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p63 in Primary Cutaneous Carcinosarcoma

Suh, Ki-Young MD; Lacouture, Mario MD; Gerami, Pedram MD

American Journal of Dermatopathology: August 2007 - Volume 29 - Issue 4 - pp 374-377
doi: 10.1097/DAD.0b013e31812f52bd
Original Article

Primary cutaneous carcinosarcomas (PCCs) are rare malignant neoplasms that are characterized by biphasic epithelial and mesenchymal differentiation. When the biphasic nature is not evident, immunohistochemical studies may be important in the diagnosis of PCCs. Although AE1/AE3 is frequently used to demonstrate the epithelial component, it may not be strongly expressed in epithelial cells that are not well-differentiated. p63 is a protein homologue of p53 that is expressed in poorly differentiated epithelial cells. We report 3 cases of PCC. The clearly epithelial areas of each tumor were frequently positive for both markers, whereas the sarcomatous areas were negative for both markers. Epithelial cells that were poorly differentiated and not easily identifiable were positive for p63 but negative for AE1/AE3. Of interest, transitional areas showed positivity for p63 alone. These 3 cases suggest that the use of both p63 and routine cytokeratin markers such as AE1/AE3 can increase the sensitivity for distinguishing epithelial cells over a range of differentiation states, which we propose will aid in the diagnosis of PCCs. In addition, the staining pattern of AE1/AE3 and p63 in these cases further supports the conversion theory of PCC.

From the Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.

The authors state that they have no financial interest in the products mentioned within this article.

Reprints: Ki-Young Suh, MD, Department of Dermatology, Feinberg School of Medicine 676 North Saint Clair Street, Suite 1600 Chicago, Illinois 60611 (e-mail: kiyoungsuh@gmail.com).

© 2007 Lippincott Williams & Wilkins, Inc.