Immunoexpression of napsin a in renal neoplasms

Diagnostic Pathology

Xiaoqi Lin¹  Stephen M Rohan¹  Bing Zhu¹ 

[1] Department of Pathology, Northwestern Memorial Hospital, Feinberg School of Medicine, Northwestern University, 251 E. Huron St., Galter Pavilion 7-132 F, Chicago 60611, IL, USA

关键词: Immunohistochemistry;    Napsin A;    Renal neoplasm;   

Others  :  1139143
DOI  :  10.1186/s13000-015-0242-z

 received in 2014-05-27, accepted in 2015-03-04,  发布年份 2015

【 摘 要 】

Background

Immunohistochemistry (IHC) for napsin A has been widely used to support a diagnosis of lung adenocarcinoma with high sensitivity. In this study, we evaluated immunoreactivity for napsin A in a broad spectrum of renal neoplasms by using tissue microarrays (TMA).

Methods

Duplicate TMA of 159 surgically excised renal neoplasms of various types were constructed. IHC for napsin A was performed on TMAs with appropriate positive and negative controls.

Results

Napsin A was expressed in Acquired cystic disease associated renal cell carcinoma (RCC) (2/2, 100.0%), chromophobe RCC (5/45, 11.1%), clear cell RCC (10/23, 43.5%), clear cell papillary RCC (9/19, 47.4%), metanephric adenoma (3/3, 100.0%), oncocytoma (13/23, 56.5%), and papillary RCC (31/37, 83.8%). Expression of napsin A was not seen in mucinous tubular and spindle cell carcinoma (0/1, 0.0%), TFE/MITF RCC 0/1, 0.0%), and urothelial carcinoma (0/6, 0.0%).

Conclusions

Napsin A is expressed in both common and rare sub-types of renal neoplasms with variable sensitivity. Based on our results, napsin A is not specific for lung adenocarcinoma. When a metastatic carcinoma of unknown primary is positive for napsin A, the differential diagnosis should include tumors of both renal and lung origin.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/9558727831304717.

【 授权许可】

   
2015 Zhu et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Mori K, Shimizu H, Konno A, Iwanaga T: Immunohistochemical localization of napsin and its potential role in protein catabolism in renal proximal tubules. Arch Histol Cytol 2002, 65:359-368.
• [2]Mori K, Kon Y, Konno A, Iwanaga T: Cellular distribution of napsin (kidney-derived aspartic protease-like protein, KAP) mRNA in the kidney, lung and lymphatic organs of adult and developing mice. Arch Histol Cytol 2001, 64:319-327.
• [3]Kadivar M, Boozari B: Applications and limitations of immunohistochemical expression of “Napsin-A” in distinguishing lung adenocarcinoma from adenocarcinomas of other organs. Appl Immunohistochem Mol Morphol 2013, 21:191-195.
• [4]Bishop JA, Sharma R, Illei PB: Napsin A and thyroid transcription factor-1 expression in carcinomas of the lung, breast, pancreas, colon, kidney, thyroid, and malignant mesothelioma. Hum Pathol 2010, 41:20-25.
• [5]Terry J, Leung S, Laskin J, Leslie KO, Gown AM, Ionescu DN: Optimal immunohistochemical markers for distinguishing lung adenocarcinomas from squamous cell carcinomas in small tumor samples. Am J Surg Pathol 2010, 34:1805-1811.
• [6]Mukhopadhyay S, Katzenstein AL: Comparison of monoclonal napsin A, polyclonal napsin A, and TTF-1 for determining lung origin in metastatic adenocarcinomas. Am J Clin Pathol 2012, 138:703-711.
• [7]Turner BM, Cagle PT, Sainz IM, Fukuoka J, Shen SS, Jagirdar J: Napsin A, a new marker for lung adenocarcinoma, is complementary and more sensitive and specific than thyroid transcription factor 1 in the differential diagnosis of primary pulmonary carcinoma: evaluation of 1674 cases by tissue microarray. Arch Pathol Lab Med 2012, 136:163-171.
• [8]Srigley JR, Delahunt B, Eble JN, Egevad L, Epstein JI, Grignon D, et al.: The International Society of Urological Pathology (ISUP) Vancouver Classification of Renal Neoplasia. Am J Surg Pathol 2013, 37:1469-1489.
• [9]Zhu B, Dalal S, Kamp DW, Lin X: Warranting investigation of primary lung adenocarcinoma in patients with an extrapulmonary malignancy and lung nodules due to high frequency. Am J Clin Pathol 2014, 141:429-436.
• [10]Samplaski MK, Zhou M, Lane BR, Herts B, Campbell SC: Renal mass sampling: an enlightened perspective. Int J Urol 2011, 18:5-19.
• [11]Al-Ahmadie HA, Alden D, Fine SW, Gopalan A, Touijer KA, Russo P, Reuter VE, Tickoo SK: Role of immunohistochemistry in the evaluation of needle core biopsies in adult renal cortical tumors: an ex vivo study. Am J Surg Pathol 2011, 35:949-961.