Template:Undifferentiated malignancy
Undifferentiated malignancy
An initial panel of cytokeratin (CK, such as by CK AE1/AE3 cocktail), S100, vimentin and LCA (CD45) can be used (see source article for subsequent work-up).[1]
Alternatively, a more comprehensive panel can be performed upfront, with the most pertinent panel suggested below (with main associated primary origins in parentheses), but it should be tailored to additional clues from each individual case:[2]
- Mucicarmine or Cytokeratin CAM 5.2 (adenocarcinoma)
- CK7 and CK20 can give a broad indication of the primary site. Still use more specific immunohistochemistry stains instead or in addition where applicable. See image below for main patterns.
- NKX3.1 in males (prostate adenocarcinoma), or PAX-8 or estrogen and progesterone receptor in females (female reproductive tract).
- TTF-1 (thyroid or lung tumor)
- GATA3 (urothelial carcinoma, breast tumor)
- CDX2 (gastrointestinal tumor)
- p63 (squamous cell carcinoma)
- S100 (neural, invasive melanoma)
- LCA (CD45) (hematopoietic)
- Synaptophysin (neuroendocrine)
[[File:CK7 and CK20 by body location.svg|thumb|center|300px|CK7 and CK20 expression by various body locations.[3]
Notes
Main page
References
- ↑ Lin F, Liu H (2014). "Immunohistochemistry in undifferentiated neoplasm/tumor of uncertain origin. ". Arch Pathol Lab Med 138 (12): 1583-610. doi:. PMID 25427040. Archived from the original. .
- ↑ Partly inspired by:
Beauchamp K, Moran B, O'Brien T, Brennan D, Crown J, Sheahan K (2023). "Carcinoma of unknown primary (CUP): an update for histopathologists. ". Cancer Metastasis Rev. doi:. PMID 37394540. Archived from the original. . - ↑
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Image sources