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IMMUNOHISTOCHEMICAL
STAINS
Available Immunoperoxidase Antibodies:
Cytoplasmic staining.
ACTIN (smooth muscle).. specific for smooth muscle. / ASR
Cytoplasmic staining.
ALK PROTEIN.. present in anaplastic large cell (cd30+) lymphomas. / ASR
Cytoplasmic and nuclear staining.
ALPHA-FETOPROTEIN (AFP)..Positive in hepatoma, endodermal sinus tumor, embryonal Ca, gastric and lung Ca / IVD
Cytoplasmic staining.
B72.3.. Marker for carcinomas; not very site specific but occasionally used as epithelial marker in mesothelioma work up. / IVD
Cytoplasmic staining.
BCA225.. see tumor marker panel / ASR
Cytoplasmic staining.
BCL-2.. may be helpful in some difficult or atypical cases of follicular lymphoma / ASR
Cytoplasmic staining.
BerEp4.. an epithelial marker; may be useful in mesothelioma workup / ASR
Cytoplasmic staining.
CA19-9.. see tumor marker panel / ASR
Cytoplasmic staining.
CA125.. see tumor marker panel / ASR
Cytoplasmic staining.
CALCITONIN.. medullary Ca of thyroid, multiple other tumors / ASR
Cytoplasmic staining.
CALDESMON.. good smooth muscle marker (possibly the best); does not stain myofibroblasts
CALPONIN (see SMM-HC).. stains myoepithelium. May show some reactivity with myofibroblasts and is best used in conjunction with SMM-HC in determining invasion on
DCIS. / ASR
CALRETININ.. a positive marker stain, in a large percent of epithelioid mesothelioma./ASR
Cytoplasmic staining.
CAM 5.2.. useful in differentiating hepatoma from other carcinomas. It is at times only positive stain in occasional small cell carcinomas. It is a broadly reactive, extensively used low molecular weight ctokeratin useful in a battery of stains to rule out carcinoma.
CARCINOEMBRYONIC ANTIGEN (CEA) Monoclonal.. GI, other carcinomas (mesotheliomas negative)/ ASR
Cytoplasmic staining.
CARCINOEMBRYONIC ANTIGEN (CEA) Polyclonal.. Positive with a sinusoidal pattern in hepatoma (must be polyclonal)
CD1a.. Langerhans cells, Histiocytosis X
CD3.. A "Pan T" marker / IVD
Membrane staining.
CD4.. Marks T helper subset; also marks macrophages and DRC's / ASR
Membrane staining.
CD5.. "Pan T" marker, also expressed in B cells of B-CLL / SLL and Mantle Cell
lymphoma / ASR
Membrane staining.
CD8.. Marks T suppressor / ASR
Membrane staining.
CD10.. Reactive in many follicular lymphomas and some cases of acute lymphocytic leukemia. Also stains most renal cell carcinomas./ ASR
Membrane staining.
CD15.. myeloid cells, mainly on granulocyte; reacts with Hodgkin and
Reed-Sternberg cells in most Hodgkin's disease cases.
Cytoplasmic staining.
CD20 (L26).. "pan B" marker / ASR
Membrane staining.
CD21.. marks follicular dendritic cells. May help deineate the follicular dendritic network in follicular lymphoma.
CD23.. B marker, helpful with CD5 in differentiation of CLL/SLL from MCL / ASR
Membrane staining.
CD30(Ki-1).. anaplastic large cell lymphomas, Hodgkin and Reed-Sternberg cells / ASR
Membrane and Golgi staining H.D. / cytoplasmic A-LCL.
CD31.. Endothelium, megakaryocytes / megakaryoblast / ASR
Membrane staining.
CD34.. hematopoietic progenitor (stem) cells and in vascular endothelial cell studies: some subtypes GIST tumors / IVD
Membrane staining.
CD43.. Equivalent to CD5 in B-CLL but works better on paraffin than CD5. / IVD
Membrane staining.
CD45(CLA).. pan leukocyte marker / IVD
Membrane staining.
CD52 (CAMPATH).. non-lineage marker specific to target CAMPATH antibody.
CD57.. This Natural Killer cell antibody has use primarily in differentiating lymphocyte predominat Hodgkin's disease (LPHD) from T cell rich B cell lymphoma (TCRBCL) and classic Hodgkin's disease and in diagnosis of T-large granular lymphocyte and natural killer cell leukemias and lymphomas. Typically one sees numerous CD57-positive T cells in LPHD and few to none in TCRBCL and classic Hodgkin's. In many LPHD the CD57-positive T cells form a ring around the L and H cells.
CD68.. macrophages; also peripheral blood monocytes, myeloid element, myeloid leukemia's / ASR
Cytoplasmic staining.
CD79.. a good alternate "pan B" marker, positive in early and late stages of Be cell maturation; useful for some B cell lymphomas (occasional B-LCL's) which fail to express cd 20.
CD99.. neuroendocrine marker; marks PNET's with Wilms tumor/ IVD
Cytoplasmic staining.
CD117 (c-kit).. GIST tumors and small cell carcinoma.
CD138.. marks plasma cell. /ASR
Primarily membrane staining.
C-erb-B2 (Her-2/neu) .. oncoprotein; prognostic factor in breast Ca; may delineate a subgroup more resistant to standard chemotherapy. / ASR
Cell membrane.
CHROMOGRANIN.. neurosecretory granules: neuroendocrine "pan endocrine" marker / IVD
Cytoplasmic staining.
CHORIONIC GONADOTROPIN (Beta).. choriocarcinoma; can be seen in numerous other malignancies / IVD
Cytoplasmic staining.
COLLAGEN TYPE IV.. Basement membrane protein, subset of sarcomas (muscle, nerve sheath, liposarcoma)
CYCLIN D1.. present in mantle cell lymphoma / ASR
Nuclear staining.
CYTOKERATIN (AE1/AE3).. a preferred "pankeratin", reactive in most human epithelia / ASR
Cytoplasmic staining.
CYTOKERATIN (903, 34betaE12).. high weight cytokeratin which reacts with all squamous and ductal epithelium and stains carcinomas, recognizes cytokeratins 1,5,10,14, which are found in complex epithelium/we us to recognize myoepithelial layer in differential diagnosis of adenosis vs prostate Ca / ASR
Cytoplasmic staining.
CYTOKERATIN 5/6.. a positive marker, present in a large percent of epithelioid mesothelioma./ ASR
Cytoplasmic staining.
CYTOKERATIN 8.. Useful (in combination with E-cadherin) for distinguishing infiltrating ductal vs lobular Ca (see E-cadherin)
CYTOKERATIN 7.. Helpful in conjunction with Cytokeratin 20, in determining primary site of carcinomas of unknown origin. / ASR
Cytoplasmic staining. (See P63)
CYTOKERATIN 20.. See Cytokeratin 7. / ASR
Cytoplasmic staining.
DESMIN.. differential diagnosis of soft tissue tumors. Desmin antibody reacts with leiomyomas and rhabdomyomas, and also could detect perivascular cells of glomustumors of the skin which confirm myogenic nature. This antibody is basically used to demonstrate the myogenic components of carcinosarcomas and malignant mixed mesodermal tumors. / IVD
Cytoplasmic staining.
E-CADHERIN.. Useful in distinguishing IDC from ILC [ ILC (-), IDC (+) ] CK8 stains both
(see CK8) / ASR
EPITHELIAL MEMBRANE ANTIGEN(EMA).. labels both normal and neoplastic epithelium. Positive staining demonstrates the epithelial origin of tumors and, in conjunction with LCA, enables an objective study of lymphomas and carcinomas. / ASR
Membrane staining.
ESTROGEN.. Prognostic/treatment guide, breast Ca, meningioma; workup of
adenocarcinoma, unknown primary. / ASR
Nuclear staining.
FACTOR VIII.. (von Willebrand's Factor) endothelial marker / IVD
Cytoplasmic staining.
GCDFP15.. Breast, salivary, sweat gland tumors
GLIAL FIBRILLARY ACIDIC PROTEIN (GFAP).. major product of astrocytic differentiation and gliomas (neurofibroma, schwannoma negative) / ASR
Cytoplasmic staining.
GLYCOPHORIN.. marks erythroid precursors.
H-CALDESMON.. Most specific smooth muscle marker (in differentiation of smooth muscle vs myoepithelial lesions) / ASR
HELICOBACTER.. reacts with H. pylori on the surface of epithelial cells of pyloric and stomach mucosa.
Cytoplasmic staining.
HEPATOCYTE.. stains the majority of hepatocellular carcinoma, including fibrolamellar variants.
Granular cytoplasmic staining.
HMB-45.. melanocytic tumors / IVD
Cytoplasmic staining.
INHIBIN.. adrenal cortical tumors, granuosa cell tumors.
Cytoplasmic staining.
KAPPA.. cytoplasmic Kappa light chains; occasionally will mark light chains of cell membrane; stains cytoplasm of R-S cells; surrogate marker of R-S cells (polyclonal kappa and lambda) / ASR
Cytoplasmic staining.
LAMBDA.. cytoplasmic Lambda light chains; occasinally will mark light chains on cell membrane; stains cytoplasm of R-S cells / ASR
Cytoplasmic staining.
LYSOZYME.. positive staining of granulocyte and monocytes/macrophages, useful marker for the demonstration of the myeloid or monocytic nature of acute leukemia, helpful in differentiating between histiocytic cells and large lymphocytes and in the classification of lymphoproliferative disorders / IVD
Cytoplasmic staining.
MART 1.. Melanoma marker: stains higher percentage of melanomas than HMB45. / IVD
Cytoplasmic staining.
MELANOMA COCKTAIL.. (includes Mart 1 and HMB 45, 50) melanocytic tumors. / ASR
Cytoplasmic staining.
MIB1 (Ki67).. Cell proliferation marker / ASR
Nuclear staining.
MYCOBACTERIUM TUBERCULOSIS .. mycobacterium tuberculosis (alternative method to the conventional Ziehl-Neelsen method)
Cytoplasmic staining.
MYELOPEROXIDASE.. myeloid marker / ASR
Cytoplasmic staining.
NSE.. neuroectodermal and neuroendocrine tumors, reactivity in other neoplasms limits usefulness / ASR
Cytoplasmic staining.
P504S.. prostate cancer marker negative in benign prostate.
P53.. prognostic marker in breast carcinoma; presence indicates a neoplastic process; thus, may be helpful in hypercellular marrows to rule out MPD, MDS / ASR
Nuclear staining.
P63.. present in normal prostate basal cells but negative in prostate carcinoma; use the same way as CK903. It is a nuclear stain.
PLACENTAL ALKALINE PHOSPHATASE (PLAP).. Seminomas
Cytoplasmic staining.
PNEUMOCYSTIS CARINI.. pneumocystis carni / IVD
The staining pattern is visualized as homogenous rings corresponding to individual cyst walls.
In addition, free extra-cystic P. carinii are stained.
PROGESTERONE.. Prognostic/treatment guide, breast Ca, meningioma; workup of adenocarcinoma, unknown primary / ASR
Nuclear staining.
PROSTATIC ACID PHOSPHATASE (PAP).. prostatic adenocarcinoma / IVD
Cytoplasmic staining.
PROSTATIC SPECIFIC ANTIGEN (PSA).. prostatic adenocarcinoma / IVD
Cytoplasmic staining.
RCC.. Renal cell carcinoma; negative in oncocytoma and chromophobe carcinoma.
Membrane and coarse globular staining in cytoplasm.
S-100.. schwannoma, neurofibroma, melanoma, retinoblastoma, granular cell tumor, benign salivary mixed tumors / ASR
Cytoplasmic staining.
ANTI-SMOOTH MUSCLE MYOSIN HEAVY CHAIN (SMM-HC).. (see Calponin)
Stains myoepithelium with minimal or no reacitvity with myofibroblasts. Useful in determininginvasion in DCIS. Should be used in conjunction with Calponin.
Note: Staining in areas of DCIS may be discontinuous, particularly in dilated ducts.
SURFACTANT apo A1.. lung non-small cell carcinomas. / ASR
Cytoplasmic staining.
SYNAPTOPHYSIN.. effective pan-neural marker as it is expressed in most neural and epithelial neuroendocrine neoplasms, regardless of the degree of differentiation / IVD
Cytoplasmic staining.
TDT.. marker of early lymphoid differentiation; not lineage specific (B,T) / ASR
Cytoplasmic and nuclear staining. (Should have nuclear staining to call positive)
TTF1 (Thyroid transcription-factor-1).. Positive in lung and thyroid carcinomas.
Nuclear staining.
THYROGLOBULIN.. thyroid neoplasms (papillary, follicular, medullary) / ASR
Cytoplasmic staining.
VILLIN.. Adenocarcinoma subset, especially gastrointestinal
VIMENTIN.. mesenchymal neoplasms, lymphomas, melanomas, salivary gland tumors Cytoplasmic staining.
Von Willebrand's factor...a.k.a. F. VIII related antigen: endothelial cells.
WT-1.. (Wilms tumor gene product)) desmoplastic small round cell tumor, mesothelioma, ovarian surface epithlial tumors, Wilms tumor, endometrial CA.
Breast Prognostic Markers:
ESTROGEN
PROGESTERONE
C-erb-B2 (Her-2-N90)
Ki67
P53
DNA ploidy by ACIS
Tumor Marker (Adenocarcinoma, Unknown Primary):
CEA
CA19.9
CA125
CK7
CK20
BCA225
Hepatoma
(ALL THREE STRONGLY RECOMMENDED)
AFP
CEA-polyclonal
Heptocyte
Hodgkins Disease
Cd3
Cd15
Cd30
Cd45
Non-Hodgkin's Lymphoma
Cd3
Cd5
Cd10
Cd20
Bcl-2
Ki67
