Cytoplasmic staining of OCT4 is a highly sensitive marker of adrenal medullary-derived tissue

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Abstract

OCT4 immunostaining has become an essential resource in diagnosing germ cell neoplasia. OCT4 is a transcription factor with a characteristic nuclear staining pattern specific to germ cell neoplasms. Our institution has observed that paraganglionic tissue consistently displayed intense cytoplasmic staining by utilizing monoclonal OCT4 antibody, and we intended to determine whether OCT4 could provide additional diagnostic utility in adrenal tumors. We used monoclonal and polyclonal OCT4 antibodies for comparison of staining patterns and intensities. Thirty-eight pheochromocytomas (8 metastatic), 22 adrenal cortical carcinomas (2 metastatic), 15 metastatic tumors to the adrenal glands, and 10 normal adrenal glands containing cortical and medullary tissue were immunostained with OCT4. A 4-tier system (0 to 3), for recording intensity and extent of cytoplasmic staining, was used. All 30 primary pheochromocytomas displayed strong and diffuse (3+3) cytoplasmic immunoexpression. Six of 8 metastatic pheochromocytomas showed strong immunoexpression (3+3), whereas the remaining 2 showed moderate intensity (2+3). All 22 adrenal cortical carcinomas, including metastatic cases, were completely negative. Only 2 metastatic tumors to the adrenal gland showed weak, cytoplasmic positivity: a small cell carcinoma and a Merkel cell carcinoma. Controls stained in an appropriate nuclear manner. Immunoelectron microscopy demonstrated the antibody interacting with neurosecretory granules. To our knowledge, the cytoplasmic expression of OCT4 in adrenal medulla and pheochromocytoma has not been specifically studied. The goal of this study is to analyze the immunoreactivity of adrenal cortical carcinoma and pheochromocytoma to OCT4 and determine the sensitivity and specificity of this particular staining pattern and to compare monoclonal and polyclonal antibodies.

Original languageEnglish
Pages (from-to)727-733
Number of pages7
JournalAmerican Journal of Surgical Pathology
Volume37
Issue number5
DOIs
StatePublished - May 2013

Fingerprint

Pheochromocytoma
Adrenocortical Carcinoma
Staining and Labeling
Adrenal Glands
Monoclonal Antibodies
Merkel Cell Carcinoma
Neoplasms
Adrenal Medulla
Small Cell Carcinoma
Glandular and Epithelial Neoplasms
Immunoelectron Microscopy
Antibodies
Germ Cell and Embryonal Neoplasms
Germ Cells
Transcription Factors
Sensitivity and Specificity

Keywords

  • adrenal cortical carcinoma
  • immunohistochemistry
  • OCT4
  • pheochromocytoma

ASJC Scopus subject areas

  • Anatomy
  • Pathology and Forensic Medicine
  • Surgery

Cite this

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title = "Cytoplasmic staining of OCT4 is a highly sensitive marker of adrenal medullary-derived tissue",
abstract = "OCT4 immunostaining has become an essential resource in diagnosing germ cell neoplasia. OCT4 is a transcription factor with a characteristic nuclear staining pattern specific to germ cell neoplasms. Our institution has observed that paraganglionic tissue consistently displayed intense cytoplasmic staining by utilizing monoclonal OCT4 antibody, and we intended to determine whether OCT4 could provide additional diagnostic utility in adrenal tumors. We used monoclonal and polyclonal OCT4 antibodies for comparison of staining patterns and intensities. Thirty-eight pheochromocytomas (8 metastatic), 22 adrenal cortical carcinomas (2 metastatic), 15 metastatic tumors to the adrenal glands, and 10 normal adrenal glands containing cortical and medullary tissue were immunostained with OCT4. A 4-tier system (0 to 3), for recording intensity and extent of cytoplasmic staining, was used. All 30 primary pheochromocytomas displayed strong and diffuse (3+3) cytoplasmic immunoexpression. Six of 8 metastatic pheochromocytomas showed strong immunoexpression (3+3), whereas the remaining 2 showed moderate intensity (2+3). All 22 adrenal cortical carcinomas, including metastatic cases, were completely negative. Only 2 metastatic tumors to the adrenal gland showed weak, cytoplasmic positivity: a small cell carcinoma and a Merkel cell carcinoma. Controls stained in an appropriate nuclear manner. Immunoelectron microscopy demonstrated the antibody interacting with neurosecretory granules. To our knowledge, the cytoplasmic expression of OCT4 in adrenal medulla and pheochromocytoma has not been specifically studied. The goal of this study is to analyze the immunoreactivity of adrenal cortical carcinoma and pheochromocytoma to OCT4 and determine the sensitivity and specificity of this particular staining pattern and to compare monoclonal and polyclonal antibodies.",
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AU - Alexander, Riley E.

AU - Cheng, Liang

AU - Grignon, David

AU - Idrees, Muhammad

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N2 - OCT4 immunostaining has become an essential resource in diagnosing germ cell neoplasia. OCT4 is a transcription factor with a characteristic nuclear staining pattern specific to germ cell neoplasms. Our institution has observed that paraganglionic tissue consistently displayed intense cytoplasmic staining by utilizing monoclonal OCT4 antibody, and we intended to determine whether OCT4 could provide additional diagnostic utility in adrenal tumors. We used monoclonal and polyclonal OCT4 antibodies for comparison of staining patterns and intensities. Thirty-eight pheochromocytomas (8 metastatic), 22 adrenal cortical carcinomas (2 metastatic), 15 metastatic tumors to the adrenal glands, and 10 normal adrenal glands containing cortical and medullary tissue were immunostained with OCT4. A 4-tier system (0 to 3), for recording intensity and extent of cytoplasmic staining, was used. All 30 primary pheochromocytomas displayed strong and diffuse (3+3) cytoplasmic immunoexpression. Six of 8 metastatic pheochromocytomas showed strong immunoexpression (3+3), whereas the remaining 2 showed moderate intensity (2+3). All 22 adrenal cortical carcinomas, including metastatic cases, were completely negative. Only 2 metastatic tumors to the adrenal gland showed weak, cytoplasmic positivity: a small cell carcinoma and a Merkel cell carcinoma. Controls stained in an appropriate nuclear manner. Immunoelectron microscopy demonstrated the antibody interacting with neurosecretory granules. To our knowledge, the cytoplasmic expression of OCT4 in adrenal medulla and pheochromocytoma has not been specifically studied. The goal of this study is to analyze the immunoreactivity of adrenal cortical carcinoma and pheochromocytoma to OCT4 and determine the sensitivity and specificity of this particular staining pattern and to compare monoclonal and polyclonal antibodies.

AB - OCT4 immunostaining has become an essential resource in diagnosing germ cell neoplasia. OCT4 is a transcription factor with a characteristic nuclear staining pattern specific to germ cell neoplasms. Our institution has observed that paraganglionic tissue consistently displayed intense cytoplasmic staining by utilizing monoclonal OCT4 antibody, and we intended to determine whether OCT4 could provide additional diagnostic utility in adrenal tumors. We used monoclonal and polyclonal OCT4 antibodies for comparison of staining patterns and intensities. Thirty-eight pheochromocytomas (8 metastatic), 22 adrenal cortical carcinomas (2 metastatic), 15 metastatic tumors to the adrenal glands, and 10 normal adrenal glands containing cortical and medullary tissue were immunostained with OCT4. A 4-tier system (0 to 3), for recording intensity and extent of cytoplasmic staining, was used. All 30 primary pheochromocytomas displayed strong and diffuse (3+3) cytoplasmic immunoexpression. Six of 8 metastatic pheochromocytomas showed strong immunoexpression (3+3), whereas the remaining 2 showed moderate intensity (2+3). All 22 adrenal cortical carcinomas, including metastatic cases, were completely negative. Only 2 metastatic tumors to the adrenal gland showed weak, cytoplasmic positivity: a small cell carcinoma and a Merkel cell carcinoma. Controls stained in an appropriate nuclear manner. Immunoelectron microscopy demonstrated the antibody interacting with neurosecretory granules. To our knowledge, the cytoplasmic expression of OCT4 in adrenal medulla and pheochromocytoma has not been specifically studied. The goal of this study is to analyze the immunoreactivity of adrenal cortical carcinoma and pheochromocytoma to OCT4 and determine the sensitivity and specificity of this particular staining pattern and to compare monoclonal and polyclonal antibodies.

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