Upper Gastrointestinal Tract



The application of immunohistochemistry in the diagnostic gastrointestinal pathology is similar to many other organ systems. The most commonly used markers are epithelial cell markers such as cytokeratin AE1/3, cytokeratin 7 and cytokeratin 20, and markers for common mesenchymal tumors such as CD117, CD34, S100, desmin, etc. Tumors of neuroendocrine origin are probably more commonly seen in the digestive and pulmonary systems. A synaptophysin and chromogranin immunostain generally can confirm their ­neuroendocrine nature. Use of immunohistochemical studies to evaluate dysplasia in Barrett’s esophagus is still investigational, although many have found p53 overexpression helpful in confirming dysplasia, particularly in high-grade dysplasia. The use of immunohistochemical studies in nonneoplastic diseases of the gastrointestinal tract is limited. Finally, immunohistochemistry, like GCDFP-15 immunostain, may play a critical role in differentiating certain metastases, such as lobular carcinoma of the breast, from primary tumors, including gastric signet ring cell carcinoma.


Dysplasia Carcinoma GIST Neuroendocrine Metastasis Keratin CD117 Synaptophysin 


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© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Department of Pathology and Laboratory MedicineGeisinger Medical CenterDanvilleUSA

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