 |
 |
 |
 |
1998 Pathologist-In-Training Award
|
|||
|---|---|---|---|
| S. Sharma, G. Sidhu, D.
Miller, J. Tan and R. Wieczorek. Metastatic Lung Adenocarcinoma to the Brain with and Without Rootlets: An Electron Microscopic (EM) and Immunohistochemical Study. NYVA Medical Center and NYU Medical Center, NY, NY. Mod Pathol 1998; 11(1):161A. |
The clinical presentation of occult metastatic adenocarcinoma to the brain is often due to lung and colon primaries. Dr. Sharma and his colleagues used electron microscopy and an immunohistochemical panel consisting of villin (a cytoskeletal protein that is associated with microvilli) and two cytokeratins (CK 7, CK 20) to distinguish between these two metastatic adenocarcinomas 2. Ultrastructural examination of twenty-three cases of metastatic lung adenocarcinoma to the brain demonstrated microvillous core rootlets in three cases and an absence of microvillous core rootlets in the remaining twenty cases. The cytokeratin immunophenotype for the metastatic lung adenocarcinomas was CK7+, CK20-. Only some of the brain metastases from the primary, lung adenocarcinomas (2/3 with rootlets and 2/20 without rootlets) showed staining for villin. Microvillous core rootlets were present in all the metastatic colon adenocarcinomas (2 brain metastases, 9 lung metastases). The immunophenotype for the brain (2) and lung metastases (9) from primary adenocarcinomas of the colon was CK7- , CK20+, Villin+. Thus, the immunohistochemical panel consisting of villin and cytokeratin 20 as well as cytokeratin 7 is helpful in identifying brain metastases from a lung primary, especially in those cases of metastatic lung adenocarcinoma in which electron microscopy demonstrates the presence of microvillous core rootlets. | ||
| Certificate | Top | ||
|
|
|
|