alcian-blue and Carcinoma--Transitional-Cell

To identify a sensitive marker for extramammary Paget's disease and to identify histochemical and immunohistochemical features that suggest occult pelvic cancer in patients with extramammary Paget's disease, we retrieved all cases between 1983 and 1992 with a Standardized Nomenclature of Medicine code of extramammary Paget's disease in the Vanderbilt University Medical Center (Nashville, Tenn) surgical pathology archives. All were stained for alcian blue/dPAS (periodic acid-Schiff), mucicarmine, AE1/AE3, cytokeratin (CAM 5.2), cytokeratin (CK) 7, CK 20, carcinoembryonic antigen (CEA), orthokeratin, prostate-specific antigen, and S-100. Sixteen cases (2 men, 14 women) were retrieved. Two had pelvic malignancies: one rectal adenocarcinoma and one transitional carcinoma. Only CK7 marked all cases. Mucins were sensitive but focal, a potential problem in small biopsy specimens. The transitional tumor had a unique staining profile (CEA- and mucin-negative). CK20 strongly marked Paget cells associated with rectal cancer; its presence suggests a large bowel lesion but is not specific. No case expressed prostate-specific antigen; its presence in a man suggests prostatic carcinoma.

Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Alcian Blue; Antiporters; Apolipoproteins; Apolipoproteins D; Biomarkers; Biopsy; Carcinoembryonic Antigen; Carcinoma, Transitional Cell; Carmine; Carrier Proteins; Coloring Agents; Female; Glycoproteins; Histocytochemistry; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratin-20; Keratins; Male; Membrane Proteins; Membrane Transport Proteins; Middle Aged; Mucins; Paget Disease, Extramammary; Pelvic Neoplasms; Prostate-Specific Antigen; Retrospective Studies; S100 Proteins

The stromal characteristics in papillary and non-papillary tumours of the urinary bladder were investigated in an attempt to improve the accuracy of histopathological diagnosis. It appeared to be possible to differentiate true papillary tumours from pseudopapillary structures lined by carcinoma in situ. Stromal differences were not found in cases of carcinoma in situ accompanied by denuding cystitis and cystitis due to other aetiological factors. It is concluded that histopathological examination of the stroma of bladder tumours improves diagnostic accuracy.

Topics: Alcian Blue; Carcinoma in Situ; Carcinoma, Transitional Cell; Connective Tissue; Cystitis; Humans; Staining and Labeling; Urinary Bladder Neoplasms