Immunohistochemistry, Prostate



Immunohistochemistry, Prostate


Gladell P. Paner, MD

Danielle E. Westfall, MD

Mahul B. Amin, MD










































































































































































































































Prostatic Adenocarcinoma and Its Mimics


Antibody


Adenocarcinoma


Seminal Vessel & Ejaculatory Duct


Nephrogenic Adenoma


Cowper Gland


Mesonephric Hyperplasia*


Stromal Sarcoma


Small Cell Carcinoma


PSA


+


−/+


−/weak +


−/+ (rare)





PAP


+


−/+


−/weak+






PSMA


+








CD57


+








AR


+


+




+



+/−


AMACR


+


−/NS


+/−





−/+ (47%)


HMCK(34βE12)



+ (basal cells)


−/+


+


−/+ (33%)




PAN-CK(AE1/AE3)


+


+


+


+


−/+



+ (dot-like)


Pax-2



+


+


ND





Actin-sm





+



−/+



Desmin





ND



−/+



MyoD1









Myogenin









CD99






ND



−/+


CD45(LCA)









ER


+/−




ND



−/+



PR


+/−




ND



+



CD34







+



p63



+ (basal cells)


−/+


+


+/−




CD117









Synaptophysin


V







+


Chromogranin


V







+


CD56


V







+


TTF-1








+


ND = No Data, V = Variable, NS = Nonspecific staining in pigment. *Mesonephric remnants also positive for CD10, calretinin, and vimentin.























Important Immunohistochemical Stains in Diagnosis of Prostate Carcinoma


Immunostain


Rationale for Use


Basal cell-associated markers HMCK(34βE12), CK5/6, p63, basal cell cocktail


Benign vs. malignant proliferation; complete absence of basal cell layer is defining criterion for invasive prostate carcinoma


Prostate carcinoma-associated marker AMACR (p504S)


Benign vs. malignant proliferation; absence of basal cell-associated markers favoring invasive prostate carcinoma


Epithelial lineage PAN-CK(AE1/AE3)


Identification of subtle infiltrating cells in post-treatment setting; in differential diagnosis of carcinoma vs. nonepithelial process or malignancy


Prostate lineage-specific marker PSA, PAP, PSMA


Prostatic vs. nonprostatic origin, e.g., Cowper gland, mesonephric remnant, nephrogenic adenoma, seminal vesicle vs. prostate cancer
































Atypical Glandular Proliferations, Small Glands


Antibody


Benign Glands


Post-Atrophic Hyperplasia and Atrophy


Prostatic Adenocarcinoma


Basal Cell Hyperplasia


Outpouching of High-Grade PIN


AAH (Adenosis)


Basal cell-associated markers


+


+ (patchy)



+


+


−/+ (patchy)


AMACR


−/+ (rare)


−/+


+ (strong circumferential)



+


−/+



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Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Immunohistochemistry, Prostate

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