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Stains
Cytokeratin AE1 / AE3
Copyright: 2003-2018, PathologyOutlines.com, Inc.
PubMed Search: Cytokeratin AE1 / AE3
Cytokeratin AE1 / AE3
Author: Nat Pernick, M.D.
Topic Completed: 1 July 2013
Revised: 26 November 2019
Copyright: 2003-2018, PathologyOutlines.com, Inc.
PubMed Search: Cytokeratin AE1 / AE3
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Table of Contents
Definition / general | Uses by pathologists | Microscopic (histologic) images | Cytology images | Positive staining - normal | Positive staining - disease | Negative stainsCite this page: Pernick N. Cytokeratin AE1 / AE3. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainsae1ae3.html. Accessed February 21st, 2020.
Definition / general
- Keratin cocktail that detects CK1 - 8, 10, 14 - 16 and 19, but does not detect CK17 or CK18
- Often referred to in literature as "keratin" or "pankeratin", although this may also refer to Cytokeratin MNF116
- May cross react with GFAP, leading to aberrant staining of glial tumors (ependymoma, glioblastoma, schwannoma, Mod Pathol 2006;19:115)
- Note: staining pattern of cocktail may be different than staining pattern of AE1 and AE3 separately, due to different pretreatment
Uses by pathologists
- Confirm or rule out epithelial nature of tissue, tumors or components of tumors (example: breast ductal lavage foam cells are not epithelial, Diagn Cytopathol 2002;27:261)
- Identify metastatic carcinoma in lymph nodes (Gynecol Oncol 2007;105:683, J Clin Pathol 2006;59:518), bone marrow (Int J Cancer 2007;120:1603) or at frozen section (Acta Histochem Cytochem 2011;44:133) by immunohistochemistry or (uncommonly) flow cytometry (J Thorac Cardiovasc Surg 2005;130:753)
- Note 1: nodal epithelial cells may represent artifact of recent biopsy, not metastatic disease (Ann Surg Oncol 2002;9:999)
- Note 2: hyalinized cytokeratin particles, without tumor cell nuclei, may cause misinterpretation (J Surg Res 2002;107:75)
- Note 3: may rarely stain nodal reticulum cells (Appl Immunohistochem Mol Morphol 2001;9:297)
- Note 4: presence of isolated nodal tumor cells / micrometastases in carcinoma has no apparent prognostic significance in carcinomas of breast (Appl Immunohistochem Mol Morphol 2006;14:426), colorectum (Clin Transl Oncol 2006;8:676), rectum (Int J Colorectal Dis 2007;22:911) and breast DCIS (Ann Surg Oncol 2005;12:254), but is a poor prognostic factor in carcinomas of cervix (Int J Gynecol Cance 2006;16:1188), endobronchial carcinoid (Ann Thorac Surg 2005;80:428), GE junction (Eur J Surg Oncol 2005;31:270), lung - nonsmall cell (Ann Surg 2002;235:133, Eur J Cardiothorac Surg 2007;31:1120) and stomach (Cancer 2002;94:2867)
- Note 5: the presence of isolated tumor cells / micrometastases in bone marrow is a poor prognostic factor in breast carcinoma (Clin Cancer Res 2004;10:5342), but not in non small cell lung carcinoma (Cancer 2004;100:794)
- Note 6: the presence of lymphovascular invasion detected only by immunohistochemistry has no prognostic value in endometrioid endometrial carcinoma (Gynecol Oncol 2004;92:653)
- Identify residual tumor post treatment (example: prostate carcinoma post hormonal treatment - Hinyokika Kiyo 2006;52:781)
- Note: when trying to identify residual tumor cells, must pay attention to nature of cells, since AE1 / AE3 may stain myofibroblasts and smooth muscle cells (Am J Surg Pathol 2007;31:390)
- Assess depth of invasion (Int J Gynecol Cancer 2004;14:665)
- Establish presence of noninvasive epithelial downgrowth after penetrating keratoplasty (Cornea 2006;25:727)
- Part of flow cytometry strategy to enrich epithelial cells in sputum (Cytometry A 2004;60:1)
Microscopic (histologic) images
Images hosted on PathOut server:
Contributed by Andrey Bychkov, M.D., Ph.D.,
Kameda Medical Center
MALT lymphoma
Strongly positive cancer
cells versus weakly positive
thyroid follicles
Cytology images
Scroll to see all images:
Images hosted on PathOut server:
epithelial-
myoepithelial
carcinoma
Thyroid anaplastic carcinoma
Kidney: atypical angiomyolipoma -
(left) is negative, normal kidney;
(right) is positive
Images hosted on other servers:
Ascitis fluid: metastatic alveolar
rhabdomyosarcoma is negative,
mesotheilal cell is internal
positive control (fig C)
Breast ductal carcinoma: nodal metastases
Breast lobular carcinoma: metastasis to lymph node - H&E and AE1 / AE3
Breast:
angiomyoepithelioma -
malignant, epithelial
component (fig C)
Duodenum: neuroendocrine carcinoma
Liver: adenomatoid tumor (fig 3)
(non small cell)
associated
lymph node
Lung cancer (non small cell) associated lymph node: frozen section
small cell
carcinoma
(fig 1D)
squamous cell
carcinoma -
acantholytic type
Pleura: poorly differentiated carcinoma
Pleura: sarcomatoid mesothelioma (fig A)
Salivary gland: acinic cell carcinoma (left, fig 4); undifferentiated sarcoma - normal ducts (right, fig b)
carcinoma
metastatic
to bone (fig 4)
sarcomatoid
carcinoma
(fig 3A)
Soft tissue: angiosarcoma - left, fig 2; right, fig 1C
Soft tissue: benign mixed tumor (fig B)
Soft tissue: myoepithelioma (fig C in both images)
Soft tissue: myxoid chondrosarcoma (fig B)
myxopapillary
ependymoma of
filum terminale
Testis: yolk sac tumor
Testis: adenomatoid tumor
Positive staining - normal
- Most epithelium
- Adenohypophysis follicular cells (Pathol Int 2005;55:244), trophoblast (Am J Clin Pathol 1991;95:137)
Positive staining - disease
- Most carcinomas
- Adenomatoid tumor (Histopathology 2000;36:109, Am J Surg Pathol 2003;27:969)
- Adenomatoid odontogenic tumor (Oral Oncol 2005;41:835)
- Aggressive angiomyxoma (27%, Virchows Arch 2005;446:157)
- Angiosarcoma - GI tract (Am J Surg Pathol 2004;28:298) and epithelioid (Ann Diagn Pathol 2005;9:33)
- Chondroblastoma and chondrosarcoma - clear cell (60%, Hum Pathol 2013;44:237)
- Chordoma (Clin Neuropathol 2004;23:277)
- Choroid plexus tumors (Arq Neuropsiquiatr 2004;62:600)
- Cylindroma (Am J Surg Pathol 2001;25:823)
- Desmoplastic small round cell tumor (Cytojournal 2005;2:6)
- Ependymoma (Appl Immunohistochem Mol Morphol 2000;8:25)
- Epithelioid sarcoma (J Cutan Pathol 2004;31:67, Am J Surg Pathol 2011;35:891)
- Female adnexal tumor of probable wolffian origin (Hum Pathol 1999;30:856)
- GI tract - reactive nodular fibrous pseudotumor (Int J Surg Pathol 2004;12:365)
- Glioblastoma multiforme and gliomas (Am J Surg Pathol 1989;13:141)
- Hemangioendothelioma - epithelioid (focal, Int J Surg Pathol 2000;8:75) and pseudomyogenic (100%, Am J Surg Pathol 2011;35:190)
- Hepatoblastoma (Pediatr Dev Pathol 2006;9:196)
- Meningioma - malignant (75%, Mod Pathol 2004;17:1129)
- Mesothelioma (Pathol Int 2007;57:190, Am J Surg Pathol 2007;31:711)
- Myoepithelial tumors (Am J Surg Pathol 2003;27:1183)
- Paraganglioma of cauda equina (Hum Pathol 2005;36:444)
- Pituitary carcinoma (Acta Cytol 2006;50:225)
- Proliferative fasciitis (46% positive, Am J Surg Pathol 2012;36:1404)
- Prostate carcinoma neuroendocrine cells (Prostate 2006;66:1399)
- Schwannoma (69% of retroperitoneum tumors, Mod Pathol 2006;19:115)
- Sertoli cell tumor (Hum Pathol 1992;23:787)
- Synovial sarcoma (usually, Am J Surg Pathol 2002;26:1434)
- Testicular / epididymal papillary cystadenoma (Am J Surg Pathol 2005;29:520)
- Thymoma (Virchows Arch A Pathol Anat Histopathol 1992;420:185)
- Trophoblastic tumors (Am J Surg Pathol 2004;28:405)
- Yolk sac tumor (Diagn Cytopathol 2006;34:421, Am J Surg Pathol 2012;36:360)
Negative stains
- Adrenocortical carcinoma (often)
- Digital fibromyxoma (Am J Surg Pathol 2012;36:789)
- Dysgerminoma (8% positive, Hum Pathol 2006;37:1015)
- Endometrial stromal sarcoma (24% positive, Mod Pathol 2005;18:40)
- Hepatocellular carcinoma (15% positive, Mod Pathol 1989;2:8)
- Lymphangioma (Hum Pathol 2011;42:1013)
- Malignant fibrous histiocytoma (15% positive, Am J Surg Pathol 2012;36:1404)
- Nodular fasciitis (9% positive, Am J Surg Pathol 2012;36:1404)
- Ovarian sex cord stromal tumors (overall 27% positive, Zhonghua Bing Li Xue Za Zhi 2004;33:217; Sertoli cell tumors are generally positive)
- Paraganglioma - lung (Ann Diagn Pathol 2004;8:237)
- Sclerosing epithelioid fibrosarcoma (usually, Zhonghua Bing Li Xue Za Zhi 2004;33:337)
- Seminoma (usually negative, Am J Surg Pathol 2005;29:500, but 20% of retroperitoneal tumors are positive, Am J Surg Pathol 2006;30:766)
- Solitary fibrous tumor (11% positive, Am J Surg Pathol 2012;36:1404)
- Wilm tumor - epithelial component (Sao Paulo Med J 2004;122:181)
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