Stains - Cytokeratin 34 beta E12

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Stains

Cytokeratin 34betaE12

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 5 January 2013, last major update January 2013
Copyright: (c) 2002-2012, PathologyOutlines.com, Inc.
PubMed Search: cytokeratin 34betaE12
Broken links/comments: click here or email CopyrightPathOut@gmail.com, subject=Stains Cytokeratin 34betaE12

Definition
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● High molecular weight keratin relatively specific for prostate basal cells
● Reacts to CK1, CK5, CK10, CK14 and possibly other keratins

Terminology
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● Also called CK903, high molecular weight keratin

Uses by pathologists
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(1) Prostate:
● Stains prostatic basal cells, even after crush artifact (J Clin Pathol 2012;65:437); can use antibody on destained H&E slides (Hum Pathol 2000;31:1155)
● Useful in biopsies (Am J Clin Pathol 2004;121:99) and even after hormonal therapy (Hum Pathol 2007;38:332)
● Note that patchy staining may rarely occur in carcinoma (Am J Surg Pathol 2002;26:1151) and negative staining is not diagnostic of carcinoma in small foci of atypical glands (Hum Pathol 2004;35:43)
● Triple cocktail with p63 and AMACR is more sensitive / specific than 34betaE12 alone (Am J Clin Pathol 2007;127:248)
● Distinguish high grade PIN (intact or fragmented basal cell layer) from adenocarcinoma (negative staining, Mod Pathol 2004;17:360)
● Distinguish cribriform basal cell hyperplasia (intact and focal multilayered staining) from cribriform PIN (fragmented or negative staining, Am J Surg Pathol 2002;26:237)
● Does stain prostatic adenoid cystic / basal carcinoma (Am J Surg Pathol 2003;27:1523) and tumors with squamous differentiation (Am J Surg Pathol 2004;28:651)

(2) Breast intraductal lesions: distinguishes lobular intraepithelial neoplasia (cytoplasmic staining, often with distinct nuclear pattern, J Histochem Cytochem 2003;51:1527) or florid ductal hyperplasia without atypia (intense staining, Am J Surg Pathol 1999;23:1048), from DCIS / ductal intraepithelial neoplasia (usually negative, Hum Pathol 2002;33:620)

(3) Urothelial lesions:
● Distinguish dysplasia (basal staining only) from carcinoma in situ (stains all urothelial layers, Hum Pathol 2000;31:745)
● Staining pattern predicts recurrence in low grade papillary urothelial neoplasms (Cancer 2003;97:1876)
● Marker of urothelial origin when used with a panel (Am J Surg Pathol 2003;27:1)

Micro images
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Kidney: collecting duct carcinoma with signet ring features

;
Prostate: normal, atrophy (two images), post-atrophic hyperplasia

Prostate: adenoid basal cell tumor

Prostate: adenocarcinoma is negative with occasional positive benign glands present

Prostate: adenocarcinoma with triple cocktail (34betaE12, AMACR, p63)

Prostate: atypical adenomatous hyperplasia

Prostate:left-atypical basal cell hyperplasia, right-basal cell hyperplasia

Prostate: high grade PIN

Prostate: sclerosing adenosis

Prostate: TURP (benign) - staining without and with antigen retrieval

Prostate: urothelial type adenocarcinoma with mucin production is focally 34BE12+

Skin: squamous cell carcinoma-acantholytic type

Thyroid: anaplastic carcinoma

Positive staining - normal
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● Prostate basal cells, skin (J Exp Clin Cancer Res 2003;22:441)
● Thyroid solid cell nests (Am J Surg Pathol 2006;30:994)

Positive staining - not carcinoma
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● Amyloid deposits associated with squamous cell carcinoma (SCC) and dysplasia in the head and neck (Pathol Int 2003;53:265)
● Breast ductal hyperplasia and lobular intraductal neoplasia (references above)
● Placental site nodules (Pathology 1999;31:328)
● Prostatic basal cell hyperplasia (Hum Pathol 2003;34:462)
● Thymoma (high grade, Rom J Morphol Embryol 1999-2004;45:153)

Positive staining - carcinoma
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● Bladder lymphoepithelioma-like carcinoma (75%, Am J Surg Pathol 2011;35:474)
● Breast metaplastic carcinoma
● Clear cell carcinoma of gynecologic tract (Int J Gynecol Pathol 2001;20:252, Int J Gynecol Pathol 2001;20:155)
● Endocervical and endometrial carcinoma (Int J Gynecol Pathol 2002;21:11)
● Kidney collecting duct carcinoma (Zhonghua Zhong Liu Za Zhi 2001;23:162)
● Lung-non small cell carcinoma (44%, Am J Surg Pathol 2003;27:1)
● Prostatic duct carcinoma (Am J Surg Pathol 1997;21:435)
● Squamous cell carcinoma (classic and basaloid, Hum Pathol 1998;29:609)
● Thyroid CASTLE tumor (Am J Surg Pathol 2006;30:994)
● Thyroid papillary carcinoma (Appl Immunohistochem Mol Morphol 2000;8:42)
● Urothelial carcinoma (80%, Am J Surg Pathol 2003;27:1) and carcinoma in situ (references above)

Negative staining
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● Paget’s disease of vulva (Zhonghua Fu Chan Ke Za Zhi 1999;34:156)
● Prostatic secretory and stromal cells
● Prostatic adenocarcinoma of usual type (references above)
● Renal clear cell carcinoma (Int J Gynecol Pathol 2001;20:155)
● Renal papillary carcinoma (Zhonghua Zhong Liu Za Zhi 2005;27:102)

End of Stains > Cytokeratin 34 beta E12

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