CK7 & CK20: Pathological Diagnosis of tumor of unknown origin

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07/10/23

Watch the full video on IGTV .
.. Combination of CK7 and CK20 is vastly used to determine the primary site in a metastatic tumor of unknown origin.

The pattern observed could be both positive (CK7+/CK20+) or both negative (CK7-/CK20-). The other pattern could be either of them showing positivity i.e (CK7+/CK20-) or (CK7-/CK20+). 1)CK7+/CK20-

To remember CK7 positive tumors , I kind of remember it “7 tumors in a 👩🏼‍⚖️female”: starting from Cervical carcinoma, endometrial carcinoma, Ovarian cancer (except mucinous ovarian cancer ) & Breast cancer. Apart from these 4 tumors specific to women the other tumors are Salivary gland tumors, thyroid tumors and lung adenocarcinoma.( along with its closest differential mesothelioma). 2) CK7-/CK20+

Now the key to remember CK 20 is I see CK 20 as 2.0 (Yeah kind of Robot 2.0 releasing today) and just remember the two letters commonly used in India 🇳🇪 which are M & C where M stands for Merkel cell carcinoma and C stands for Colorectal carcinoma.

3) CK7-/CK20-

I did mention before that CK is absent from the steroid secreting cell so its absent from adrenal cortical carcinomas , below the adrenal are kidneys and most common Renal tumor is clear cell carcinoma. . Below the kidneys is a very small organs in males called prostate which is also negative for CK7 & CK20 and above them are is a an organ which becomes large in males is Liver 🥃, which is again CK7 & CK20 negative.

4) CK7+/CK20+
Both positive tumors are the major organs that have been left out. Outside the liver is Bile duct , so extra hepatic bile duct tumors are CK7+/CK20+, the bile drains into the gall bladder, the other bladder which we know is urinary bladder and urothelial cancers are also CK7/CK20 + in majority of bladder cancer. Other important organs the were left out in GIT are stomach and pancreas who in majority of cases are CK7+/CK20 +.
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