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Fig. 1 | Diagnostic Pathology

Fig. 1

From: CK20 versus AMACR and p53 immunostains in evaluation of Urothelial Carcinoma in Situ and Reactive Atypia

Fig. 1

The most characteristic pattern of staining in urothelial carcinoma in situ (CIS) was of diffuse, full thickness (+) staining for AMACR (a) and CK20 (b). AMACR typically demonstrated reduced intensity and a granular cytoplasmic pattern, as compared to CK20; additionally, reactive urothelium in the nest of cystitis cystica underlying the surface CIS demonstrates expected negativity for both markers. Two examples of the challenges in the use of these markers where AMACR added utility included one case of reactive urothelium showing negative AMACR (c) but aberrantly positive CK20, relatively strong in most of the thickness of the urothelium (d). Additionally, we noted examples of small biopsies where AMACR was negative (e) but CK20 appeared positive (f), even if relatively weakly so, due in part to staining of normal umbrella cells sectioned tangentially en face

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