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Metaplastic breast carcinomas: are they of myoepithelial differentiation?: immunohistochemical profile of the sarcomatoid subtype using novel myoepithelial markers.
Am J Surg Pathol. 2005 Mar; 29(3):347-53.AJ

Abstract

We investigated 20 spindle cell (sarcomatoid) metaplastic carcinomas (MCs) without squamous differentiation. In addition, five high-grade phyllodes tumors were assessed for comparison. Our immunohistochemical antibody panel included pan-cytokeratin (CK), low molecular weight CK (CK8/18), four basal cell type CKs (34betaE12, CK5/6, CK14, and CK17), vimentin antibodies, as well as antibodies to established (SMA, CD10, p63, S-100, maspin, calponin, GFAP, SM-myosin), and novel (CD29, 14-3-3sigma) myoepithelial markers. Sixteen of the 20 tumors (80%) expressed at least two markers of the combination CD10/p63/SMA. S-100 detected 1 case negative for CD10/p63/SMA and 3 cases that only expressed one marker of this combination. While 18 MCs (90%) were positive for CD29, 14-3-3sigma (11 cases) and maspin (9 cases) were observed in 55% and 45%, respectively. Antibodies to pan-CK and the basal cell type CKs were strongly reactive in 12 tumors (60%), but in 6 cases (30%) positivity for these markers was weak and only focal; 2 MCs showed no positivity for CK. The stromal component of all phyllodes tumors was positive for vimentin, whereas all other investigated markers were absent except for focal p63 and CD10 expression in 1 case each. Our findings convincingly show a myoepithelial immunophenotype in sarcomatoid MCs, which is demonstrated by the presence of basal cell type CKs and the combination of the established myoepithelial markers CD10, p63, SMA, and S-100. We conclude that tumors with weak or even absent CK expression should only be diagnosed as primary sarcomas of the breast after exclusion of a myoepithelial immunophenotype. CD29 and 14-3-3sigma represent valuable novel myoepithelial markers in these diagnostically difficult cases.

Authors+Show Affiliations

Department of Pathology, Medical University of Graz, Graz, Austria. sebastian.leibl@klinikum-graz.atNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15725803

Citation

Leibl, Sebastian, et al. "Metaplastic Breast Carcinomas: Are They of Myoepithelial Differentiation?: Immunohistochemical Profile of the Sarcomatoid Subtype Using Novel Myoepithelial Markers." The American Journal of Surgical Pathology, vol. 29, no. 3, 2005, pp. 347-53.
Leibl S, Gogg-Kammerer M, Sommersacher A, et al. Metaplastic breast carcinomas: are they of myoepithelial differentiation?: immunohistochemical profile of the sarcomatoid subtype using novel myoepithelial markers. Am J Surg Pathol. 2005;29(3):347-53.
Leibl, S., Gogg-Kammerer, M., Sommersacher, A., Denk, H., & Moinfar, F. (2005). Metaplastic breast carcinomas: are they of myoepithelial differentiation?: immunohistochemical profile of the sarcomatoid subtype using novel myoepithelial markers. The American Journal of Surgical Pathology, 29(3), 347-53.
Leibl S, et al. Metaplastic Breast Carcinomas: Are They of Myoepithelial Differentiation?: Immunohistochemical Profile of the Sarcomatoid Subtype Using Novel Myoepithelial Markers. Am J Surg Pathol. 2005;29(3):347-53. PubMed PMID: 15725803.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Metaplastic breast carcinomas: are they of myoepithelial differentiation?: immunohistochemical profile of the sarcomatoid subtype using novel myoepithelial markers. AU - Leibl,Sebastian, AU - Gogg-Kammerer,Margit, AU - Sommersacher,Andrea, AU - Denk,Helmut, AU - Moinfar,Farid, PY - 2005/2/24/pubmed PY - 2005/4/9/medline PY - 2005/2/24/entrez SP - 347 EP - 53 JF - The American journal of surgical pathology JO - Am. J. Surg. Pathol. VL - 29 IS - 3 N2 - We investigated 20 spindle cell (sarcomatoid) metaplastic carcinomas (MCs) without squamous differentiation. In addition, five high-grade phyllodes tumors were assessed for comparison. Our immunohistochemical antibody panel included pan-cytokeratin (CK), low molecular weight CK (CK8/18), four basal cell type CKs (34betaE12, CK5/6, CK14, and CK17), vimentin antibodies, as well as antibodies to established (SMA, CD10, p63, S-100, maspin, calponin, GFAP, SM-myosin), and novel (CD29, 14-3-3sigma) myoepithelial markers. Sixteen of the 20 tumors (80%) expressed at least two markers of the combination CD10/p63/SMA. S-100 detected 1 case negative for CD10/p63/SMA and 3 cases that only expressed one marker of this combination. While 18 MCs (90%) were positive for CD29, 14-3-3sigma (11 cases) and maspin (9 cases) were observed in 55% and 45%, respectively. Antibodies to pan-CK and the basal cell type CKs were strongly reactive in 12 tumors (60%), but in 6 cases (30%) positivity for these markers was weak and only focal; 2 MCs showed no positivity for CK. The stromal component of all phyllodes tumors was positive for vimentin, whereas all other investigated markers were absent except for focal p63 and CD10 expression in 1 case each. Our findings convincingly show a myoepithelial immunophenotype in sarcomatoid MCs, which is demonstrated by the presence of basal cell type CKs and the combination of the established myoepithelial markers CD10, p63, SMA, and S-100. We conclude that tumors with weak or even absent CK expression should only be diagnosed as primary sarcomas of the breast after exclusion of a myoepithelial immunophenotype. CD29 and 14-3-3sigma represent valuable novel myoepithelial markers in these diagnostically difficult cases. SN - 0147-5185 UR - https://www.unboundmedicine.com/medline/citation/15725803/Metaplastic_breast_carcinomas:_are_they_of_myoepithelial_differentiation:_immunohistochemical_profile_of_the_sarcomatoid_subtype_using_novel_myoepithelial_markers_ L2 - http://dx.doi.org/10.1097/01.pas.0000152133.60278.d2 DB - PRIME DP - Unbound Medicine ER -