Pancreas Ductal carcinoma

FIGURE 10.7. Immunostained p53 antigen in the moderately differentiated invasive ductal carcinoma of the pancreas of a 54-year-oid female the majority of the nuclei are stained. Sections were microwaved and incubated in mouse monoclonal antibody DO-1. Courtesy of Ming Dong. 

Most interestingly, lOPNs, typically lack KRAS2 mutations ° 726 stark contrast with any other tumor types in the pancreas characterized by ductal-mucinous differentiation including greater than 90% of invasive ductal carcinomas and almost half of IPMNs. 

Saitou M, Goto M, Horinouchi M, et al. MUC4 expression is a novel prognostic factor in patients with invasive ductal carcinoma of the pancreas. / Clin Pathol. 2005 58 845-852. 

Fig. 3. Immunohistochemical expression of (a) hK7 by the epithelium of eccrine glands of the skin (monoclonal antibody, clone 73.2), (b) hK13 by the epithelium of the bronchus (monoclonal antibody, clone IIC1), (c) hK5 by the ductal epithelium of the parotid gland (polyclonal antibody), (d) hK7 by the esophageal glands (monoclonal antibody, clone 73.2), (e) hK13 by the gastric mucosa (monoclonal antibody, clone 2-17), (f) hK6 by the large intestine mucosa (polyclonal antibody), (g) hK10 in an islet of Langerhans in the pancreas (monoclonal antibody, clone 5D3), (h) hKll by the epithelium of the urinary tubuli (monoclonal antibody), (i) hKll by a papillary renal cell carcinoma (monoclonal antibody).

Primary adenocarcinomas of the lung are typically CK7-F, CK20-, and CEA-f, whereas colorectal carcinomas are CK7-, CK20-F, and CEA-i- ductal and lobular breast carcinomas are CK7-f, CK20-, and often CEA-I- and ovarian carcinomas are CK7-I-, CK20 , and CEA-.121,125-129,224-227 Neoplasms that typically are strongly positive for most CEA antibodies include adenocarcinomas of the lung, colon, stomach, biliary tree, pancreas, urinary bladder, endocervix, paranasal... 

In the pancreas, squamous cells can be encountered in injured ductal epithelium as a result of a metaplastic process. The same metaplastic phenomenon also seems to take place focally in some examples of DA. When this finding is prominent (>25% of the tumor is the cut-off the authors use), the tumor is classified as adenosquamous carcinoma, and if it is exclusively squamous, then squamous cell carcinoma.Most of the tumors express CKs (CAM 5.2, AE1/AE3, CK5/6, CK7, CKS, CK13, CK18, CK19, and CK20), EMA, CA19-9, CEA, and B72.3.i7Ti76 Typically, CK5/6,... 

Luttges J, Vogel I, Menke M, et al. Clear cell carcinoma of the pancreas an adenocarcinoma with ductal phenotype. Histopa-thology. 1998 32 444-448. 

Hoorens A, Prenzel K, Lemoine NR, Kloppel G. Undifferentiated carcinoma of the pancreas analysis of intermediate filament profile and Ki-ras mutations provides evidence of a ductal oh n. J Pathol. 1998 185 53-60. 

Luttges J, Zamboni G, Longnecker D, Kloppel G. The immunohistochemical mucin expression pattern distinguishes different types of intraductal papillary mucinous neoplasms of the pancreas and determines their relationship to mucinous noncys-tic carcinoma and ductal adenocarcinoma. Am J Surg Pathol. 2001 25 942-948. 

Satoh K, Sasano H, Shimos awa T, et al. An immunohistochemical study of the c-erbB-2 oncogene product in intraductal mucin-hypersecreting neoplasms and in ductal cell carcinomas of the pancreas. Cancer. 1993 72 51-56. 

Witkiewicz AK, Brody JB, Constantino CL, et al. Adenosquamous carcinoma of the pancreas harbors KRAS2, DPC4 and TP53 molecular alterations similar to pancreatic ductal adenocarcinoma. Mod Pathol. 2009 22 325A. 

Tajiri T, Tate G, Kunimura T, et ak Histologic and immunohistochemical comparison of intraductal mbular carcinoma, intraductal papillary-mucinous carcinoma, and ductal adenocarcinoma of the pancreas. Pancreas. 2004 29 116-122. 

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