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TTF-1, Thyroid transcription factor
Interpretation: nuclear stain
Uses: primary vs. metastatic lung carcinoma, pleural lung carcinoma vs. mesothelioma, pulmonary small cell carcinoma vs. Merkel cell carcinoma
Positive staining (normal): lung type II pneumocytes and Clara cells, thyroid follicular and parafollicular C cells
Positive staining (disease):
Lung carcinoma: small cell (90%), adenocarcinoma (75%); large cell (40%); squamous cell (5%, AJSP 2001;25:363)
Thyroid: hyperplastic and neoplastic thyroid tissue but less common/lower levels in undifferentiated thyroid carcinomas (Mod Path 2000;13:570)
Other tumors: small cell carcinomas of lung and various sites (Mod Path 2000;13:238; AJSP 2001;25:815); colorectal carcinomas to lung may be positive (Mod Path 2005;18:1371), small cell carcinoma of bladder (39%, Hum Path 2005;36:718)
Negative staining: Merkel cell carcinoma of skin, most non-pulmonary non-small cell carcinomas
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