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Stains

Synaptophysin

Reviewer: Nat Pernick, M.D. (see Reviewers page)
Revised: 10 December 2011, last major update November 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Pathophysiology
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● Most abundant synaptic vesicle membrane glycoprotein, present in neuronal presynaptic vesicles
● Gene is at Xp11.23-p11.22
● May regulate endocytosis to ensure vesicle availability during and after sustained neuronal activity (Neuron 2011;70:847)
● Specific, but not sensitive for neuroendocrine tumors
● More sensitive in well differentiated tumors
● Granular cytoplasmic pattern in small cell carcinoma reflects neurosecretory granules

Uses by Pathologists
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● Common neuroendocrine marker (also chromogranin and CD56)

Micro images
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Adrenal gland: left-corticomedullary mixed tumor, middle-adrenocortical adenoma, right-adrenocortical carcinoma

       
Bladder: left-paraganglioma, middle-small cell carcinoma, right-mixed small cell / urothelial carcinoma


Bladder: small cell carcinoma (cytology)


Breast: colloid carcinoma

           
Breast: neuroendocrine carcinoma (left 2 images), neuroendocrine DCIS (right 2 images)

   
CNS: left-chordoma, right-gangliocytoma

       
Colonic polyp - tubulovillous adenoma with microcarcinoids


Colon: small cell carcinoma (fig D)


Esophagus: small cell carcinoma


Kidney: carcinoid tumor (cell block)


Merkel cell carcinoma metastatic to heart


Neuroblastoma (retropharyngeal mass)


Stomach: carcinoid tumor (left side-fig 4B)


Testis: Leydig cell tumor


Thymic carcinoma (type C thymoma), nonkeratinizing squamous cell carcinoma type

Positive staining - normal
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● Adrenal medulla, neuronal cells, neuroendocrine cells, pineal gland

Positive staining - disease
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● Neuroendocrine cells / tumors at all sites (carcinoid tumor, neuroendocrine carcinoma, paraganglioma, small cell carcinoma)
● Adrenal gland: adrenocortical adenoma and carcinoma, neuroblastoma, oncocytoma, pheochromocytoma
● CNS: central neurocytoma, gangliocytic paraganglioma, ganglioneuroma and other ganglion cell tumors (Hum Pathol 1990;21:271), medulloblastoma/central PNET, pleomorphic xanthoastrocytoma (variable), retinoblastoma
● Lung: adenocarcinoma-well differentiated fetal type
● Other: desmopslastic small cell tumor, glomus tumor, medullary thyroid carcinoma, Merkel cell carcinoma (Am J Clin Pathol 2011;135:831), myxoid chondrosarcoma (variable), parathyroid carcinoma of thymus (variable)

Negative staining
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● Urothelial carcinoma

End of Stains > Synaptophysin

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