identifiers of cell types (GCDFP, PSA, TTF-1)
62
Q

CK7+/CK20+

A

Transitional cell carcinoma

Pancreatic carcinoma

Ovarian mucinous carcinoma

50% of gastric CA

63
Q

CL7-/CK20+

A

Colorectal adenocarcinoma

Merkel cell carcinoma

64
Q

CK7+/CK20-

A

Non-small cell cancer of the lung

Small cell cancer of the lung

Breast cancer, ductal and lobular

Nonmucinous ovarian cancer

Endometrial adenocancer

Mesothelioma

Squamous cell cancer of the cervix

65
Q

CK7-/CK20-

A

Squamous cell cancer of the lung

Prostate adenocancer

Renal cell cancer

Hepatoma

Thymus

66
Q

Prostate (MCUP)

A

PSA
Se 100
Sp 99

67
Q

Lung (MCUP)

A

TTF-1
Se 91
Sp 98

68
Q

Colon

A

CDX-2
Se 83
Sp 96

CK20
Se 68
Sp 91

69
Q

Colon and stomach

A

CDX-2
Se 56
Sp 98

70
Q

Colon, stomach, pancreas

A

CK20
Se 36
Sp 97

71
Q

Breast

A

GCDFP-15
Se 54
Sp 96

72
Q

Breast and ovary

A

ER
Se 74
Sp 95

73
Q

Ovary and pancreas

A

CA 125
Se 88
Sp 88

Mesothelin
Se 85
Sp 85

74
Q

Stomach and pancreas

A

Lysozyme
Se 65
Sp 69

CK 7
Se 72
Sp 96

75
Q

Work-up lineage for lymphoma

A

CD20+: B cell lymphoma

CD3+: T cell or NK cell lymphoma

CD20-/CD3-: nonhematolymphoid, plasmacytoma, anaplastic lymphoma, t cell lymphoma, lymphoblastic lymphoma

76
Q

TdT

A

Important markers for classifying lymphomas:

Precursor lymphoblastic lymphoma

77
Q

CD5, CD23

A

Important markers for classifying lymphomas:

Chronic lymphocytic lymphoma

78
Q

Cyclin D1 (aka BCL-1 and PRAD): nuclear positivity

A

Important markers for classifying lymphomas:

Mantle cell lymphoma

79
Q

CD10 (or BCL-6)

A

Important markers for classifying lymphomas:

Follicular lymphoma

80
Q

Ki67 (~100% proliferation index)

A

Important markers for classifying lymphomas:

Burkitt lymphoma

81
Q

CD10, follicular dendritic cell markers (extrafollicular meshworks)

A

Important markers for classifying lymphomas:

Angioimmunoblastic T cell lymphoma

82
Q

CD30, ALK

A

Important markers for classifying lymphomas:

Anaplastic large cell lymphoma

83
Q

Biomarkers in prostate CA

A

PSA - cytoplasmic expression in glandular epithelium

Basal cell markers - p63, HMW-CK
Alpha-methyl-CoA racemase (AMACR) - recently identified as being overexpressed in prostatic adenocarcinoma (80%)

84
Q

GCDFP-15

A

Gross cystic disease fluid protein - 15

85
Q

IHC panel of small round cell tumors in children

A

CK - carcinoma

LCA - lymphoma

Desmin - rhabdomyosarcoma

CD99 - Ewings sarcoma/PNET

86
Q

IHC panel of small round cell tumors in adults

A

CK - carcinoma

LCA - lymphoma

Vimentin, S100 - sarcoma

Chromogranin/Synaptophysin - PNET

87
Q

IHC panel of endometrial and endocervical, primary

A

Both: CK7(-)/CK20(+)

Endocervical: p16, CEA

Endometrial: vimentin, ER

88
Q

IHC panel in subclassification of the most common lung cancers

A

SCCA: p63, CK5/6, CK7(-)

AdenoCA: TTF-1, CK7(+)

Small cell: chromogranin/synaptophysin, variable CK positivity

89
Q

IHC panel of atypical small acinar proliferation in prostate biopsy cases.

A

AMACR

Myoepithelial markers: p63, 34BA12 or HMWCK, SMA

90
Q

IHC panel of DCIS vs Invasive Ductal Carcinoma breast biopsy cases

A

Myoepithelial markers: p63, actin, SMA

CK5/6: (+)ADH with low grade DCIS

91
Q

IHC panel of mature B cell neoplasm

A

Follicular lymphoma: Bcl-2

MALT: cytokeratin
3
4
5

92
Q

IHC panel in differentiating HL from NHL

A

LCA
CD30: golgi and cytoplastmic membrane
CD15: golgi and cytoplasmic membrane
CD20
CD3
Fascin (cytoplasmic expression in HL)

93
Q

IHC panel in differentiating lung, thyroid, hepatocellular, primary.

A

Thyroid:
CK7+/CK20-
TTF-1(+): nuclear
TGB(+): cytoplasmic

Lung:
CK7+/CK20-
TTF-1(+): nuclear
TGB(-): cytoplasmic

Liver:
CK7-/CK20-
AFP: poorly diff hepatocellular CA
Hepar-1: well to mod diff hepatocellular CA

94
Q

Pattern of bcl-2 expression in reactive lymphadenopath

A

Interfollicular and paracortical

95
Q

Pattern of bcl-2 expression in follicular lymphoma

A

Within the follicles

96
Q

CD56 (NCAM)

NSE

A

Olfactory neuroblastoma

97
Q

Medium-sized lymphoma

A

Lymphoblastic lymphoma: TdT

Follicular lymphoma

98
Q

Positive for HMB-45

A

Epitheloid angiomyolipoma

Melanoma

99
Q

RCC, CD10

A

Renal cell CA

100
Q

CD19

A

The earliest IHC marker for B-lineage differentiation.

101
Q

CD20

A

Acquired late in pre-B-cell stage of maturation; lost at the plasma cell stage.

102
Q

CD20: cytoplasmic staining

A

Strongly positive: half of lymphoblastic lymphoma/leukemia; all mature B-cell lymphomas; Reedsternberg cells in 1/4 cases of HL

103
Q

CD21

A

IHC marker found in follicular dendritic cells and some B lymphocytes; helps identify the hyperplastic islands of dendritic cells in angioimmunoblastic T-cell lymphoma.

104
Q

CD22

A

IHC marker strongly expressed in hairy cell leukemia.

105
Q

CD23

A

IHC marker that is most useful in distinguishing B-cell CLL/SLL from other entities and remains present in CLL/SLL that has undergone large cell transformation.

106
Q

CD79a

A

Expressed in nearly all of the assayed precursor B-cell lymphoblastic lymphoma/leukemias, with no T-cell staining. Also positive in mature B-cell lymphomas.

107
Q

DBA.44

A

Strongly stains the cytoplasm of most hairy cell leukemias, marginal zone lymphomas, and large cell lymphomas

108
Q

CD2

A

IHC marker for early T-cell antigen in a normal lymph node.

109
Q

CD3 (cell membrane

A

Positive with most T-cell lymphomas except anaplastic large cell lymphomas and NK leukemias/lymphomas. Very specific for T-cell derivation.

110
Q

CD4

A

It interacts with HLA class II during antigen recognition, and defines a helper-inducer subset of T cells. Expressed in most mature T-cell lymphomas.

111
Q

CD5

A

Detectable on the surface of most thymocytes and immature peripheral T cells and in a small subset of circulating B cells. Primarily used in the detection of B cell CLL/SLL and mantle cell lymphoma.

112
Q

CD7

A

It has the distinction of being the most frequently lost T-subset marker in malignancies, particularly on mycosis fungiodes.

Also present on non-T-cell malignancies, including NK tumors and AML

113
Q

CD8

A

This antigen defines the suppressor/cytotoxic T-cell subset

114
Q

t(2;5)

A

Anaplastic large cell lymphoma

115
Q

t(11;14)

A

Mantle cell lymphoma

116
Q

Cyclin D1 (aka BCL-1 and PRAD 1): nuclea

A

Hallmark of mantle cell lymphomas. Weaker signal in hairy cell leukemia and plasmacytoma.

117
Q

t(14;18)

A

Follicular lymphoma

118
Q

Found in app 3/4 of cases of follicular lymphoma.

A

BCL-2: stains malignant follicles

Reversed pattern in lymph nodes exhibiting follicular hyperplasia

119
Q

BCL-2

A

Normally present in the cytoplasm of follicular mantle B lymphocytes, occasional germinal center cells, and many T lymphocytes

120
Q

BCL-6

A

Expressed normally in germinal center lymphocytes.

Expressed in a variety of B-cell neoplasms. Also detected in L&H variants of nodular lymphocyte predominant Hodgkin disease.

121
Q

CD1a

A

Ag associated with beta 2 macroglobulin. Found in a subset of precursor T-lymphoblastic lymphoma/leukemia.

122
Q

CD10 (CALLA)

A

Almost always present on the surface of precursor B lymphoblastic and Burkitt’s lymphomas, many FL and some DLBCL along with MM

123
Q

CD15

A

X hapten or Lewis X antigen

124
Q

CD15: membranous with a paranuclear dot-like Golgi localization

A

Marker for RS cells of classical HL. Also used to stain adenocarcinomas.

125
Q

CD25

A

IL-2 receptor. Expressed on hairy cell leukemia and adult T-cell leukemia/lymphoma.

126
Q

Burkitt’s lymphoma

A

Ki-67 index (nuclear staining)

127
Q

Follicular lymphoma

A

BCL-2 positivity in enlarged follicles

128
Q

Reactive hyperplasia

A

BCL-2 positivity around follicles

129
Q

TdT

A

Almost always present in the nucleus of lymphoblastic lymphoma cells

130
Q

CD20+

BCL-2+

A

Mantle cell lymphoma
Follicular lymphoma
Some marginal zone lymphoma

131
Q

B-CLL/SLL vs Mantle cell lymphoma

A

B-CLL/SLL:
CD23 (+)
Cyclin D1 (-)

Mantle cell lymphoma:
CD23 (-)
Cyclin D1 (+)

132
Q

B-CLL/SLL vs Follicular lymphoma

A

B-CLL/SLL:
CD10 (-)
CD5/CD43 (+)

133
Q

ZAP-70

A

Predicts poor outcome in B-CLL

134
Q

Mature B lymphocytes vs plasma cells

A

Mature B lymphocytes:
CD45RB (+)
CD20 (+)

135
Q

BCL-2

A

Sensitive for follicular lymphoma but not specific

QIHC maryjw79 @ gmail email 4 access (16 decks)

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