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Fellowship and boards study > What's my stain, what's my stain > Flashcards

What's my stain, what's my stain Flashcards

1
Q

Alveolar soft part sarcoma

A

TFE3 +, transcription factor PAS-D+ rhomboid crystals

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2
Q

Synovial sarcoma

A

TLE1+; CK+; SSX-SS18 stain

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3
Q

Solitary fibrous tumor

A

STAT6 + BCL2 + CD34 +

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4
Q

Myofibroma

A

SMA+ MSA+ Desmin -

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5
Q

Paraganglioma

A

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

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6
Q

Granular cell tumor

A

S100+, CD68+

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7
Q

Congenital epulis

A

S100-

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8
Q

Hemangioma of infancy

A

GLUT1 +

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9
Q

Leiomyoma

A

MSA +, SMA +, desmin +

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10
Q

Liposarcoma

A

MDM2 +, CDK4+

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11
Q

Angiosarcoma

A

Factor 8 +, CD31 +, CD34+ FLI-1 +, ERG +

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12
Q

Kaposi sarcoma

A

HHV 8 + aka LANA-1 + (protein encoded by HHV8) ERG+ CD34+ CD31 + (some but not all) FLI-1 + (so HHV8 differentiates from angiosarc)

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13
Q

Rosai-Dorfman Disease

A

CD68+ CD163+ S100 + CD1a -

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14
Q

Secretory Carcinoma

A

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

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15
Q

Neurofibroma

A

S100 + CD34 +

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16
Q

Pleomorphic Adenoma

A

Myoepithelial markers: p63 + SMA + Epithelial markers: CAM5.2 CK7 Genetic mutation: PLAG1 + Neuro / Dendritic markers: SOX10 + GFAP +

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17
Q

Melanoma

A

S100+ (spindle cell melanoma retains) Melan-A+ HMB45 + SOX10 + (spindle cell melanoma retains) Tyrosinase + MITF+

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18
Q

Small Round Blue Cell Tumor

A

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))

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19
Q

Langerhans Cell Histiocytosis

A

aka: eosinophilic granuloma (solitary) CD1a + S100 + Langerin + (AKA CD207)

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20
Q

Rosai-Dorfman

A

Aka: LN sinus histiocytosis with massive LAD CD68+ S100 + CD163 + CD1a - (emperipoesis on histo)

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21
Q

Osteosarcoma

A

MDM2 +

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22
Q

Plasma cell neoplasm

A

CD138+, CD79a+, Kappa / Lamda ISH

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23
Q

Ectomesenchymal Chondromyxoid tumor

A

GFAP +; RREB1-MKL2 fusion

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24
Q

Granulomatous inflammation

A

AFB, GMS, PAS

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25
Q

DIF Patterns: Lupus Erythematosus

A

SHAGGY / GRANULAR band at basement membrane zone with IgM, IgG, C3

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26
Q

IIF Pattern: Wegner Granulomatosis

A

PR3-ANCA (Proteinase-3 antineutrophil cytoplasm antibodies, prev c-ANCA) and MPO-ANCA (myeloperoxidase, prev p-ANCA) directed against cytoplasmic components of neutrophils

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27
Q

IIF Pattern: Lichenoid drug reactions

A

string of pearls (annular pattern) along cell membrane of the basal cell layer with IgG

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28
Q

DIF Patterns: Pemphigus Vulgaris

A

“Chicken wire” IgG, IgM, C3 in intercellular spaces of epithelial cells

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29
Q

DIF Patterns: Paraneoplastic pemphigus

A

weakly positive IgG, C3 intercellular zones of the epithelium AND/OR a linear deposition at the basement membrane zone

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30
Q

DIF Patterns: Mucous membrane pemphigoid

A

linear band of immunoreactants )IgG, C3 at the basement membrane zone

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31
Q

DIF Patterns: Bullous pemphigoid

A

Continuous linear band of immunoreactants (IgG, C3) localized to the basement membrane zone

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32
Q

DIF Patterns: Erythema multiforme

A

Non-diagnostic (granular C3 + around blood vessels)

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33
Q

DIF Patterns: Lichen Planus

A

Fibrinogen, basement membrane zone

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34
Q

DIF: Chronic Ulcerative Stomatitis

A

“speckled” IgG in the basal and parabasal nuclei

35
Q

Ewing sarcoma

A

CD99, FLI-1, SMARCB1

36
Q

Acinic Cell Carcinoma

A

DOG1, SOX10, PASD+ , NR4A3+ (due to t(4,9))

PASD+ granules

alpha-1-antichymotrypsin

alpha amylase

Myoepithelial markers: p63, p40, SMA

37
Q

Adenoid Cystic Carcnoma

A

Biphasic (ducal and myoepithelial): Epithelial Markers: CAM5.2, CK7 Myoepithelial Markers: P63+, P40+ Others: CD43, CKIT

38
Q

Polymorphous Adenocarcinoma

A

Monophasic (ducal proliferation only): Epithelial Markers: CAM5.2, CK7 Myoepithelial markers: P63+, P40-

39
Q

Malignant peripheral nerve sheath tumor

A

S100, SOX10, h3k27me3

40
Q

CEOT

A

Congo red +, apple green birefringence

41
Q

Nodular Faciitis

A

MYH9-USP6 gene fusion SMA+ MSA+ Calponin + S100 - Desmin -

42
Q
A

Pemphigus Vulgaris: “Chicken wire” IgG, IgM, C3 in intercellular spaces of epithelial cells

43
Q
A

Pemphigus Vulgaris

“Chicken wire” IgG, IgM, C3 in intercellular spaces of epithelial cells

44
Q
A

Mucous membrane pemphigoid

linear band of immunoreactants )IgG, C3 at the basement membrane zone

45
Q
A

Mucous membrane pemphigoid

linear band of immunoreactants )IgG, C3 at the basement membrane zone

46
Q
A

Erythema multiforme

Non-diagnostic (granular C3 + around blood vessels)

Regezi: “EM: non-specific fine granular basement membrane zone fluorescence for C3”

47
Q
A

Lichen Planus

Fibrinogen (shaggy?), basement membrane zone

Regezi: “BMZ and supericial LP fluor for fibrinogen and apoptotic body fluorescence for IgM”

48
Q
A

Lichen Planus

Fibrinogen (shaggy?), basement membrane zone

Regezi: “BMZ and supericial LP fluor for fibrinogen and apoptotic body fluorescence for IgM”

49
Q
A

Lupus Erythematosus

SHAGGY / GRANULAR band at basement membrane zone with IgM, IgG, C3

Regezi :”course-granular BMZ for IgM”

50
Q

Metastatic Renal Cell Carcinoma

A

PAX 8+, CD10 +, CAIX +

51
Q

Metastatic Prostate Adenocarcinoma

A

Most common: NKX3.1, PSA, AMACR

FOXA1+, HSD3B2+, ROCK1 PAP

52
Q

Metastatic Breast, Invasive Ductal Carcinoma

A

MUC4, EMA, CK7, ER/PR, GATA3

53
Q

Metastatic Lung Adenocarcinoma

A

CK7, NAPSIN-A, TTF-1

54
Q

Metastatic Thyroid Carcinoma

A

TTF-1, Thyroglobulin, PAX8

55
Q

Metastatic Colon Adenocarcinoma

A

CDX2, CK20, AMACR, CD10 (stromal cells)

56
Q

Merkel Cell Carcinoma

A

CK20 (classic dot-like perinuclear), MCPyV, Chromo/Synapto, CD56, neuron specific enolase (NSE), Argyrophilic granules can be seen with Grimelius stain

57
Q

Myopericytoma

A

SMA +

muscle specific actin +

h-caldesmon +

CD34 -

58
Q

Myofibroma

A

muscle specific actin (MSA/HHF35) +

SMA +

Desmin -

pan-actin +

59
Q

Inflammatory myofibroblastic tumor

A

POsitive: SMA, alpha smooth muscle actin, calponin, ALK

60
Q

Glioma

61
Q

Sebaceous carcinoma

A

adipophilin to highight sebocytes

EMA (not specific)

LeuM1

62
Q

Amorphous material in biopsy specimens of ligeneous gingivitis/conjunctivitis

A

Fraser-Lendrum IHC

Negative for amyloid stains

63
Q

Psedomyogenic hemangioendothelioma

A

FLI1+, FOSB+, CD34-, CD31+/-, ERG+, AE1/AE3+

64
Q

Salivary duct carcinoma

A

Positive: Androgen receptor, HER2, EGFR, CK7, EMA (GATA3 nuclear)

Focal + GCDFP-15

Negative: ER and PR

Ki67 is high

65
Q

Follicular lymphoma

A

GC markers: CD10+, BCL6+

BCL2+- normally stains the mantle zone but instead will be positive in the GC

PAN B cell markers: CD79a, CD 19, CD20

66
Q

Mantle cell lymphoma

A

CD43+, cyclin D1+, SOX11+, CD19+, CD20+, CD5+

GC markers are negative: BCL6- CD10-

67
Q

Marginal zone lymphoma

A

CD19+, CD20+, BCL2+

GC markers neg: CD10-, BCL6-

CD5-, cyclin D1-

68
Q

CLL/SLL

A

Positive: CD79a, CD5, CD43, CD19, BCL2

Negative GC: CD10, BCL6

Negative: cyclin D1, SOX11

69
Q

Tuberculosis

A

fluorescence microscopy of auramine-rhodamine stains

Ziehl-Neelson

AFB

70
Q

Salivary lymphoepithelial carcinoma

A

CK, EBV, c-kit, EMA (all in carcinoma component)

Surrounding lymphoid component is negative for these

71
Q

Follicular cells of the thyroid

A

Thyroglobulin = most specific

TTF-1

EMA, LMWK, EMA, ER beta, T3/T4

72
Q

Colloid of the thyroid

A

thyroglobulin, Alcian blue, PAS, T3, T4

73
Q

C cells of the thyroid

A

calcitonin, calcitonin gene related peptide (CGRP), neuron specific enolase, chromogranin A, synaptophysin, CEA, somatostatin

C cells are metachromatic with toluidine blue

NEGATIVE for thyroglobulin

74
Q

Fite stain

75
Q

Auramine-rhodamine

A

Florescent stain for acid-fast bacteria

-mycobacteria tuberculosis

76
Q

Ziehl-Neelson stains

A

acid fast bacteria

aka mycobacteria

77
Q

Fraser-Lendrum stains?

A

Fibrin of plasminogen deficiency

78
Q

Amorphous material of lipoid proteinosis stain?

79
Q

Leishmaniasis

80
Q

Grimelius stains?

A

intracytoplasmic granules of Merkel cell carcinoma

81
Q

Epithelioid hemangioendohelioma

A

CD31+, FLI1+, ERG +

Nuckear positivty with CAMTA1 in cases with corresponding fusion

82
Q

Meningioma

A

EMA+, CK18+, ER+, PR+

83
Q

NK T cell lymphoma

A

CD3, CD56, TIA1, granzyme B, perforin +

EBER +

CD4/5/8 -

84
Q

Olfactory neuroblastoma

A

NSE, chromo, synapto, CD56 +

CD99, p63, FLI1, CD45 -

Fellowship and boards study (8 decks)

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