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1:
Benign Prostate Glands - Keratin Immunostain
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Comments: The antibody to high molecular weight keratin 34bE12 stains all normal basal cells as seen in this image. The stromal cells and acinar epithelial cells do not stain.
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2:
Atrophic Prostate Glands - Keratin Immunostain
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Comments: The basal cell layer may be fragmented or even absent in many benign conditions such as atrophy (as seen here), inflammation, and atypical adenomatous hyperplasia. Keratin 34bE12 immunostain can be extremely helpful in distinguishing atrophy from atrophic pattern of adenocarcinoma.
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3:
Post-Atrophic Hyperplasia - Keratin
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Comments: Keratin 34bE12 immunostain shows a continuous basal cell layer around most glands in this example of post-atrophic hyperplasia, a common benign mimic of adenocarcinoma.
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4:
Atypical Adenomatous Hyperplasia - Keratin
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Comments: Atypical adenomatous hyperplasia (AAH), when encountered in needle biopsies, can be extremely difficult to distinguish from cancer. Keratin 34bE12 immunostain will demonstrate at least a few residual basal cells in AAH as seen here.
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5:
High-grade PIN & Cancer - Keratin
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Comments: Note the progressive loss of basal cell layer in this image from right to left. The basal cell layer is intact in benign glands (upper right), fragmented in high-grade PIN glands (middle) and completely absent in adenocarcinoma (left).
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6:
Prostatic AdenoCA (Gleason 3+4=7)
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Comments: A focus of adenocarcinoma (Gleason 3+4=7) in a needle biopsy. Two benign glands are seen in this field (arrow, and bottom-right). Look for basal cells in these 2 glands in the next image.
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7:
Prostatic AdenoCA (Gleason 3+4=7) - Keratin
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Comments: The two benign glands referred to in the previous image show intact basal cell layer. The malignant glands show total absence of staining with keratin 34bE12 antibody.
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9:
Prostate AdenoCA - Keratin Immunostain
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Comments: Keratin 34bE12 immunostain nicely demonstrates absence of basal cell layer in the atypical glands supporting the diagnosis of adenocarcinoma.
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10:
Prostate Adenoid Basal Cell Tumor - Keratin
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Comments: Adenoid basal cell tumor showing intense immunoreactivity with keratin 34bE12 antibody. Interestingly, in this case the immunostaining is intense in the central portion of cell clusters. The peripheral cells show little or no staining.
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