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Cutaneous and mammary apocrine carcinomas have different immunoprofiles.

Abstract
Often the distinction of cutaneous apocrine carcinoma from metastatic mammary apocrine carcinoma to the skin can be a diagnostic dilemma because both tumors share similar histologic features and have overlapping immunohistochemical profile. We compared the expression of adipophilin, cytokeratin 5/6, p63, GATA3, mammaglobin, androgen receptor, estrogen receptor, progesterone receptor, and HER2 by immunohistochemistry in 14 cutaneous apocrine carcinomas (11 primary tumors, 3 metastases) and 26 primary apocrine carcinomas of the breast. Whereas focal adipophilin staining was seen in 36% (5/14) of cutaneous apocrine carcinoma, strong and diffuse adipophilin staining was seen in 88% (22/25) of mammary apocrine carcinoma (P = .0013). Differences in estrogen receptor and progesterone receptor expression were also statistically significant (P = .018 and .043). Androgen receptor was strongly positive in all cutaneous and mammary cases. Although there was no significant difference in the frequency of expression of cytokeratin 5/6, p63, HER2, GATA3, and mammaglobin in cutaneous apocrine carcinoma versus mammary apocrine carcinoma, strong and diffuse cytokeratin 5/6 and/or mammaglobin expression were seen only in cutaneous apocrine carcinoma. In conclusion, cutaneous apocrine carcinoma is likely adipophilin- ER+ PR+/- HER2- and can exhibit strong and diffuse cytokeratin 5/6 and/or mammaglobin expression. On the contrary, a mammary apocrine carcinoma is likely adipophilin+ ER- PR- and often exhibit 3+ HER2 with corresponding HER2 gene amplification. A panel of adipophilin, ER, PR, HER2, cytokeratin 5/6, and mammaglobin may be helpful in distinguishing cutaneous apocrine carcinoma from mammary apocrine carcinoma.
AuthorsAdriano Piris, Yan Peng, Chakib Boussahmain, Lydia R Essary, Thomas M Gudewicz, Mai P Hoang
JournalHuman pathology (Hum Pathol) Vol. 45 Issue 2 Pg. 320-6 (Feb 2014) ISSN: 1532-8392 [Electronic] United States
PMID24342430 (Publication Type: Journal Article)
Copyright© 2014.
Chemical References
  • AR protein, human
  • Biomarkers, Tumor
  • CKAP4 protein, human
  • ESR1 protein, human
  • Estrogen Receptor alpha
  • GATA3 Transcription Factor
  • GATA3 protein, human
  • Keratin-5
  • Keratin-6
  • Mammaglobin A
  • Membrane Proteins
  • PLIN2 protein, human
  • Perilipin-2
  • Receptors, Androgen
  • Receptors, Progesterone
  • Receptor, ErbB-2
Topics
  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor (biosynthesis)
  • Breast Neoplasms (diagnosis, immunology, pathology)
  • Estrogen Receptor alpha (biosynthesis)
  • Female
  • GATA3 Transcription Factor (biosynthesis)
  • Humans
  • Immunohistochemistry
  • Keratin-5 (biosynthesis)
  • Keratin-6 (biosynthesis)
  • Male
  • Mammaglobin A (biosynthesis)
  • Membrane Proteins (biosynthesis)
  • Middle Aged
  • Perilipin-2
  • Receptor, ErbB-2 (biosynthesis)
  • Receptors, Androgen (biosynthesis)
  • Receptors, Progesterone (biosynthesis)
  • Retrospective Studies
  • Skin Neoplasms (diagnosis, immunology, pathology, secondary)
  • Sweat Gland Neoplasms (genetics, immunology, pathology)

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