Table 2

Immunohistochemical and Tissue of Origin Test results

Immunohistochemistry Results

Tissue of Origin (TOO) Test results



Case No.

Negative

Positive

Suspected tissues based on clinicopathology

TOO result

TOO SS

Rule out tissues

Consistent

Management Value


1

BRST-2, CK20, TTF-1, ER, PR, Her2/neu

CK7

Pancreas, Breast, Upper GI

Indeterminate

22.1

8

--

--

2

PSA

CK20, CK7, CDX2*

Kidney

Colorectal

83.7

14

No*

Yes

3

BRST-2, CK20, TTF-1, ER, PR, Her2/neu

CK20, CK7, WT1

Ovary or Breast

Ovary

87.6

14

Yes

Yes

4

chromogranin, synaptophysin, calretinin, TTF-1, PR

CK20, CK7, CDX-2, CK5/6, MOC31, ER, CEA

GI Primary, Colorectal

Colorectal

81.8

13

Yes

Yes

5

CDX-2, CD31, CK20, Melan A, S-100, TTF-1

AE1/AE3, CK7

Renal cell carcinoma

Indeterminate

24.7

11

--

--

6

Thyroglobulin

TTF-1

Lung, Thyroid

Breast

61.2

12

No*

Yes

7

CK20, PSA, TTF-1

CK7, AE1/AE3, keratin 903, p63

Lung

Indeterminate

23.6

8

--

8

BRST-2, CD10, CD45, C-kit

CDX-2, CAM5.2, CK20, CK7, Keratin

Colorectal

Colorectal

64.1

12

Yes

Yes

9

CK20, CK7, TTF-1, ER, PR

Colorectal, Ovary

Lung

35.5

10

No*

Yes

10

CDX-2*, CK20, CK7

Colorectal, Ovary

Colorectal

71.2

13

Yes

Yes

11

ER, PR, Her2/neu, BRST-2, CDX-2, CK20

CK7, p53, WT1

Breast, Ovary

Ovarian

86.6

14

Yes

Yes

12

chromogranin, synaptophysin, surfactant, TTF, CK20, LCA, CA-125, Her2/neu

ER, PR, monoclonal CEA, focal CK7

Breast, Ovary, Uterine

Breast

96.4

14

Yes

Yes

13

Her2/neu, PR

estrogen receptor (10% cells staining at 1+)

Breast

Breast

95

14

Yes

Yes

14

HMB45, Tyrosinase, Melan-A, RCC, ER

CK7, AE1/AE3, CAM 5.2, TTF, S100, surfactant protein, CK20; weak CDX-2

Lung

Ovarian

87.5

13

No*

Yes

15

EGF-R

Lung

Lung

66.9

12

Yes

Yes

16

LeuM1, S100

PLAP, CA-125, monoclonal CEA

Pancreas, Ovary

Pancreas

39.5

11

Yes

Yes

17

PSA, neuroendocrine markers, S100

mucicarmine, CEA, cytokeratin

Colon, Prostate, Stomach, Lung

Pancreas

37.3

10

No*

Yes

18

PSA, TTF, calretinin, thrombomodulin, P63

CK7, CK20, monoclonal CEA, CDX-2

Esophagus, Stomach, Pancreas, Biliary

Breast

36.1

10

No*

Yes

19

smooth myo actin, desmin, S100, HMB-45, CD34, chromogranin, CK7

focal C-kit, focal synaptophysin, focal CK20, mucicarmine, PAS

Colon

Colorectal

31.5

8

Yes

Yes

20

Not available

Not available

None

Indeterminate

24

9

--

--

21

mucicarmine, HepPar, alpha-fetoprotein, synaptophysin

CEA monoclonal/polyclonal, Cam-5.2, AE1

Liver, Cholangiocarcinoma

Indeterminate

20.7

9

--

--


* Still a plausible primary call given the overall patient presentation and clinicopathologic findings; see text for discussion.

SS: Similarity Score; AE: cytokeratin; BRST: Breast; C-kit: cytokine receptor CD117; CA-125: cancer antigen 125; Cam 5.2: anti-cytokeratin; CD: cluster of differentiation; CDX: an intestine-specific transcription factor; CEA: carcinoembryonic antigen; CK: cytokeratin; ER: estrogen receptor; HepPar: hepatocyte paraffin; Her-2/neu: human epidermal growth factor receptor 2; HMB-45: human melanoma black; LeuM1: a granulocyte-related differentiation antigen; P53: tumor protein 53, a transcription factor; P63: a P53-related nuclear protein; PAS: periodic acid Schiff stain; PLAP: placenta-like alkaline phosphatase; PR: progesterone receptor; PSA: prostate-specific antigen; RCC: renal cell carcinoma marker; S-100: a neuroectodermal antigen; TTF-1: thyroid transcription factor-1; WT1: Wilms' tumor protein-1

Monzon et al. Diagnostic Pathology 2010 5:3   doi:10.1186/1746-1596-5-3

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