Discovered on (but not restricted to) GIST

L' Anoctamin-1 (ANO1) è una proteina canale del cloro calcio-attivata inizialmente descritta nei GIST, nota anche con il nome di Discovered on Gist 1 (DOG1). L' anticorpo commerciale anti-DOG1 è quindi  entrato rapidamente a far parte della famiglia dei markers per i GIST ed è utile soprattutto nei rari GIST negativi per cKIT. Studi successivi hanno però mostrato come l' espressione di questa proteina non fosse limitata ai soli GIST. Infatti DOG1 rappresenta un marker di differenziazione acinare sia nelle ghiandole salivari che nel pancreas ed è stato osservato inoltre anche nei condroblastomi. Ma nulla e più preoccupante, dal punto di vista diagnostico differenziale, dell' espressione di DOG1 in un subset di leiomiomi, sarcomi sinoviali e leiomiosarcomi, in questi ultimi anche (raramente) in associazione con il cKIT. Questo ci ricorda la necessità di adoperare sempre con cautela le nostre armi immunoistochimiche, da utilizzare preferibilmente in associazione e inscrivendole nel più ampio quadro clinico e morfologico.

Bibliografia:

Miettinen M, Wang ZF, Lasota J. DOG1 antibody in the differential diagnosis of gastrointestinal stromal tumors: a study of 1840 cases. Am J Surg Pathol. 2009 Sep;33(9):1401-8.

Chênevert J, et al.  DOG1: a novel marker of salivary acinar and intercalated duct differentiation. Mod Pathol. 2012 Jul;25(7):919-29.

Bergmann F, et al. Discovered on gastrointestinal stromal tumor 1 (DOG1) is expressed in pancreatic centroacinar cells and in solid-pseudopapillary neoplasms--novel evidence for a histogenetic relationship. Hum Pathol. 2011 Jun;42(6):817-23.

Akpalo H, Lange C, Zustin J. Discovered on gastrointestinal stromal tumour 1 (DOG1): a useful immunohistochemical marker for diagnosing chondroblastoma. Histopathology. 2012 Jun;60(7):1099-106.

Sah SP, McCluggage WG. DOG1 immunoreactivity in uterine leiomyosarcomas. J Clin Pathol. 2013 Jan;66(1):40-3.

Immunohistochemical pitfalls in prostate pathology.

The diagnosis of prostatic adenocarcinoma relies on a constellation of architectural, cytological, and immunohistochemical features. Although the diagnosis of prostatic adenocarcinoma is straightforward in most cases, due to earlier detection of the disease in the modern era, pathologists have become increasingly challenged in diagnosing small foci of cancer when only a few atypical glands are present in needle biopsies. Immunohistochemistry has therefore become an essential tool in the evaluation of such foci to confirm the absence of basal cells. [...] We herein review the utility as well as the limitations of immunohistochemistry in the diagnosis of prostatic adenocarcinoma, and we describe the most important pitfalls in the interpretation of various immunostains that pathologists should be aware of to minimize misdiagnoses.

Dall' Abstract di Brimo F, Epstein JI. Immunohistochemical pitfalls in prostate pathology.


Bibliografia:


Brimo F, Epstein JI. Immunohistochemical pitfalls in prostate pathology. Hum Pathol. 2012 Mar;43(3):313-24.

Prostatic atrophy mimicking adenocarcinoma. Basal cell staining is patchy with some glands that are negative. Basal cells are labeled with HMWCK (red chromogen). Negative glands are otherwise identical to the positive glands, such that the entire lesion is consistent with prostatic atrophy (da Brimo F, Epstein JI. Immunohistochemical pitfalls in prostate pathology).

Pitfalls in Diagnostic Hematopathology

The complexity involved in the histological interpretation of lymph nodes and other lymphoid tissue specimens suspected of harbouring lymphoma is underappreciated [...]  there remains a need to maintain skills in smaller district hospitals, to ensure lymphoma recognition in unexpected circumstances, to permit clinically useful interim diagnoses when needed urgently and to sustain training in haematopathology among junior pathologists. In this review a range of potential pitfalls in lymphoid tissue pathology is outlined, arising at all stages from specimen preparation to reporting. 

(Dall'abstract di Wilkins BS. Pitfalls in lymphoma pathology: avoiding errors in diagnosis of lymphoid tissues)

Bibliografia

Wilkins BS. Pitfalls in lymphoma pathology: avoiding errors in diagnosis of lymphoid tissues. J Clin Pathol. 2011 Jun;64(6):466-76.

Wilkins BS. Pitfalls in bone marrow pathology: avoiding errors in bone marrow trephine biopsy diagnosis. J Clin Pathol. 2011 May;64(5):380-6

Hasserjian RP. Reactive versus neoplastic bone marrow: problems and pitfalls. Arch Pathol Lab Med. 2008 Apr;132(4):587-94