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Utility of CK7 and CK20 immunohistochemistry in the detection of synchronous breast and colon carcinoma in a pleural effusion: A case report and supporting survey of archival material
Author(s) -
Stopyra G.A.,
Warhol M.J.,
Multhaupt H.A.B.
Publication year - 2001
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.2002
Subject(s) - medicine , cytokeratin , pathology , malignant pleural effusion , immunohistochemistry , breast carcinoma , pleural effusion , carcinoma , effusion , keratin 8 , breast cancer , cancer , lung cancer , surgery
Abstract We present a case of synchronous breast and colon carcinoma in a pleural effusion, to our knowledge the first such reported case in the English‐language literature. The patient was a 55‐yr‐old white female with known metastatic breast and colon carcinoma who developed a malignant pleural effusion which demonstrated two strikingly different populations of malignant cells by immunohistochemical study of cell block material. One cell population demonstrated a cytokeratin (CK)7+/CK20−/ER+ phenotype, while the other demonstrated a CK7−/CK20+/ER− phenotype, consistent with breast and colon origin, respectively. An immunohistochemical survey of archival breast and colon primary and metastatic carcinomas confirmed the established CK7+/CK20− phenotype of breast and CK7−/CK20+ phenotype of colon primary carcinomas, and the maintenance of this phenotype in metastases thereof. A survey of benign and malignant mesothelial lesions confirmed the absence of staining for estrogen receptor, but showed 6/10 cases weakly positive for CK20, which has not been described in other published series. This unusual case graphically illustrates the utility of cytokeratin subset immunohistochemistry in effusion cytology. Diagn. Cytopathol. 25:54–58, 2001. © 2001 Wiley‐Liss, Inc.