TTF-1 in pulmonary adenocarcinoma

 

 

Peripheral parenchymal type

33/373

 

Indeterminate group (between peripheral and central types)

56/773

Central bronchial type

7/143

   

Atypical alveolar hyperplasia

5/53

   

By tumour subtype:

mixed pattern

55/653

non-mucinous bronchoalveolar carcinoma

9/93, 24/265, 30/326

acinar, papillary or tubular

10/143

solid with mucin

14/253

mucinous, other than mucinous bronchoalveolar carcinoma and signet ring cell

8/112, 2/43

mucinous bronchoalveolar carcinoma

3/102, 1/23, 3/145, 4/186

signet ring cell

14/171, 2/22, 1/13

Clear cell

1/23

Pleomorphic / sarcomatoid with adenocarcinoma

3/63, 17/214

   

When examining by areas of tumour with a particular pattern, some tumours being mixed:

non-mucinous bronchoalveolar-like

32/333

mucinous bronchoalveolar-like

1/43

papillary

11/113

inseparable papillary/tubular

15/183

tubular

40/483

solid

42/583

Poorly differentiated adenocarcinoma

4/103

mucinous

2/63

   
 

 Reference 7

components

TTF-1

 

 

total

1-10% of nuclei

11-50% of nuclei

51-90% of nuclei

>90% of nuclei

Group A: adenocarcinomas with Clara/type II (with or without a bronchial surface epithelial component), in addition to other components

Clara/Type II

87/87

1

5

4

77

mixed Clara/type II and bronchial surface epithelial component

39/39

1

7

9

22

bronchial surface epithelial component

5/5

1

2

1

1

goblet cell component

0/1

0

0

0

0

poorly differentiated component

41/44

6

9

14

12

Total

105/105

1

10

29

65

Group B: adenocarcinomas with components including bronchial surface epithelial component and/or goblet cell component, but lacking a Clara/type II component

bronchial surface epithelial component

6/15

3

2

0

1

mixed bronchial surface epithelial and goblet cell component

1/10

1

0

0

0

poorly differentiated component

4/15

2

1

0

1

Total

7/33

4

2

0

1

Group C: adenocarcinomas with only a poorly differentiated component

8/10

1

2

3

2

             

Although TTF-1 is extremely useful in identifying primary pulmonary carcinomas, it is commonly negative in mucinous bronchoalveolar carcinomas5, which may also be positive for CDX-2 and CK20, but are also positive for CK7 and retain negativity for villin.

References

1 Merchant, S. H., Amin, M. B., Tamboli, P., Ro, J., Ordonez, N. G., Ayala, A. G., Czerniak, B. A., Ro, J. Y. Primary signet-ring cell carcinoma of lung: immunohistochemical study and comparison with non-pulmonary signet-ring cell carcinomas. Am J Surg Pathol 2001;25:1515-1519

2 Rossi, G., B. Murer, et al. (2004). "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 28(4): 442-52.

3 Stenhouse, G., N. Fyfe, et al. (2004). "Thyroid transcription factor 1 in pulmonary adenocarcinoma." J Clin Pathol 57(4): 383-7. (with clarification from author)

4 Rossi, G., Cavazza, A., Sturm, N., Migaldi, M., Facciolongo, N., Longo, L., Maiorana, A. and Brambilla, E. Pulmonary carcinomas with pleomorphic, sarcomatoid, or sarcomatous elements: a clinicopathologic and immunohistochemical study of 75 cases. Am J Surg Pathol 2003;27:311-24.

5 Goldstein, N. S. and M. Thomas (2001). "Mucinous and nonmucinous bronchioloalveolar adenocarcinomas have distinct staining patterns with thyroid transcription factor and cytokeratin 20 antibodies." Am J Clin Pathol 116(3): 319-25.

6 Saad, R. S., Y. L. Liu, et al. (2004). "Prognostic significance of thyroid transcription factor-1 expression in both early-stage conventional adenocarcinoma and bronchioloalveolar carcinoma of the lung." Hum Pathol 35(1): 3-7.

7 Maeshima AM, Omatsu M, Tsuta K, et al. Immunohistochemical expression of TTF-1 in various cytological subtypes of primary lung adenocarcinoma, with special reference to intratumoral heterogeneity. Pathol Int 2008; 58:31-7

 

This page last revised 27.11.2008.

©SMUHT/PW Bishop