Merkel cell carcinoma with an unusual immunohistochemical profile
The clinical and morphological picture of Merkel cell carcinoma (MCC) may be rather challenging; therefore, the immunohistochemical profile plays a relevant role in confirming the microscopic diagnosis. A panel of antibodies including cytokeratins 20, 7 and epithelial membrane antigen, and neuronspe...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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PAGEPress Publications
2009-12-01
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| Series: | European Journal of Histochemistry |
| Subjects: | |
| Online Access: | http://ejh.pagepress.org/index.php/ejh/article/view/1539 |
| _version_ | 1818145351820902400 |
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| author | G. Faa D. Ribuffo G. Senes C. Manieli L. Pilloni |
| author_facet | G. Faa D. Ribuffo G. Senes C. Manieli L. Pilloni |
| author_sort | G. Faa |
| collection | DOAJ |
| description | The clinical and morphological picture of Merkel cell carcinoma (MCC) may be rather challenging; therefore, the immunohistochemical profile plays a relevant role in confirming the microscopic diagnosis. A panel of antibodies including cytokeratins 20, 7 and epithelial membrane antigen, and neuronspecific enolase is used in confirming the morphological diagnosis of MCC. The majority of MCCs express CK20 and are CK7-negative. Herein, we present a case of primary cutaneous neuroendocrine carcinoma with an atypical immunohistochemical pattern. A 83-years old woman presented with a painless plaque, red to violaceous in colour, located in the leg. The skin tumor was excided, formalin-fixed and paraffinembedded. Tissue sections were immunostained with a panel of antibodies routinely utilized in complex primary skin tumors for evidencing epithelial and neuroendocrine differentiation of tumor cells. The neuroendocrine differentiation of tumor cells was evidenced by their immunoreactivity for synaptophysin, chromograninA and neuron-specific enolase. Tumor cells also showed diffuse cytoplasmic staining for CK7. No immunoreactivity was detected for CK20 and thyroid transcription factor-1. Our data, together with previous rare reports of CK20-/CK7+ MCCs, lay stress on the importance of routinely utilizing a panel of antibodies in the differential diagnosis of complex primary carcinomas of the skin and may have important implications in expanding the differential diagnosis of skin tumors. In particular, caution should be taken in excluding the diagnosis of MCC only on the basis of the absence of reactivity of tumor cells for CK20, favouring the wrong diagnosis of less aggressive skin tumors. |
| first_indexed | 2024-12-11T12:02:05Z |
| format | Article |
| id | doaj.art-6411be8e4344460ebc568a80b431f469 |
| institution | Directory Open Access Journal |
| issn | 1121-760X |
| language | English |
| last_indexed | 2024-12-11T12:02:05Z |
| publishDate | 2009-12-01 |
| publisher | PAGEPress Publications |
| record_format | Article |
| series | European Journal of Histochemistry |
| spelling | doaj.art-6411be8e4344460ebc568a80b431f4692022-12-22T01:08:04ZengPAGEPress PublicationsEuropean Journal of Histochemistry1121-760X2009-12-0153427527810.4081/ejh.2009.275Merkel cell carcinoma with an unusual immunohistochemical profileG. FaaD. RibuffoG. SenesC. ManieliL. PilloniThe clinical and morphological picture of Merkel cell carcinoma (MCC) may be rather challenging; therefore, the immunohistochemical profile plays a relevant role in confirming the microscopic diagnosis. A panel of antibodies including cytokeratins 20, 7 and epithelial membrane antigen, and neuronspecific enolase is used in confirming the morphological diagnosis of MCC. The majority of MCCs express CK20 and are CK7-negative. Herein, we present a case of primary cutaneous neuroendocrine carcinoma with an atypical immunohistochemical pattern. A 83-years old woman presented with a painless plaque, red to violaceous in colour, located in the leg. The skin tumor was excided, formalin-fixed and paraffinembedded. Tissue sections were immunostained with a panel of antibodies routinely utilized in complex primary skin tumors for evidencing epithelial and neuroendocrine differentiation of tumor cells. The neuroendocrine differentiation of tumor cells was evidenced by their immunoreactivity for synaptophysin, chromograninA and neuron-specific enolase. Tumor cells also showed diffuse cytoplasmic staining for CK7. No immunoreactivity was detected for CK20 and thyroid transcription factor-1. Our data, together with previous rare reports of CK20-/CK7+ MCCs, lay stress on the importance of routinely utilizing a panel of antibodies in the differential diagnosis of complex primary carcinomas of the skin and may have important implications in expanding the differential diagnosis of skin tumors. In particular, caution should be taken in excluding the diagnosis of MCC only on the basis of the absence of reactivity of tumor cells for CK20, favouring the wrong diagnosis of less aggressive skin tumors.http://ejh.pagepress.org/index.php/ejh/article/view/1539Merkel cell carcinoma, immunohistochemical profile, CK20 negative, CK7 positive. |
| spellingShingle | G. Faa D. Ribuffo G. Senes C. Manieli L. Pilloni Merkel cell carcinoma with an unusual immunohistochemical profile European Journal of Histochemistry Merkel cell carcinoma, immunohistochemical profile, CK20 negative, CK7 positive. |
| title | Merkel cell carcinoma with an unusual immunohistochemical profile |
| title_full | Merkel cell carcinoma with an unusual immunohistochemical profile |
| title_fullStr | Merkel cell carcinoma with an unusual immunohistochemical profile |
| title_full_unstemmed | Merkel cell carcinoma with an unusual immunohistochemical profile |
| title_short | Merkel cell carcinoma with an unusual immunohistochemical profile |
| title_sort | merkel cell carcinoma with an unusual immunohistochemical profile |
| topic | Merkel cell carcinoma, immunohistochemical profile, CK20 negative, CK7 positive. |
| url | http://ejh.pagepress.org/index.php/ejh/article/view/1539 |
| work_keys_str_mv | AT gfaa merkelcellcarcinomawithanunusualimmunohistochemicalprofile AT dribuffo merkelcellcarcinomawithanunusualimmunohistochemicalprofile AT gsenes merkelcellcarcinomawithanunusualimmunohistochemicalprofile AT cmanieli merkelcellcarcinomawithanunusualimmunohistochemicalprofile AT lpilloni merkelcellcarcinomawithanunusualimmunohistochemicalprofile |