Immunohistochemistry Stains

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Stain
Description
ACTH
Adrenocorticotropic hormone:
  • Subclassifies pituitary adenomas
Adenovirus
  • Specific to all subtypes of adenovirus
AE1/AE3
  • Cytokeratin antibody cocktail for acidic and basic cytokeratins
ALK-1
Anaplastic lymphoma kinase 1:
  • Reacts with the NPM-ALK fusion protein expressed by t(2;5) positive anaplastic large cell lymphomas
Alpha-1-Antichymotrypsin
Alpha 1 ACT:
  • Aids in identifying hepatomas and some germ cell neoplasms
  • Histiocyte marker for normal/neoplastic tissue
Alpha-1-Antitrypsin
Alpha 1 AT:
  • Expressed by cells of histolytic origin
  • Aids in identifying germ cell and histolytic neoplasms, as well as embryonal and some lung carcinomas
Alpha Fetoprotein
  • Expressed by neoplastic liver and gonad tissue
  • Aids in identifying bladder carcinomas, yolk sac tumors, some germ cell tumors and a high proportion of hepatocellular carcinoma
B72.3
Tumor-associated glycoprotein (TAG.72):
  • Recognizes tumor-associated oncofetal antigen
  • Aids in identifying adenocarcinomas and breast carcinomas
BAf47/Ini-1
  • Indicative of a tumor suppressor role
  • Heterozygous tumors in the soft tissues of the head and neck
BAX
  • Member of bcl-2 family
  • Has pro-apoptotic activity
  • Promotes cellular apoptosis
BCL-2
B-cell lymphoma-2:
  • Proto-oncogene
  • Over expression increases life span in B-cells
  • Aids in identifying colorectal adenomas, carcinomas, and many follicular and diffuse B-cell lymphomas
BCL-6
  • Transcription factor important in germinal center formation
  • Aids in identifying large cell lymphomas, Burkitt lymphoma, and Hodgkin lymphoma (nodular, lymphocyte predominant)
BCL-x
  • Regulates cell death
  • Expressed in cordical thymocytes, megakaryocytes, red blood cell precursors, some types of myeloid cells, spermatocytes and spermatids in the testis, mammary epithelial cells, secretory and basal epithelial cells of the prostate, gastrointestinal epithelial cells, and differentiated keratinocytes in the upper layers of the epidermis
  • Aids in identifying plasma cells, activated lymphocytes, Reed-Sternberg cells in Hodgkin lymphoma
Ber-Ep4
  • Epithelial cell membrane glycoprotein
  • Differentiates mesothelial from epithelial cells
  • Aids in identifying mammary Paget disease, lung adenocarcinomas, trichoepitheliomas, dermatofibromas, basal cell carcinomas, and other carcinomas
Beta-Catenin
  • Binds to cytoplasmic region of e-cadherin molecule
  • Plays a role in cell adhesion, signal transmission, and actin cytoskeleton anchoring
  • Aids in identifying skin, liver, ovary, brain, prostate, and some breast cancers, as well as endometrial, ovarian, and colon carcinomas
Beta F-1
Beta framework 1; BF-1:
  • Recognizes T-cell receptor (TCR) beta subunit
  • Aids in characterizing alpha-beta T-cell receptors from T-cell clones or polyclonal populations of T-cells
  • Aids in diagnosing T-cell lineage neoplasms
BG8
  • Aids in the diagnosis and prognosis of cholagiocarcinoma, hepatocellular carcinoma and breast cancer
  • Expressed in large bowl tumors and colorectal carcinomas
  • May be useful in the classification of human renal and bladder tumors
BK Virus
  • B-galactosidase — BK virus large T 9amino acids 622-695 fusion protein)
  • Does not react with JCV virus, SV40, or polyoma large T antigens
BOB.1
B-cell Oct-binding protein 1; OBF-1 —:
  • Expressed in spleen and peripheral blood leukocytes, Reed-Sternberg cells, B-cells, and germinal centers
  • Aids in differentiating Hodgkin lymphomas and B-cell lymphomas
BRST II (GCDFP-15)
  • Gross cystic disease fluid protein-15
  • Produced by cells with apocrine function
  • Differentiation marker for mammary carcinomas
  • Extramammary Paget disease
C4d
  • Deposits in peritubular capillary might distinguish between Acute Humoral Rejection (AHR) and Acute Cellular Rejection (ACR).
  • AHR: deposits prominently and diffusely in the peritubular capillaries, intense staining has been seen in a widespread, uniform distribution
CA-125 (OC 125)
  • High molecular weight glycoprotein
  • Expressed by normal epithelial cells of the pleura, pericardium, peritoneum, fallopian tube, endometrium, and endocervix
  • Aids in identifying non-mucinous epithelial ovarian carcinomas, serous and endometrioid adenocarcinomas, Krukenberg tumors, and uterine myomas
Calcitonin
  • Thyroid parafollicular cells (C-cells)
  • Thyroid medullary carcinomas
Caldesmon (h-CD)
  • High molecular weight isoform is H-caldesmon
  • Calcium-, calmodulin-, tropomyosin-, and actin-binding protein
  • Regulates smooth muscle contraction
  • Aids in identifying angioleiomyomas, glomus tumors, GIST, some endometrial stromal tumors, and uterine smooth muscle tumors (benign or malignant)
  • Differentiates uterine smooth muscle (usually positive) and endometrial stromal differentiation (usually negative)
Calponin
  • Can be used to characterize the differentiation process of mammary myoepithelial cells in the developing mammary glad, investigate the nature of myoepithelial cells and to study the development of human smooth muscle cells.
  • High expression might be used as an additional marker of vascular smooth muscle cells, myopithelial cells in normal and benign human mammary gland, and certain stromal myofibroblasts.
Calretinin
  • Calcium-binding protein
  • Mesothelial cells: 89% sensitive, 90% specific for differentiating mesotheliomas from lung adenocarcinomas
  • Aids in identifying mesothelial hyperplasia and epithelioid mesotheliomas
CAM 5.2 LMW
  • Cytokeratin 8/18 , low molecular weight cytokeratin
  • Hepatocellular and renal cell carcinomas
  • Aids in identifying neuroendocrine carcinoma, melanomas (3%), nuclear inclusions of rhabdoid tumors (composed of tangled intermediate filaments made up of CK8 and vimentin), and mutations associated with idiopathic cirrhosis and chronic hepatitis
Caspase 3
CCP32:
  • Control mediator of apoptosis
  • Present in epithelial cells of the skin, renal proximal tubules and collecting ducts, epithelioreticular cells of the thymus and bronchial, colonic and salivary duct epithelia, chondrocytes, bone osteocytes, megakaryocytes, mature neutrophils of bone marrow, and plasma cells of the tonsil, lymph node, and bone marrow
  • Expressed by most intermediate to high-grade non-Hodgkin B-cell lymphomas, mantle cell lymphomas, Burkitt lymphomas, and immunoblastic lymphomas
Cathepsin D
  • Breast carcinoma prognosis
  • Aids in identifying metastases
  • Response to hormone therapy
CCC9
Complement Component C9:
  • Final protein of the membrane attack complex
  • Pore forming protein found in cytotoxic T-cells
CD1a
  • Non-polymorphic MHC class I-related cell surface glycoprotein
  • Expressed by interdigitating reticulum cells, cortical thymocytes, thymomas, langerhans cells and Langerhans histiocytosis cells (histiocytosis X)
  • Aids in identifying some T-cell lymphomas and leukemias
CD2 (LFA-2)
  • Mediates adhesion of activated T-cells and thymocytes with antigen-presenting and target cells
  • Expressed by T-lymphocytes and cortical thymocytes
  • Aids in identifying natural killer cells and most malignant cells of T-cell origin
CD3
  • Binds to the non-glycosylated epsilon chain of CD3 complex
  • Present in T-lymphocytes, thymocytes/early thymocytes
  • Expressed on normal and neoplastic T-cells
CD4 (4B12)
  • Present on a subset of helper/inducer T-cells, thymocytes, and at a lower level on monocytes
  • Aids in identifying cutaneous T-cell lymphoma, including mycosis fungoides and HTLV-1-associated adult T-cell leukemia and lymphoma
CD5
  • Expressed in T-lymphocytes, thymocytes and subset of B-lymphocytes in lymph nodes
  • Aids in identifying T-cell leukemias, most B-cell chronic lymphocytic leukemias (B-CLL) and mantle cell lymphomas/T- and B-cell lymphomas
CD7
  • Earliest T-cell-specific antigen to be expressed in lymphocytes
  • Present in thymocytes , most peripheral T-lymphocyte, most natural killer cells
  • Aids in identifying T-cell lymphomas and leukemias of T-cell origin
CD8
  • Expressed on a cytotoxic/suppressor subset of T-lymphocyte natural killer cells, thymocytes, and on a subpopulation of null cells
  • Aids in identifying T-cell lymphomas/leukemias
CD10
  • Common acute lymphoblastic leukemia antigen (CALLA)
  • Aids in identifying lymphoblastic lymphoma, Burkitt lymphoma, follicular lymphoma, CML and with differential diagnosis of small B-cell lymphomas and subtyping of lymphoblastic leukemias
CD15 (Leu M1)
  • Hapten X
  • Present in Reed-Sternberg cells, 90% granulocytes, 30-60% monocytes
  • Absent from lymphocytes
  • Expressed by some non-Hodgkin lymphomas, mycosis fungoides and some leukemias
CD20 (L26)
  • Expressed on B-cell precursors and mature B-cells, but lost following differentiation into plasma cells
  • B-lymphocytes: germinal center cells, mantle zone lymphocytes, and interfollicular lymphocytes, but not T-cells, plasma cells, or histiocytes
  • Aids in identifying common acute lymphoblastic leukemia, pre-B acute lymphoblastic leukemia, CLL, prolymphocytic leukemia, hairy cell leukemia, lymphoma cell leukemia, B-cell lymphomas, including Burkitt, Waldenstrom, and immunoblastic B-cell
  • May show some membrane staining of Reed-Sternberg cells in Hodgkin lymphoma
CD21
  • C3D receptor, CR2, and EBV receptor
  • Expressed by follicular dendritic cells, mature B-cells, some types of epithelial cells, reactive hyperplasia, and plasma cells
  • Low expression on T-cell ALL cells, subset of normal thymocytes and mature T-cells, lymphocytes in the mantle zone, sinus lining cells, and monocytoid B-cells
  • Aids in identifying B-cell CLL, follicular lymphoma, low-grade MALT-type B-cell lymphoma, primary salivary gland and gastric lymphoma, T-cell and histiocyte-rich B-cell lymphoma, angioimmunoblastic T-cell lymphoma, nodular lymphocyte-predominant Hodgkin lymphoma, follicular dendritic sarcoma and some Reed-Sternberg cells not expressing other B- or T-cell-associated markers.
CD22
  • BL-CAM
  • Expressed on B-lymphocytes
  • Low expression on myeloid leukemias and non-T-cell ALL
  • Aids in identifying Hairy cell leukemia and in typing mature leukemias
CD23
  • Expressed by activated B-lymphocytes, activated macrophages, and a portion of follicular dendritic cells
  • Aids in differentiating small lymphocytic lymphoma (+) and mantle cell lymphoma (-)
CD25
  • Mediates helper, suppressor, and cytotoxic functions
  • Expressed on T-cells, HTLV-1-transformed T- and B-cells, EVB-transformed B-cells, myeloid precursors, and oligodendrocytes
  • Aids in study of inflammatory and malignant conditions
CD30
  • Ki-1 positive lymphoma
  • Ber-H2
  • Expressed by activated B- and T-lymphocytes, Reed-Sternberg cells
  • Aids in identifying Hodgkin lymphoma, lymphomatoid papulosis, anaplastic large cell lymphoma, some peripheral pleomorphic T-cell lymphomas (both HTLV-1 positive and negative) including those of angioimmunoblastic type and Lennert type and embryonal carcinoma
CD31
  • Platelet-endothelial cell adhesion molecule
  • Expressed by endothelial cells
  • Glycoprotein in platelets
  • Aids in evaluating vascularization in normal and neoplastic tissue and demonstrating endothelial cellderived tumors
CD34 (QBEND10)
  • Human progenitor cell antigen
  • Present in immature hematopoietic cells and vascular endothelial cells
  • Expressed by some acute myeloid leukemias, undifferentiated leukemias, and acute lymphoblastic leukemias
CD35
  • Mediates neutrophil and monocte phagocytosis of particles coated with C3b and or C4b
  • Shows strong staining pattern on follicular dendritic cells
  • Aids in characterization of histocytic/dendritic cell neoplasms and follicular dendritic cell sarcomas
CD42b
  • Platelet glycoprotein Ib
  • Expressed on platelets and megakaryocytes in bone marrow
  • Aids in phenotyping megakaryoblastic leukemias
  • Absence of CD42b on platelets may indicate Bernard-Soulier syndrome
CD43 (L60)
  • Expressed on T-lymphocytes, B-lymphocytes, and granulocytes
  • Aids in identifying cells of lymphoid lineage and T-cell lymphomas, and mantle cell lymphomas
CD45 LCA
Leukocyte common antigen —:
  • Expressed on the majority of leukocytes
  • Aids in differentiating lymphoid from non-lymphoid neoplasms
CD45 R
  • 4KB5; isoform of CD45
  • Reacts with most B-cells and a small sub population of T-cells and monocytes
  • Expressed by T-cell lymphomas/mature B-cell lymphomas
  • Aids in classifying Hodgkin lymphomas
CD45 RO (UCHL-1)
  • UCHL-1; isoform of CD45
  • Reacts with most T-lymphocytes, macrophage, and Langerhans cells
  • Reacts very rarely with B-lymphocytes
  • Aids in identifying T-cell lymphomas, histiocytosis, and T-cell/monocytic leukemias
  • Reacts very rarely with B-cell lymphomas and leukemias
CD52 (Campath)
  • Expressed by lymphocytes, monocytes, eosinophils, thymocytes, and macrophages
  • Expressed by most lymphoid-derived malignancies
  • Variable expression on myeloma cell
CD56
Neural cell adhesion molecule (NCAM) —:
  • Expressed on natural killer cells and most neuroectodermal tissues
  • Retinoblastoma, medulloblastoma, astrocytoma, neuroblastoma, and rhabdomyosarcoma
CD57 (Leu-7)
Leu-7, HNK1:
  • Expressed by a subset of natural killer cells and some T-lymphocytes
  • Reacts with myelin-associated glycoprotein in neuroectodermal tissue
  • Aids in identifying small cell lung carcinoma, NK lymphocyte-mediated cytotoxicity, AIDS and AIDS-related complex (ARC), NK and T-cell subset tumors and neural tissue neoplasms
CD61 (gpIIa)
  • Expressed on platelets and megakaryocytes
  • Specific for cells showing megakaryoblastic differentiation
  • Aids in identifying megakaryocytic/megakaryoblastic leukemias
CD68 (KP-1)
KP-1:
  • Expressed by Macrophages, blood monocytes, and mast cells, and the cell population known as "plasmacytoid T-cells" in reactive lymph nodes
  • Strong to moderate staining in acute myeloid leukemia (AML), chronic myeloid leukemia (CML), true histiocytic neoplasia, melanoma, and some B-cell neoplasms (usually small lymphocytic lymphoma [SLL]) and weak staining in hairy cell leukemia
CD74 (LN2)
  • Invariant chain of HLA-DR
  • Expressed on null cells, mantle zone B-cells, interfollicular hisiocytes and germinal center cells
  • Aids in identifying B-cell lymphomas/leukemias, Reed-Sternberg cells, Hodgkin mononuclear cells and classifing lymphomas/leukemias
CD75(w) (LN1)
  • Expressed on mature B-cells but not on plasma cells
  • Expression is reported to be particularly high in germinal centers
  • Expression level increases in B-cells upon activation
  • Low level expression is reported for a fraction of T-cells and on a broad range of epithelial cell types
CD79a
  • Expressed on pre B-cells until plasma cell stage
  • Found as intracellular component in plasma cells
  • Aids in identifying acute leukemia of precursor B-cell type (common ALL), B-cell lymphomas and some myelomas
CD95
  • APO-1/Fas
  • Mediator of apoptosis
  • Expressed in epithelial cell types, some myoepithelial cells in mammary and dermal glands, dendritic cells in light zone of the follicle, sinusoidal B-cells, majority of histiocytic cells, osteoblasts, renal mesangial cells, vascular smooth muscle cells, brain capillaries, hepatocytes, and fetal part of the placenta
  • Weak reactivity with sub-population of T-cells and follicle center B-blasts
  • Epithelial tumors: breast carcinoma (ductal invasive, lobular invasive, and mucinous types), renal cell carcinoma, endometrial carcinoma, gastric carcinoma, and large cell/squamous cell carcinoma of the lung
  • Non-epithelial tumors: follicular B-cell lymphoma, mediastinal B-cell lymphoma, leiomyosarcoma, malignant fibrous histiocytoma, aggressive fibromatosis, malignant mesothelioma, fibroma, epitheloid sarcoma, and alveolar soft part sarcoma
CD99 (013)
  • MIC2 gene products
  • Glycoprotein HBA 71 antigen
  • Aids in identifying primitive peripheral neuroectodermal tumors, peripheral neuroepitheliomas, Ewing sarcoma and lymphoblastic lymphoma
CD117 (c-kit)
  • Proto-oncogene
  • Inhibitor of apoptotic cell death
  • Aids in identifying small and large cell lung carcinomas, GIST, AML, CML (in blast crisis), breast carcinomas, glioblastomas and melanomas
CD138 (Syndecan-1)
  • Transmembrane heparin sulphate glycoprotein
  • Expressed by normal lymphoid cells, IgG plasma cells, Pre B-cells and immature B-cells
  • Co-receptor for differentiation growth factors
  • Differentiates squamous cell carcinomas, postgerminal center B-cells, and plasma cells
  • Expressed in plasma cells of CLL, plasmacytoid lymphomas, and myelomas
CDX2
  • Exclusively marks nuclei of colonic epithelial cells and colorectal cancers
  • May be involved in the regulation of proliferation and differentiation in intestinal epithelial cells
  • May be used identifying metastatic colon carcinoma
CEA (monoclonal)
Carcinoembryonic antigen:
  • Specific marker for colon carcinoma
  • Associated with other cancers: breast, stomach, and lung (see CEA polycolonal)
CEA (polyclonal)
CD56e; biliary glycoprotein 1:
  • Reacts with CEA and CEA-like proteins
  • Normal colon: small intestinal crypts and apical surfaces of epithelial cells, small intestinal goblet cell mucin (not intracytoplasmic)
  • Breast: some epithelial cell membranes expressed
  • Liver: biliary tract, hepatocytes are positive
  • Lung adenocarcinomas or mesotheliomas: 85% sensitive, 96% specific for lung adenocarcinoma, diffuse cytoplasmic staining with membrane enhancement
  • Hepatocellular or non-hepatocellular carcinomas: canalicular pattern has 50-90% sensitivity for hepatocellular carcinoma and greater than 95% specificity
  • Present also with lung adenocarcinoma, medullary thyroid carcinoma, colonic adenocarcinoma, pancreatic adenocarcinoma, and hepatocellular carcinoma
Chromogranin A
  • Expressed in neuronal cells and in secretory granules of endocrine cells: parathyroid gland, adrenal medulla, anterior pituitary gland, islet cells of the pancreas, and C-cells of the thyroid
  • Aids in identifying neuroendocrine tumors: pituitary adenomas, islet cell tumors, phaeochromocytomas, medullary thyroid carcinomas, Merkel cell tumors, and carcinoids
CK 5/6
Cytokeratins 5 and 6:
  • Stratified squamous epithelial cytokeratin
  • Aids in diagnosing low differentiated pavement epithelium carcinoma, adenocarcinoma, and mesothelioma
  • Differentiates epithelial mesotheliomas (positive-cytoplasmic staining with perinuclear enhancement) from lung adenocarcinoma (89% sensitive, 95% specific)
CK 7
Cytokeratin 7:
  • Reacts with most glandular and transitional epithelia: breast, lung, bladder, female genital tract (endometrium, fallopian tube), gastrointestinal tract (gallbladder, hepatic ducts, pancreatic ducts), urinary tract, and bile duct
  • Present with subtypes of ovarian, pulmonary, and breast adenocarcinomas, transitional cell carcinomas, tumors of female genital tract (endometrium, fallopian tube), urothelial carcinomas, breast carcinomas, and lung carcinomas
CK 19
  • Reacts with a large number of epithelial cell types, including many ductal and glandular epithelia
  • Aides in identification of many benign and malignant epithelial lesions
CMV
Cytomegalovirus:
  • Reacts with the delayed and early DNA-binding protein p52
  • Does not crossreact with other herpesviruses or adenoviruses
c-Myc
  • Proto-oncogene
  • Over expressed frequently in AIDS-related lymphomas, diffuse large cell lymphomas, post transplant lymphoproliferative disease, B-ALL (leukemic counterpart of Burkitt lymphoma)
  • Present in 10-15% of T-ALL
  • 90% amplified: Burkitt lymphoma
  • Amplified: breast, colon, and small cell lung carcinomas
Collagen IV
  • Reacts with basement membranes in kidney, skin, striated and smooth muscle, spleen, lymph node, lung, placenta, and tendon
D2-40
  • High sensitivity and specificity for lymphatic endothelium
  • Can be used as a reliable lymphatic endothelial cell marker in the evaluation of lymphatic involvement in tumors
DBA.44
  • Developed against the B-cell antigen
  • Aids in identifying Hairy cell leukemia (particularly "hairy" cytoplasmic processes), some follicular center cell lymphomas, high grade B-cell lymphomas, splenic lymphomas with villous lymphocytes
Desmin
  • Intermediate filament present in smooth and striated muscle
  • Expressed in reactive mesothelial cells, myoblasts, myofibroblasts (variable), endometrial stroma, and smooth muscle cells
  • Aids in idenitifying smooth muscle tumors (leiomyosarcomas), myogenic sarcomas, striated muscle tumors (rhabdomyosarcoma), PNET, neuroblastomas, and intra-abdominal desmoplastic small round cell tumors
EBV LMP
Epstein-Barr virus latent membrane protein:
  • Identifies EBV-infected B-cell immunoblasts, 20-50% of EBV-associated undifferentiated nasopharyngeal carcinomas, EBV-associated tumor cells in Hodgkin lymphoma, 20-30% of CD30-positive ALCLs, acute infectious mononucleosis, and some peripheral T-cell lymphomas
  • Does not react with EBV-positive Burkitt
E-Cadherin
Cellular adhesion molecule:
  • Loss associated with invasive carcinoma
  • Differentiates LCIS from DCIS in indeterminate breast carcinoma
  • Reduced expression in invasive bladder cancer and ductal carcinoma
  • No expression in lobular carcinoma and LCIS
EGFR (H-11)
Epidermal growth factor receptor:
  • Over expression in approximately 40% of glioblastomas, less frequently in lower grade astrocytomas, schwannomas, ependymomas, medulloblastomas, meningiomas, and pituitary adenomas
  • Lung tissue: over expression in squamous cell carcinomas, adenocarcinomas, and large cell carcinomas
  • Over expression in a portion of squamous cell carcinomas of the head and neck, vulva, cervix, ovary and endometrium, and thyroid tumors
EGFR (PharmDx™)
Epidermal growth factor receptor:
  • Aids in identifying colorectal cancer patients eligible for ERBITUX™ drug therapy
EMA
Epithelial membrane antigen:
  • Prognostic
  • Expressed by almost all glandular and ductal epithelial cells including breast and pancreas, activated T-cells, monocytes, some B-cells, follicular dendritic cells, and perineurial cells
  • Aids in identifying most adenocarcinomas, anaplastic large cell lymphomas, epithelioid sarcomas, meningiomas, some mesotheliomas, myelomas, Paget disease, plasmacytomas, squamous cell tumors, and metastatic carcinomas
  • Associated with invasion in pancreatic tumors
ERA (MOC-31)
Epithelial related antigen (MOC-31):
  • Aids in identifying adenocarcinomas, squamous cell carcinomas, adenomas, small cell lung cancers, carcinoids, adenocystic carcinomas, and carcinosarcomas
Estrogen
Estrogen receptor-alpha:
  • Prognostic for breast cancer
  • Predictive for response of breast cancers to hormonal therapy
  • Differentiates endocervical from endometrial adenocarcinomas
Factor VIII
  • Associates with the von Willebrand factor
  • Expressed by endothelial cells and megakaryocytes
  • Aids in identifying vascular tumors
Factor XIIIa
  • Blood pro-enzyme identified in platelets, megakaryocytes, and fibroblast-like mesenchymal or histiocytic cells present in the placenta, uterus, and prostate
  • Present in monocytes, macrophages, and dermal dendritic cells
  • Aids in differentiating dermatofibromas, dermatosarcoma protuberans, and desmoplastic malignant melanomas
  • Positive in capillary hemangioblastomas, hemangioendotheliomas, hepatocellular carcinomas, hemangiopericytomas, xanthogranulomas, glomus tumors, and meningiomas
Fascin
  • Reacts with reticulum cells from the T-cell zones of lymph nodes, dendritic cells, interstitial dendritic cells (variable), histiocytes, smooth muscle, endothelial cells, squamous mucosal cells, and lining cells of the splenic sinuses
  • Present in Reed-Sternberg cells
  • Aids in identifying the majority of Hodgkin lymphomas, HIV-related lymphoid hyperplasia (decreasing with advanced disease), and a subset of high-grade breast carcinomas
Fli-1
Friend leukemia insertion site 1:
  • Anti-apoptotic activity
  • Expressed in heart, lung, spleen, and thymus
  • Aids in identifying erythroleukemias, lymphoblastic lymphomas, and Ewing sarcomas
FLK-1 (VEGF-R2)
Vascular endothelial growth factor receptor:
  • Regulation of vasculogenesis and angiogenesis
  • Differentiates endothelial cells
Galactin-3
  • When present in the nucleus, it may play a role in anti-tumor activities
  • Expression in the cytoplasm could favor tumor progression
Gastrin
  • Expressed in G-cells of the pyloric antrum
  • Aids in identifying G-cell hyperplasia and gastrin-secreting tumors
GFAP
Glial fibrillary acidic protein:
  • Expressed in astrocytes and some CNS ependymal cells
  • Identifies astrocytomas and ependymomas
  • Many neural tumors, such as neuroblastomas, schwannomas, and extra-CNS tumors, do not stain
Glucagon
  • Expressed in A-cells of the endocrine pancreas
  • Identifies hyperplastic islet cells of the pancreas and their tumors
GLUT-1
  • Involved in glucose transport across epithelial and endothelial barrier tissues
  • Stains the membrane of normal erythrocytes in various normal and neoplastic tissues
Glycophorin A
  • Expressed in erythroid cells
  • Identifies M6 subtype of acute myeloblastic leukemia, erythroleukemia, and erythroblasts
HBcAg
Hepatitis B core antigen:
  • Expressed by type-B viral hepatitis-infected cells
HBsAg
Hepatitis B surface antigen:
  • Expressed by liver cells infected with type-B viral hepatitis
Helicobacter pylori
  • Reacts with antigens of the H. pylori organism
Hemoglobin
  • Expressed on normoblasts in bone marrow and to a lesser degree on erythrocytes
HER2 (4B5)
  • Proto-oncogene
  • Over expressed in 30—40% of breast carcinomas
  • Predictive response to Herceptin® therapy
HercepTest™
  • Aids in identifying breast cancer patients eligible for Herceptin™ therapy
HHV8
Human herpes virus type 8 (latent nuclearantigen):
  • Aids in identifying multicentric Castleman disease, angioimmunoblastic lymphadenopathies, and Kaposi sarcoma
HMB-45
Melanoma-specific antigen:
  • Expressed in junctional cells, blue nevus cells, and fetal and neonatal melanocytes
  • Reacts with the majority of melanomas and other tumors with melanoma/melanocytic differentiation, including melanotic schwannoma clear cell sarcoma
HSA
Hep Par-1:
  • Expressed in hepatocytes
  • Differentiates hepatocellular carcinomas and metastatic carcinomas
  • Differential diagnosis of hepatocellular carcinomas, cholangiocarcinomas, and hepatoblastomas
HSV I
Herpes simplex virus I:
  • Reacts with HSV type 1 specific antigen and antigens common for HSV types 1 and 2
HSV II
Herpes simplex virus II:
  • Reacts with HSV type 2 specific antigen and antigens common for HSV types 1 and 2
Human Chorionic Gonadotropin
hCG:
  • Expressed on placental trophoblasts
  • Aids in identifying trophoblastic germ cell tumor
Human Growth Hormone
HGH:
  • Identifies somatotroph cells of the human adenohypophysis
  • Subclassifies pituitary adenomas
  • Identifies adenocarcinomas, squamous cell carcinomas, and large cell carcinomas of non-pituitary origin
Human Placental Lactogen
HPL:
  • Reacts with placental syncytrotrophoblastic cells
  • Identifies placental site trophoblastic tumors and exaggerated placental sites
IgA
  • Alpha chains of Ig
IgD
  • Delta chains of IgD
IgG
  • Gamma chains of IgG
IgM
  • Mu chains of IgM
Inhibin
  • Expressed in Sertoli cells, granulosa cells, and prostate, brain, and adrenal cells
  • Present in sex-cord stromal tumors (including Sertoli cell tumors), adrenocortical tumors, placental and gestational trophoblastic lesions, granular cell tumors of gallbladder and extrahepatic bile ducts, and some carcinomas
Insulin
  • Secreted by B-cells of the islets of Langerhans
  • Identifies insulin-producing islet cell tumors, hyperplastic islet cells, and islet cells originating in pancreatic ductules
Kappa
  • Reacts with free kappa chains and those in intact immunoglobulin molecules
  • Restricted expression suggests monoclonality and neoplastic process
Keratin 903 (HMW)
High molecular weight keratin, 34βE12:
  • Specific to prostate basal cells
  • Rules out prostatic adenocarcinoma
  • High grade PIN demonstrates K 903 staining
  • Identifies squamous cell carcinomas, urothelial carcinomas, adenocarcinomas of ductal origin (breast, pancreas), and small benign acinar lesions of the prostate
  • Aids in differentiating mesotheliomas from lung adenocarcinomas
Ki-67 (Mib-1)
  • Proliferation index indicator
  • Determines growth fraction
  • Aids in differentiating melanoma from nevus cells for sentinel node biopsy
  • Distinguishes benign and malignant adrenocortical tumors
Lambda
  • Reacts with free lambda chains and those in intact immunoglobulin molecules
  • Restricted expression suggests monoclonality and neoplastic process
Laminin
  • Reacts with receptors at cell surfaces, which results in changes in behavior of cells during embryonic development and regeneration.
Lysozyme (Muramidase)
  • Histiocytic and bacteriolytic enzyme
  • Present in granulocytes, monocytes, macrophages, histiocytes, normal hematopoietic cells, and some epithelial cells
  • Present in myeloid leukemias
Mast Cell Tryptase
  • Present in secretory granules of mast cells
  • Present with inflammatory diseases
Microsatellite Instability
MSI:
  • MLH1, MSH2, MSH6, and PMS2
  • Mismatch repair proteins (MMR)
  • Detects hereditary non-polyposis colon cancer (HNPCC)
Muc-1 Glycoprotein
  • Expressed in mucin-secreting epithelial cells of normal endometrium, kidney, lung, pancreas, and stomach
  • Utilized in the detection of Muc-1 glycoprotein in benign and malignant tumors
Muc-2 Glycoprotein
Mucin core protein:
  • Expressed in intestinal goblet cells
  • Predicts colorectal origin for Paget disease
  • Identifies mucinous, colonic, and gastric tumors
Muc-4 Glycoprotein
  • Stains stomach, colon, and the endothelial cells of small blood vessels and capillaries
  • Strong positive staining in colon polyps, colon carcinoma, and gastric adenocarcinoma
  • Positive staining also demonstrated in lung adenocarcinoma and ovarian mucinous adenocarcinoma
Muc-5AC Glycoprotein
  • Expressed in stomach and endocervical glands
  • Expressed in extramammary Paget disease
  • Characterizes mucin expression in interstitial metaplasia and gastric tumors
Muscle Specific Actin
  • Present in skeletal, cardiac, smooth muscle, and myoepithelial cells
  • Identifies soft tissue tumors with muscle differentiation (leiomyomas, leiomyosarcomas, and rhabdomyosarcomas), some pleomorphic liposarcomas, the majority of glomus tumors, occasional desmoid tumors, and myofibroblasts in some lesions
Myeloperoxidase
MPO:
  • Reacts with myeloperoxidase from granulocytes
  • Aids in differentiating lymphoid leukemias from myeloid leukemias
  • Identifies granulocytic sarcomas
Myo D-1
  • Myogenic transcriptional regulatory protein
  • Expressed early in skeletal muscle differentiation and in normal fetal muscle
  • Marker for myogenic differentiation
  • Sensitive, but not specific, for rhabdomyosarcoma
  • Aids in differentiating alveolar from embryonal rhabdomyosarcomas
Myogenin
  • Myogenic transcriptional regulatory protein
  • Early expression in skeletal muscle differentiation and in cells of skeletal muscle origin
  • Sensitive and specific for rhabdomyosarcomas and some Wilms tumors
  • Present in desmoid tumors, infantile myofibromatosis, synovial sarcoma, infantile fibrosarcoma, and entrapped atrophic or regenerative skeletal muscle
Myoglobin
  • Oxygen binding protein
  • Expressed by striated muscle (cardiac, skeletal)
  • Present in rhabdomyosarcoma and other tumors with skeletal muscle differentiation
Myosin
  • Contractile protein
  • Expressed in smooth muscle (non-sarcomeric) and skeletal muscle (sarcomeric) forms
  • Aids in muscle differentiation
CK 20
Cytokeratin 20:
  • Expressed in intestinal epithelium, gastric foveolar epithelium, some endocrine cells of the upper portions of the pyloric glands, urethelium, and Merkel cells in epidermis
  • Aids in identifying colorectal carcinoma, adenomas of the gallbladder and bile ducts, ductal cell adenocarcinomas of the pancreas, mucinous ovarian tumors, transitional cell carcinomas, and Merkel cell carcinomas of the skin
  • Gastrointestinal adenocarcinomas express CK20 to a lesser degree
NeuN
  • Aids in the definitive identification of neuronal elements in ganglion cell tumors or hamartomas, in which a distinction between atypical glial cells and neurons may be difficult.
  • May be used, similarly, for the study of neuronal loss in epilepsy, neurodegenerative diseases, or other conditions
Neurofilament (68kD)
  • Cytoskeletal element in nerve axons/dendrites
  • Reacts with neurons, neuronal processes, peripheral nerves, sympathetic ganglion cells, and adrenal medulla
  • Identifies neuroblastoma and gangliomas
NSE
Neuron-specific enolase:
  • Expressed by neuronal or neuroendocrine cells and their tumors: neuroblastomas and retinoblastomas
  • May label non-neuronal tumors: meningiomas, medulloblastomas, astrocytomas, glioblastomas, oligoastrocytomas, oligodendrogliomas, pituitary adenomas, schwannomas, ependymomas, meningosarcomas, gliosarcomas, small cell lung cancer, melanomas, and germ cell tumors
2-Oct
Octamer-binding transcription factor 2:
  • B-cell lymphomas
p16
F-12:
  • Negative regulator of the cell cycle
  • Prognostic significance (breast, colon, stomach, lung, and pituitary)
p21
WAF1/Cip1:
  • Inhibits and blocks cell cycle progression
  • Present in melanomas, pancreatic carcinomas, cervical carcinomas, thymomas, thyroid carcinomas, breast carcinomas, head and neck carcinomas, colon carcinomas, and Hodgkin lymphoma
p27
Kip1:
  • Regulates progression from G¹ into S phase
  • Loss may contribute to oncogenesis and tumor progression
  • Prognostic significance (breast, colon, stomach, lung, and pituitary)
p53
  • Tumor suppressor protein; prognostic indicator
p80
  • Specific for the t(2;5)(p23;q35) translocation found in anaplastic large cell lymphomas
P504S
  • Prostate
  • α-Methylacyl-CoA Racemase (AMCAR)
  • Specific for prostate adenocarcinomas
  • Detected in two premalignant lesions: high-grade prostatic intraepithelial neoplasia (PIN) and atypical adenomatous hyperplasia
PAP
Prostate acid phosphatase:
  • Reacts with prostatic epithelial cells and hyperplastic prostate
  • Present in carcinomas of the prostate and metastatic cells of prostate carcinoma, bladder carcinomas, and carcinoid tumors
Parathyroid Hormone
PTH:
  • Reacts with parathyroid epithelial cells
  • Present in adenomas and primary and secondary hyperplasias
PAX-5
  • Member of the paired box family
  • B-cell-specific activator protein (BSAP)
  • Expressed in pro-, pre-, and mature B-cells, but not in plasma cells
  • Present in pre B-cell acute lymphoblastic leukemias and classic Hodgkin lymphomas
  • Aids in differential diagnosis of lymphoplasmacytic lymphomas or plasmacytomas
PHF-Tau
  • Tau is abnormally phosphorlated in Alzheimer´s disease
  • Main component in paired helical filaments (PHFs) and neurofibrillary tangles
p-glycoprotein
  • MDR1, multidrug resistance to cancer
  • CD243
  • Transport protein that pumps toxins and steroid hormones out of cells
  • Expressed in adrenal cortex, biliary caniliculi, blood-brain endothelium, blood-testicle endothelium, placenta, GI endothelium, proximal renal tubules, and some bone marrow stem cells
  • Predictive of response to chemotherapy
  • Prognostic for osteosarcom
PGP 9.5
Protein gene product 9.5:
  • Expressed in neurons, neuroendocrine cells, and melanocytes
  • Present in neuronal neoplasias (carcinoid tumors)
Placental Alkaline Phosphatase
PLAP:
  • Expressed by placenta
  • Present in most germ cell tumors, and breast, lung, stomach, pancreas, and ovarian carcinomas
Plasma Cell (VS38c)
  • Reacts with plasma cells
  • Present in lymphoplasmacytoid lymphomas, some non-Hodgkin lymphomas, malignant melanomas, myelomas, and plasmacytomas
Pneumocystis javii
  • Detects presence of Pneumocystis javii in infected tissue and free trophozoites
Procollagen I
  • Secreted by fibroblasts into the extracellular matrix, where it is cleaved to form collagen
  • Expression and secretion of procollagen is an important feature of wound-healing and tissue-repair processes to which the desmoplastic stroma of malignancy have sometimes been compared
Progesterone
  • Identifies A and B forms of progesterone
  • Predictive of response to hormone therapy for breast carcinoma and endometrial cancer
  • Aids in differentiating endocervical from endometrial adenocarcinomas
Prolactin
  • Produced in the anterior pituitary gland
  • Subclassifies pituitary adenomas
PSA
Prostate-specific antigen:
  • Expressed by prostatic glandular epithelial cells and periurethral and perianal glands
  • Present in prostatic carcinomas, tumors of the colon, liver, lung, parotid, adrenal, and ovary, and, rarely, in metaplasias of the bladder walls
PTEN
MMAC1, TEP1:
  • Suppresses cellular proliferation
  • Expressed on prostate epithelium, some breast ductal epithelium, lower crypts of gastric mucosa, and some glial cells
Rb1
Retinoblastoma gene product 1:
  • Tumor suppressor
  • Reacts with fibroblasts, endothelial cells, and lymphoid cells
S-100
  • Brain protein composed of S-100a and S-100b
  • Expressed in neural crest (Schwann cells, melanocytes, glial cells), chondrocytes, adipocytes, myoepithelial cells, macrophages, Langerhans cells, and dendritic cells
  • Present in 95% of melanomas (including desmoplastic and spindle cell tumors), 50% of malignant peripheral nerve sheath tumors, clear cell sarcomas, and occasional breast and undifferentiated carcinomas
SKp-2
  • p45; cell cycle regulatory protein
Smooth Muscle Actin
  • Reacts with the alpha-smooth muscle isoform
  • Present in smooth muscle cells of vessels, parenchymes, myoepithelial cells, pericytes, and some stromal cells in the intestine, testis, and ovary
  • Aids in differentiating leiomyosarcoma from rhabdomyosarcoma
Somatostatin
  • Hormone of the hypothalamus
  • Labels D-cells of the pancreas and hypothalamic parvicellular region
  • Present in islet cell tumors
  • Aids in identifying neuroendocrine neoplasms and hyperplasia of the pancreatic islet
Survivin
  • Abundantly re-expressed in transformed cells and in the most common cancers of the lung, colon, pancreas, breast, and prostate
  • Appears to be situated at the crossroads of cell death and cell division, governing a check point involved in cytokinesis while also suppressing apoptosis
Synaptophysin
  • Labels neuroendocrine cells and neurons in the brain, spinal cord, and retina
  • Present in neuroendocrine tumors and neuroendocrine tumors of epithelial type
TdT
  • Used in subtyping of blastic leukemias
  • Positive in all Acute Lymphoblastic Leukemia (ALL), except Burkitt´s and B-cell FAB L-3
  • Positive in Lymphoblastic crisis of Chromic Myelogenous Leukemia (CML-BC-ALL) and Lymphoblastic Lymphoma
  • Some non-lymphocytic leukemias express positivity, but there is less intensity and greater variability
Thyroglobulin
  • Protein synthesized by the follicular epithelial cells of the thyroid
  • Aids in the localization of thyroglobulin in hyperplastic and neoplastic thyroid and in monitoring of patients after treatment for follicular carcinomas
TIA-1
T-cell intracytoplasmic antigen:
  • Reacts with 50-60% of CD8 lymphocytes, 10% of CD4 lymphocytes, monocytes, granulocytes, activated CD4 T-cells, activated NK cells, and con A-activated thymocytes
  • Aids in differentiating T-cell leukemias and lymphomas from B-cell leukemias and lymphomas
Topoisomerase II Alpha
TOPO II alpha:
  • Prognostic indicator
  • May be predictive of response to treatment with enzyme inhibitors
Toxoplasmosis
  • Detects the presence of Toxoplasma gondii in infected tissues
TRAP
  • Found in hairy cells, osteoclasts, activated macrophages, and giant cells
  • Useful as a marker for hairy cell leukemia in bone marrow
TSH
Thyroid stimulating hormone:
  • Labels thyrotrophic cells of the pituitary
  • Subclassifies pituitary adenomas
TTF-1
Thyroid transcription factor-1:
  • Expressed in lung and thyroid epithelial cells
  • Present in pulmonary small cell carcinomas, some pulmonary non-small cell carcinomas, papillary carcinomas, follicular carcinomas and goiter, thyroid medullary carcinomas, and thyroid papillary carcinomas
  • Aids in differentiating pulmonary adenocarcinomas from breast carcinomas
Ubiquitin
  • Detects intracellular ubiquinated filamentous inclusions in the periphery of senile plaques and neurofibrillary tangles in Alzheimer disease and Lewy bodies in Parkinson disease
Ulex Europaeus
  • Plant lectin
  • Recognizes sugar moieties (H antigen corresponding to O blood group) in endothelial cells and epithelium
  • Present in angiosarcomas
VEGF-C
  • Ligand for both VEGFR-2 (FLK1) and VEGFR-3 (FLT4)
  • Major regulator of physiological and pathological angiogenesis and lymphangiogenesis
Villin
  • Sensitive and relatively specific for gastrointestinal and pancreatic adenocarcinoma
  • Aids in differentiating metastatic colon adenocarcinomas from lung adenocarcinomas
Vimentin
  • Aids in identifying Melanomas and schwannomas
WT-1
  • Aids in identifying Wilms´ tumor, mesotheliomas
p63
  • Differentiates prostatic adenocarcinoma and benign prostatic tissue.
  • Also distinguishes poorly differentiated squamous cell carcinoma from small cell carcinoma or adenocarcinoma.