Immunohistochemical and histochemical stains useful in the differential diagnosis of various carcinomas

Tumor type	Typical immunohistochemical staining
Carcinoma	Positive: Pankeratin, AE 1/3, CAM 5.2, OSCAR, EMA Negative: CD 45 Variable: CK 7, CK 20, S-100, vimentin
Colorectal carcinoma	Positive: CK 20, CDX-2 Negative: CK 7
Lung carcinoma
Adenocarcinoma	Positive: TTF-1, napsin A, CK 7, mucicarmine, PAS-D Negative: Thyroglobulin
Squamous cell carcinoma	Positive: p 40, p 63, CK 5/6, desmoglein Negative: CK 7 (usually)
Small-cell carcinoma	Positive: TTF-1, high proliferative rate (Ki-67, MIB-1) Variable: Chromogranin, synaptophysin
NUT carcinoma	Positive: NUT carcinoma
Thoracic SMARCA4 undifferentiated tumor	Negative: BRG1 (SMARCA4)
Neuroendocrine carcinoma	Positive: Chromogranin, synaptophysin, epithelial stains
Germ cell tumor	Positive: HCG, AFP, Oct4 transcription factor, placental alkaline phosphatase, epithelial stains
Hepatocellular carcinoma	Positive: Hep par 1, CEA, AFP, glypican 3 Negative: CK 7, CK 20
Renal cell carcinoma	Positive: Pan keratin, CAM 5.2, Pax-8, CK 7, vimentin, RCC, CD 10 Negative: CK 20, CEA
Prostate carcinoma	Positive: PSA, prostatic acid phosphatase Negative: CK 7, 20
Pancreas carcinoma	Positive: CA 19-9, CK 7, CDX-2, CK 17 Variable: CK 20
Breast carcinoma	Positive: ER, PR, Her-2-neu, CK 7, gross cystic fluid protein 15, epithelial stains, GATA 3, mammaglobin Negative: CK 20
Ovarian carcinoma	Positive: CK 7, WT-1, Pax-8, ER Negative: CK 20, CDX-2
Thyroid carcinoma	Positive: Thyroglobulin, TTF-1, CK 7

CAM: cell adhesion molecule; EMA: epithelial membrane antigen; CD: cluster of differentiation; CK: cytokeratin; S-100: S-100 protein; CDX: caudal-type homeobox transcription factor 2; TTF-1: thyroid transcription factor 1; PAS-D: Periodic Acid Schiff with diastase predigestion; NUT: nuclear protein of the testis; HCG: human chorionic gonadotropin; AFP: alpha-fetoprotein; Hep par: hepatocyte paraffin 1 monoclonal antibody; CEA: carcinoembryonic antigen; Pax: paired box gene; RCC: renal cell carcinoma; PSA: prostate-specific antigen; CA: carbohydrate antigen; ER: estrogen receptor; PR: progesterone receptor; Her-2: human epidermal growth factor receptor 2; WT-1: Wilms tumor 1 protein.

References:

Thunnissen E, Kerr KM, Herth FJ, et al. The challenge of NSCLC diagnosis and predictive analysis on small samples. Practical approach of a working group. Lung Cancer 2012; 76:1.
Pelosi G, Rossi G, Bianchi F, et al. Immunohistochemistry by means of widely agreed-upon markers (cytokeratins 5/6 and 7, p63, thyroid transcription factor-1, and vimentin) on small biopsies of non-small cell lung cancer effectively parallels the corresponding profiling and eventual diagnoses on surgical specimens. J Thorac Oncol 2011; 6:1039.
ImmunoQuery. Elsevier. Available from: http://www.immunoquery.com (Accessed on September 30, 2014).
Kandalaft PL, Gown AM. Practical application in immunohistochemistry: Carcinoma of unknown primary site. Arch Pathol Lab Med 2016; 140:508.

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Immunohistochemical and histochemical stains useful in the differential diagnosis of various carcinomas