title: Cutaneous and mammary apocrine carcinomas have different immunoprofiles.
abstract: Often the distinction of cutaneous apocrine carcinoma from metastatic mammary apocrine carcinoma to the skin can be a diagnostic dilemma because both tumors share similar histologic features and have overlapping immunohistochemical profile. We compared the expression of adipophilin, cytokeratin 5/6, p63, GATA3, mammaglobin, androgen receptor, estrogen receptor, progesterone receptor, and HER2 by immunohistochemistry in 14 cutaneous apocrine carcinomas (11 primary tumors, 3 metastases) and 26 primary apocrine carcinomas of the breast. Whereas focal adipophilin staining was seen in 36% (5/14) of cutaneous apocrine carcinoma, strong and diffuse adipophilin staining was seen in 88% (22/25) of mammary apocrine carcinoma (P = .0013). Differences in estrogen receptor and progesterone receptor expression were also statistically significant (P = .018 and .043). Androgen receptor was strongly positive in all cutaneous and mammary cases. Although there was no significant difference in the frequency of expression of cytokeratin 5/6, p63, HER2, GATA3, and mammaglobin in cutaneous apocrine carcinoma versus mammary apocrine carcinoma, strong and diffuse cytokeratin 5/6 and/or mammaglobin expression were seen only in cutaneous apocrine carcinoma. In conclusion, cutaneous apocrine carcinoma is likely adipophilin- ER+ PR+/- HER2- and can exhibit strong and diffuse cytokeratin 5/6 and/or mammaglobin expression. On the contrary, a mammary apocrine carcinoma is likely adipophilin+ ER- PR- and often exhibit 3+ HER2 with corresponding HER2 gene amplification. A panel of adipophilin, ER, PR, HER2, cytokeratin 5/6, and mammaglobin may be helpful in distinguishing cutaneous apocrine carcinoma from mammary apocrine carcinoma.
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA 02114; Department of Pathology, Harvard Medical School, Boston, MA 02114.
authors.forename: Adriano
authors.initials: A
authors.lastname: Piris
authors.affiliation: Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75235.
authors.forename: Yan
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA 02114.
authors.forename: Chakib
authors.initials: C
authors.lastname: Boussahmain
authors.affiliation: Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, TX 75235.
authors.forename: Lydia R
authors.initials: LR
authors.lastname: Essary
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA 02114; Department of Pathology, Harvard Medical School, Boston, MA 02114.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Gudewicz
authors.affiliation: Department of Pathology, Massachusetts General Hospital, Boston, MA 02114; Department of Pathology, Harvard Medical School, Boston, MA 02114. Electronic address: mhoang@partners.org.
authors.forename: Mai P
authors.initials: MP
authors.lastname: Hoang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology; D047628:Estrogen Receptor alpha / Q000096:biosynthesis; D005260:Female; D050990:GATA3 Transcription Factor / Q000096:biosynthesis; D006801:Humans; D007150:Immunohistochemistry; D053555:Keratin-5 / Q000096:biosynthesis; D053553:Keratin-6 / Q000096:biosynthesis; D008297:Male; D060785:Mammaglobin A / Q000096:biosynthesis; D008565:Membrane Proteins / Q000096:biosynthesis; D008875:Middle Aged; D000070780:Perilipin-2; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000096:biosynthesis; D011944:Receptors, Androgen / Q000096:biosynthesis; D011980:Receptors, Progesterone / Q000096:biosynthesis; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000473:pathology / Q000556:secondary; D013544:Sweat Gland Neoplasms / Q000235:genetics / Q000276:immunology* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor; D047628:Estrogen Receptor alpha; D050990:GATA3 Transcription Factor; D053555:Keratin-5; D053553:Keratin-6; D060785:Mammaglobin A; D008565:Membrane Proteins; D000070780:Perilipin-2; D018719:Erb-b2 Receptor Tyrosine Kinases; D011944:Receptors, Androgen; D011980:Receptors, Progesterone; C410798:AR protein, human; C081876:CKAP4 protein, human; C506487:ESR1 protein, human; C494749:GATA3 protein, human; C000602982:PLIN2 protein, human
keywords: Adipophilin; Androgen receptor; Cytokeratin 5/6; Estrogen receptor; GATA3; HER2/neu; Mammaglobin; Progesterone receptor; p63