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Immunohistochemical staining of papillary breast lesions.
Appl Immunohistochem Mol Morphol. 2007 Jun; 15(2):145-53.AI

Abstract

The separation of ductal papilloma from intraductal papillary carcinoma of the breast on hematoxylin and eosin stained sections often presents diagnostic difficulty. Immunohistochemical staining is often employed in diagnosis, historically with smooth muscle actin (SMA). In this study, the staining characteristics of a panel of myoepithelial markers (calponin, p63, P-cadherin), were compared with SMA, and the epithelial expression of CD44s was assessed in 99 papillary lesions. SMA, calponin, and p63 demonstrated myoepithelial cells in 61%, 63%, and 65% of papillary lesions, respectively. However, specificity was quite variable. Calponin-stained stromal myofibroblasts (35% of cases), vessel pericytes (92%), and endothelial cells (69%), though each to a lesser degree than SMA. Calponin also showed cross reactivity with epithelium in 18% of cases. p63 was almost completely restricted to myoepithelial cell nuclei, and did not stain vascular smooth muscle or myofibroblasts. However, p63 stained the epithelial component in one papillary carcinoma, a basal layer of cells in 1 biphasic invasive carcinoma, and the cytoplasm in 1 case. P-cadherin stained both epithelial and myoepithelial cells. The epithelial expression of CD44s and did not distinguish papillomas from papillary carcinomas. Thus, P-cadherin and CD44s are not useful in the characterization of papillary lesions. Given increased specificity as compared with SMA, the combination of p63 and calponin is recommended for analysis of breast papillary lesions.

Authors+Show Affiliations

Department of Pathology, Stanford University Medical Center, Stanford, CA 94305, USA. troxellm@ohsu.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17525625

Citation

Troxell, Megan L., et al. "Immunohistochemical Staining of Papillary Breast Lesions." Applied Immunohistochemistry & Molecular Morphology : AIMM, vol. 15, no. 2, 2007, pp. 145-53.
Troxell ML, Masek M, Sibley RK. Immunohistochemical staining of papillary breast lesions. Appl Immunohistochem Mol Morphol. 2007;15(2):145-53.
Troxell, M. L., Masek, M., & Sibley, R. K. (2007). Immunohistochemical staining of papillary breast lesions. Applied Immunohistochemistry & Molecular Morphology : AIMM, 15(2), 145-53.
Troxell ML, Masek M, Sibley RK. Immunohistochemical Staining of Papillary Breast Lesions. Appl Immunohistochem Mol Morphol. 2007;15(2):145-53. PubMed PMID: 17525625.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Immunohistochemical staining of papillary breast lesions. AU - Troxell,Megan L, AU - Masek,Marilyn, AU - Sibley,Richard K, PY - 2007/5/26/pubmed PY - 2007/7/10/medline PY - 2007/5/26/entrez SP - 145 EP - 53 JF - Applied immunohistochemistry & molecular morphology : AIMM JO - Appl Immunohistochem Mol Morphol VL - 15 IS - 2 N2 - The separation of ductal papilloma from intraductal papillary carcinoma of the breast on hematoxylin and eosin stained sections often presents diagnostic difficulty. Immunohistochemical staining is often employed in diagnosis, historically with smooth muscle actin (SMA). In this study, the staining characteristics of a panel of myoepithelial markers (calponin, p63, P-cadherin), were compared with SMA, and the epithelial expression of CD44s was assessed in 99 papillary lesions. SMA, calponin, and p63 demonstrated myoepithelial cells in 61%, 63%, and 65% of papillary lesions, respectively. However, specificity was quite variable. Calponin-stained stromal myofibroblasts (35% of cases), vessel pericytes (92%), and endothelial cells (69%), though each to a lesser degree than SMA. Calponin also showed cross reactivity with epithelium in 18% of cases. p63 was almost completely restricted to myoepithelial cell nuclei, and did not stain vascular smooth muscle or myofibroblasts. However, p63 stained the epithelial component in one papillary carcinoma, a basal layer of cells in 1 biphasic invasive carcinoma, and the cytoplasm in 1 case. P-cadherin stained both epithelial and myoepithelial cells. The epithelial expression of CD44s and did not distinguish papillomas from papillary carcinomas. Thus, P-cadherin and CD44s are not useful in the characterization of papillary lesions. Given increased specificity as compared with SMA, the combination of p63 and calponin is recommended for analysis of breast papillary lesions. SN - 1541-2016 UR - https://www.unboundmedicine.com/medline/citation/17525625/Immunohistochemical_staining_of_papillary_breast_lesions_ L2 - https://doi.org/10.1097/01.pai.0000210420.45869.f4 DB - PRIME DP - Unbound Medicine ER -