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Thyroid transcription factor-1 may be expressed in ductal adenocarcinoma of the prostate:a potential pitfall

¹ Department of Pathology, Singapore General Hospital, Singapore
² Department of Pathology and Laboratory Medicine,Tan Tock Seng Hospital, Singapore
³ Department of Urology, Tan Tock Seng Hospital, Singapore
⁴ Department of Urology, Singapore General Hospital, Singapore
⁵ Department of Pathology, Singapore General Hospital, Singapore

Correspondence to:
Dr Puay-Hoon Tan
Department of Pathology, Singapore General Hospital, Outram Road, Singapore 169608; tan.puay.hoon@singhealth.com.sg Received for publication 17 February 2007.

The first 150 words of the full text of this article appear below.

We report a case of prostatic ductal adenocarcinoma which expressed thyroid transcription factor-1 (TTF-1) on immunohistochemical examination, and highlight the fact that this aberrant staining is a potential pitfall in the evaluation of this lesion. Prostatic core biopsy specimens from a 65-year-old man revealed an adenocarcinoma with large-calibre glands lined by stratified hyperchromatic nuclei. There was no accompanying conventional acinar adenocarcinoma and TTF-1 was distinctly positive in the nuclei of the malignant cells. This led to a search for possible lung and other primaries. When a thorough systemic investigation disclosed no evidence of other primary tumours, a radical prostatectomy was performed which revealed predominant ductal adenocarcinoma with a minor component of acinar adenoarcinoma. TTF-1 measurement was repeated which showed staining confined to the ductal adenocarcinoma. Prostate specific antigen (PSA), PSAP and racemase were also found. Our findings underscore the increasing spectrum of lesions that may express TTF-1 on immunohistochemical examination.

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