CDX-2, MUC-2 and B-catenin as intestinal markers in pure mucinous carcinoma of the breast

García-Labastida, Laura Elvira; Garza‐Guajardo, Raquel; Barboza-Quintana, Oralia; Rodríguez‐Sánchez, Iram P.; Áncer‐Rodríguez, Jesús; Flores‐Gutiérrez, Juan Pablo; Gómez‐Macías, Gabriela Sofía

doi:10.1186/0717-6287-47-43

Cited by 12 publications

(7 citation statements)

References 33 publications

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“…It has also been documented that MCs with high expression of MUC2 are having less lymphovascular invasion and lymph node metastasis. 18 Bae et al 2 observed that nodal status and adjuvant therapy are better prognostic markers.…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Study of Mucinous Carcinoma of Breast with Emphasis on Cytological Features: A Study at Tertiary Care Teaching Hospital of South India

Chikkannaiah¹,

Thangngeo²,

Guruprasad³

et al. 2020

J Lab Physicians

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Introduction Mucinous carcinoma (MC) is a rare form of breast cancer. It accounts for 1 to 7% of the cases and characterized by the presence of extracellular mucin (ECM). Depending on the amount of mucin, it is classified into pure mucinous carcinoma (> 90%, PMC) and mixed mucinous carcinoma (MMC; < 90%). In comparison to most common subtypes, MC is having better prognosis. There exist clinicopathological differences among PMC and MMC and also MC and IDC-NOS. Materials and Methods MCs diagnosed between January 2012 and December 2017 were included. Fine needle aspiration cytology smears were screened for cellularity, ECM, nuclear pleomorphism, signet ring cells (SRC), mucinophages, and myxovascular fragments (MVF). Histopathology slides were screened to confirm the diagnosis. Immunohistochemistry slides were graded as per the standard protocol. Statistical analyses were performed by SPSS software. Results In the present study, MC constituted 3.3%. The mean age of the patients was 50.9 years. ECM, mucinophages, and SRC were the key diagnostic cytological features. The PMC and MMC were clinicopathologically distinct with respect to gross findings and lymph node status. MMCs were highly proliferative. The mean duration of follow-up was 24.5 months. Complications were more common in MMC than PMC. Lymph node involvement is the key prognostic factor and it is independent of other prognostic factors like age, size, and hormonal receptor status. Conclusion PMC are rare subtype of breast cancer. The diagnostic cytological features are ECM, MVF, and SRC. MMC and PMC are clinicopathologically and genetically distinct.

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Section: Discussionmentioning

confidence: 99%

Clinicopathological Study of Mucinous Carcinoma of Breast with Emphasis on Cytological Features: A Study at Tertiary Care Teaching Hospital of South India

Chikkannaiah¹,

Thangngeo²,

Guruprasad³

et al. 2020

J Lab Physicians

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“…These primary tumors were broken down by site of origin as follows: colorectal (44), ovary (60 total; 18 mucinous adenocarci-nomas, 41 mucinous borderline tumors, 1 mucinous cystadenoma), breast (31), lung (26), uterus (28 total; 26 endometrial, 2 endocervical), pancreas (15 total; 7 mucinous/colloid adenocarcinomas, 6 mucinous cystic neoplasms, 2 intraductal papillary mucinous neoplasms), and stomach/esophagus (15). In regard to the technical aspects and stain-scoring approach of this study, our method mirrored that of the one described in our group's previous work on SATB2 staining in mucinous tumors.…”

Section: Methodsmentioning

confidence: 99%

“…20 Historically, nuclear CDX2 expression in breast primaries has been minimal to nonexistent (ranging from 0% to 2%). [23][24][25][26][27][28][29][30][31] In a study with 40 breast adenocarcinomas of exclusively mucinous phenotype undertaken by de Andrade Natal et al, 29 all cases were negative for CDX2 expression. Additionally, in a cohort of 33 breast and 50 gastrointestinal (upper and lower) signet ring cell adenocarcinomas reported by Hui et al, 30 CDX2 staining was 100% specific for tumors of gastrointestinal origin.…”

Section: Mucinous Carcinomas Of the Lower Gastrointestinal Tractmentioning

confidence: 99%

“…Unfortunately, both markers show significant expression in gastric and esophageal mucinous carcinomas, indicating that additional immunohistochemical stains should still be sought out that can more accurately differentiate these tumors from mCRCs. Interestingly, SATB2 may show higher specificity with regard to mucinous pancreatic tumors and (31) 0 (0) 0 (0) Lung (26) 0 (0) 0 (0) Uterus (28) 0 (0) 1 (3.6) Pancreas (15) 0 (0) 4 (26.7) Stomach and esophagus (15) 0 (0) 5 (33.3) Total noncolorectal mucinous tumors (175) 0 (0) 16 (9.1)…”

Section: Mucinous Carcinomas Of the Lower Gastrointestinal Tractmentioning

confidence: 99%

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SATB2 Versus CDX2: A Battle Royale for Diagnostic Supremacy in Mucinous Tumors

Brettfeld

Ramos

Berry

et al. 2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.-Metastatic mucinous tumors present a diagnostic challenge for pathologists as tumor histomorphology is often nonspecific and optimal immunoprofiles are still under investigation.Objective.-To present a head-to-head comparison of special AT-rich sequence-binding protein 2 (SATB2) and caudal type homeobox 2 (CDX2) expression in a diverse array of primary mucinous tumors.Design.-SATB2 and CDX2 immunohistochemical stains were performed on whole sections from 44 mucinous colorectal carcinomas and 175 noncolorectal mucinous tumors. A nuclear scoring system measuring intensity (0-3þ) and percentage staining (0 ¼ ,5%, 1 ¼ 5%-49%, 2 ¼ !50%) was implemented, producing an additive histologic score (H-score).Results.-SATB2 demonstrated acceptable accuracy at low to moderate expression levels (H-scores of 1-4). With these H-score cutoffs, overall accuracy was greater than 90%. In contrast, CDX2's accuracy rivaled that of SATB2 only at an H-score of 5 (89.0%), as its specificity suffered at lower expression levels (,70.0% at H-scores of 1-4). Using a moderate H-score cutoff of 3 or higher, significant differences for both sensitivity and specificity were identified between SATB2 and CDX2 (P ¼ .01 for sensitivity and P , .001 for specificity), though these stains were near equivalent when each was interpreted as positive at its respective optimal H-score (SATB2 ! 3 and CDX2 ¼ 5).Conclusions.-SATB2 is a more accurate marker of colorectal origin across a variety of expression levels compared with CDX2 when applied to mucinous tumors from a host of primary sites. However, these stains are near equivalent when each is interpreted at its optimal expression level.

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“…The expression of different mucin positive proteins was not specific enough, since studies have shown that they can be expressed in various mucinous carcinomas [12]. However, CDX-2 belonging to the homeobox protein family, and beta-catenin (a cell adhesion molecule), are mostly positive in mucinous carcinomas of the GI tract, but negative in both PMCS and MMBC [13]. Mucinous carcinoma is a lesion that rarely metastasizes but has a high local recurrence rate.…”

Section: Discussionmentioning

confidence: 99%

Limitations of Immunohistochemistry in Diagnosis of a Primary Mucinous Carcinoma of the Skin and Its Metastasis

Mann

Schad

Mann³

et al. 2020

Asp Biomed Clin Case Rep

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We describe the case of a 67-year-old female patient who presented with an unclear swelling on the right supraclavicular neck, two years after resection of a mucinous carcinoma on the right mastoid. Two pathological reports from separate universities diagnosed the primary mastoid skin lesion as a metastatic adenocarcinoma. Strikingly, GATA binding protein 3 (GATA3) and mammaglobin, both immunomarkers found in breast cancer, were positive. An urgent search for the primary tumor most likely in the breast was commenced. However, as no other primary tumor could be detected at that time, a Primary Mucinous Carcinoma of the Skin (PMCS) was also debated. Two years later neck node enlargement was suspicious for lymph node metastasis during ultrasound examination and conservative neck dissection was performed. Immunohistochemistry revealed again GATA 3, Mammaglobin, estrogen, and progesterone receptor positive tissue. Using a variety of other markers, we were unable to detect neither significant morphological nor immunohistochemical characteristics that distinguished the lesion from a mucinous carcinoma of mammary origin. Following a detailed review of the clinical context, we concluded the lesion to be consistent with a late metastasis of a PMCS. This report demonstrates the limitations of currently used histopathological and immunohistochemical differentiation in metastatic mucinous carcinoma.

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CDX-2, MUC-2 and B-catenin as intestinal markers in pure mucinous carcinoma of the breast

Cited by 12 publications

References 33 publications

Clinicopathological Study of Mucinous Carcinoma of Breast with Emphasis on Cytological Features: A Study at Tertiary Care Teaching Hospital of South India

Clinicopathological Study of Mucinous Carcinoma of Breast with Emphasis on Cytological Features: A Study at Tertiary Care Teaching Hospital of South India

SATB2 Versus CDX2: A Battle Royale for Diagnostic Supremacy in Mucinous Tumors

Limitations of Immunohistochemistry in Diagnosis of a Primary Mucinous Carcinoma of the Skin and Its Metastasis

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