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
Hauptverfasser: Plotzke, Jaclyn M., Zhao, Raymond, Hrycaj, Steven M., Harms, Paul W., Mehra, Rohit, Chan, May P.
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container_end_page 1251
container_issue 10
container_start_page 1246
container_title Journal of cutaneous pathology
container_volume 48
creator Plotzke, Jaclyn M.
Zhao, Raymond
Hrycaj, Steven M.
Harms, Paul W.
Mehra, Rohit
Chan, May P.
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
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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 &amp; Sons A/S. 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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. 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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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