Table 2 |
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|
Immunohistochemical and Tissue of Origin Test results |
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|
Immunohistochemistry Results |
Tissue of Origin (TOO) Test results |
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|
|
|
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|
Case No. |
Negative |
Positive |
Suspected tissues based on clinicopathology |
TOO result |
TOO SS |
Rule out tissues |
Consistent |
Management Value |
|
|
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|
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 |
-- |
-- |
|
|
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|
* 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 |
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|
Monzon et al. Diagnostic Pathology 2010 5:3 doi:10.1186/1746-1596-5-3 |
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