biopsy of metastatic cancer of unknown primary

Pathology

• histology (hematoxylin & eosin (H&E) staining
  • psammoma bodies, papillary configuration
    • ovarian cancer
    • thyroid cancer
  • signet ring cells
    • gastric cancer
    • colon cancer
    • breast cancer
    • ovarian tract
    • bladder cancer
    • prostate cancer
• immunohistochemistry
  • leukocyte common antigen (CD45) -> lymphoid neoplasm
  • Leu-M1 -> Hodgkin's disease
  • epithelial membrane antigen -> carcinoma
  • cytokeratin intermediate filaments -> carcinoma
  • carcinoembryonic antigen (CEA) -> carcinoma
  • HMB45 -> melanoma
  • desmin -> sarcoma
  • thyroglobulin -> thyroid carcinoma
  • calcitonin -> medullary thyroid carcinoma
  • myoglobin -> rhabdomyosarcoma
  • prostate-specific antigen -> prostate cancer
  • prostatic acid phosphatase -> prostate cancer
  • alpha-fetoprotein (AFP)
    • liver cancer
    • gastric cancer
    • germ cell cancer
  • placental alkaline phosphatase -> germ cell cancer
  • B- & T-cell markers -> lymphoid neoplasm
  • S-100 protein
    • neuroendocrine tumor
    • melanoma
  • gross cystic fluid protein
    • breast cancer
    • sweat gland tumor
  • factor VIII
    • Kaposi's sarcoma
    • angiosarcoma
• flow cytometry
  • T-cell markers -> lymphoid neoplasm
• ultrastructure (electron microscopy)
  • actin-myosin filaments -> rhabdomyosarcoma
  • secretory granules -> neuroendocrine tumors
  • desmosomes -> carcinoma
  • premelanosomes -> melanoma
• cytogenetics
  • isochromosome 12p; 12q(-) -> germ cell tumor
  • t(11;12)
    • Ewing's sarcoma
    • primitive neuroectodermal tumor
  • t(8;14) -> lymphoid neoplasm
  • 3p(-)
    • small cell carcinoma of the lung
    • renal cell carcinoma
    • mesothelioma
  • t(X;18) -> synovial sarcoma
  • t(12;16) -> myxoid liposarcoma
  • t(12;22) -> clear cell sarcoma (melanoma of soft parts)
  • t(2;13) -> alveolar rhabdomyosarcoma
  • 1p(-) -> neuroblastoma
• receptor analysis
  • estrogen receptor -> breast cancer
  • progesterone receptor -> breast cancer
• molecular biological studies
  • immunoglobulin gene rearrangement -> lymphoid neoplasm
  • bcl2 gene rearrangement -> B-cell neoplasm
  • T-cell receptor gene rearrangement -> T-cell neoplasm

More general terms

• tissue biopsy

Additional terms

• metastatic cancer of unknown primary