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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : -25 مورد

Ancillary tests in thymic epithelial tumors

Ancillary tests in thymic epithelial tumors
Thymoma
Cellular component Expressed Negative
Neoplastic epithelial cells
  • Keratin AE1/AE3, CAM 5.2, CK5/6, p40, p63
  • PAX8 (100% type A, 93% type B thymomas using polyclonal antibody[1,2])
  • CD20 (some type A, AB)
  • Bcl-2 +/–
  • TTF-1 (rare type A)[2]
  • CK20
Thymocytes
  • TdT (may be absent in type A and B3 thymoma)
  
Thymic carcinoma
Carcinoma subtype Expressed Negative
Squamous cell carcinoma
  • p40, p63, CK5/6
  • CD5 +/–
  • CD117 +/–
  • PAX-8 (polyclonal)
  • CK20
NUT carcinoma
  • NUT
  • p40, CK5/6 +/–
  • TTF-1, CD34 +/–
  • t[15;19] BRD4-NUT translocation; other translocations or fusions involving the NUT locus can occur
  • Simple karyotype
  
Low-grade papillary adenocarcinoma[3]
  • CK7
  • CK8
  • EMA+
  • BerEP4+
  • CD5 +/–
  • CEA +/–
  • CD117 +/–
  • CK20
  • CDX2
  • Thyroglobulin
  • Calcitonin
  • TTF-1
  • PAX8
Mucoepidermoid carcinoma[4]
  • MAML2 rearrangement
  
Enteric-type adenocarcinoma[3]
  • CK20
  • CDX2
  • MUC2
  • CK7 +/–
  • CD5 +/–
  • TTF-1
  • CD117
Adenocarcinoma, NOS[3]
  • Pancytokeratin
  • CD5 +/–
  • CEA +/–
  • CA19-9 +/–
  • CK7 +/–
  • CK20
  • CDX2
  • MUC2
Immunostains aiding in the distinction between thymic carcinoma and metastases[2,5]
Immunostain; % positive cases Thymic carcinoma Metastases
CD5 20 to 100 0 to 34*
CD117 60 to 87 20 to 100
CD5 & CD117 54 to 65 0Δ
CD205 52 to 76 4 to 27
FoxN1 59 13
PAX8 0 to 80◊ 0 to 33Δ◊
PAX8 & CD117 69 0
PAX8 & CD5 46 0
CAM: cell adhesion molecule; CK: creatine kinase; PAX8: paired box 8; CD: cluster of differentiation; Bcl: B-cell lymphoma; TTF-1: transcription termination factor 1; TdT: terminal deoxynucleotidyl transferase; BRD4: bromodomain-containing 4; NUT: nuclear protein of the testis; MAML2: mastermind-like transcriptional coactivator 2; FoxN1: forkhead box N1; SP19: chymotrypsin-like serine protease.
* Adenocarcinoma of gastrointestinal tract, breast, lung, gynecologic organs, epithelioid sarcoma, mesothelioma, urothelial carcinoma; clone dependent.
¶ Squamous cell carcinoma of lung, gastrointestinal stromal tumor, germ cell tumors.
Δ Squamous cell carcinomas of lung (clone SP19, clone not provided in other study).[6,7]
◊ Clone-dependent (0 for monoclonal PAX8, 58 to 69% [thymic carcinoma] and 2.4 to 6% [lung carcinomas] for polyclonal PAX8).[2]
References:
  1. Weissferdt A, Moran CA. Pax8 expression in thymic epithelial neoplasms: An immunohistochemical analysis. Am J Surg Pathol 2011; 35:1305.
  2. Asirvatham JR, Esposito MJ, Bhuiya TA. Role of PAX-8, CD5, and CD117 in distinguishing thymic carcinoma from poorly differentiated lung carcinoma. Appl Immunohistochem Mol Morphol 2014; 22:372.
  3. WHO Classification of Tumours Editorial Board. Thoracic tumours. In: WHO Classification of Tumours, 5th ed, International Agency for Research on Cancer, Lyon, France 2021. Available online at tumourclassification.iarc.who.int/chapters/35.
  4. Roden AC, Erickson-Johnson MR, Yi ES, Garcia JJ. Analysis of MAML2 rearrangement in mucoepidermoid carcinoma of the thymus. Hum Pathol 2013; 44:2799.
  5. Kwon AY, Han J, Chu J, et al. Histologic characteristics of thymic adenocarcinomas: Clinicopathologic study of a nine-case series and a review of the literature. Pathol Res Pract 2017; 213:106.
  6. Jha V, Sharma P, Mandal AK. Utility of cluster of differentiation 5 and cluster of differentiation 117 immunoprofile in distinguishing thymic carcinoma from pulmonary squamous cell carcinoma: A study on 1800 non-small cell lung cancer cases. Indian J Med Paediatr Oncol 2017; 38:430.
  7. Kriegsmann M, Muley T, Harms A, et al. Differential diagnostic value of CD5 and CD117 expression in thoracic tumors: a large scale study of 1465 non-small cell lung cancer cases. Diagn Pathol 2015; 10:210.
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