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Stains Flashcards

1
Q

Stains for histiocytes/ Fibrous Histiocytoma:

A

α1 antichymotrypsin-­‐ histiocytes, Fibrous Histiocytoma

CD1a-­‐ for Langerghans cells of Langerhans Cell Disease (Langerin is better)

CD32-­‐ for Fibrous Histiocytoma

CD43-­‐ T cells, histiocytes CD45RO-­‐ T cells, histiocytes

CD68-­‐ Macrophages, histiocytes (Fibrous Histiocytoma) and lysosomes of Granular Cell Tumor

CD163-­‐ monocyte/ macrophage lineage Factor XIIIa

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2
Q

Stains for vascular markers/ vascular tumors:

A

Bcl-­‐2-­‐ Solitary fibrous tumor
CD31-­‐ endothelial cells
CD34-­‐ Solitary Fibrous Tumor, Hemangiopericytoma, (also: Dermatofibrosarcoma Protuberans) CD99-­‐ + in Solitary Fibrous Tumor
Factor VIII

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3
Q

Lymphoma/ Leukemia Stains:

A

CD3-­‐ T cell
CD5-­‐ T cell, mantle cells, B-­‐CLL/ B-­‐SLL
CD10-­‐ T cell, follicular B cells, Follicular Lymphoma, Burkitt Lymphoma (myc translocation t(8;14))
CD15-­‐ Hodgkin’s Disease (R/S cell)
CD19-­‐ B cells
CD20-­‐ B cells (NOT plasma cells); “popcorn cell” in Hodgkin’s
CD22-­‐ B cells but NOT plasma cells (like CD20), good for B cell neoplasms
CD23-­‐ B cells, follicular dendritic cells, + in B-­‐CLL/ B-­‐SLL.
CD30-­‐ R/S cell, activated B and T cells CD43-­‐ T cells, histiocytes (+ in B-­‐CLL/ B-­‐SLL) CD45 (LCA)-­‐ RA-­‐ B cells
RB-­‐ All leukocytes, but NOT plasma cells (+ in leukemias and lymphomas) RO (UCHL1)-­‐ T cells, histiocytes, myeloid cells (good for T cell neoplasms)
CD56-­‐ NK T cell sinonasal lymphomas (Midline Lethal Granuloma), which can also be EBV+ (???) CD70-­‐ R/S cell
CD79a-­‐ B cells, including plasma cells; “popcorn cell” in Hodgkin’s
CD86-­‐ R/S cell

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4
Q

Some Specific Leukemias/ Lymphomas: (everything is Bcl-­‐2 pos. except the “Ms”-­‐ Mantle and MALT.

A

BCLL (B cell chronic lymphocytic leukemia) /SLL (Small lymphocytic lymphoma)-­‐ CD5, 23, 43, Bcl-­‐2

Mantle cell lymphoma-­‐ CD5, 20, 43, 79a, Cyclin D1, Bcl-­‐1 (t(11(Bcl-­‐1);14(IgH))-­‐ juxtaposition of Bcl-­‐1 w/ IgH promoter)

Marginal Zone (MALT Lymphomas)-­‐ CD20, 21, 22 (they’re neg. for CD10) (also CD, 35, and 79a. Ki-­‐67 is mostly neg.); histologically, they appear as medium-­‐sized “monocytoid” cells (B cells) with “crinkled” nuclei and clear or pale staining cytoplasm (t(11;18)).

Follicular-­‐ CD10, 20, 22, 23, Bcl-­‐2 (also CD19, and 79a) (t(14;18-­‐ the juxtaposition of Bcl-­‐2 (on 18) w/ the IgH promoter(on 14)

Diffuse B cell-­‐ CD20, Bcl-­‐2, Bcl-­‐6 (on chromo 3 (???) for some), t(14(IgH);18(Bcl-­‐2))

ALCL (Anaplastic large cell lymphoma)-­‐ CD3, 30, Bcl-­‐2 (and CD2 and 4, which are T cell markers), also + for the ALK protein (t(2(ALK);5), creating the NPM-­‐ALK fusion protein)

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5
Q

Unknown Lymphoproliferative Panel:

A

CD45
CD3, 5, 43 for T Cells (and CD56 for NK cell neoplasm)
CD20 and 79 for B Cells
CD10, Bcl-­‐2 for follicular lymphoma
CD15, 30 for R/S cells
CD68 for histiocytes
CD20, 23 for dendritic cells
Κ and λ for clonality

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6
Q

Follicular Dendritic Cells:

A

CD21
CD23 (also + in B-­‐CLL/ B-­‐SLL)
CD35
all are + in follicular dendritic cell sarcoma

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7
Q

Keratins:

A

AE1, AE3: low molecular weight keratins (Spindle Cell Carcinoma)
CAM 5.2: low molecular weight keratin (Spindle Cell Carcinoma, Oat Cell Carcinoma of the Lung)
CK7: pos. in sinonasal or lung mets, negative in GI or Merkel Cell Carcinoma
CK20: neg. in sinonasal or lung mets, + in GI, Merkel Cell Carcinoma
CK14: oncocytic tumors

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8
Q

Myoepithelial markers

Myoep cells

A

Smooth muscle actin + S-­‐100 +
Calponin + Calponin +
p63 (variable) EMA +
GFAP + Ker +
…combined with cytokeratin positivity

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9
Q

Myoepithelial markers:

Myoep tumors

A

S-­‐100 +
Calponin +
EMA +
Ker +
SMA (variable, maybe lower)

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10
Q

AE1: Low molecular weight keratin
AE3: Low molecular weight keratin

Kermix (pancytokeratin)

A

Kermix (pancytokeratin)Low molecular weight keratin (seen in spindle cell carcinoma).
Two stains - Kermix (pancytokeratin)

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11
Q

Actin

A

smooth muscle-­‐ leiomyoma;

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12
Q

AFB (Fite, Ziehl-­‐Neelson):

A

Acid fast bacilli-­‐ mycobacteria (TB, Leprosy).

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13
Q

Alcian Blue

A

Acidic mucopolysaccharides (stains them blue).

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14
Q

Bcl-­‐1

A

Mantle cell lymphoma (along with Cyclin-­‐D1).

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15
Q

Bcl-­‐2

A

T and B-­‐Cells, follicular lymphoma, solitary fibrous tumor.

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16
Q

Ber-­‐EP4

A

+ in basal cell carcinoma, -­‐ in ameloblastoma

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17
Q

C3

A

stains at the basement membrane in lupus.

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18
Q

Calponin

A

: Smooth muscle specific proteins (good for myoepithelial cells).

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19
Q

CAM5.2

A

Low molecular weight keratin (seen in spindle cell carcinoma, oat cell carcinoma of the lung,
other cell types of epithelial origin) (it’s actually Ker 8 and 18).

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20
Q

C-­‐ANCA

A

Cytoplasmic Anti-­‐Neutrophil Cytoplasmic Antibodies-­‐ test for Wegener’s Granulomatosis (also P (perinuclear)-­‐ANCA.

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21
Q

CDX2

A

: Intestinal epithelium; intestinal adenocarcinoma.

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22
Q

CD1a

A

Langerhan’s cell histiocytes.

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23
Q

CD3

A

T-­‐Cell specific, + in ALCL.

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24
Q

CD4:

A

Mycoses fungoides, angioimmunoblastic T-­‐cell lymphoma

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25
CD5:
T-­‐Cells, mantle cells, + in B-­‐CLL/ B-­‐SLL along with CD23; + in Mantle cell lymphoma (NOT + in MALT Lymphoma).
26
CD10 (a.k.a. CALLA):
T-­‐Cells, follicular center B-­‐Cells (+ in Follicular Lymphoma, -­‐ in mantle cells); + in Burkitt Lymphoma (t(8;14), the myc translocation); also good for Renal cell ca.
27
CD11c CD25 CD103
Hairy cell leukemia.
28
CD15/30:
Hodgkin lymphoma (Reed-­‐Sternberg cell).
29
CD19:
B-­‐Cells.
30
CD20 (Leu-­‐26):
Pan B-­‐Cell marker (not plasma cells), “popcorn cell” in Hodgkin’s Lymphoma (a non-­‐ classical R/S cell that’s – for CD15&30 and + for CD19, 20, 22, 79a and Bcl-­‐6), + in MALT Lymphoma.
31
CD22:
B cells but NOT plasma cells (like CD20), good for B cell neoplasms; + in MALT.
32
CD31:
Endothelial cells (better for angiosarcoma than CD34).
33
CD32:
Stain for fibrous histiocytoma.
34
CD34:
Endothelial cells/ vascular marker, pos. in Solitary fibrous tumor (also Bcl-­‐2), Hemangiopericytoma and Dermatofirosarcoma protuberans. It’s neg. in BFH. Also, pos. in spindle cell lipoma (Δ16q13).
35
CD45:
Leukocyte Common Antigen (LCA)-­‐ CD45RA: B-­‐Cells; CD45RB : All leukocytes, NOT plasma cells, + in leukemias and lymphomas. CD45RO (UCHL1): T-­‐Cells, histiocytes, lymphoid cells (good for T cell neoplasms); classic R/S cells are CD45 negative; + in “popcorn cells” (a. k. a. L&H cells) of Nodular lymphocyte-­‐predominant Hodgkin’s Disease (NLPHD).
36
CD56:
NK T-­‐cell sinonasal lymphomas (midline lethal granuloma-­‐ also can use Granzyme B), which can be EBV + ; also, some cells of MNETI.
37
CD68:
Macrophages, histiocytes, osteoclast-­‐like giant cells (stains lysosomes, Granular Cell Tumor) CD70: Reed-­‐Sternberg cell.
38
CD79a:
“popcorn cell” in Hodgkin’s Lymphoma, B cells (including plasma cells); + in Mantle cell lymphoma and Follicular lymphoma.
39
CD86:
Reed-­‐Sternberg cell.
40
CD99
(HBA71; the MIC-­‐2 gene product): Ewing’s sarcoma (Primitive neuroectodermal tumor, translocation 11:22), synovial sarcoma (translocation X:18), SFT, HPC, mesenchymal chondrosarcoms (NOT chordoma)
41
CD117 (c-­‐kit, PDGFRα):
+ in GIST; pos. in Adenoid cystic ca., neg. in PLGA like for CD43).
42
CD138: .
Plasmablastic Lymphoma (seen in HIV), plasmacytoma
43
CD163:
Monocyte/ macrophage lineage (histiocytes); pos. in BFH, neg. in DFSP.
44
CD207
Langerhans cells (Langerhans cell histiocytosis).
45
Chromogranin
Neurendocrine lesions (not specific without other neurendocrine markers).
46
CK7
sinonasal or lung mets (CK7+/CK20-­‐), + in synovial sarcoma (along with AE1, AE3 and CK1); + in many salivary gland tumors like myoepithelioma.
47
CK20
Merkel cell tumor, colon cancer-­‐ good for checking for metastatic disase (CK7-­‐/CK20+).
48
Congo Red
Amyloid (apple green birefringence in polarized light).
49
Crystal Violet
Amyloid (metachromatic).
50
Cyclin-­‐D1:
Mantle cell lymphoma. (also BCL-1)
51
Cytokeratin:
Positive in SCC, myoepithelial cells (which are calponin and sma +). Desmin: Stain for mesenchymal cells (good for skeletal and smooth muscle; negative in myofibromatosis).
52
Desmin:
Stain for mesenchymal cells (good for skeletal and smooth muscle; negative in myofibromatosis).
53
EBER-­‐1:
EBV (ISH method)
54
EMA:
Epithelial Membrane Antigen-­‐ stains nerve sheath (with S-­‐100 indicates a nerve sheath tumor).
55
Estrogen receptor:
breast carcinoma
56
Factor VIII:
Endothelial cell stain.
57
Factor XIIIa:
Stain for BFH (benigh fibrous histiocytoma) Neg. in DFSP (also good for dermal dendrocytes).
58
GCDFP:
Gross Cystic Disease Fluid Protein-­‐ Breast Ca., along with ER and PR receptors.
59
GFAP:
Glial Fibrillary Acidic Protein-­‐ neural stain; myoepithelial cells (like in PA); also, paraganglioma.
60
Giemsa:
Mast cell granules, acidic MPS, eosinophils, Leishmania.
61
GLUT-­‐1 :
pos. in Hemangioma of infancy, but neg. in developmental vascular malformations
62
Granzyme B:
NK T-­‐cell sinonasal lymphomas (midline lethal granuloma).
63
H-­‐Caldesmon
+ in leiomyosarcoma (along with SMA and desmin).
64
HMB 45:
Positive in melanoma, MNETI, positive in lipofuscin.
65
Melan-­‐A (MART-­‐1):
Melanin (melanoma).
66
Myogenin:
Nucleus of Rhabdomyosarcoma. (w/ myoD1)
67
MyoD1:
Nucleus of Rhabdomyosarcoma. (w/ Myogenin)
68
PSA:
Prostate specific antigen; useful for demonstrating prostatic differentiation in mets.
69
Rhabdomyosarcoma:
Myogenin and MyoD1 positive.
70
S-­‐100:
Myoepithelial cell tumors (not normal myoepithelial cells), neural (ex: neurofibroma), adipocytes, chondrocytes (chondrosarc), chordoma, melanoma, GCT of adult (NOT congenital epulis of the newborn), rhabdomyoma.
71
Sirius red:
amyloid
72
Smooth Muscle Actin (SMA):
Smooth muscle-­‐ leiomyoma, myofibroblasts, myoepithelial cells (non-­‐ specific. However, in myoepithelial tumors, SMA is decreased or absent).
73
Smooth muscle myosin (SMMS): .
pos. in leiomyosarcoma
74
Synaptophysin:
Neurendocrine lesions, MNETI.
75
TFE-­‐3:
pos. in Alveolar soft part sarcoma (nuclear stain).
76
TTF-­‐1:
Marker for small cell lung ca (so TTF can rule out a met to the lung, vs. a primary small cell).
77
Verhoeff-­‐van Gieson:
Elastic fibers (elastic fibers-­‐black; collagen-­‐red; nuclei, muscles, nerves-­‐yellow).
78
Vimentin:
Stains for intermediate fibers in cells of connective tissue, like myoepithelial cells in myoepithelioma (causes plasmacytoid cells to appear as pink “hyaline cells” but this is non-­‐ specific).
79
Warthin Starry Stain
A silver stain for mycobacteria (Cat Scratch Disease). Also good for Treponema pallidum.
80
Ziehl-­‐Neelson
an acid fast bacillus stain (TB and Leprosy).

AAOMP Guide (25 decks)

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