Distinctive immunohistochemical profile of mucinous cystic neoplasms of pancreas, ovary and lung

Histol Histopathol. 2009 Jan;24(1):77-82. doi: 10.14670/HH-24.77.


Mucinous cystic neoplasms (MCNs) of the pancreas, ovary and lung have a similar histologic appearance. We investigated if immunohistochemical (IHC) studies could help in separating these neoplasms. Twenty-six ovarian MCNs (invasive carcinoma and borderline tumor), 12 pancreatic MCNs (invasive carcinoma, and with moderate or high-grade dysplasia), and 3 pulmonary MCNs (only invasive carcinoma) were retrieved. Our study demonstrated that pancreatic MCNs are positive for CDX-2 (67%), PDX-1 (100%), CK7 (83%) and CK20 (100%), while are negative for CA-125. The IHC profile of ovarian intestinal type MCN is similar to that of pancreatic MCNs, except for lower frequency of CDX-2 expression (29% vs. 67%). Ovarian endocervical like MCNs are positive for CA-125 (100%) and CK7 (100%), while are negative for CDX-2, PDX-1 and CK20. Pulmonary MCNs are positive for CDX-2 (100%), CK7 (100%) and CK20 (100%), while are negative for PDX-1 and CA-125. All tumors are negative for TTF-1, D2-40 and WT-1. We concluded that an IHC panel of CDX-2, PDX-1, CA-125, and CK20 is useful in separating MCNs of the pancreas, ovary and lung.

MeSH terms

  • Adenocarcinoma, Mucinous / diagnosis*
  • Adenocarcinoma, Mucinous / metabolism
  • Adult
  • Aged
  • Biomarkers, Tumor / analysis*
  • CA-125 Antigen / biosynthesis
  • CDX2 Transcription Factor
  • Female
  • Homeodomain Proteins / biosynthesis
  • Humans
  • Immunohistochemistry
  • Keratin-20 / biosynthesis
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / metabolism
  • Male
  • Middle Aged
  • Neoplasm Metastasis / diagnosis*
  • Ovarian Neoplasms / diagnosis*
  • Ovarian Neoplasms / metabolism
  • Pancreatic Neoplasms / diagnosis*
  • Pancreatic Neoplasms / metabolism
  • Trans-Activators / biosynthesis


  • Biomarkers, Tumor
  • CA-125 Antigen
  • CDX2 Transcription Factor
  • Homeodomain Proteins
  • Keratin-20
  • Trans-Activators
  • pancreatic and duodenal homeobox 1 protein