|
Type of carcinoma |
Cytokeratin (Moll's catalog) |
||||||||
|
CK4 |
|||||||||
|
Ductal |
grade I |
|
|
18/234, 10/105 |
|
|
|
|
0/105 |
|
grade II |
|
|
30/324, 37/465 |
|
|
|
0/465, 4/856 |
||
|
grade III |
|
|
12/134, 43/455 |
|
|
|
3/455, 4/186 |
||
|
grade not stated |
|
|
37/387, 17/198, 5/69 |
|
|
|
|
7/387, 1/198, 0/69, 0/6713 |
|
|
total |
|
|
209/232 (90%) |
|
|
|
|
19/334 (6%) |
|
|
Lobular |
|
|
|
78/822, 11/117, 5/74 |
|
|
|
|
4/822, 1/117, 0/713 |
|
Cribriform |
|
|
|
5/52 |
|
|
|
|
0/52 |
|
Tubular |
|
|
|
10/102 |
|
|
|
|
1/102 |
|
|
|
|
9/112, 2/34, 13/147 |
|
|
|
|
3/112, 1/46, 0/147, 0/913 |
|
|
Medullary |
typical |
0/241 |
6/241 |
23/241 |
3/241 |
24/241 |
1/241 |
||
|
atypical |
0/71 |
3/71 |
7/71 |
7/71 |
1/71 |
7/71 |
1/71 |
||
|
metastatic |
0/101 |
2/101 |
9/101 |
2/101 |
10/101 |
9/101 |
0/101 |
||
|
|
|
|
2/32 |
|
|
|
|
1/32 |
|
|
Mucinous cystadeno-carcinoma |
|
|
|
4/43 |
|
|
|
|
0/43 |
|
Carcinoma NOS |
|
8%(3/39)10 |
|
|
|
|
|
|
|
|
Overall |
|
|
|
387/423 (91%) |
|
|
|
125/130 (96%) |
41/698 (6%) |
See also the coordinate expression of cytokeratins 7 and 20
Cytokeratin 8 staining of DCIS and invasive ductal carcinoma is diffusely cytoplasmic. This contrasts with the perinuclear staining of CLIS and invasive lobular carcinoma (which results in "bag of marbles" impression). This difference in the pattern of staining is retained even in those tumours which otherwise do not demonstrate characteristic histomorphological features (i.e. solid or pleomorphic type of lobular carcinoma). E-Cadherin shows a similar peripheral-predominant immunostaining pattern (33/33 cases) in ductal carcinoma while lobular carcinomas were negative (all 15 cases)11.
Cytokeratin 5/6 immunophenotyping may be useful in differentiating benign epithelial proliferations from those which are atypical or malignant10:
|
luminal epithelial cells |
myoepithelial cells |
||
|
normal breast tissue |
terminal duct lobular unit |
87% |
38% |
|
terminal duct |
76% |
98% |
|
|
major and lactiferous duct |
67% |
100% |
|
|
fibrocystic disease |
cysts |
21% |
87% |
|
apocrine metaplasia |
0 |
92% |
|
|
benign proliferations |
adenosis |
50% |
45% |
|
sclerosing adenosis |
52% |
88% |
|
|
ductal hyperplasia of usual type |
97% |
93% |
|
|
papilloma/papillomatosis |
50% |
82% |
|
|
fibroadenoma |
33% |
83% |
|
|
adenomyoepithelioma |
67% |
67% |
|
|
atypical hyperplasia |
atypical ductal hyperplasia |
7% |
95% |
|
atypical lobular hyperplasia |
26% |
83% |
|
|
carcinoma in situ |
ductal carcinoma in situ |
4% |
94% |
|
lobular carcinoma in situ |
17% |
83% |
|
|
invasive carcinoma, NOS |
9% |
myoepithelial cells absent |
|
References
7Wang NP, Zee S, Zarbo RJ et al.Coordinate expression of cytokeratins 7 and 20 defines unique subsets of carcinomas. Appl Immunohist 1995;3:99-107.
8Savera AT, Torres FX, Linden MD et al. Primary versus metastatic pulmonary adenocarcinoma: an Immunohistochemical study using villin, cytokeratin 7 and 20. Appl Immunohist 1996;86-94.
©SMUHT/PW Bishop