Napsin A, a New Marker for Lung Adenocarcinoma, Is Complementary and More Sensitive and Specific Than Thyroid Transcription Factor 1 in the Differential Diagnosis of Primary Pulmonary Carcinoma: Evaluation of 1674 Cases by Tissue Microarray

Turner, Bradley M.; Cagle, Philip T.; Sáinz, Irma M.; Fukuoka, Junya; Shen, Steven S.; Jagirdar, Jaishree

doi:10.5858/arpa.2011-0320-oa

Cited by 204 publications

(175 citation statements)

References 30 publications

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“…Primary adenocarcinoma of the bladder and secondary adenocarcinoma from its adjacent organs should be ruled out based on immunohistochemical studies, which may be used to determine the origin of the primary tumor from uncommon sites, such as colorectal, breast or lung. Positive staining for TTF-1, CK7 and Napsin A have been demonstrated to be reliable markers for the identification of lung adenocarcinoma (2,11). In the present case report, the tumor cells stained positive for TTF-1, CK7 and Napsin A.…”

Section: Discussionsupporting

confidence: 61%

Metastatic lung adenocarcinoma to the bladder: A case report

Liu

et al. 2015

Oncology Letters

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Abstract. Urothelial cancer is the most frequently diagnosed type of malignant tumor in the bladder, of which primary adenocarcinoma accounts for a small percentage. Secondary malignancies, in particular metastatic adenocarcinoma from the lung, are exceedingly rare, with only six cases previously reported in the literature. The present study describes the case of a 71-year-old Chinese male patient with known lung cancer for >2 years, who was diagnosed with metastatic adenocarcinoma to the bladder. The histopathological characteristics and immunohistochemical features of the patient are reported. It was proposed that pathologists should consider the possibility of metastatic adenocarcinoma from the lung, rather than assume a diagnosis of primary adenocarcinoma of the bladder or direct invasion of adenocarcinoma from the surrounding organs. Furthermore, it is essential to determine the medical history of each patient and observe the immunohistochemical features of all tumors prior to diagnosis. IntroductionBladder cancer is the fifth most common type of malignant tumor. Among bladder malignancies, urothelial carcinomas are the most frequent histological type, of which adenocarcinoma, squamous cell cancer and small-cell cancer account for small percentages (1,2). Primary adenocarcinomas were reported to account for 0.5-2% of primary bladder epithelial malignancies; these malignancies most commonly arise in the urachus (3).In addition, secondary adenocarcinomas may also occur as a result of direct invasion from the surrounding organs, including prostate, colorectal and cervical sites (3). Furthermore, metastatic spread may occur via lymphogenous or hematogenous routes (4). However, the bladder is not a favored site for tumor metastases; in particular, adenocarcinoma from the lung is exceptionally rare (5). The present study describes a case of metastatic adenocarcinoma from the lung to the bladder and reports the histopathological characteristics and immunohistochemical features of the patient. The aim of the present study was to emphasize the importance of considering of metastatic adenocarcinoma from the lung as a possible diagnosis, in addition to primary adenocarcinoma and direct invasion of adenocarcinoma from the immediate surrounding organs. Case reportA 71-year-old Chinese male with known lung cancer for >2 years was referred to the People's Liberation Army 205 Hospital (Jinzhou, China) due to a gross hematuria, which had persisted for 5 days. This initial diagnosis of lung adenocarcinoma occurred >2 years previously, when the patient was admitted to a local hospital due to a cough and expectoration. Following the initial admission to hospital, a thoracic computed tomography (CT) revealed a 3x2x2 cm mass in the lower lobe of the patient's left lung; consequently, a needle biopsy was performed and the patient was diagnosed with adenocarcinoma of the lung (histological sections were not available for review). The patient elected not to undergo any therapy, including surgical resection, chemical therapy or radi...

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Section: Discussionsupporting

confidence: 61%

Metastatic lung adenocarcinoma to the bladder: A case report

Liu

et al. 2015

Oncology Letters

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] Similarly, IHC markers, including p40, cytokeratin (CK) 5/6, CK5, and p63, are used in supporting the diagnosis of SCC. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] More than 90% of SCC cases are positive for each of these markers. exclusive (Table 1; Figure 1, a through d).…”

Section: Primary Lung Adc and Sccmentioning

confidence: 99%

Utility of Immunohistochemistry in the Diagnosis of Pleuropulmonary and Mediastinal Cancers: A Review and Update

Zhang

Deng

Cagle

2014

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Immunohistochemistry has become an indispensable ancillary tool for the accurate classification of pleuropulmonary and mediastinal neoplasms necessary for therapeutic decisions and predicting prognostic outcome in the era of personalized medicine. Diagnostic accuracy has significantly improved because of the continuous discoveries of tumor-associated biomarkers and the development of effective immunohistochemical panels.Objective.-To increase the accuracy of diagnosis and classify pleuropulmonary neoplasms through immunohistochemistry.Data Sources.-Literature review, authors' research data, and personal practice experience.Conclusions.-This review article has shown that appropriately selecting immunohistochemical panels enables pathologists to effectively diagnose most primary pleuropulmonary neoplasms and differentiate primary lung tumors from a variety of metastatic tumors to the lung. The discovery of new mutation-specific antibodies identifying a subset of specific gene-arranged lung tumors provides a promising alternative and cost-effective approach to molecular testing. Knowing the utilities and pitfalls of each tumor-associated biomarker is essential to avoiding potential diagnostic errors.

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“…The expression of napsin A has been reported to be high in lung adenocarcinoma samples (11), while an additional study noted that a large quantity of tissue array samples, with the exception of lung and renal cancer specimens, had extremely low expression (12). Furthermore, the napsin A expression rate was observed to be higher than that of TTF-1 in lung adenocarcinomas.…”

Section: Discussionmentioning

confidence: 96%

Immunostaining for thyroid transcription factor 1, Napsin A, p40, and cytokeratin 5 aids in differential diagnosis of non-small cell lung carcinoma

et al. 2015

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Abstract. The present study aimed to examine the effectiveness of immunostaining of cytological specimens in discerning squamous from non-squamous cell carcinoma. Various combinations of six antibodies were examined in order to determine the optimal combination for use in differential diagnosis. Immunostaining was performed using tumor imprint smears obtained from 70 lung carcinoma cases. The results were scored based on positive area and intensity. For objective evaluation, scores for thyroid transcription factor 1 (TTF-1), napsin A, and CK CAM5.2 were expressed with positive values, while those for p40, cytokeratin (CK) 5/6 and CK5 were expressed with negative values. Histograms were produced to evaluate which combination was the most effective in differentiating squamous cell carcinoma from adenocarcinoma. The sensitivity for these molecules in adenocarcinoma was 88% for TTF-1, 85% for napsin A, and 100% for CAM5.2. In squamous cell carcinomas, sensitivity was determined to be 90% for p40, 86% for CK5, and 76% for CK5/6. The specificity for these molecules was calculated as 100%, 95%, 43%, 98%, 100% and 95%, respectively. Each combination was evaluated for scoring and the values were averaged. The most effective combination for mode and mean was TTF-1, napsin A, p40, and CK5, for which all adenocarcinomas had a score >1, and all squamous cell carcinomas scored <-2. Immunostaining scoring may therefore be useful for the differential diagnosis of these carcinomas when a limited number of tumor cells are present.

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Napsin A, a New Marker for Lung Adenocarcinoma, Is Complementary and More Sensitive and Specific Than Thyroid Transcription Factor 1 in the Differential Diagnosis of Primary Pulmonary Carcinoma: Evaluation of 1674 Cases by Tissue Microarray

Cited by 204 publications

References 30 publications

Metastatic lung adenocarcinoma to the bladder: A case report

Metastatic lung adenocarcinoma to the bladder: A case report

Utility of Immunohistochemistry in the Diagnosis of Pleuropulmonary and Mediastinal Cancers: A Review and Update

Immunostaining for thyroid transcription factor 1, Napsin A, p40, and cytokeratin 5 aids in differential diagnosis of non-small cell lung carcinoma

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