Application of Immunohistochemistry to the Genitourinary System (Prostate, Urinary Bladder, Testis, and Kidney)

Abstract

Abstract Context.—The variety of morphologic patterns of different entities of the genitourinary tract can present a diagnostic dilemma for the pathologist. This is especially true in cases of mimics of cancer, a cancer of unknown primary, or poorly differentiated tumors, in which it is hard to assign histogenesis needed to plan the correct therapy for the patient. Immunohistochemistry offers a better capacity than hematoxylin-eosin staining alone to differentiate human tissue types. Also, in the past decades, several techniques had been developed to differentiate between benign and malignant processes with morphologic overlap. By using immunohistochemistry in selected cases, the rate of false-negative and false-positive diagnoses can be reduced, and some patients are afforded the opportunity to get more specific or effective therapy as a result. Objective.—For each subgroup of genitourinary system tumors, common diagnostic problems are reviewed, and immunohistochemical markers useful in addressing these problems are discussed, along with expected patterns of immunoreactivity. Data Sources.—The pertinent literature, with focus on immunohistochemical staining of tumors of the genitourinary tract. Conclusions.—The addition of immunohistochemistry to the diagnostic armamentarium for genitourinary pathologic diagnosis has increased the sensitivity and specificity of diagnoses and aided in the selection of optional therapeutic regimens in selected cases.