Thyroid transcription factor-1 is expressed in extrapulmonary small cell carcinomas but not in other extrapulmonary neuroendocrine tumors

S. Nicholas Agoff, Laura W. Lamps, Abraham T. Philip, Mahul Amin, Rodney A. Schmidt, Lawrence D. True, Andrew L. Folpe

Research output: Contribution to journalArticle

257 Citations (Scopus)

Abstract

Thyroid transcription factor-1 (TTF-1) is a nuclear homeodomain transcription factor that is expressed in the developing thyroid, respiratory epithelium, and diencephalon. TTF-1 is thought to be expressed specifically in pulmonary or thyroid neoplasms, and it is expressed in a significant subset of pulmonary non-small cell carcinomas, small cell carcinomas, and carcinoids but not in nonpulmonary, non-small cell carcinomas. Neuroendocrine tumors from sites other than the lung have not been evaluated for TTF-1 expression. We examined TTF-1 expression using immunohistochemistry on formalin-fixed, paraffin-embedded sections of 49 gastrointestinal carcinoids; 15 pancreatic islet cell tumors; 21 paragangliomas; 8 medullary thyroid carcinomas; 7 small cell carcinomas of the uterine cervix; 4 prostate, 4 bladder, and 6 Merkel cell (primary cutaneous neuroendocrine) carcinomas; and 1 renal carcinoma. No gastrointestinal carcinoid tumor, pancreatic islet cell tumor, paraganglioma, or Merkel cell carcinoma expressed TTF-1. All of the medullary thyroid carcinomas strongly expressed TTF-1. However, 44% of nonpulmonary small cell carcinomas were also TTF-1 positive, including four of four prostate, two of four bladder, and one of seven cervical small cell carcinomas. We conclude that TTF-1 expression is not specific for small cell carcinomas of pulmonary origin and should not be used to distinguish primary from metastatic small cell carcinomas in extrapulmonary sites. However, TTF-1 expression may be useful in distinguishing Merkel cell carcinomas and cutaneous metastasis of small cell carcinomas. Among well-differentiated neuroendocrine tumors, TTF-1 expression seems to be present only in carcinoid tumors of the lung and medullary carcinomas of the thyroid and may be of differential diagnostic value when dealing with a metastatic well- differentiated neuroendocrine tumor.

Original languageEnglish (US)
Pages (from-to)238-242
Number of pages5
JournalModern Pathology
Volume13
Issue number3
DOIs
StatePublished - Jan 1 2000

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Small Cell Carcinoma
Neuroendocrine Tumors
Carcinoid Tumor
Merkel Cell Carcinoma
Paraganglioma
Lung
Prostate
Urinary Bladder
Merkel Cells
thyroid nuclear factor 1
Carcinoma
Neuroendocrine Carcinoma
Respiratory Mucosa
Diencephalon
Skin
Thyroid Neoplasms
Cervix Uteri
Paraffin
Formaldehyde
Lung Neoplasms

All Science Journal Classification (ASJC) codes

  • Pathology and Forensic Medicine

Cite this

Thyroid transcription factor-1 is expressed in extrapulmonary small cell carcinomas but not in other extrapulmonary neuroendocrine tumors. / Agoff, S. Nicholas; Lamps, Laura W.; Philip, Abraham T.; Amin, Mahul; Schmidt, Rodney A.; True, Lawrence D.; Folpe, Andrew L.

In: Modern Pathology, Vol. 13, No. 3, 01.01.2000, p. 238-242.

Research output: Contribution to journalArticle

Agoff, S. Nicholas ; Lamps, Laura W. ; Philip, Abraham T. ; Amin, Mahul ; Schmidt, Rodney A. ; True, Lawrence D. ; Folpe, Andrew L. / Thyroid transcription factor-1 is expressed in extrapulmonary small cell carcinomas but not in other extrapulmonary neuroendocrine tumors. In: Modern Pathology. 2000 ; Vol. 13, No. 3. pp. 238-242.
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