Stains
NUTM1

Deputy Editor: Debra Zynger, M.D.
Brendan C. Dickson, M.D., M.Sc.

Topic Completed: 2 May 2018

Revised: 5 February 2019

Copyright: 2003-2019, PathologyOutlines.com, Inc.

PubMed Search: NUTM1

Brendan C. Dickson, M.D., M.Sc.
Page views in 2018: 501
Page views in 2019 to date: 642
Cite this page: Dickson, B. NUTM1. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/stainsnutm1.html. Accessed July 21st, 2019.
Definition / general
  • NUTM1 (NUT midline carcinoma family member 1) encodes the NUT family member 1 protein (also known as: nuclear protein in testis, FAM22H and NUT)
  • NUT carcinoma is characterized by the fusion of NUTM1 with another gene (e.g., BRD4); resulting oncoprotein causes tumor growth (Genes Dev 2015;29:1507, Proc Natl Acad Sci U S A 2017;114:E4184)
  • Translocations involving NUTM1 can be detected by immunohistochemistry for NUT
Essential features
Pathophysiology
  • Function of the NUT protein remains poorly understood
  • NUT carcinoma is characterized by the fusion of NUTM1 with another gene (e.g., BRD4, BRD3 or NSD3, among others); these proteins bind acetylated chromatin; these domains result in dysregulated transcription of genes, including cMYC and TP63, which promote tumor growth (Genes Dev 2015;29:1507, Proc Natl Acad Sci U S A 2017;114:E4184)
Interpretation
Uses by pathologists
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Brendan Dickson, M.D.

NUT carcinoma arising in the sinonasal tract: H&E

NUT carcinoma arising in the sinonasal tract: IHC

Positive staining - normal
Positive staining - disease
Negative staining - normal
  • Breast
  • Large intestine
  • Liver (minority of cases may contain cytoplasmic and nuclear blush)
  • Lung
  • Prostate
  • Thymus
  • Tonsil (Am J Surg Pathol 2009;33:984)
Negative staining - disease
  • Adenocarcinoma, NOS
  • Ewing sarcoma
  • Nasopharyngeal carcinoma
  • Neuroblastoma
  • Renal cell carcinoma
  • Rhabdomyosarcoma
  • Rhabdoid tumor
  • Serous carcinoma
  • Sinonasal undifferentiated carcinoma
  • Small cell carcinoma
  • Squamous cell carcinoma, NOS
  • Urothelial carcinoma (Am J Surg Pathol 2009;33:984)
Board review question #1
    A mediastinal mass is biopsied, which shows a morphologically undifferentiated carcinoma. Which of the following staining patterns would be most consistent with classification as NUT carcinoma?

  1. Nuclear expression in > 90% of cells with a speckled pattern
  2. Nuclear expression in > 90% of cells with an even / uniform pattern
  3. Cytoplasmic expression in < 90% of cells with a speckled pattern
  4. Cytoplasmic expression in < 90% of cells with an even / uniform pattern
Board review answer #1
A. Nuclear expression in > 90% of cells with a speckled pattern. In NUT carcinoma most tumor cells are positive for this biomarker, which is expressed in the nucleus with a speckled distribution. In contrast, germ cell tumors often have only focal tumor staining, which is expressed in the nucleus with an even/uniform distribution.
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