A Metastatic Tumor Of Unknown Primary, Is A Term Of The Past

By | يونيو 11, 2014

Not uncommonly, we face a case of metastatic carcinoma in the lung, liver, bone or in the brain and the primary is not known. The search for the primary site may cost the patient a lot of time, effort and money by performing the various investigations. To cut these investigations short, we have made use of the advances made in Immunohistochemistry lately in discovering the many primary sites of carcinoma or sarcomas by performing a panel of immunohistochemical staining. This knowledge has a great impact on the treatment regimens on different metastatic malignant tumors

:For example

Thyroid tumors : Positive for Thyroglobulin and Thyroid Transcription Factor

Lung tumor: Positive for TTF-1

(Breast tumors: Positive for GCDFP-15 (in addition to Estrogen and progesterone receptors

Colorectal carcinoma: Positive for Cytokeratin 20 and negative for HMW cytokeratin

Mesothelioma: Positive for mesothelin and negative for CEA and TTF-1

(Hepatocellular carcinoma: Positive for alpha-fetoprotein , CD66e and CD 34 (in canilcular pattern

Vascular tumor: Positive for CD 34

Squamous cell carcinoma: Positive for HMW Cytokeratin and negative for LMW Cytokeratin

(Prostate carcinoma: Positive for Prostate Specific Antigen (PSA

Ovarian carcinoma: Positive for CA-125 and Cytokeratin 20

(Neuroendocrine tumor: Positive for Chromogranin, Synaptophysin, (in thyroid: positive for Calcitonin

Pancreatic carcinoma: Positive for CD66e , Cytokeratin 20 , Cytokeratin 7 and HMW Cytokeratin

Transitional cell carcinoma of the bladder: Positive for HMW Cytokeratin and Cytokeratin 20 but negative for CD66e

Rhabdomyosarcoma: Positive for Myo-D1

Renal cell carcinoma of the kidney: Positive for pancytokeratin, Negative for Cytokeratin 20 , CD66, and HMW Cytokeratin

Germ cell tumor: positive for B-HCG, PLAP and /or alpha feto-protein

All the above Immunostaining can be performed on Fine Needle Aspiration Cytology smears and on biopsy tissue sections

Now, in the first medical laboratory, we have all these wide range of immunophenotyping to detect any case of unknown primary

We, in the First Medical Laboratory, are dedicated to bring the best of laboratory medicine to clinical practice to Jordan

.Dr. Hussam Abu- Farsakh, M.D

American boards of Anatomic, Clinical Pathology and Cytopathology

 

Circular: is a periodic circular that distributed to clinician informing them about new and important tests available at First Medical Laboratory. All information listed are supported by recent literature