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S-100A1 is a reliable marker in distinguishing nephrogenic adenoma from prostatic adenocarcinoma

Cossu Rocca, Paolo Alessandro and Contini, Marcella and Brunelli, Matteo and Festa, Antonella and Pili, Francesca and Gobbo, Stefano and Eccher, Albino and Mura, Antonica and Massarelli, Giovannino (2009) S-100A1 is a reliable marker in distinguishing nephrogenic adenoma from prostatic adenocarcinoma. The American Journal of Surgical Pathology, Vol. 33 (7), p. 1031-1036. eISSN 1532-0979. Article.

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DOI: 10.1097/PAS.0b013e31819c6ff9

Abstract

Nephrogenic adenoma is a benign lesion that may occur at any site of the genitourinary tract, usually in association with previous urothelial injuries. Although its pathogenesis is still debated, recent studies seem to confirm its derivation from renal tubular epithelium, rather than from a metaplastic process of urothelium. In addition to its uncertain origin, there can be diagnostic difficulty in distinguishing nephrogenic adenoma from prostatic adenocarcinoma, particularly with lesions arising in the prostatic urethra. So far, immunohistochemical stains are often needed to make such a distinction, and several markers have been proposed, often with controversial results. S100A1 is a calcium binding protein that has been recently reported to be expressed in renal tubular cells and in a subset of renal cell neoplasms. Alpha-methylacyl-CoA racemase (AMACR), a recently identified prostate cancer marker, has also been found to be expressed in renal tubules and in some renal epithelial neoplasms. In this study, we investigated the expression of S100A1 and AMACR in 18 nephrogenic adenomas and in 100 prostatic adenocarcinomas. A strong and distinct cytoplasmic or nucleocytoplasmic staining of S100A1 was found in 17 out of 18 cases of nephrogenic adenoma (94%), but never in prostatic adenocarcinoma. In contrast, AMACR expression was detected in 14 of 18 nephrogenic adenomas (78%) and in 96 of 100 prostatic adenocarcinomas (96%). We conclude that (1) S100A1 is a specific and sensitive immunohistochemical marker to differentiate nephrogenic adenoma from prostatic adenocarcinoma; (2) AMACR immunostaining does not seem to be a useful marker in distinguishing between these 2 lesions; (3) given that both S100A1 and AMACR have been reported to be expressed in renal tubular cells and in a subset of renal cell neoplasms, our findings confirm the histogenetic relationship between nephrogenic adenoma and renal tubular epithelium.

Item Type:Article
ID Code:3520
Status:Published
Refereed:Yes
Uncontrolled Keywords:S-100A1, nephrogenic adenoma, prostatic adenocarcinoma
Subjects:Area 06 - Scienze mediche > MED/08 Anatomia patologica
Divisions:001 Università di Sassari > 03 Istituti > Anatomia patologica
Publisher:Lippincott Williams & Wilkins
eISSN:1532-0979
Deposited On:25 Jan 2010 10:28

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