If a mediastinal node shows Napsin A positivity and GATA3 negativity, which origin is more likely?

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Multiple Choice

If a mediastinal node shows Napsin A positivity and GATA3 negativity, which origin is more likely?

Explanation:
Immunohistochemistry uses markers to hint at where a metastasis came from. Napsin A is a marker typically seen in lung adenocarcinoma (and helps distinguish it from other cancers), while GATA3 is commonly expressed in breast and urothelial carcinomas. If a mediastinal node is Napsin A positive and GATA3 negative, that pattern strongly points to a pulmonary (lung) origin rather than breast or urothelial. Disfavoring breast/urothelial origin by lack of GATA3 expression makes the lung the most likely source. If TTF-1 were also positive, it would further reinforce lung origin, but the given profile already supports a lung primary.

Immunohistochemistry uses markers to hint at where a metastasis came from. Napsin A is a marker typically seen in lung adenocarcinoma (and helps distinguish it from other cancers), while GATA3 is commonly expressed in breast and urothelial carcinomas. If a mediastinal node is Napsin A positive and GATA3 negative, that pattern strongly points to a pulmonary (lung) origin rather than breast or urothelial. Disfavoring breast/urothelial origin by lack of GATA3 expression makes the lung the most likely source. If TTF-1 were also positive, it would further reinforce lung origin, but the given profile already supports a lung primary.

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