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GATA3 Expression in Prostatic Adenosquamous Carcinoma: A Potential Diagnostic Pitfall.
Susan K Potterveld1, Sean R Williamson2, Khaleel I Al-Obaidy3
1Department of Pathology, Stanford Medical Center, Stanford, CA, USA.
International Journal of Surgical Pathology
|April 2, 2024
Summary
GATA3 immunohistochemistry (IHC) can be positive in prostatic adenosquamous carcinoma, challenging its use in differentiating from urothelial carcinoma. Awareness of this pitfall is crucial for accurate cancer diagnosis.
Area of Science:
- Uropathology
- Surgical Pathology
- Oncologic Pathology
Background:
- Urothelial carcinoma and prostatic adenocarcinoma share overlapping histologic features, complicating pathological diagnosis.
- GATA binding protein 3 (GATA3) immunohistochemistry (IHC) is a valuable tool, typically identifying urothelial carcinoma and excluding prostatic adenocarcinoma.
Purpose of the Study:
- To investigate the diagnostic pitfall of GATA3 positivity in prostatic adenosquamous carcinoma.
- To evaluate the utility of GATA3 and other markers in distinguishing prostatic adenosquamous carcinoma from urothelial carcinoma.
Main Methods:
- Retrospective review of 17 prostatic adenosquamous carcinoma cases.
- GATA3 immunohistochemistry (IHC) was performed or reviewed.
- Analysis of other relevant immunostains, including p63 and NKX3.1.
Main Results:
- GATA3 positivity was observed in 9 of 17 (53%) prostatic adenosquamous carcinomas, primarily in squamous regions.
- GATA3-positive tumors frequently co-expressed p63.
- NKX3.1 was consistently positive in the glandular components of prostatic adenosquamous carcinoma.
Conclusions:
- GATA3 can be expressed in prostatic adenosquamous carcinoma, presenting a potential diagnostic challenge.
- Pathologists must be aware of GATA3 immunoreactivity in mixed glandular/squamous carcinomas when considering prostatic origin.
- Combined use of GATA3, p63, and NKX3.1 aids in accurate diagnosis of prostatic adenosquamous carcinoma.
