Pancreatoblastoma : Immunostains

Comments:
Immunohistochemical Profile of Pancreatoblastoma: The diverse immunohistochemical profile of pancreatoblastoma is a reflection of different lines of maturation within the tumor. The tumor cells are positive for acinar markers (trypsin, chymotrypsin, lipase), BCL10, neuroendocrine markers (synaptophysin, chromogranin A), and ductal markers (CK7, CK19). Oncofetal antigens such as α-fetoprotein, α1-antitrypsin, and CEA are also positive.

The squamoid nests are variably positive for cytokeratins 8, 18, 19, and EMA. Given the involvement of β-catenin pathway, there is abnormal nuclear and cytoplasmic accumulation of β-catenin which can be demonstrated immunohistochemically (as shown in this image). In some cases, β-catenin positivity is limited to squamoid nests.

Image courtesy of: Elizabeth Montgomery, MD; used with permission.