Carcinomas of ovary and lung with clear cell features: Can immunohistochemistry help in differential diagnosis?

Nicole R. Howell, Wenxin Zheng, Liang Cheng, Carmen Tornos, Philip Kane, Michael Pearl, Eva Chalas, Sharon X. Liang

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Metastatic lung carcinomas with clear cell morphology can be confused with primary ovarian clear cell carcinomas. We performed immunohistochemical stains in 14 cases of non-small cell lung carcinomas with clear cell features and 14 cases of ovarian clear cell carcinomas using a panel of markers, including thyroid transcription factor 1 (TTF-1), carcinoembryonic antigen (CEA), Wilms tumor gene 1, octamer-binding transcription factor 4 (OCT-4), cancer antigen 125 (CA-125), estrogen receptor, and progesterone receptor. Among non-small cell lung carcinomas with clear cell features, 87.5% of adenocarcinomas (or 50% overall frequency in lung carcinomas) were positive for TTF-1, whereas none of the ovarian clear cell carcinomas were positive (P = 0.002). All 14 ovarian clear cell carcinomas stained for CA-125 as compared with 1 non-small cell lung carcinoma (P < 0.001). On the other hand, 85% of non-small cell lung carcinomas stained for CEA, whereas none of the ovarian clear cell carcinomas did (P < 0.001). Interestingly, 4 ovarian clear cell carcinomas (28%) showed positive staining for the germ cell marker OCT-4. Either lung or ovarian carcinomas stained for Wilms tumor gene 1, estrogen receptor, or progesterone receptor very infrequently; and the difference between the 2 groups was not statistically significant. Our results suggest that an immunohistochemical panel consisting of TTF-1, CEA, CA-125, and OCT-4 is helpful in distinguishing most pulmonary and ovarian carcinomas with clear cell features.

Original languageEnglish (US)
Pages (from-to)134-140
Number of pages7
JournalInternational Journal of Gynecological Pathology
Volume26
Issue number2
DOIs
StatePublished - Apr 1 2007

Keywords

  • Clear cell carcinoma
  • Immunohistochemistry
  • Lung
  • Non-small cell lung carcinoma
  • OCT-4
  • Ovary

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Obstetrics and Gynecology

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