Cancer of unknown primary in a mare: case report and comparative pathology review

2021 ◽  
pp. 104063872110305
Author(s):  
Emily J. Brinker ◽  
Serena Ceriotti ◽  
Maria C. Naskou ◽  
Elizabeth A. Spangler ◽  
Erin S. Groover ◽  
...  
Keyword(s):  
Internal Control ◽  
Ultrasound Examination ◽  
Primary Site ◽  
Unknown Primary ◽  
Thyroid Transcription Factor 1 ◽  
Thyroid Transcription Factor ◽  
Napsin A ◽  
Peritoneal Effusion ◽  
Transcription Factor 1 ◽  
Pathology Review

A 25-y-old Percheron mare was admitted to the teaching hospital because of lethargy and intractable dyspnea. Thoracoabdominal ultrasound examination identified severe peritoneal effusion, mild bilateral pleural effusion, and a diffuse pulmonary nodular pattern. Cytology of peritoneal fluid revealed a hypercellular sample with clusters of neoplastic polygonal cells and admixed macrophages. Euthanasia was followed by postmortem examination; marked bi-cavitary effusion was present, and innumerable up to 4-cm diameter, round-to-floriform nodules were diffusely evident throughout serosal surfaces as well as the pulmonary and hepatic parenchyma. Disseminated adenocarcinoma, predominantly affecting lung and liver with widespread serosal implantation, was confirmed on light microscopy. Neoplastic cells had strong immunolabeling for pancytokeratin and lacked immunoreactivity to vimentin, napsin A, and Pax8. Cytokeratin 7 and thyroid transcription factor-1 were non-contributory given absent and inconsistent internal control reactivity, respectively. Such results, combined with the lack of a major mass that would indicate a primary site, were supportive of carcinoma of unknown primary site, which remains a conundrum in human oncology, and is poorly explored in veterinary medicine, mainly as a result of clinical and diagnostic limitations.

Utility of Tissue-Specific Transcription Factors Thyroid Transcription Factor 1 and Cdx2 in Determining the Primary Site of Metastatic Adenocarcinomas to the Brain

2007 ◽  
Vol 131 (11) ◽  
pp. 1686-1690
Author(s):  
Leah B. Strickland-Marmol ◽  
Andras Khoor ◽  
Sandra K. Livingston ◽  
Amyn Rojiani
Keyword(s):  
Transcription Factor ◽  
Transcription Factors ◽  
Primary Site ◽  
Unknown Primary ◽  
Metastatic Adenocarcinoma ◽  
Tissue Specific ◽  
Thyroid Transcription Factor 1 ◽  
Thyroid Transcription Factor ◽  
Transcription Factor 1 ◽  
The Brain

AbstractContext.—Brain metastases of adenocarcinoma of unknown primary pose a diagnostic dilemma to the surgical pathologist. Although the most common source in these cases is the lung, determining a primary source is difficult on routinely stained slides. Immunohistochemical stain panels including differential cytokeratins, hormone receptors, and breast-specific proteins are commonly used in these cases. Recently, attention has turned to tissue-specific transcription factors, such as thyroid transcription factor 1 (TTF-1) and Cdx2, in the appraisal of metastatic adenocarcinomas.Objective.—To characterize the previously unpublished immunohistochemical expression of the relatively new tissue-specific transcription factor Cdx2 in metastatic adenocarcinomas to the brain.Design.—We reviewed the surgical pathology files of the H. Lee Moffitt Cancer Center and Research Institute, Tampa, Fla, and retrieved 38 consecutive cases of metastatic adenocarcinoma (22 pulmonary, 10 breast, 6 gastrointestinal [2 esophagus/gastroesophageal junction, 4 colorectal]) to the brain with confirmation of the primary site by chart review and histologic evaluation. Sections were immunohistochemically stained with antibodies to TTF-1, Cdx2, and cytokeratins 7 and 20 by standard methods.Results.—Specificities and positive predictive values for Cdx2 and TTF-1 equaled 100% for metastatic gastrointestinal and pulmonary adenocarcinomas, respectively. The negative predictive value of Cdx2 was also very high at 97%.Conclusions.—Cdx2 is a specific and valuable tool for the surgical pathologist when faced with the common problem of metastatic adenocarcinoma of unknown primary. In conjunction with TTF-1, cytokeratin 7, and cytokeratin 20, Cdx2 can accurately differentiate the most common sources of metastatic adenocarcinoma to the brain.

Expressions of Thyroid Transcription Factor-1, Napsin A, p40, p63, CK5/6 and Desmocollin-3 in Non-Small Cell Lung Cancer, as Revealed by Imprint Cytology Using a Malinol-Based Cell-Transfer Technique

2015 ◽  
Vol 59 (6) ◽  
pp. 457-464 ◽  
Author(s):  
Toshiaki Kawai ◽  
Susumu Tominaga ◽  
Sadayuki Hiroi ◽  
Koji Kameda ◽  
Sho Ogata ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Small Cell ◽  
Imprint Cytology ◽  
Small Cell Lung ◽  
Thyroid Transcription Factor 1 ◽  
Thyroid Transcription Factor ◽  
Napsin A ◽  
Transcription Factor 1

Background: The introduction of new therapies has made it important to differentiate between adenocarcinoma and squamous cell carcinoma. To allow the use of various immunocytochemical stains on limited materials, we tried transferring cells from a given smear to multiple slides. Using touch-preparation samples of 215 surgically resected non-small cell lung carcinomas of confirmed histologic classification (adenocarcinoma,n = 101; squamous cell carcinoma,n = 114), we performed immunocytochemistry for thyroid transcription factor-1, napsin A, p40, p63, CK5/6 and desmocollin-3, and compared cytologic staining results with the corresponding resection. Methods: We examined: (a) the expressions of the above 6 antibodies on cells transferred from touch imprints of resected specimens, the extent of staining being considered positive if more than 5% of the area was stained, and (b) the sensitivity, specificity, positive predictive value and negative predictive value for each antibody. Results: The histologic corresponding rate with Papanicolaou staining was only 73%. Regarding the differentiation of adenocarcinoma from squamous cell carcinoma, the sensitivity and specificity for napsin A in adenocarcinoma were 80 and 97%, respectively, while those for p40 in squamous cell carcinoma were 84 and 98%, respectively. Conclusion: The immunocytochemical expressions of napsin A and p40 in imprint cytology seem to be of great utility for the accurate histological differentiation of lung cancers.

Prostatakarzinom imitiert metastasiertes Bronchialkarzinom – Ein Fallbericht

2017 ◽  
Vol 38 (09) ◽  
pp. 586-588
Author(s):  
Konstantinos Drosos ◽  
Klaus Höfner
Keyword(s):  
Transcription Factor ◽  
Thyroid Transcription Factor 1 ◽  
Thyroid Transcription Factor ◽  
Napsin A ◽  
Transcription Factor 1

ZusammenfassungEs wird über den Fall eines PSA-negativen und lokal fortgeschrittenen azinären Prostatakarzinoms berichtet, das bei thyroid transcription factor-1 (TTF-1) Expression eine Metastase eines bereits behandelten Bronchialkarzinoms imitierte. Unseres Wissens ist ein TTF-1 positiv azinäres Prostatakarzinom bisher nur ein Mal in der Literatur dokumentiert. Die Bestimmung des Immunophänotyps des Karzinoms mit Napsin A, CK7 und CK20 in Kombination mit der Beurteilung des gesamten Krankheitsverhaltens waren für die definitive Diagnose eines primären Prostatakarzinoms entscheidend.

Napsin A Is Differentially Expressed in Sclerosing Hemangiomas of the Lung

2012 ◽  
Vol 136 (12) ◽  
pp. 1580-1584 ◽  
Author(s):  
Lindsay A. Schmidt ◽  
Jeffrey L. Myers ◽  
Jonathan B. McHugh
Keyword(s):  
Transcription Factor ◽  
Respiratory Epithelium ◽  
Type Ii ◽  
Cell Of Origin ◽  
Ultrastructural Studies ◽  
Thyroid Transcription Factor 1 ◽  
Thyroid Transcription Factor ◽  
Napsin A ◽  
Type Ii Pneumocytes ◽  
Transcription Factor 1

Context.—Sclerosing hemangiomas (SH) are lung tumors characterized by surface cuboidal cells and round stromal cells. The cell of origin remains controversial, though immunohistochemical and ultrastructural studies suggest primitive respiratory epithelium. Napsin A, a human aspartic proteinase found primarily in type II pneumocytes and alveolar macrophages, is emerging as a helpful immunohistochemical marker in characterizing the origin of lung neoplasms, and may be of use in evaluating SH. Objective.—To evaluate napsin A immunohistochemical staining in SH to further characterize the cell of origin. Design.—Six cases of SH were stained for napsin A, as well as thyroid transcription factor 1 and cytokeratin in selected cases. Results.—Surface and round cells were positive for thyroid transcription factor 1 in all cases stained with this marker. Cytokeratins were positive in surface cells in all cases stained with this marker; 2 cases had focal cytokeratin staining in round cells. Round cells had focal napsin A staining in 1 case (17%); surface cells were napsin positive in all cases. Conclusions.—The observation of thyroid transcription factor 1 positivity in both surface and round cells in all SH suggests primitive respiratory epithelium as the cell of origin of SH. Our napsin A findings support this, with positivity in surface cells of all tumors (100%), and focal round cell staining in only 1 (17%). In fact, surface cells may represent entrapped type II pneumocytes, which normally express napsin A in a granular cytoplasmic pattern, similar to surface cells. The coexpression of thyroid transcription factor 1 and napsin A also introduces a caveat in differentiating primary pulmonary adenocarcinomas from SH in small biopsy specimens.

Tissue-Preserving Antibody Cocktails to Differentiate Primary Squamous Cell Carcinoma, Adenocarcinoma, and Small Cell Carcinoma of Lung

2013 ◽  
Vol 137 (9) ◽  
pp. 1274-1281 ◽  
Author(s):  
Alan F. Brown ◽  
Deepika Sirohi ◽  
Junya Fukuoka ◽  
Philip T. Cagle ◽  
Maria Policarpio-Nicolas ◽  
...  
Keyword(s):  
Transcription Factor ◽  
Cell Carcinoma ◽  
Small Cell ◽  
Lung Cancers ◽  
Thyroid Transcription Factor 1 ◽  
Thyroid Transcription Factor ◽  
Napsin A ◽  
Cytokeratin 5 ◽  
Transcription Factor 1 ◽  
Desmoglein 3

Context.—With the availability of cell type–specific therapies, differentiating primary lung squamous cell carcinomas (SCCs) and adenocarcinomas (ACAs) has become important. The limitations of small sample size and the need to conserve tissue for additional molecular studies necessitate the use of sensitive and specific marker panels on a single slide. Objective.—To distinguish SCC from ACA and small cell carcinoma (SmCC) of lung using 2 novel tissue-conserving cocktails. Design.—We compared two antibody cocktails, desmoglein 3 + cytokeratin 5/napsin A and p40/thyroid transcription factor 1 (Biocare Medical, Concord, California) in diagnosing SCC and ACA of the lung on tissue microarray, cytology, and surgical specimens. Both lung and nonlung tissue were evaluated on an 1150-core tissue microarray that contained 200 lung cancers. A microarray of 35 SmCCs and 5 small cell SCCs was also evaluated. Results.—A cocktail of desmoglein 3 + cytokeratin 5/napsin A provided diagnostic accuracy in lung cancers with a sensitivity and specificity of 100% in SCCs and a sensitivity of 86% and a specificity of 100% in ACAs. A p40/thyroid transcription factor 1 cocktail showed p40 to have a specificity of 92% and a sensitivity of 93% in SCCs, whereas thyroid transcription factor 1 had a specificity of 100% and a sensitivity of 77% in ACAs. Cell blocks of fine-needle aspiration cytology compared with corresponding surgical (n = 20) specimens displayed similar findings. The p40 was useful in differentiating bladder from prostate carcinoma with 88% sensitivity. Isolated carcinomas from nonlung tissues were desmoglein 3 + cytokeratin 5 positive. Napsin A was positive in 22% of renal tumors as previously observed. Both cocktails were excellent in differentiating SmCCs and small cell SCCs because none of the SmCCs stained with p40. Conclusions.—Both antibody cocktails are excellent in differentiating primary lung ACA from SCC, as well as excluding SmCC and ACAs from all other sites on small specimens. A cocktail of desmoglein 3 + cytokeratin 5/napsin A is slightly superior compared with p40/thyroid transcription factor 1 cocktail.

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