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Adrenal Gland

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Handbook of Practical Immunohistochemistry

Abstract

This chapter is an overview of frequently used markers in the differential diagnosis of both common and rare tumors of the adrenal gland, with a focus on the effective markers employed for differentiating primary adrenal tumors and their mimics including metastatic renal cell carcinoma, hepatocellular carcinoma, and malignant melanoma. Other useful panels in the differential diagnosis of pheochromocytoma, adrenal cortical neoplasms, and small blue cell tumors are also addressed. There are 19 tables in this chapter with immunohistochemical markers answering questions that may arise when examining hematoxylin and eosin-stained tumor sections. A summary of useful and frequently used markers is also provided, in addition to some representative photomicrographs, and the author’s experience with a few tested antibodies. The effective diagnostic panels of antibodies for several entities are outlined.

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References

  1. Boyle JL, Haupt HM, Stern JB, Multhaupt HA. Tyrosinase expression in malignant melanoma, desmoplastic melanoma, and peripheral nerve tumors. Arch Pathol Lab Med. 2002;126(7):816–22.

    PubMed  CAS  Google Scholar 

  2. Brat DJ, Giannini C, Scheithauer BW, Burger PC. Primary melanocytic neoplasms of the central nervous systems. Am J Surg Pathol. 1999;23(7):745–54.

    Article  PubMed  CAS  Google Scholar 

  3. Brown FM, Gaffey TA, Wold LE, Lloyd RV. Myxoid neoplasms of the adrenal cortex: a rare histologic variant. Am J Surg Pathol. 2000;24(3):396–401.

    Article  PubMed  CAS  Google Scholar 

  4. Busam KJ, Iversen K, Coplan KA, et al. Immunoreactivity for A103, an antibody to melan-A (Mart-1), in adrenocortical and other steroid tumors. Am J Surg Pathol. 1998;22(1):57–63.

    Article  PubMed  CAS  Google Scholar 

  5. Chetty R, Pillay P, Jaichand V. Cytokeratin expression in adrenal phaeochromocytomas and extra-adrenal paragangliomas. J Clin Pathol. 1998;51(6):477–8.

    Article  PubMed  CAS  Google Scholar 

  6. Cho EY, Ahn GH. Immunoexpression of inhibin alpha-subunit in adrenal neoplasms. Appl Immunohistochem Mol Morphol. 2001;9(3):222–8.

    Article  PubMed  CAS  Google Scholar 

  7. Chu P, Wu E, Weiss LM. Cytokeratin 7 and cytokeratin 20 expression in epithelial neoplasms: a survey of 435 cases. Mod Pathol. 2000;13(9):962–72.

    Article  PubMed  CAS  Google Scholar 

  8. Chu PG, Arber DA, Weiss LM. Expression of T/NK-cell and plasma cell antigens in nonhematopoietic epithelioid neoplasms. An immunohistochemical study of 447 cases. Am J Clin Pathol. 2003;120(1):64–70.

    Article  PubMed  Google Scholar 

  9. Collini P, Mezzelani A, Modena P, et al. Evidence of neural differentiation in a case of post-therapy primitive neuroectodermal tumor/Ewing sarcoma of bone. Am J Surg Pathol. 2003;27(8):1161–6.

    Article  PubMed  Google Scholar 

  10. Fetsch PA, Powers CN, Zakowski MF, Abati A. Anti-alpha-inhibin: marker of choice for the consistent distinction between adrenocortical carcinoma and renal cell carcinoma in fine-needle aspiration. Cancer. 1999;87(3):168–72.

    Article  PubMed  CAS  Google Scholar 

  11. Fogt F, Vortmeyer AO, Poremba C, Minda M, Harris CA, Tomaszewski JE. bcl-2 Expression in normal adrenal glands and in adrenal neoplasms. Mod Pathol. 1998;11(8):716–20.

    PubMed  CAS  Google Scholar 

  12. Ghorab Z, Jorda M, Ganjei P, Nadji M. Melan A (A103) is expressed in adrenocortical neoplasms but not in renal cell and hepatocellular carcinomas. Appl Immunohistochem Mol Morphol. 2003;11(4):330–3.

    Article  PubMed  CAS  Google Scholar 

  13. Gluer S, Zense M, von Schweinitz D. Cell adhesion molecules and intermediate filaments on embryonal childhood tumors. Pathol Res Pract. 1998;194(11):773–80.

    Article  PubMed  CAS  Google Scholar 

  14. Jorda M, De MB, Nadji M. Calretinin and inhibin are useful in separating adrenocortical neoplasms from pheochromocytomas. Appl Immunohistochem Mol Morphol. 2002;10(1):67–70.

    Article  PubMed  Google Scholar 

  15. Lin BT, Bonsib SM, Mierau GW, Weiss LM, Medeiros LJ. Oncocytic adrenocortical neoplasms: a report of seven cases and review of the literature. Am J Surg Pathol. 1998;22(5):603–14.

    Article  PubMed  CAS  Google Scholar 

  16. Lugli A, Forster Y, Haas P, et al. Calretinin expression in human normal and neoplastic tissues: a tissue microarray analysis on 5233 tissue samples. Hum Pathol. 2003;34(10):994–1000.

    Article  PubMed  CAS  Google Scholar 

  17. Mahfouz S, Aziz AA, Gabal SM, el-Sheikh S. Immunohistochemical study of CD99 and EMA expression in ependymomas. Medscape J Med. 2008;10(2):41.

    PubMed  Google Scholar 

  18. Matsuki Y, Tanimoto A, Hamada T, Sasaguri Y. Histidine decarboxylase expression as a new sensitive and specific marker for small cell lung carcinoma. Mod Pathol. 2003;16(1):72–8.

    Article  PubMed  Google Scholar 

  19. McCluggage WG, Maxwell P. Adenocarcinomas of various sites may exhibit immunoreactivity with anti-inhibin antibodies. Histopathology. 1999;35(3):216–20.

    Article  PubMed  CAS  Google Scholar 

  20. McCluggage WG, Maxwell P, Patterson A, Sloan JM. Immunohistochemical staining of hepatocellular carcinoma with monoclonal antibody against inhibin. Histopathology. 1997;30(6):518–22.

    Article  PubMed  CAS  Google Scholar 

  21. Miettinen M, Lehto VP, Virtanen I. Immunofluorescence microscopic evaluation of the intermediate filament expression of the adrenal cortex and medulla and their tumors. Am J Pathol. 1985;118(3):360–6.

    PubMed  CAS  Google Scholar 

  22. Miettinen M, Lindenmayer AE, Chaubal A. Endothelial cell markers CD31, CD34, and BNH9 antibody to H- and Y-antigens–evaluation of their specificity and sensitivity in the diagnosis of vascular tumors and comparison with von Willebrand factor. Mod Pathol. 1994;7(1):82–90.

    PubMed  CAS  Google Scholar 

  23. Munro LM, Kennedy A, McNicol AM. The expression of inhibin/activin subunits in the human adrenal cortex and its tumours. J Endocrinol. 1999;161(2):341–7.

    Article  PubMed  CAS  Google Scholar 

  24. Pelkey TJ, Frierson Jr HF, Mills SE, Stoler MH. The alpha subunit of inhibin in adrenal cortical neoplasia. Mod Pathol. 1998;11(6):516–24.

    PubMed  CAS  Google Scholar 

  25. Viswanathan S, George S, Ramadwar M, Medhi S, Arora B, Kurkure P. Evaluation of pediatric abdominal masses by fine-needle aspiration cytology: a clinicoradiologic approach. Diagn Cytopathol. 2010;38(1):15–27.

    PubMed  Google Scholar 

  26. Wirnsberger GH, Becker H, Ziervogel K, Hofler H. Diagnostic immunohistochemistry of neuroblastic tumors. Am J Surg Pathol. 1992;16(1):49–57.

    Article  PubMed  CAS  Google Scholar 

  27. Zubovits J, Buzney E, Yu L, Duncan LM. HMB-45, S-100, NK1/C3, and MART-1 in metastatic melanoma. Hum Pathol. 2004;35(2):217–23.

    Article  PubMed  CAS  Google Scholar 

  28. Abramowsky CR, Katzenstein HM, Alvarado CS, Shehata BM. Anaplastic large cell neuroblastoma. Pediatr Dev Pathol. 2009;12(1):1–5.

    Article  PubMed  Google Scholar 

  29. Alsabeh R, Mazoujian G, Goates J, Medeiros LJ, Weiss LM. Adrenal cortical tumors clinically mimicking pheochromocytoma. Am J Clin Pathol. 1995;104(4):382–90.

    PubMed  CAS  Google Scholar 

  30. Argani P, Erlandson RA, Rosai J. Thymic neuroblastoma in adults: report of three cases with special emphasis on its association with the syndrome of inappropriate secretion of antidiuretic hormone. Am J Clin Pathol. 1997;108(5):537–43.

    PubMed  CAS  Google Scholar 

  31. Arola J, Liu J, Heikkila P, et al. Expression of inhibin alpha in adrenocortical tumours reflects the hormonal status of the neoplasm. J Endocrinol. 2000;165(2):223–9.

    Article  PubMed  CAS  Google Scholar 

  32. Clarke MR, Weyant RJ, Watson CG, Carty SE. Prognostic markers in pheochromocytoma. Hum Pathol. 1998;29(5):522–6.

    Article  PubMed  CAS  Google Scholar 

  33. Franquemont DW, Mills SE, Lack EE. Immunohistochemical detection of neuroblastomatous foci in composite adrenal pheochromocytoma–neuroblastoma. Am J Clin Pathol. 1994;102(2):163–70.

    PubMed  CAS  Google Scholar 

  34. Hachitanda Y, Tsuneyoshi M, Enjoji M. An ultrastructural and immunohistochemical evaluation of cytodifferentiation in neuroblastic tumors. Mod Pathol. 1989;2(1):13–9.

    PubMed  CAS  Google Scholar 

  35. Hoang MP, Ayala AG, Albores-Saavedra J. Oncocytic adrenocortical carcinoma: a morphologic, immunohistochemical and ultrastructural study of four cases. Mod Pathol. 2002;15(9):973–8.

    Article  PubMed  Google Scholar 

  36. Kimura N, Nakazato Y, Nagura H, Sasano N. Expression of intermediate filaments in neuroendocrine tumors. Arch Pathol Lab Med. 1990;114(5):506–10.

    PubMed  CAS  Google Scholar 

  37. Komminoth P, Roth J, Schroder S, Saremaslani P, Heitz PU. Overlapping expression of immunohistochemical markers and synaptophysin mRNA in pheochromocytomas and adrenocortical carcinomas. Implications for the differential diagnosis of adrenal gland tumors. Lab Invest. 1995;72(4):424–31.

    PubMed  CAS  Google Scholar 

  38. Loy TS, Phillips RW, Linder CL. A103 immunostaining in the diagnosis of adrenal cortical tumors: an immunohistochemical study of 316 cases. Arch Pathol Lab Med. 2002;126(2):170–2.

    PubMed  Google Scholar 

  39. Mackenzie IS, Ashby MJ, Donovan T, Voutnis DD, Brown MJ. Bilateral adrenal masses: phaeochromocytoma or melanoma? J R Soc Med. 2006;99(3):153–5.

    Article  PubMed  CAS  Google Scholar 

  40. Sbragia L, Oliveira-Filho AG, Vassallo J, Pinto GA, Guerra-Junior G, Bustorff-Silva J. Adrenocortical tumors in Brazilian children: immunohistochemical markers and prognostic factors. Arch Pathol Lab Med. 2005;129(9):1127–31.

    PubMed  Google Scholar 

  41. Shekitka KM, Sobin LH. Ganglioneuromas of the gastrointestinal tract. Relation to Von Recklinghausen disease and other multiple tumor syndromes. Am J Surg Pathol. 1994;18(3):250–7.

    Article  PubMed  CAS  Google Scholar 

  42. Smithey BE, Pappo AS, Hill DA. C-kit expression in pediatric solid tumors: a comparative immunohistochemical study. Am J Surg Pathol. 2002;26(4):486–92.

    Article  PubMed  Google Scholar 

  43. Stojadinovic A, Brennan MF, Hoos A, et al. Adrenocortical adenoma and carcinoma: histopathological and molecular comparative analysis. Mod Pathol. 2003;16(8):742–51.

    Article  PubMed  Google Scholar 

  44. Thomas JO, Olu-Eddo AA. Immunocytochemistry in the diagnosis of small blue cell tumours of childhood. West Afr J Med. 2006;25(3):199–204.

    PubMed  CAS  Google Scholar 

  45. Wang LL, Perlman EJ, Vujanic GM, et al. Desmoplastic small round cell tumor of the kidney in childhood. Am J Surg Pathol. 2007;31(4):576–84.

    Article  PubMed  Google Scholar 

  46. Zhang PJ, Genega EM, Tomaszewski JE, Pasha TL, LiVolsi VA. The role of calretinin, inhibin, melan-A, BCL-2, and C-kit in differentiating adrenal cortical and medullary tumors: an immunohistochemical study. Mod Pathol. 2003;16(6):591–7.

    Article  PubMed  Google Scholar 

  47. Gaffey MJ, Traweek ST, Mills SE, et al. Cytokeratin expression in adrenocortical neoplasia: an immunohistochemical and biochemical study with implications for the differential diagnosis of adrenocortical, hepatocellular, and renal cell carcinoma. Hum Pathol. 1992;23(2):144–53.

    Article  PubMed  CAS  Google Scholar 

  48. Miettinen M. Neuroendocrine differentiation in adrenocortical carcinoma. New immunohistochemical findings supported by electron microscopy. Lab Invest. 1992;66(2):169–74.

    PubMed  CAS  Google Scholar 

  49. Renshaw AA, Granter SR. A comparison of A103 and inhibin reactivity in adrenal cortical tumors: distinction from hepatocellular carcinoma and renal tumors. Mod Pathol. 1998;11(12):1160–4.

    PubMed  CAS  Google Scholar 

  50. Schmitt A, Saremaslani P, Schmid S, et al. IGFII and MIB1 immunohistochemistry is helpful for the differentiation of benign from malignant adrenocortical tumours. Histopathology. 2006;49(3):298–307.

    Article  PubMed  CAS  Google Scholar 

  51. Shin SJ, Hoda RS, Ying L, DeLellis RA. Diagnostic utility of the monoclonal antibody A103 in fine-needle aspiration biopsies of the adrenal. Am J Clin Pathol. 2000;113(2):295–302.

    Article  PubMed  CAS  Google Scholar 

  52. Vargas MP, Vargas HI, Kleiner DE, Merino MJ. Adrenocortical neoplasms: role of prognostic markers MIB-1, P53, and RB. Am J Surg Pathol. 1997;21(5):556–62.

    Article  PubMed  CAS  Google Scholar 

  53. Wick MR, Cherwitz DL, McGlennen RC, Dehner LP. Adrenocortical carcinoma. An immunohistochemical comparison with renal cell carcinoma. Am J Pathol. 1986;122(2):343–52.

    PubMed  CAS  Google Scholar 

  54. Grignon DJ, Ro JY, Mackay B, et al. Paraganglioma of the urinary bladder: immunohistochemical, ultrastructural, and DNA flow cytometric studies. Hum Pathol. 1991;22(11):1162–9.

    Article  PubMed  CAS  Google Scholar 

  55. Lloyd RV, Blaivas M, Wilson BS. Distribution of chromogranin and S100 protein in normal and abnormal adrenal medullary tissues. Arch Pathol Lab Med. 1985;109(7):633–5.

    PubMed  CAS  Google Scholar 

  56. Lloyd RV, Shapiro B, Sisson JC, Kalff V, Thompson NW, Beierwaltes WA. An immunohistochemical study of pheochromocytomas. Arch Pathol Lab Med. 1984;108(7):541–4.

    PubMed  CAS  Google Scholar 

  57. Shipley WR, Hammer RD, Lennington WJ, Macon WR, et al. Paraffin immunohistochemical detection of CD56, a useful marker for neural cell adhesion molecule (NCAM) in normal and neoplastic fixed tissues. Appl Immunohistochem. 1997;5(2):87–93.

    Article  CAS  Google Scholar 

  58. Sikri KL, Varndell IM, Hamid QA, et al. Medullary carcinoma of the thyroid. An immunocytochemical and histochemical study of 25 cases using eight separate markers. Cancer. 1985;56(10):2481–91.

    Article  PubMed  CAS  Google Scholar 

  59. Stevenson AJ, Chatten J, Bertoni F. CD99 (p30/32MIC2) neuroectodermal/Ewing’s sarcoma antigen as an immunohistochemical marker: review of more than 600 tumors and the literature experience. Appl Immunohistochem. 1994;2:231–40.

    Google Scholar 

  60. Verhofstad AAJ, Steinbusch HWM, Joosten JWJ, Penke B, Varga J, Goldstein M. Immunocytochemical localization of noradrenaline, adrenaline and serotonin. In: Polak JM, Van Noorden S, editors. Immunocytochemistry: practical applications in pathology and biology. Bristol, England: Wright-PSG; 1983. p. 143.

    Google Scholar 

  61. DeLellis RA. Proliferation markers in neuroendocrine tumors: useful or useless? A critical reappraisal. Verh Dtsch Ges Pathol. 1997;81:53–61.

    PubMed  CAS  Google Scholar 

  62. Fellinger EJ, Garin-Chesa P, Triche TJ, Huvos AG, Rettig WJ. Immunohistochemical analysis of Ewing’s sarcoma cell surface antigen p30/32MIC2. Am J Pathol. 1991;139(2):317–25.

    PubMed  CAS  Google Scholar 

  63. Hess E, Cohen C, DeRose PB, Yost B, Costa MD. Nonspecificity of p30/p32MIC2 immunolocalization with the 013 monoclonal antibody in the diagnosis of Ewing’s sarcoma: application of an algorithmic immunohistochemical analysis. Appl Immunohistochem. 1997;5:94–103.

    Article  CAS  Google Scholar 

  64. Miettinen M, Chatten J, Paetau A, Stevenson A. Monoclonal antibody NB84 in the differential diagnosis of neuroblastoma and other small round cell tumors. Am J Surg Pathol. 1998;22(3):327–32.

    Article  PubMed  CAS  Google Scholar 

  65. Ordonez NG. Desmoplastic small round cell tumor: II: an ultrastructural and immunohistochemical study with emphasis on new immunohistochemical markers. Am J Surg Pathol. 1998;22(11):1314–27.

    Article  PubMed  CAS  Google Scholar 

  66. Scotlandi K, Serra M, Manara MC, et al. Immunostaining of the p30/32MIC2 antigen and molecular detection of EWS rearrangements for the diagnosis of Ewing’s sarcoma and peripheral neuroectodermal tumor. Hum Pathol. 1996;27(4):408–16.

    Article  PubMed  CAS  Google Scholar 

  67. Weidner N, Tjoe J. Immunohistochemical profile of monoclonal antibody O13: antibody that recognizes glycoprotein p30/32MIC2 and is useful in diagnosing Ewing’s sarcoma and peripheral neuroepithelioma. Am J Surg Pathol. 1994;18(5):486–94.

    Article  PubMed  CAS  Google Scholar 

  68. Kurtin PJ, Bonin DM. Immunohistochemical demonstration of the lysosome-associated glycoprotein CD68 (KP-1) in granular cell tumors and schwannomas. Hum Pathol. 1994;25(11):1172–8.

    Article  PubMed  CAS  Google Scholar 

  69. Trojanowski JQ, Lee VM, Schlaepfer WW. An immunohistochemical study of human central and peripheral nervous system tumors, using monoclonal antibodies against neurofilaments and glial filaments. Hum Pathol. 1984;15(3):248–57.

    Article  PubMed  CAS  Google Scholar 

  70. Aydin H, Magi-Galluzzi C, Lane BR, et al. Renal angiomyolipoma: clinicopathologic study of 194 cases with emphasis on the epithelioid histology and tuberous sclerosis association. Am J Surg Pathol. 2009;33(2):289–97.

    Article  PubMed  Google Scholar 

  71. Davis CJ, Barton JH, Sesterhenn IA. Cystic angiomyolipoma of the kidney: a clinicopathologic description of 11 cases. Mod Pathol. 2006;19(5):669–74.

    Article  PubMed  Google Scholar 

  72. Eble JN, Amin MB, Young RH. Epithelioid angiomyolipoma of the kidney: a report of five cases with a prominent and diagnostically confusing epithelioid smooth muscle component. Am J Surg Pathol. 1997;21(10):1123–30.

    Article  PubMed  CAS  Google Scholar 

  73. Fetsch PA, Fetsch JF, Marincola FM, Travis W, Batts KP, Abati A. Comparison of melanoma antigen recognized by T cells (MART-1) to HMB-45: additional evidence to support a common lineage for angiomyolipoma, lymphangiomyomatosis, and clear cell sugar tumor. Mod Pathol. 1998;11(8):699–703.

    PubMed  CAS  Google Scholar 

  74. Fujii T, Zen Y, Sato Y, et al. Podoplanin is a useful diagnostic marker for epithelioid hemangioendothelioma of the liver. Mod Pathol. 2008;21(2):125–30.

    PubMed  CAS  Google Scholar 

  75. Hoon V, Thung SN, Kaneko M, Unger PD. HMB-45 reactivity in renal angiomyolipoma and lymphangioleiomyomatosis. Arch Pathol Lab Med. 1994;118(7):732–4.

    PubMed  CAS  Google Scholar 

  76. Jimenez RE, Eble JN, Reuter VE, et al. Concurrent angiomyolipoma and renal cell neoplasia: a study of 36 cases. Mod Pathol. 2001;14(3):157–63.

    Article  PubMed  CAS  Google Scholar 

  77. L’Hostis H, Deminiere C, Ferriere JM, Coindre JM. Renal angiomyolipoma: a clinicopathologic, immunohistochemical, and follow-up study of 46 cases. Am J Surg Pathol. 1999;23(9):1011–20.

    Article  PubMed  Google Scholar 

  78. Makhlouf HR, Ishak KG, Shekar R, Sesterhenn IA, Young DY, Fanburg-Smith JC. Melanoma markers in angiomyolipoma of the liver and kidney: a comparative study. Arch Pathol Lab Med. 2002;126(1):49–55.

    PubMed  Google Scholar 

  79. Makhlouf HR, Remotti HE, Ishak KG. Expression of KIT (CD117) in angiomyolipoma. Am J Surg Pathol. 2002;26(4):493–7.

    Article  PubMed  Google Scholar 

  80. Martignoni G, Pea M, Bonetti F, et al. Carcinomalike monotypic epithelioid angiomyolipoma in patients without evidence of tuberous sclerosis: a clinicopathologic and genetic study. Am J Surg Pathol. 1998;22(6):663–72.

    Article  PubMed  CAS  Google Scholar 

  81. Miettinen M, Fernandez M, Franssila K, Gatalica Z, Lasota J, Sarlomo-Rikala M. Microphthalmia transcription factor in the immunohistochemical diagnosis of metastatic melanoma: comparison with four other melanoma markers. Am J Surg Pathol. 2001;25(2):205–11.

    Article  PubMed  CAS  Google Scholar 

  82. Roma AA, Magi-Galluzzi C, Zhou M. Differential expression of melanocytic markers in myoid, lipomatous, and vascular components of renal angiomyolipomas. Arch Pathol Lab Med. 2007;131(1):122–5.

    PubMed  Google Scholar 

  83. Sturtz CL, Dabbs DJ. Angiomyolipomas: the nature and expression of the HMB45 antigen. Mod Pathol. 1994;7(8):842–5.

    PubMed  CAS  Google Scholar 

  84. Tsui WM, Colombari R, Portmann BC, et al. Hepatic angiomyolipoma: a clinicopathologic study of 30 cases and delineation of unusual morphologic variants. Am J Surg Pathol. 1999;23(1):34–48.

    Article  PubMed  CAS  Google Scholar 

  85. Zavala-Pompa A, Folpe AL, Jimenez RE, et al. Immunohistochemical study of microphthalmia transcription factor and tyrosinase in angiomyolipoma of the kidney, renal cell carcinoma, and renal and retroperitoneal sarcomas: comparative evaluation with traditional diagnostic markers. Am J Surg Pathol. 2001;25(1):65–70.

    Article  PubMed  CAS  Google Scholar 

  86. Srivastava A, Padilla O, Fischer-Colbrie R, Tischler AS, Dayal Y. Neuroendocrine secretory protein-55 (NESP-55) expression discriminates pancreatic endocrine tumors and pheochromocytomas from gastrointestinal and pulmonary carcinoids. Am J Surg Pathol. 2004;28(10):1371–8.

    Article  PubMed  Google Scholar 

  87. Chu PG, Ishizawa S, Wu E, Weiss LM. Hepatocyte antigen as a marker of hepatocellular carcinoma: an immunohistochemical comparison to carcinoembryonic antigen, CD10, and alpha-fetoprotein. Am J Surg Pathol. 2002;26(8):978–88.

    Article  PubMed  Google Scholar 

  88. De Young BR, Frierson Jr HF, Ly MN, Smith D, Swanson PE. CD31 immunoreactivity in carcinomas and mesotheliomas. Am J Clin Pathol. 1998;110(3):374–7.

    PubMed  Google Scholar 

  89. Fan Z, van de Rijn M, Montgomery K, Rouse RV. Hep par 1 antibody stain for the differential diagnosis of hepatocellular carcinoma: 676 tumors tested using tissue microarrays and conventional tissue sections. Mod Pathol. 2003;16(2):137–44.

    Article  PubMed  Google Scholar 

  90. Higgins JP, Montgomery K, Wang L, et al. Expression of FKBP12 in benign and malignant vascular endothelium: an immunohistochemical study on conventional sections and tissue microarrays. Am J Surg Pathol. 2003;27(1):58–64.

    Article  PubMed  Google Scholar 

  91. Kaufmann O, Koch S, Burghardt J, Audring H, Dietel M. Tyrosinase, melan-A, and KBA62 as markers for the immunohistochemical identification of metastatic amelanotic melanomas on paraffin sections. Mod Pathol. 1998;11(8):740–6.

    PubMed  CAS  Google Scholar 

  92. Kornstein MJ, Rosai J. CD5 labeling of thymic carcinomas and other nonlymphoid neoplasms. Am J Clin Pathol. 1998;109(6):722–6.

    PubMed  CAS  Google Scholar 

  93. Lugli A, Tornillo L, Mirlacher M, Bundi M, Sauter G, Terracciano LM. Hepatocyte paraffin 1 expression in human normal and neoplastic tissues: tissue microarray analysis on 3,940 tissue samples. Am J Clin Pathol. 2004;122(5):721–7.

    Article  PubMed  CAS  Google Scholar 

  94. O’Connell FP, Pinkus JL, Pinkus GS. CD138 (syndecan-1), a plasma cell marker immunohistochemical profile in hematopoietic and nonhematopoietic neoplasms. Am J Clin Pathol. 2004;121(2):254–63.

    Article  PubMed  Google Scholar 

  95. Oliveira AM, Tazelaar HD, Myers JL, Erickson LA, Lloyd RV. Thyroid transcription factor-1 distinguishes metastatic pulmonary from well-differentiated neuroendocrine tumors of other sites. Am J Surg Pathol. 2001;25(6):815–9.

    Article  PubMed  CAS  Google Scholar 

  96. Petri BJ, Speel EJ, Korpershoek E, et al. Frequent loss of 17p, but no p53 mutations or protein overexpression in benign and malignant pheochromocytomas. Mod Pathol. 2008;21(4):407–13.

    Article  PubMed  CAS  Google Scholar 

  97. Srodon M, Westra WH. Immunohistochemical staining for thyroid transcription factor-1: a helpful aid in discerning primary site of tumor origin in patients with brain metastases. Hum Pathol. 2002;33(6):642–5.

    Article  PubMed  CAS  Google Scholar 

  98. Thompson LD. Pheochromocytoma of the adrenal gland scaled score (PASS) to separate benign from malignant neoplasms: a clinicopathologic and immunophenotypic study of 100 cases. Am J Surg Pathol. 2002;26(5):551–66.

    Article  PubMed  Google Scholar 

  99. Wieczorek TJ, Pinkus JL, Glickman JN, Pinkus GS. Comparison of thyroid transcription factor-1 and hepatocyte antigen immunohistochemical analysis in the differential diagnosis of hepatocellular carcinoma, metastatic adenocarcinoma, renal cell carcinoma, and adrenal cortical carcinoma. Am J Clin Pathol. 2002;118(6):911–21.

    Article  PubMed  Google Scholar 

  100. Frierson Jr HF, Moskaluk CA, Powell SM, et al. Large-scale molecular and tissue microarray analysis of mesothelin expression in common human carcinomas. Hum Pathol. 2003;34(6):605–9.

    Article  PubMed  CAS  Google Scholar 

  101. Iezzoni JC, Mills SE, Pelkey TJ, Stoler MH. Inhibin is not an immunohistochemical marker for hepatocellular carcinoma. An example of the potential pitfall in diagnostic immunohistochemistry caused by endogenous biotin. Am J Clin Pathol. 1999;111(2):229–34.

    PubMed  CAS  Google Scholar 

  102. Kaiserling E, Xiao JC, Ruck P, Horny HP. Aberrant expression of macrophage-associated antigens (CD68 and Ki-M1P) by Schwann cells in reactive and neoplastic neural tissue. Light- and electron-microscopic findings. Mod Pathol. 1993;6(4):463–8.

    PubMed  CAS  Google Scholar 

  103. Kakar S, Muir T, Murphy LM, Lloyd RV, Burgart LJ. Immunoreactivity of Hep Par 1 in hepatic and extrahepatic tumors and its correlation with albumin in situ hybridization in hepatocellular carcinoma. Am J Clin Pathol. 2003;119(3):361–6.

    Article  PubMed  Google Scholar 

  104. Lau SK, Prakash S, Geller SA, Alsabeh R. Comparative immunohistochemical profile of hepatocellular carcinoma, cholangiocarcinoma, and metastatic adenocarcinoma. Hum Pathol. 2002;33(12):1175–81.

    Article  PubMed  Google Scholar 

  105. Lau SK, Weiss LM, Chu PG. Differential expression of MUC1, MUC2, and MUC5AC in carcinomas of various sites: an immunohistochemical study. Am J Clin Pathol. 2004;122(1):61–9.

    Article  PubMed  Google Scholar 

  106. Lee ES, Han EM, Kim YS, et al. Occurrence of c-kit+ tumor cells in hepatitis B virus-associated hepatocellular carcinoma. Am J Clin Pathol. 2005;124(1):31–6.

    Article  PubMed  Google Scholar 

  107. Lee MJ, Lee HS, Kim WH, Choi Y, Yang M. Expression of mucins and cytokeratins in primary carcinomas of the digestive system. Mod Pathol. 2003;16(5):403–10.

    Article  PubMed  Google Scholar 

  108. Micchelli ST, Vivekanandan P, Boitnott JK, Pawlik TM, Choti MA, Torbenson M. Malignant transformation of hepatic adenomas. Mod Pathol. 2008;21(4):491–7.

    Article  PubMed  CAS  Google Scholar 

  109. Minervini MI, Demetris AJ, Lee RG, Carr BI, Madariaga J, Nalesnik MA. Utilization of hepatocyte-specific antibody in the immunocytochemical evaluation of liver tumors. Mod Pathol. 1997;10(7):686–92.

    PubMed  CAS  Google Scholar 

  110. Murakata LA, Ishak KG, Nzeako UC. Clear cell carcinoma of the liver: a comparative immunohistochemical study with renal clear cell carcinoma. Mod Pathol. 2000;13(8):874–81.

    Article  PubMed  CAS  Google Scholar 

  111. Ordonez NG. Application of mesothelin immunostaining in tumor diagnosis. Am J Surg Pathol. 2003;27(11):1418–28.

    Article  PubMed  Google Scholar 

  112. Pan CC, Chen PC, Tsay SH, Chiang H. Cytoplasmic immunoreactivity for thyroid transcription factor-1 in hepatocellular carcinoma: a comparative immunohistochemical analysis of four commercial antibodies using a tissue array technique. Am J Clin Pathol. 2004;121(3):343–9.

    Article  PubMed  CAS  Google Scholar 

  113. Sasaki M, Tsuneyama K, Ishikawa A, Nakanuma Y. Intrahepatic cholangiocarcinoma in cirrhosis presents granulocyte and granulocyte-macrophage colony-stimulating factor. Hum Pathol. 2003;34(12):1337–44.

    Article  PubMed  CAS  Google Scholar 

  114. Terracciano LM, Glatz K, Mhawech P, et al. Hepatoid adenocarcinoma with liver metastasis mimicking hepatocellular carcinoma: an immunohistochemical and molecular study of eight cases. Am J Surg Pathol. 2003;27(10):1302–12.

    Article  PubMed  Google Scholar 

  115. Tickoo SK, Zee SY, Obiekwe S, et al. Combined hepatocellular-cholangiocarcinoma: a histopathologic, immunohistochemical, and in situ hybridization study. Am J Surg Pathol. 2002;26(8):989–97.

    Article  PubMed  Google Scholar 

  116. Yamauchi N, Watanabe A, Hishinuma M, et al. The glypican 3 oncofetal protein is a promising diagnostic marker for hepatocellular carcinoma. Mod Pathol. 2005;18(12):1591–8.

    PubMed  CAS  Google Scholar 

  117. Hasegawa T, Hirose T, Ayala AG, et al. Adult neuroblastoma of the retroperitoneum and abdomen: clinicopathologic distinction from primitive neuroectodermal tumor. Am J Surg Pathol. 2001;25(7):918–24.

    Article  PubMed  CAS  Google Scholar 

  118. Pituch-Noworolska A, Zaremba M, Wieczorek A. Expression of proteins associated with therapy resistance in rhabdomyosarcoma and neuroblastoma tumour cells. Pol J Pathol. 2009;60(4):168–73.

    PubMed  Google Scholar 

  119. Goldsmith JD, Pawel B, Goldblum JR, et al. Detection and diagnostic utilization of placental alkaline phosphatase in muscular tissue and tumors with myogenic differentiation. Am J Surg Pathol. 2002;26(12):1627–33.

    Article  PubMed  Google Scholar 

  120. Hasegawa T, Matsuno Y, Niki T, et al. Second primary rhabdomyosarcomas in patients with bilateral retinoblastoma: a clinicopathologic and immunohistochemical study. Am J Surg Pathol. 1998;22(11):1351–60.

    Article  PubMed  CAS  Google Scholar 

  121. Heerema-McKenney A, Wijnaendts LC, Pulliam JF, et al. Diffuse myogenin expression by immunohistochemistry is an independent marker of poor survival in pediatric rhabdomyosarcoma: a tissue microarray study of 71 primary tumors including correlation with molecular phenotype. Am J Surg Pathol. 2008;32(10):1513–22.

    Article  PubMed  Google Scholar 

  122. Nascimento AF, Fletcher CD. Spindle cell rhabdomyosarcoma in adults. Am J Surg Pathol. 2005;29(8):1106–13.

    PubMed  Google Scholar 

  123. Wang J, Tu X, Sheng W. Sclerosing rhabdomyosarcoma: a clinicopathologic and immunohistochemical study of five cases. Am J Clin Pathol. 2008;129(3):410–5.

    Article  PubMed  Google Scholar 

  124. Gustafson S, Medeiros LJ, Kalhor N, Bueso-Ramos CE. Anaplastic large cell lymphoma: another entity in the differential diagnosis of small round blue cell tumors. Ann Diagn Pathol. 2009;13(6):413–27.

    Article  PubMed  Google Scholar 

  125. Kagami Y, Suzuki R, Taji H, et al. Nodal cytotoxic lymphoma spectrum: a clinicopathologic study of 66 patients. Am J Surg Pathol. 1999;23(10):1184–200.

    Article  PubMed  CAS  Google Scholar 

  126. Osajima-Hakomori Y, Miyake I, Ohira M, Nakagawara A, Nakagawa A, Sakai R. Biological role of anaplastic lymphoma kinase in neuroblastoma. Am J Pathol. 2005;167(1):213–22.

    Article  PubMed  CAS  Google Scholar 

  127. Passoni L, Longo L, Collini P, et al. Mutation-independent anaplastic lymphoma kinase overexpression in poor prognosis neuroblastoma patients. Cancer Res. 2009;69(18):7338–46.

    Article  PubMed  CAS  Google Scholar 

  128. Rassidakis GZ, Georgakis GV, Oyarzo M, Younes A, Medeiros LJ. Lack of c-kit (CD117) expression in CD30+ lymphomas and lymphomatoid papulosis. Mod Pathol. 2004;17(8):946–53.

    Article  PubMed  CAS  Google Scholar 

  129. Folpe AL, Goldblum JR, Rubin BP, et al. Morphologic and immunophenotypic diversity in Ewing family tumors: a study of 66 genetically confirmed cases. Am J Surg Pathol. 2005;29(8):1025–33.

    PubMed  Google Scholar 

  130. Frostad B, Tani E, Brosjo O, Skoog L, Kogner P. Fine needle aspiration cytology in the diagnosis and management of children and adolescents with Ewing sarcoma and peripheral primitive neuroectodermal tumor. Med Pediatr Oncol. 2002;38(1):33–40.

    Article  PubMed  CAS  Google Scholar 

  131. Macak J, Mukensnabl P, Kawano N, Bobot L, Duskova M, Vacha P. Intra-abdominal desmoplastic small-cell tumor of the peritoneum [in Czech]. Cesk Patol. 2003;39(2):69–75.

    PubMed  CAS  Google Scholar 

  132. Olsen SH, Thomas DG, Lucas DR. Cluster analysis of immunohistochemical profiles in synovial sarcoma, malignant peripheral nerve sheath tumor, and Ewing sarcoma. Mod Pathol. 2006;19(5):659–68.

    Article  PubMed  CAS  Google Scholar 

  133. Terrier-Lacombe MJ, Guillou L, Chibon F, et al. Superficial primitive Ewing’s sarcoma: a clinicopathologic and molecular cytogenetic analysis of 14 cases. Mod Pathol. 2009;22(1):87–94.

    Article  PubMed  CAS  Google Scholar 

  134. Wong NA, Melegh Z. Antigen retrieval and primary antibody type affect sensitivity but not specificity of CD117 immunohistochemistry. Histopathology. 2009;54(5):529–38.

    Article  PubMed  Google Scholar 

  135. Beaty MW, Fetsch P, Wilder AM, Marincola F, Abati A. Effusion cytology of malignant melanoma. A morphologic and immunocytochemical analysis including application of the MART-1 antibody. Cancer. 1997;81(1):57–63.

    Article  PubMed  CAS  Google Scholar 

  136. Hitchcock MG, McCalmont TH, White WL. Cutaneous melanoma with myxoid features: twelve cases with differential diagnosis. Am J Surg Pathol. 1999;23(12):1506–13.

    Article  PubMed  CAS  Google Scholar 

  137. King R, Busam K, Rosai J. Metastatic malignant melanoma resembling malignant peripheral nerve sheath tumor: report of 16 cases. Am J Surg Pathol. 1999;23(12):1499–505.

    Article  PubMed  CAS  Google Scholar 

  138. Bastide C, Arroua F, Carcenac A, Anfossi E, Ragni E, Rossi D. Primary malignant melanoma of the adrenal gland. Int J Urol. 2006;13(5):608–10.

    Article  PubMed  Google Scholar 

  139. Nonaka D, Laser J, Tucker R, Melamed J. Immunohistochemical evaluation of necrotic malignant melanomas. Am J Clin Pathol. 2007;127(5):787–91.

    Article  PubMed  Google Scholar 

  140. Wilson RW, Moran CA. Primary melanoma of the lung: a clinicopathologic and immunohistochemical study of eight cases. Am J Surg Pathol. 1997;21(10):1196–202.

    Article  PubMed  CAS  Google Scholar 

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Kaspar, H.G. (2011). Adrenal Gland. In: Lin, F., Prichard, J. (eds) Handbook of Practical Immunohistochemistry. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-8062-5_12

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