Evaluation of Napsin A, TTF-1, p63, p40, and CK5/6 Immunohistochemical Stains in Pulmonary Neuroendocrine Tumors

Zhang, Chen; Schmidt, Lindsay; Hatanaka, Kazuhito; Thomas, Dafydd G.; Lagstein, Amir; Myers, Jeffrey L.

doi:10.1309/ajcpga0iua8bhqez

Cited by 50 publications

(34 citation statements)

References 21 publications

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“…In TTF1-positive nonsmall cell tumors, napsin A may play a role in classification of NE tumors, as it may be positive in a subset of large cell NE carcinomas (LCNECs), which are molecularly similar to adenocarcinoma, helping to separate them from high-grade NE tumors such as small cell carcinoma, which are typically napsin A-negative. 7,8 The use of surfactant protein A is discouraged, as its performance is inferior. 9,10 As a marker of squamous cell carcinoma, p63 was more frequently used in IHC analysis before introduction of the p40 antibody.…”

Section: Key Questionsmentioning

confidence: 99%

Best Practices Recommendations for Diagnostic Immunohistochemistry in Lung Cancer

Yatabe

Đačić

Borczuk

et al. 2019

Journal of Thoracic Oncology

248

221

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Since the 2015 WHO classification was introduced into clinical practice, immunohistochemistry (IHC) has figured prominently in lung cancer diagnosis. In addition to distinction of small cell versus non-small cell carcinoma, patients' treatment of choice is directly linked to histologic subtypes of non-small cell carcinoma, which pertains to IHC results, particularly for poorly differentiated tumors. The use of IHC has improved diagnostic accuracy in the classification of lung carcinoma, but the interpretation of IHC results remains challenging in some instances. Also, pathologists must be aware of many interpretation pitfalls, and the use of IHC should be efficient to spare the tissue for molecular testing. The International Association for the Study of Lung Cancer Pathology Committee received questions on practical application and interpretation of IHC in lung cancer diagnosis. After discussions in several International Association for the Study of Lung Cancer Pathology Committee meetings, the issues and caveats were summarized in terms of 11 key questions covering common and important diagnostic situations in a daily clinical practice with some relevant challenging queries. The questions cover topics such as the best IHC markers for distinguishing NSCLC subtypes, differences in thyroid transcription factor 1 clones, and the utility of IHC in diagnosing uncommon subtypes of lung cancer and distinguishing primary from metastatic tumors. This article provides answers and explanations for the key questions about the use of IHC in diagnosis of lung carcinoma, representing viewpoints of experts in thoracic pathology that should assist the community in the appropriate use of IHC in diagnostic pathology.

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Section: Key Questionsmentioning

confidence: 99%

Best Practices Recommendations for Diagnostic Immunohistochemistry in Lung Cancer

Yatabe

Đačić

Borczuk

et al. 2019

Journal of Thoracic Oncology

248

221

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“…It also lacks diffuse staining for CK5/6. 8,14,35,36 The proliferation index is >50% and is approaching 100% 8,34 (Fig. 9).…”

Section: Cancer Cytopathology August 2018mentioning

confidence: 94%

“…(Fig. ) Carcinoids lack expression of CK5/6, p40 and napsin A, but may show focal expression of p63 in a small proportion of cases …”

Section: Pulmonary Neuroendocrine Tumors and Their Differential Diagnmentioning

confidence: 99%

“…8) Carcinoids lack expression of CK5/6, p40 and napsin A, but may show focal expression of p63 in a small proportion of cases. 35,36 Small cell carcinoma is positive for pancytokeratin and CAM5.2 with dot-like paranuclear or diffuse cytoplasmic staining pattern, but negative for high molecular weight keratins. Small cell carcinoma can show diffuse and strong staining for synaptophysin and CD56 but tends to show focal and weak staining with chromogranin; in fact, if staining for chromogranin is strong, consideration should be given to the possibility of an AC, because it is unusual for SCC to exhibit strong positivity for chromogranin.…”

Section: Cancer Cytopathology August 2018mentioning

confidence: 99%

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A practical guide for ancillary studies in pulmonary cytologic specimens

Auger

Brimo

Kanber

et al. 2018

Cancer Cytopathology

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Although most pulmonary cytologic specimens obtained by either exfoliation or fine needle aspirates can be reliably and accurately diagnosed based on pure morphologic criteria alone, a small proportion of cases require ancillary studies for either refining a diagnosis, for resolving a differential diagnosis or increasingly, for predictive purposes in primary lung carcinomas. This article aims to provide practical guidance on the use of common ancillary studies in pulmonary cytologic specimens. Cancer Cytopathol 2018;000:000-000. © 2018 American Cancer Society.

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“…Its sensitivity for pulmonary NETs (typical and atypical carcinoids) ranges from 28% to 77%. [215][216][217][218][219][220][221] It essentially excludes other sites of origin if positive in a well-differentiated NET. It should be mentioned here, however, that some small cell carcinomas of nonpulmonary origin can be positive for TTF-1.…”

Section: Grading Neuroendocrine Neoplasms By Ki-67mentioning

confidence: 99%

Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas

Wang¹,

Kim²,

Koo³

et al. 2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Immunomarkers with diagnostic, therapeutic, or prognostic values have been increasingly used to maximize the benefits of clinical management of patients with neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. Objectives.— To review the characteristics of immunomarkers that are commonly used in surgical pathology practice for neoplasms of the gastrointestinal tract, liver, biliary tract, and pancreas, and to summarize the clinical usefulness of immunomarkers that have been discovered in recent years in these fields. Data Sources.— Data sources include literature review, authors' research data, and personal practice experience. Conclusions.— Immunohistochemistry is an indispensable tool for the accurate diagnosis of neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. Useful immunomarkers are available to help distinguish malignant neoplasms from benign conditions, determine organ origins, and subclassify neoplasms that are morphologically and biologically heterogeneous. Specific immunomarkers are also available to help guide patient treatment and assess disease aggressiveness, which are keys to the success of personalized medicine. Pathologists will continue to play a critical role in the discovery, validation, and application of new biomarkers, which will ultimately improve patient care.

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Evaluation of Napsin A, TTF-1, p63, p40, and CK5/6 Immunohistochemical Stains in Pulmonary Neuroendocrine Tumors

Cited by 50 publications

References 21 publications

Best Practices Recommendations for Diagnostic Immunohistochemistry in Lung Cancer

Best Practices Recommendations for Diagnostic Immunohistochemistry in Lung Cancer

A practical guide for ancillary studies in pulmonary cytologic specimens

Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas

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