Immunohistochemical expression of PAX8, PAX2, and cytokeratin in melanomas
Background Deviations from the classic melanocytic immunophenotype in melanoma can present a diagnostic challenge. PAX8 and PAX2 are common markers for renal or Müllerian differentiation. While most PAX8+ or PAX2+ carcinomas are seldom confused with melanoma, some cases may show a more ambiguous imm...
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Veröffentlicht in: | Journal of cutaneous pathology 2021-10, Vol.48 (10), p.1246-1251 |
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description | Background
Deviations from the classic melanocytic immunophenotype in melanoma can present a diagnostic challenge. PAX8 and PAX2 are common markers for renal or Müllerian differentiation. While most PAX8+ or PAX2+ carcinomas are seldom confused with melanoma, some cases may show a more ambiguous immunophenotype, especially when MiTF family altered renal cell carcinoma (MiTF‐RCC) is in the differential diagnosis. Neither PAX8 nor PAX2 expression has been reported in melanoma to date. We aimed to better characterize PAX8, PAX2, and cytokeratin immunoreactivity in a large series of melanomas.
Methods
Tissue microarrays consisting of 263 melanomas were immunostained for PAX8, PAX2, and cytokeratin and graded by an h‐score.
Results
PAX8 expression was seen in 7.9% of melanomas and was significantly associated with spindle cytomorphology. PAX2 was positive in one (0.4%) melanoma. Cytokeratin positivity was seen in three (1.2%) cases and was associated with metastases.
Conclusions
PAX8 is expressed in a subset of melanomas and may be strong/extensive. As PAX8 positivity does not exclude a diagnosis of melanoma, it should be used in conjunction with other immunohistochemical markers, such as cytokeratin and PAX2, when melanoma, MiTF‐RCC, and other PAX8+ tumors are in the differential diagnosis. |
doi_str_mv | 10.1111/cup.14041 |
format | Article |
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Deviations from the classic melanocytic immunophenotype in melanoma can present a diagnostic challenge. PAX8 and PAX2 are common markers for renal or Müllerian differentiation. While most PAX8+ or PAX2+ carcinomas are seldom confused with melanoma, some cases may show a more ambiguous immunophenotype, especially when MiTF family altered renal cell carcinoma (MiTF‐RCC) is in the differential diagnosis. Neither PAX8 nor PAX2 expression has been reported in melanoma to date. We aimed to better characterize PAX8, PAX2, and cytokeratin immunoreactivity in a large series of melanomas.
Methods
Tissue microarrays consisting of 263 melanomas were immunostained for PAX8, PAX2, and cytokeratin and graded by an h‐score.
Results
PAX8 expression was seen in 7.9% of melanomas and was significantly associated with spindle cytomorphology. PAX2 was positive in one (0.4%) melanoma. Cytokeratin positivity was seen in three (1.2%) cases and was associated with metastases.
Conclusions
PAX8 is expressed in a subset of melanomas and may be strong/extensive. As PAX8 positivity does not exclude a diagnosis of melanoma, it should be used in conjunction with other immunohistochemical markers, such as cytokeratin and PAX2, when melanoma, MiTF‐RCC, and other PAX8+ tumors are in the differential diagnosis.</description><identifier>ISSN: 0303-6987</identifier><identifier>EISSN: 1600-0560</identifier><identifier>DOI: 10.1111/cup.14041</identifier><identifier>PMID: 33934372</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Biomarkers, Tumor - analysis ; Carcinoma - diagnosis ; Cytokeratin ; Diagnosis, Differential ; Differential diagnosis ; Humans ; Immunohistochemistry ; Immunoreactivity ; Keratins - analysis ; Keratins - biosynthesis ; Melanoma ; Melanoma - diagnosis ; Melanoma, Cutaneous Malignant ; Metastases ; Microphthalmia-associated transcription factor ; MiTF ; PAX2 ; Pax2 protein ; PAX2 Transcription Factor - analysis ; PAX2 Transcription Factor - biosynthesis ; PAX8 ; Pax8 protein ; PAX8 Transcription Factor - analysis ; PAX8 Transcription Factor - biosynthesis ; Renal cell carcinoma ; Skin Neoplasms - diagnosis ; Tumors</subject><ispartof>Journal of cutaneous pathology, 2021-10, Vol.48 (10), p.1246-1251</ispartof><rights>2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2021 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3881-f76b3aeefad63e815df4ccaeeb6069d107b1b81d0484dffe3b2bd2b0a9b0e3a13</citedby><cites>FETCH-LOGICAL-c3881-f76b3aeefad63e815df4ccaeeb6069d107b1b81d0484dffe3b2bd2b0a9b0e3a13</cites><orcidid>0000-0002-0802-2883 ; 0000-0002-2005-9988 ; 0000-0002-0650-1266</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fcup.14041$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fcup.14041$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33934372$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Plotzke, Jaclyn M.</creatorcontrib><creatorcontrib>Zhao, Raymond</creatorcontrib><creatorcontrib>Hrycaj, Steven M.</creatorcontrib><creatorcontrib>Harms, Paul W.</creatorcontrib><creatorcontrib>Mehra, Rohit</creatorcontrib><creatorcontrib>Chan, May P.</creatorcontrib><title>Immunohistochemical expression of PAX8, PAX2, and cytokeratin in melanomas</title><title>Journal of cutaneous pathology</title><addtitle>J Cutan Pathol</addtitle><description>Background
Deviations from the classic melanocytic immunophenotype in melanoma can present a diagnostic challenge. PAX8 and PAX2 are common markers for renal or Müllerian differentiation. While most PAX8+ or PAX2+ carcinomas are seldom confused with melanoma, some cases may show a more ambiguous immunophenotype, especially when MiTF family altered renal cell carcinoma (MiTF‐RCC) is in the differential diagnosis. Neither PAX8 nor PAX2 expression has been reported in melanoma to date. We aimed to better characterize PAX8, PAX2, and cytokeratin immunoreactivity in a large series of melanomas.
Methods
Tissue microarrays consisting of 263 melanomas were immunostained for PAX8, PAX2, and cytokeratin and graded by an h‐score.
Results
PAX8 expression was seen in 7.9% of melanomas and was significantly associated with spindle cytomorphology. PAX2 was positive in one (0.4%) melanoma. Cytokeratin positivity was seen in three (1.2%) cases and was associated with metastases.
Conclusions
PAX8 is expressed in a subset of melanomas and may be strong/extensive. As PAX8 positivity does not exclude a diagnosis of melanoma, it should be used in conjunction with other immunohistochemical markers, such as cytokeratin and PAX2, when melanoma, MiTF‐RCC, and other PAX8+ tumors are in the differential diagnosis.</description><subject>Biomarkers, Tumor - analysis</subject><subject>Carcinoma - diagnosis</subject><subject>Cytokeratin</subject><subject>Diagnosis, Differential</subject><subject>Differential diagnosis</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Immunoreactivity</subject><subject>Keratins - analysis</subject><subject>Keratins - biosynthesis</subject><subject>Melanoma</subject><subject>Melanoma - diagnosis</subject><subject>Melanoma, Cutaneous Malignant</subject><subject>Metastases</subject><subject>Microphthalmia-associated transcription factor</subject><subject>MiTF</subject><subject>PAX2</subject><subject>Pax2 protein</subject><subject>PAX2 Transcription Factor - analysis</subject><subject>PAX2 Transcription Factor - biosynthesis</subject><subject>PAX8</subject><subject>Pax8 protein</subject><subject>PAX8 Transcription Factor - analysis</subject><subject>PAX8 Transcription Factor - biosynthesis</subject><subject>Renal cell carcinoma</subject><subject>Skin Neoplasms - diagnosis</subject><subject>Tumors</subject><issn>0303-6987</issn><issn>1600-0560</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kE1Lw0AQhhdRbK0e_AMS8KLQtLPZZJMcS_GjUrAHC97C7mZCU5NszCZo_71bUz0IDsMMDA8Pw0vIJYUJtTVVXT2hPvj0iAwpB3Ah4HBMhsCAuTyOwgE5M2YLQHnEg1MyYCxmPgu9IXlalGVX6U1uWq02WOZKFA5-1g0ak-vK0Zmzmr1G4_30xo6oUkftWv2GjWjzyrFdYiEqXQpzTk4yURi8OOwRWd_fvcwf3eXzw2I-W7qKRRF1s5BLJhAzkXKGEQ3SzFfKHiQHHqcUQkllRFPwIz_NMmTSk6knQcQSkAnKRuSm99aNfu_QtEmZG4WFfQN1ZxIv8KgfM8oDi17_Qbe6ayr7naVCH-KAh3vhbU-pRhvTYJbUTV6KZpdQSPYBJzbg5Dtgy14djJ0sMf0lfxK1wLQHPvICd_-bkvl61Su_AFewhCU</recordid><startdate>202110</startdate><enddate>202110</enddate><creator>Plotzke, Jaclyn M.</creator><creator>Zhao, Raymond</creator><creator>Hrycaj, Steven M.</creator><creator>Harms, Paul W.</creator><creator>Mehra, Rohit</creator><creator>Chan, May P.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TM</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-0802-2883</orcidid><orcidid>https://orcid.org/0000-0002-2005-9988</orcidid><orcidid>https://orcid.org/0000-0002-0650-1266</orcidid></search><sort><creationdate>202110</creationdate><title>Immunohistochemical expression of PAX8, PAX2, and cytokeratin in melanomas</title><author>Plotzke, Jaclyn M. ; Zhao, Raymond ; Hrycaj, Steven M. ; Harms, Paul W. ; Mehra, Rohit ; Chan, May P.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3881-f76b3aeefad63e815df4ccaeeb6069d107b1b81d0484dffe3b2bd2b0a9b0e3a13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Biomarkers, Tumor - analysis</topic><topic>Carcinoma - diagnosis</topic><topic>Cytokeratin</topic><topic>Diagnosis, Differential</topic><topic>Differential diagnosis</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Immunoreactivity</topic><topic>Keratins - analysis</topic><topic>Keratins - biosynthesis</topic><topic>Melanoma</topic><topic>Melanoma - diagnosis</topic><topic>Melanoma, Cutaneous Malignant</topic><topic>Metastases</topic><topic>Microphthalmia-associated transcription factor</topic><topic>MiTF</topic><topic>PAX2</topic><topic>Pax2 protein</topic><topic>PAX2 Transcription Factor - analysis</topic><topic>PAX2 Transcription Factor - biosynthesis</topic><topic>PAX8</topic><topic>Pax8 protein</topic><topic>PAX8 Transcription Factor - analysis</topic><topic>PAX8 Transcription Factor - biosynthesis</topic><topic>Renal cell carcinoma</topic><topic>Skin Neoplasms - diagnosis</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Plotzke, Jaclyn M.</creatorcontrib><creatorcontrib>Zhao, Raymond</creatorcontrib><creatorcontrib>Hrycaj, Steven M.</creatorcontrib><creatorcontrib>Harms, Paul W.</creatorcontrib><creatorcontrib>Mehra, Rohit</creatorcontrib><creatorcontrib>Chan, May P.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cutaneous pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Plotzke, Jaclyn M.</au><au>Zhao, Raymond</au><au>Hrycaj, Steven M.</au><au>Harms, Paul W.</au><au>Mehra, Rohit</au><au>Chan, May P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immunohistochemical expression of PAX8, PAX2, and cytokeratin in melanomas</atitle><jtitle>Journal of cutaneous pathology</jtitle><addtitle>J Cutan Pathol</addtitle><date>2021-10</date><risdate>2021</risdate><volume>48</volume><issue>10</issue><spage>1246</spage><epage>1251</epage><pages>1246-1251</pages><issn>0303-6987</issn><eissn>1600-0560</eissn><abstract>Background
Deviations from the classic melanocytic immunophenotype in melanoma can present a diagnostic challenge. PAX8 and PAX2 are common markers for renal or Müllerian differentiation. While most PAX8+ or PAX2+ carcinomas are seldom confused with melanoma, some cases may show a more ambiguous immunophenotype, especially when MiTF family altered renal cell carcinoma (MiTF‐RCC) is in the differential diagnosis. Neither PAX8 nor PAX2 expression has been reported in melanoma to date. We aimed to better characterize PAX8, PAX2, and cytokeratin immunoreactivity in a large series of melanomas.
Methods
Tissue microarrays consisting of 263 melanomas were immunostained for PAX8, PAX2, and cytokeratin and graded by an h‐score.
Results
PAX8 expression was seen in 7.9% of melanomas and was significantly associated with spindle cytomorphology. PAX2 was positive in one (0.4%) melanoma. Cytokeratin positivity was seen in three (1.2%) cases and was associated with metastases.
Conclusions
PAX8 is expressed in a subset of melanomas and may be strong/extensive. As PAX8 positivity does not exclude a diagnosis of melanoma, it should be used in conjunction with other immunohistochemical markers, such as cytokeratin and PAX2, when melanoma, MiTF‐RCC, and other PAX8+ tumors are in the differential diagnosis.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>33934372</pmid><doi>10.1111/cup.14041</doi><tpages>6</tpages><orcidid>https://orcid.org/0000-0002-0802-2883</orcidid><orcidid>https://orcid.org/0000-0002-2005-9988</orcidid><orcidid>https://orcid.org/0000-0002-0650-1266</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Biomarkers, Tumor - analysis Carcinoma - diagnosis Cytokeratin Diagnosis, Differential Differential diagnosis Humans Immunohistochemistry Immunoreactivity Keratins - analysis Keratins - biosynthesis Melanoma Melanoma - diagnosis Melanoma, Cutaneous Malignant Metastases Microphthalmia-associated transcription factor MiTF PAX2 Pax2 protein PAX2 Transcription Factor - analysis PAX2 Transcription Factor - biosynthesis PAX8 Pax8 protein PAX8 Transcription Factor - analysis PAX8 Transcription Factor - biosynthesis Renal cell carcinoma Skin Neoplasms - diagnosis Tumors |
title | Immunohistochemical expression of PAX8, PAX2, and cytokeratin in melanomas |
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