Utility of Immunohistochemistry in Distinguishing Primary Adnexal Carcinoma From Metastatic Breast Carcinoma to Skin and Squamous Cell Carcinoma

The American Journal of Dermatopathology
Aida Valencia-GuerreroKristine M Cornejo

Abstract

The distinction between primary adnexal carcinoma (PAC) from metastatic breast carcinoma (BrCa) to skin and squamous cell carcinoma (SCC), particularly those with ductal differentiation (SCCDD), can be quite challenging, despite adequate history. The aim of the study was to determine the utility of an immunohistochemistry (IHC) panel to differentiate these entities and apply them to ambiguous tumors. Twenty-seven PAC, 7 metastatic BrCa, 28 SCC, and 16 ambiguous cases (SCCDD vs. PAC, n = 13 and metastatic BrCa vs. PAC, n = 3) were analyzed using CD23, PAX5, D2-40, P63, and CD117 immunohistochemistry. A total of 9 (33%) PAC were CD117 positive, whereas all metastatic BrCa and SCC were negative (P = 0.0002). D2-40 was expressed in 16 (59%) PAC and 16 (57%) SCC cases, but none of the metastatic BrCa cases (P = 0.0041). Of the 13 ambiguous tumors with a differential diagnosis of SCCDD versus PAC, all were positive for P63, 10 were positive for D2-40, and 1 was positive for CD117. Of the 3 ambiguous tumors with a differential diagnosis of PAC versus metastatic BrCA, 2 were positive for CD117, whereas none showed reactivity for D2-40 or P63. All cases were negative for CD23 and PAX5. Our study indicates that CD117 reactivity favors a ...Continue Reading

References

Aug 19, 2007·Journal of Cutaneous Pathology·Jason CarvalhoLinglei Ma
Aug 25, 2007·Advances in Anatomic Pathology·Andrew L Feldman, Ahmet Dogan
Dec 31, 2014·Archives of Pathology & Laboratory Medicine·Tammie Ferringer
Jan 31, 2015·The American Journal of Dermatopathology·Haruto NishidaShigeo Yokoyama
Jan 1, 2015·Dermatopathology·Leigh A ComptonChristine G Lian
Jan 18, 2017·Journal of Cutaneous Pathology·Mara Therese P Evangelista, Jeffrey P North

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Citations

Jul 9, 2020·International Journal of Dermatology·Reason WilkenMary L Stevenson
Nov 21, 2019·International Journal of Molecular Sciences·Artem SmirnovEleonora Candi

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