Eble JN, Sauter G., Epstein JI, Sesterhenn IA - iarc
Eble JN, Sauter G., Epstein JI, Sesterhenn IA - iarc
Eble JN, Sauter G., Epstein JI, Sesterhenn IA - iarc
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A<br />
B<br />
Fig. 3.20 A, B Adenocarcinoma with mucinous fibroplasia (collagenous micronodules).<br />
A<br />
B<br />
Fig. 3.21 A Adenocarcinoma with perineural invasion. B Prostate cancer with glomerulations.<br />
spectrum and low molecular weight<br />
cytokeratins. However, only basal cells<br />
express high molecular weight cytokeratins<br />
{309}. One high molecular monoclonal<br />
cytokeratin antibody, clone<br />
34βE12, recognizes 57 and 66 kilodalton<br />
cytokeratins in stratum corneum corresponding<br />
to Moll numbers 1, 5, 10 and<br />
14, and is widely used as a basal cell<br />
specific marker active in paraffin-embedded<br />
tissue following proteolytic digestion<br />
{66,309,918,1048,1765,2374,2905}.<br />
34βE12 is also immunoreactive against<br />
squamous, urothelial, bronchial/pneumocyte,<br />
thymic, some intestinal and ductal<br />
epithelium (breast, pancreas, bile duct, salivary<br />
gland, sweat duct, renal collecting<br />
duct), and mesothelium {918}. An<br />
immunoperoxidase cocktail containing<br />
monoclonal antibodies to cytokeratins 5 and<br />
6 is also an effective basal cell stain {1286}.<br />
Since uniform absence of a basal cell<br />
layer in prostatic acinar proliferations is<br />
one important diagnostic feature of invasive<br />
carcinoma and basal cells may be<br />
inapparent by H&E stain, basal cell specific<br />
immunostains may help to distinguish<br />
invasive prostatic adenocarcinoma<br />
from benign small acinar cancer - mimics<br />
which retain their basal cell layer, e.g.<br />
glandular atrophy, post-atrophic hyperplasia,<br />
adenosis (atypical adenomatous<br />
hyperplasia), sclerosing adenosis and<br />
radiation induced atypia {66,1048,2905}.<br />
Because the basal cell layer may be<br />
interrupted or not demonstrable in small<br />
numbers of benign glands, the complete<br />
absence of a basal cell layer in a small<br />
focus of acini cannot be used alone as a<br />
definitive criterion for malignancy; rather,<br />
absence of a basal cell layer is supportive<br />
of invasive carcinoma only in acinar<br />
proliferations which exhibit suspicious<br />
cytologic and / or architectural features<br />
on H&E stain {1048}. Conversely, some<br />
early invasive prostatic carcinomas, e.g.<br />
microinvasive carcinomas arising in<br />
association with or independent of high<br />
grade prostatic intraepithelial neoplasia,<br />
may have residual basal cells {1952}.<br />
Intraductal spread of invasive carcinoma<br />
and entrapped benign glands are other<br />
proposed explanations for residual basal<br />
cells {66,2905}. Rare prostatic adenocarcinomas<br />
contain sparse neoplastic glandular<br />
cells, which are immunoreactive for<br />
34βE12, yet these are not in a basal cell<br />
distribution {66,2374}. The use of antibodies<br />
for 34βE12 is especially helpful<br />
for the diagnosis for of deceptively<br />
benign appearing variants of prostate<br />
cancer. Immunohistochemistry for cytokeratins<br />
7 and 20 have a limited diagnostic<br />
use in prostate pathology with the<br />
exception that negative staining for both<br />
markers, which can occur in prostate<br />
Acinar adenocarcinoma 173