Determining the site of origin of mucinous adenocarcinoma

Mucinous adenocarcinomas of similar appearance may arise from various primary sites.

Primary site of mucinous tumour

CK7

CK20

CDX-2

b-catenin (nuclear)

MUC-1

MUC-2

MUC-5AC

MUC-6

WT-1

pax-8

other

focal/weak(heterogenous)

diffuse(homogenous)

Lung

16/161

5/161

2/161

0/161, 0/1010, 0/3011, 10%12

0/161

15/161, 0/78, 58%12

4/161,
0/78,
0/1010, 18%12

6/78,
10/1010, 98%12

5/161,
7/78,
75%12

0/161

Napsin: 0/161
TTF-1: 0/161

Breast

18/181

0/181

18/181, 17/177

18/181,16/177

2/177

9/181,12/177

16/181

9/181

0/181

Stomach

11/121

8/121

10/121

2/121

5/121

6/121

11/121

7/121

0/121, 0/413

0/121

Ampulla

1/41

3/41

1/41

2/41

4/41

3/41

0/41, 0/413

0/41

Pancreas

24/251

15/251

1/251

2/251

16/251

13/251

21/251

0/251, 0/1313

0/251

Appendix

11/271

26/271

24/271

3/271

4/271

27/271

0/271

Colorectum

6/371,
6/232, 0/113, 7/414, 13/299

36/371,
20/232, 11/113, 31/414, 17/299

8/371, 4/414

29/371, 26/414, 10/105, 29/299

24/371,
19/232, 40/416

4/371

37/371, 21/144

1/414

3/371

0/371, 0/2413

0/371

Anus

2/51

5/51

1/51

4/51

3/51

2/51

5/51

0/51

Bladder

3/41

4/41

2/41

0/41

1/41

4/41

0/41

Ovary

17/191, 34/432, 11/113, 20/224, 3/149

9/191, 19/432, 8/113, 10/224, 6/149

4/191, 1/224, 15/165, 3/149

1/191, 1/224

0/191, 4/432

6/191

4/19 , 0/22

11/224

3/191

2/191, 0/1113

0/191

9/191

Endometrium

3/31

0/31

3/31

1/31

0/31

2/31

0/31

3/31

Cervix

5/51

0/51

5/51

2/51

5/51

3/51, 3/813

0/51

1/51

References

1 Chu PG, Chung L, Weiss LM, Lau SK. Determining the site of origin of mucinous adenocarcinoma: an immunohistochemical study of 175 cases. Am J Surg Pathol. 2011 Dec;35(12):1830-6.

2 Chou YY, Jeng YM, Kao HL, Chen T, Mao TL, Lin MC. Differentiation of ovarian mucinous carcinoma and metastatic colorectal adenocarcinoma by immunostaining with beta-catenin. Histopathology. 2003 Aug;43(2):151-6.

3 Brown RW, Campagna LB, Dunn JK, Cagle PT. Immunohistochemical identification of tumor markers in metastatic adenocarcinoma. A diagnostic adjunct in the determination of primary site. Am J Clin Pathol. 1997 Jan;107(1):12-9.

4 Shin JH, Bae JH, Lee A, Jung CK, Yim HW, Park JS, et al. CK7, CK20, CDX2 and MUC2 Immunohistochemical staining used to distinguish metastatic colorectal carcinoma involving ovary from primary ovarian mucinous adenocarcinoma. Jpn J Clin Oncol. 2010 Mar;40(3):208-13.

5 Fraggetta F, Pelosi G, Cafici A, Scollo P, Nuciforo P, Viale G. CDX2 immunoreactivity in primary and metastatic ovarian mucinous tumours. Virchows Arch. 2003 Dec;443(6):782-6.

Hanski C, Hofmeier M, Schmitt-Graff A, Riede E, Hanski ML, Borchard F, et al. Overexpression or ectopic expression of MUC2 is the common property of mucinous carcinomas of the colon, pancreas, breast, and ovary. J Pathol. 1997 Aug;182(4):385-91.

6 Ikeda S, Shimizu Y, Fujimori M, Ishizaki Y, Kurihara T, Ojima Y, et al. Immunohistochemical and mutational analyses of beta-catenin, Ki-ras, and p53 in two subtypes of colorectal mucinous carcinoma. Clin Cancer Res. 2003 Nov 15;9(15):5660-5.

Ji H, Isacson C, Seidman JD, Kurman RJ, Ronnett BM. Cytokeratins 7 and 20, Dpc4, and MUC5AC in the distinction of metastatic mucinous carcinomas in the ovary from primary ovarian mucinous tumors: Dpc4 assists in identifying metastatic pancreatic carcinomas. Int J Gynecol Pathol. 2002 Oct;21(4):391-400. REQUEST FROM LIBRARY

7 Matsukita S, Nomoto M, Kitajima S, Tanaka S, Goto M, Irimura T, et al. Expression of mucins (MUC1, MUC2, MUC5AC and MUC6) in mucinous carcinoma of the breast: comparison with invasive ductal carcinoma. Histopathology. 2003 Jan;42(1):26-36.

8 Awaya H, Takeshima Y, Yamasaki M, Inai K. Expression of MUC1, MUC2, MUC5AC, and MUC6 in atypical adenomatous hyperplasia, bronchioloalveolar carcinoma, adenocarcinoma with mixed subtypes, and mucinous bronchioloalveolar carcinoma of the lung. Am J Clin Pathol. 2004 May;121(5):644-53.

9 Raspollini MR, Amunni G, Villanucci A, Baroni G, Taddei A, Taddei GL. Utility of CDX-2 in distinguishing between primary and secondary (intestinal) mucinous ovarian carcinoma: an immunohistochemical comparison of 43 cases. Appl Immunohistochem Mol Morphol. 2004 Jun;12(2):127-31. FULL TEXT

10Rossi G, Murer B, Cavazza A, Losi L, Natali P, Marchioni A, et al. Primary mucinous (so-called colloid) carcinomas of the lung: a clinicopathologic and immunohistochemical study with special reference to CDX-2 homeobox gene and MUC2 expression. Am J Surg Pathol. 2004 Apr;28(4):442-52.

11 Saad RS, Cho P, Silverman JF, et al. Usefulness of Cdx2 in separating mucinous bronchioloalveolar adenocarcinoma of the lung from metastatic mucinous colorectal adenocarcinoma. Am J Clin Pathol 2004; 122:421-7

12 Tsuta K, Ishii G, Nitadori J, et al. Comparison of the immunophenotypes of signet-ring cell carcinoma, solid adenocarcinoma with mucin production, and mucinous bronchioloalveolar carcinoma of the lung characterized by the presence of cytoplasmic mucin. J Pathol 2006; 209:78-87

13 Vang R, Gown AM, Barry TS, Wheeler DT, Ronnett BM. Immunohistochemistry for estrogen and progesterone receptors in the distinction of primary and metastatic mucinous tumors in the ovary: an analysis of 124 cases. Mod Pathol. 2006 Jan;19(1):97-105.

14 Vang R, Gown AM, Wu LS, Barry TS, Wheeler DT, Yemelyanova A, et al. Immunohistochemical expression of CDX2 in primary ovarian mucinous tumors and metastatic mucinous carcinomas involving the ovary: comparison with CK20 and correlation with coordinate expression of CK7. Mod Pathol. 2006 Nov;19(11):1421-8.

Vang R, Gown AM, Barry TS, Wheeler DT, Yemelyanova A, Seidman JD, et al. Cytokeratins 7 and 20 in Primary and Secondary Mucinous Tumors of the Ovary: Analysis of Coordinate Immunohistochemical Expression Profiles and Staining Distribution in 179 Cases. Am J Surg Pathol. 2006 Sep;30(9):1130-9.

Mucinous adenocarcinomas of similar appearance may arise from various primary sites.

References

1 Chu PG, Chung L, Weiss LM, Lau SK. Determining the site of origin of mucinous adenocarcinoma: an immunohistochemical study of 175 cases. Am J Surg Pathol. 2011 Dec;35(12):1830-6.

2 Chou YY, Jeng YM, Kao HL, Chen T, Mao TL, Lin MC. Differentiation of ovarian mucinous carcinoma and metastatic colorectal adenocarcinoma by immunostaining with beta-catenin. Histopathology. 2003 Aug;43(2):151-6.

4 Shin JH, Bae JH, Lee A, Jung CK, Yim HW, Park JS, et al. CK7, CK20, CDX2 and MUC2 Immunohistochemical staining used to distinguish metastatic colorectal carcinoma involving ovary from primary ovarian mucinous adenocarcinoma. Jpn J Clin Oncol. 2010 Mar;40(3):208-13.

5 Fraggetta F, Pelosi G, Cafici A, Scollo P, Nuciforo P, Viale G. CDX2 immunoreactivity in primary and metastatic ovarian mucinous tumours. Virchows Arch. 2003 Dec;443(6):782-6.

Hanski C, Hofmeier M, Schmitt-Graff A, Riede E, Hanski ML, Borchard F, et al. Overexpression or ectopic expression of MUC2 is the common property of mucinous carcinomas of the colon, pancreas, breast, and ovary. J Pathol. 1997 Aug;182(4):385-91.

This page last revised 8.3.2012