Medicine of the Future in America

Skin metastasis from an occult esophageal adenocarcinoma: CASE PRESENTATION (Part 3)

Immunohistochemical findings Immunohistochemical findings
For the immunohistochemical studies, formalin-fixed and paraffin-embedded sections were stained using the standard avidin-biotin-peroxidase complex method. The following monoclonal antibodies were applied: AE1/AE3, 1:50 dilution, Dako A/S, Denmark; CK7 (QV-TL12/30), 1:50 dilution, Dako; CK20, 1:100 dilution, Dako; epithelial membrane antigen, 1:200 dilution, Dako; p53 (DO7), 1:100 dilution, Dako; and c-erbB-2, 1:80 dilution, (Dako).
Diaminobenzidine was used to visualize the reaction product. CK7 and CK20 were treated with citrate and microwaved for antigen retrieval.The immunohistochemical features in the metastatic skin tumour were similar to those in the esophageal adenocarcinoma. The immunohistochemical study indicated an epithelial origin for both the metastatic and the primary tumour.
Both the skin and the esophageal tumour cells showed diffuse immunostaining with AE1/AE3 (Figures 4A and 4B) and diffuse membrane staining with epithelial membrane antigen. Immunostaining was negative for CK20, but positive for CK7 in both samples (Figures 5A and 5B). p53 demonstrated diffuse nuclear staining in both specimens (Figures 6A and 6B). No immunostaining was noted for c-erbB-2 in the tumour cells of skin and of the esophagus. Shop online to always get cialis professional enjoying safe and quick shopping.
The immunohistochemical staining (Table 1) provided evidence that the skin metastasis originated from the esophageal carcinoma.
Figure_4Figure 4) Immunostaining for cytokeratin (AE1/AE3) shows strong positivity in tumour cells of the skin (A) (original magnification x400); and esophagus (B) (original magnification x100)
Figure_5Figure 5) Immunohistochemical staining for CK7 shows positivity for both the skin metastasis (A) (original magnification x400); and esophageal tumour cells (B) (original magnification x100)
Figure_6Figure 6) Immunohistochemical staining for p53 is positive in the skin (A) and in the esophageal tumour cells (B). Original magnification x200

TABLE 1 The result of immunohistochemical staining of the skin metastasis and the esophageal carcinoma

CK C (AE1/AE3) EMA CK20 CK7 p53 c-erbB-2
Primary tumour + + + +
Secondary tumour + + + +
This entry was posted in Skin metastasis and tagged Cutaneous metastases, Esophageal adenocarcinoma, Histology, Oncology, Pathology.
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