2003;39:1990–2005. Glycogen-rich cytoplasm is PAS positive, diastase sensitive Prognosis: Depends on stage (low stage behaves well). CK7 was diffusely positive in case 2 (>50% of tumor cells) and focally positive in case 5 (<10% of tumor cells) (2/8). Cytokeratin 7 decorates squamous cell carcinoma and squamous dysplasias of the cervix. An adenocarcinoma with co-expression of CK7, ER and GATA3 is highly specific for breast primary; however, rarely, urothelial carcinoma, choriocarcinoma, … There are clusters and tubules of atypical cells forming glandular clusters with small lumina containing mucinous secretions . The expected immunoprofile of a lower gastrointestinal tumor is CK7 negative, CK20 positive and CDX2 positive, with the reverse generally associated with a primary ovarian tumor. Primary sites of origin include the gastrointestinal tract,155-157 appendix,158,159 cervix,160 pancreas,161 and biliary system.162 Features favoring metastatic disease to the ovaries include a concomitant extraovarian neoplasm, bilateral ovarian involvement, tumor implants on external ovarian surfaces, multinodular involvement of ovarian parenchyma, and extensive lymphovascular space invasion.163 Additional microscopic features typically associated with primary colon cancers include a garland or cribriform growth pattern, segmental destruction of glands, intraluminal “dirty” necrosis, absence of squamous metaplasia, and nuclear grade disproportionately high relative to the degree of gland formation.156,157, In problematic cases, immunostaining for CK7 and CK20, as well as CDX2, may be helpful. adenocarcinoma show positive immunoreactivity for CK7. 2020 Sep 26;8(18):4200-4206. doi: 10.12998/wjcc.v8.i18.4200. ScienceDirect ® is a registered trademark of Elsevier B.V. ScienceDirect ® is a registered trademark of Elsevier B.V. Urologic Surgical Pathology (Fourth Edition), Immunohistology of the Female Genital Tract, Diagnostic Immunohistochemistry (Third Edition), Immunohistochemistry of the Gastrointestinal Tract, Pancreas, Bile Ducts, Gallbladder and Liver, Diagnostic Immunohistochemistry (Second Edition), Immunohistology of Metastatic Carcinoma of Unknown Primary, Ductal Adenocarcinoma, Including Variants, Diagnostic Pathology: Hepatobiliary and Pancreas (Second Edition), Comprehensive Cytopathology (Third Edition), Epithelial Neoplasms of the Small Intestine, Surgical Pathology of the GI Tract, Liver, Biliary Tract, and Pancreas (Second Edition), Modern Surgical Pathology (Second Edition), Diagnostic Pathology: Neoplastic Dermatopathology (Second Edition). CDX2 expression at both cut-off levels (> 5% and > 50%) had a higher sensitivity (96.6% and 78%) than the CK phenotype. Park JW, Jeong JM, Cho KS, Cho SY, Cheon JH, Choi DH, Park SJ, Kim HK. Chromophobe RCCs are also usually positive for C-kit (a transmembrane receptor with tyrosine kinase activity in its intracellular domain) in 83–100% of cases and are negative for vimentin (Fig. The exception, again, is the endocervical variant of primary mucinous carcinoma, which is frequently positive for these hormone receptors.153. (Right) This eosinophilic variant of CH-RCC has a nested growth pattern and cells with granular eosinophilic cytoplasm, histologic features that overlap with renal oncocytoma. In Diagnostic Pathology: Hepatobiliary and Pancreas (Second Edition), 2017, Positive for claudin-4, fascin, mesothelin, S100 protein, Loss of nuclear expression of p16 (> 90%) and DPC4/SMAD4 (55%), Neoplastic epithelial cells suspended in large pools of extracellular mucin, Colloid component must comprise at least 80% of tumor, Almost always arises in association with intestinal-type IPMN, Signet ring cells comprise > 50% of tumor, Metastasis from stomach, breast, and colon should be excluded, Squamous differentiation in at least 30% of tumor, Carcinomas with mixed differentiation: By definition, each component should comprise at least 30% of tumor, Mixed acinar-ductal-neuroendocrine carcinoma, Poorly differentiated carcinoma with pushing rather than infiltrating borders, Some cases have prominent tumor-infiltrating lymphocytes, Associated with microsatellite instability, Lynch syndrome, EBV, Better prognosis than conventional ductal adenocarcinoma, Undifferentiated carcinoma ± osteoclastic-like giant cells, Majority of tumor cells do not show any specific differentiation, Anaplastic giant cell variant: Pleomorphic tumor cells mixed with bizarre multinucleated tumor giant cells, Sarcomatoid carcinoma variant: Composed of malignant spindle cells, Carcinosarcoma variant: Adenocarcinoma mixed with sarcomatoid spindle cell elements, Undifferentiated carcinoma with osteoclast-like giant cells: Pleomorphic spindle cells mixed with nonneoplastic, osteoclast-like giant cells, Giant cells often have > 20 nuclei and are found around necrosis and hemorrhage, Often associated with PanIN, PDAC, or mucinous cystic neoplasm, Significant component demonstrates hepatocellular differentiation, Hepatocellular markers (arginase-1, Hep-Par1) positive, Can occur in association with ductal adenocarcinoma, acinar cell carcinoma, or neuroendocrine carcinoma, Metastasis from liver primary should be excluded, Clear cytoplasm resembles renal cell carcinoma, Uncommon tumors of probable ductal phenotype, Oncocytic carcinoma, nonmucinous carcinoma, glycogen-poor cystadenocarcinoma, choriocarcinoma, ciliated cell adenocarcinoma, microadenocarcinoma, Ruth L. Katz, Savitri Krishnamurthy, in Comprehensive Cytopathology (Third Edition), 2008, Chromophobe RCC commonly express CK-7, ranging from 50 to 100% in several studies, which is very often focal rather than diffuse. Metastases to the skin can present as an umbilical nodule. Specific cytokeratin expression gives valuable information as to the primary site of a carcinoma. MiR-30a and miR-200c differentiate cholangiocarcinomas from gastrointestinal cancer liver metastases. Of various clinicopathologic parameters, tumor The CK7+/CK20- expression pattern was observed in only 2% (2 of 118) of colorectal carcinomas. Careers. The second, termed peritoneal mucinous carcinomatosis, has deposits of mucinous epithelium with architectural and cytologic malignant features floating in the mucin (see Fig. Arch Pathol Lab Med. CK7 was positive in six of seven ChRCCs (Figure 4 B), whereas 10 of 12 (83.3%) renal oncocytomas were negative (Figure 4 C), of which, two (16.7%) showed few scattered immunoreactivity in < 10% of tumor cells and were considered negative. -. The CK7 test is an important examination in pathology for determining tumours as well as cancers. Pancreatic and gastric tumors mostly had to be grouped together. PLoS One. 4c), CDX2 (Fig. 2004 May;10(5):BR139-43. In the remaining 75% of cases, the result will be helpful in determining the site of origin of the tumour Additionally, epithelial tumor markers, CK (especially CK7) and EMA, are also positive in these tumors [192–197]. Panels of immunohistochemical markers help determine primary sites of metastatic adenocarcinoma. The histologic appearance of case 2 was rather typical for classical ES, with epithelioid tumor cells and areas of geographic necrosis . Cancer. doi: 10.1054/cdip.2001.0079. From: Urologic Surgical Pathology (Fourth Edition), 2020, Joseph T. Rabban, ... Charles Z. Zaloudek, in Diagnostic Immunohistochemistry (Third Edition), 2010, Cytokeratin 7 (CK7) is a type II basic low molecular weight cytokeratin that is found in simple epithelia in a variety of organs, including all epithelia in the female genital tract.305,306 Epithelial tumors of the ovary and fallopian tube all exhibit cytoplasmic and/or membrane staining for CK7.307-309 This characteristic staining pattern of female genital tract tumors can be used, usually in combination with staining for other keratins such as CK20, to differentiate primary female genital tract adenocarcinomas from adenocarcinomas arising in other organs.149,310 A panel of immunostains needs to be evaluated because some primary ovarian neoplasms fail to stain for CK7 and a proportion of metastatic carcinomas in the ovary are CK7-positive.311, Neal S. Goldstein, David S. Bosler, in Diagnostic Immunohistochemistry (Second Edition), 2006, Antibodies: CK7, CK20, CEA, CA 125, vimentin, CD56, CDX2, ER (Fig. Methods: Cytokeratins 7 and 20 are most useful in this respect. Hematoxylin-eosin stain (left upper), cytokeratin (CK)7 (right upper), CK20 (left lower), and thyroid transcription factor-1 (TTF-1) (right lower). Mucinous adenocarcinoma of the buttock associated with hidradenitis: A case report. CK7 shows strong and diffuse cytoplasmic staining in this metastatic gastric carcinoma. 2008 Jan;27(1):92-100. doi: 10.1097/pgp.0b013e31815698e7. World J Clin Cases. Skip to main content. David J. Dabbs, in Diagnostic Immunohistochemistry (Second Edition), 2006. 7.2). Clipboard, Search History, and several other advanced features are temporarily unavailable. eCollection 2021. CK20 was positive (mostly patchy) in 44.7% (P < 0.001) of the UC and in 5.9% of the PC cases. Unable to load your collection due to an error, Unable to load your delegates due to an error. Hyperchromatic oval to spindle-shaped cells show indistinct cytoplasmic borders with a fibrillary background. Epub 2018 Oct 5. Eur J Cancer. (Left) Strong membrane-dominant immunostaining for cytokeratin 7 is characteristic of CH-RCC and can help in the differential diagnosis with clear cell RCC and oncocytoma. CK7 is a 54 kD type II simple keratin that has a restricted distribution compared with keratins 8 and 18. Transitional cell carcinoma(+) versus squamous cell carcinoma(−). -, Park SY, Kim BH, Kim JH, Lee S, Kang GH. NCI CPTC Antibody Characterization Program, Varadhachary GR. Of 157 HCCs, 93 were CK7(−)CK19(−), 49 were CK7(+)-CK19(−), 1 was CK7(−)CK19(+), and 14 were CK7(+)-CK19(+). Strong cytoplasmic CK7 staining may be a characteristic feature of this tumor, whereas it is negative or focally positive in renal oncocytoma (Fig. Our results were comparable to those of a study by Bassily et al. Can be associated with vascular thrombosis and paraneoplastic hypercalcemia DDX: Yolk sac tumor→Positive Glypican-3, AFP, SALL4; Negative CK7 Dysgerminoma→Positive Oct3/4, SALL4 ; Negative CK7 This is metastatic gastric carcinoma, which first presented as a skin metastasis in an older adult patient. Privacy, Help CK7 and TTF-1 are positive in the cytoplasm and nuclei of tumor cells, respectively (original magnification ×200). Background/objective: 8600 Rockville Pike In Diagnostic Pathology: Neoplastic Dermatopathology (Second Edition), 2017, Metastatic Small Intestinal Carcinoma: CK-PAN. Colorectal carcinomas (R–N) versus lung, breast, thymus, and ovarian carcinomas (largely positive). Med Sci Monit. CK7 may be expressed in 20–50% of cells in rectal adenocarcinomas that are unassociated with perianal Paget's disease, and is typically expressed in Paget's cells of mammary and extramammary sites.95 For diagnostic purposes, carcinomas that are metastatic in the lymph nodes, liver, or brain and immunostain strongly with CK7 may have origin in the lung, breast, ovary, endometrium, bladder, or neuroendocrine system.
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