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. Author manuscript; available in PMC: 2020 Nov 29.

Published in final edited form as: Adv Anat Pathol. 2020 May;27(3):114–163. doi: 10.1097/PAP.0000000000000256

Image 16. — Immunohistochemical Work Up of Squamous Cell vs. Urothelial Carcinoma: (A) This tumor in the rectum was initially diagnosed as a squamous cell carcinoma based on the combination of (B) positive p40 and (D) negative CK20 staining. (C) CK7 staining was also performed. (E) I added a GATA-3, which demonstrates diffuse, moderate-to-strong staining. Although anogenitourinary squamous cell carcinomas can express GATA-3, the extent of staining in this case is most in keeping with urothelial carcinoma, and, in fact, this patient had a history of bladder cancer. CK20 staining is only seen in 50% of urothelial carcinomas, and CK7 staining is more common in urothelial (>90%) than squamous cell (30%) carcinoma. Uroplakin II (or S100P)-positivity would also support a diagnosis of urothelial carcinoma.

Image 16. — Immunohistochemical Work Up of Squamous Cell vs. Urothelial Carcinoma: (A) This tumor in the rectum was initially diagnosed as a squamous cell carcinoma based on the combination of (B) positive p40 and (D) negative CK20 staining. (C) CK7 staining was also performed. (E) I added a GATA-3, which demonstrates diffuse, moderate-to-strong staining. Although anogenitourinary squamous cell carcinomas can express GATA-3, the extent of staining in this case is most in keeping with urothelial carcinoma, and, in fact, this patient had a history of bladder cancer. CK20 staining is only seen in 50% of urothelial carcinomas, and CK7 staining is more common in urothelial (>90%) than squamous cell (30%) carcinoma. Uroplakin II (or S100P)-positivity would also support a diagnosis of urothelial carcinoma.