What's my stain, what's my stain Flashcards
Alveolar soft part sarcoma
TFE3 +, transcription factor PAS-D+ rhomboid crystals
Synovial sarcoma
TLE1+; CK+; SSX-SS18 stain
Solitary fibrous tumor
STAT6 + BCL2 + CD34 +
Myofibroma
SMA+ MSA+ Desmin -
Paraganglioma
Chromo +, synapto + main tumor cells Sustentacular cells: s100+ ***same as a pheochromocytoma- these tumor are only different because paraganglioma is outside adrenal and pheochromcytoma is inside the adrenal medulla
Granular cell tumor
S100+, CD68+
Congenital epulis
S100-
Hemangioma of infancy
GLUT1 +
Leiomyoma
MSA +, SMA +, desmin +
Liposarcoma
MDM2 +, CDK4+
Angiosarcoma
Factor 8 +, CD31 +, CD34+ FLI-1 +, ERG +
Kaposi sarcoma
HHV 8 + aka LANA-1 + (protein encoded by HHV8) ERG+ CD34+ CD31 + (some but not all) FLI-1 + (so HHV8 differentiates from angiosarc)
Rosai-Dorfman Disease
CD68+ CD163+ S100 + CD1a -
Secretory Carcinoma
Secretory Material: PAS Alcean Blue Mammaglobin Tumor cells Mammaglobin S100 STAT5a BRST2 (aka GCDFP15) CKs Myoepithelial markers are negative Molecular: t(12,15) ETV6-NTRK3
Neurofibroma
S100 + CD34 +
Pleomorphic Adenoma
Myoepithelial markers: p63 + SMA + Epithelial markers: CAM5.2 CK7 Genetic mutation: PLAG1 + Neuro / Dendritic markers: SOX10 + GFAP +
Melanoma
S100+ (spindle cell melanoma retains) Melan-A+ HMB45 + SOX10 + (spindle cell melanoma retains) Tyrosinase + MITF+
Small Round Blue Cell Tumor
MR SLEEP Melanoma (S100,SOX10,HMB45,Melan-A, etc) Rhabdomyosarcoma(Desmin,Myogenin, MyoD1) Sinonasal Undiff Ca (SNUC) (AE1/AE3, PanCK) Lymphoma (CD45, CD20, CD3) Ethesioneuroblastoma (olfactory) (S100, Synapto,Chromo,) Ewing Sarcoma (CD99, SMARCB1, FLI-1) Pituitary Adenoma (EGFR, Synapto,Chromo, Negative for most hormone markers (TSH,ACTH,LH,GH,FSH))
Langerhans Cell Histiocytosis
aka: eosinophilic granuloma (solitary) CD1a + S100 + Langerin + (AKA CD207)
Rosai-Dorfman
Aka: LN sinus histiocytosis with massive LAD CD68+ S100 + CD163 + CD1a - (emperipoesis on histo)
Osteosarcoma
MDM2 +
Plasma cell neoplasm
CD138+, CD79a+, Kappa / Lamda ISH
Ectomesenchymal Chondromyxoid tumor
GFAP +; RREB1-MKL2 fusion
Granulomatous inflammation
AFB, GMS, PAS
DIF Patterns: Lupus Erythematosus
SHAGGY / GRANULAR band at basement membrane zone with IgM, IgG, C3
IIF Pattern: Wegner Granulomatosis
PR3-ANCA (Proteinase-3 antineutrophil cytoplasm antibodies, prev c-ANCA) and MPO-ANCA (myeloperoxidase, prev p-ANCA) directed against cytoplasmic components of neutrophils
IIF Pattern: Lichenoid drug reactions
string of pearls (annular pattern) along cell membrane of the basal cell layer with IgG
DIF Patterns: Pemphigus Vulgaris
“Chicken wire” IgG, IgM, C3 in intercellular spaces of epithelial cells
DIF Patterns: Paraneoplastic pemphigus
weakly positive IgG, C3 intercellular zones of the epithelium AND/OR a linear deposition at the basement membrane zone
DIF Patterns: Mucous membrane pemphigoid
linear band of immunoreactants )IgG, C3 at the basement membrane zone
DIF Patterns: Bullous pemphigoid
Continuous linear band of immunoreactants (IgG, C3) localized to the basement membrane zone
DIF Patterns: Erythema multiforme
Non-diagnostic (granular C3 + around blood vessels)
DIF Patterns: Lichen Planus
Fibrinogen, basement membrane zone