Immunohistochemistry for the Differentiation of Peritoneal Disseminated Carcinoma of Unknown Origin

Sato, Tae; Ohwada, Akihiko; Miyaji, Atsuko; Miyazaki, Ryoichiro; Suzuki, Mitsuaki; Matsumoto, Takeshi

doi:10.2169/internalmedicine.43.415

Cited by 11 publications

(10 citation statements)

References 16 publications

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“…Finally, pitfalls may be observed when studying cancer antigens, such as CA19.9, CA125 and CA150, since these markers display extensive cross-reactions and related antibodies are known to react to several normal and neoplastic epithelial cells of different origins 136 – 140…”

Section: Pitfalls In Results Interpretationmentioning

confidence: 99%

Technical pitfalls potentially affecting diagnoses in immunohistochemistry

2008

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Result of the immunohistochemical reactions routinely used in diagnostic surgical pathology should be properly interpreted, since false results, related to technical and interpretative pitfalls may lead to incorrect diagnosis. The main sources of such pitfalls are reviewed, analytically described and related to different steps (fixation, tissue processing and embedding, decalcification, antigen retrieval) which may affect the accuracy of immunohistochemistry. In addition, the presence of endogenous enzyme activity, improper binding of avidin to endogenous biotin, incorrect use of antibodies, chromogen and detection systems, as well as incorrect interpretation may produce unreliable data. The high frequency and extension of such pitfalls make mandatory the use of internal and external controls and adoption of cross-validation programmes. The present study, supported by an extensive review of the related literature, is intended as a guideline leading to proper interpretation of immunohistochemical data, an essential component of the diagnostic process. Experience on the antigen retrieval procedures for different antigens is also presented.

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Section: Pitfalls In Results Interpretationmentioning

confidence: 99%

Technical pitfalls potentially affecting diagnoses in immunohistochemistry

2008

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“…As ILC may present only as an asymmetric density rather than a dominant tumor mass [2], it could be missed on routine mammography evaluation. Histopathological and immunohistochemical analysis of biopsy specimen taken from GI metastatic sites are key in determining primary tumors [3]. Although GI metastases from ILC have been rare, the recognition of these entities is very important for making prompt diagnosis and providing appropriate treatment.…”

Section: Introductionmentioning

confidence: 99%

Invasive Lobular Breast Cancer Presenting an Unusual Metastatic Pattern in the Form of Peritoneal and Rectal Metastases: A Case Report

et al. 2011

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Gastrointestinal metastases from invasive lobular breast cancer are uncommon with the stomach and small intestines being the most common metastatic sites. Peritoneal and rectal metastases are very rare and only rarely occur as the first manifestation of disease. We herein report the case of a 47-year-old woman who presented with abdominal carcinomatosis as a first sign of invasive lobular breast carcinoma (ILC). Identifying the most important immunohistochemical markers for ILC: gross cystic disease fluid protein 15, estrogen and progesterone receptors enabled a correct diagnosis. After a six year disease-free period, relapse occurred with severe obstruction due to rectal metastasis from lobular breast carcinoma. Since there was no widespread metastatic disease, surgery with concomitant hormonal therapy was performed.

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“…Differentiation between these primaries is necessary for treatment options, prognosis, and response to the therapy. 2,3 It has been shown that patients with advanced ovarian cancer are more responsive to chemotherapy than those with pancreatic cancer. 4,5 There are no reliable cytomorphological features to differentiate metastatic carcinoma of pancreas from ovary in effusion cytology.…”

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confidence: 99%

Combination of MUC5ac and WT‐1 immunohistochemistry is useful in distinguishing pancreatic ductal carcinoma from ovarian serous carcinoma in effusion cytology

Han

Pansare

Al‐Abbadi

et al. 2010

Diagnostic Cytopathology

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Malignant ascites may be the first presentation of an unsuspected cancer. Pancreas and ovary are among the organs that are usually evaluated as a source of primary. The purpose of this study is to investigate a panel of immunohistochemical stains to help differentiate pancreatic from ovarian carcinoma. We evaluated the immunohistochemical staining of eight commercially available antibodies MUC1, MUC2, MUC5ac, Wilm's tumor susceptibility gene 1 (WT1), cytokeratin 7 (CK7), CK20, CA125, and CA19.9 in 25 effusion specimens with evidence of metastatic carcinoma including 14 ovarian serous carcinomas, 9 pancreatic adenocarcinomas, and 2 unknown primaries. Primary ovarian serous carcinomas were positive for WT-1 (100%), CK7 (93%), CK20 (43%), CA125 (100%), CA19.9 (50%), MUC1 (100%), MUC2 (0%), and MUC5ac (0%). Primary pancreatic carcinomas were positive for MUC5ac (100%), MUC1 (100%), CA19.9 (100%), CK7 (78%), CK20 (22%), CA125 (89%), WT-1 (0%), and MUC 2 (0%). The combination of MUC5ac positivity/WT-1 negativity was seen in 100% of pancreatic carcinoma, whereas MUC5ac negativity/WT-1 positivity in 100% of ovarian serous carcinoma. It appears that the combination of MUC5ac and WT-1 stains is useful in distinguishing pancreatic ductal from ovarian serous carcinoma in body fluid cytology.

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Immunohistochemistry for the Differentiation of Peritoneal Disseminated Carcinoma of Unknown Origin

Abstract: We report a woman with ascites, hydrothorax, pancreatic tumor, left cystic ovarian tumor, and an elevated serum cancer antigen 125 level.

Cited by 11 publications

References 16 publications

Technical pitfalls potentially affecting diagnoses in immunohistochemistry

Technical pitfalls potentially affecting diagnoses in immunohistochemistry

Invasive Lobular Breast Cancer Presenting an Unusual Metastatic Pattern in the Form of Peritoneal and Rectal Metastases: A Case Report

Combination of MUC5ac and WT‐1 immunohistochemistry is useful in distinguishing pancreatic ductal carcinoma from ovarian serous carcinoma in effusion cytology

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