SIGNIFICANCE OF IMMUNOHISTOCHEMISTRY IN ACCURATE CHARACTERIZATION OF MALIGNANT TUMORS
Abstract
Background: To determine in a large series of surgical biopsies the role and significance ofimmunohistochemistry in the adequate and accurate characterization of malignant tumors.Methods: A retrospective study of 20,000 consecutive surgical biopsies reported in the Section ofHistopathology, AKU in 2003. Data was obtained by retrieving the filed surgical biopsy reports inthe section. Results and Conclusions: Out of the 20,000 biopsies, 6534 (32.67%) wereneoplastic. 4726 neoplasms (72.33%) were malignant, and 1808 (27.67%) were benign.Immunohistochemistry was performed on 29.49% of malignant tumors, and 4.97% of benigntumors. Immunos were performed on only 2.82% of routine squamous cell carcinomas andadenocarcinomas of various organs, and in only 1.9% of infiltrating breast carcinomas, thecommonest malignant tumors in females. In contrast, immunos were performed on 97.12% ofnon-Hodgkin’s lymphomas, 97.94% of Hodgkin’s lymphomas, 98.09% of malignant spindle cellneoplasms, 87.96% of small round blue cell tumors of childhood, 87.30% of neuroendocrineneoplasms, and 84.37% cases of malignant melanomas. In addition, immunos were performed onall cases of malignant undifferentiated neoplasms and were able to resolve the issue in over 89%of such cases. Immunos were also performed on 54.74% of metastatic tumors. Lymph nodes werethe commonest organs on which immunos were performed i.e. 96.50% of lymph node tumors,followed by CNS and renal neoplasms with 33.01% and 25.92% respectively.Key Words: Malignant tumours, Karachi, ImmunochemistryReferences
Slapak CA, Kufe DW. Principles of cancer therapy. In
Isselbacher KJ, Braunvald E, Wilson JD, Martin JB, Fauci
AS, Kasper DL eds: Harrison’s Principles of Internal
Medicine, 13th Edition. Vol 2, 1994; McGraw-Hill, Inc.
-1840.
Coindre JM. Immunohistochemistry in the diagnosis of soft
tissue tumors. Histopathology 2003; 43: 1-16.
Mukai K, Rosai J. Applications of immunoperoxidase
techniques in surgical pathology. In Wolff M, Fenoglio CM,
eds: Progress in Surgical Pathology, Vol 1. New York, 1980,
Masson Publishing USA, Inc. 15-99.
Special techniques in Surgical Pathology. In Rosai J, ed :
Rosai and Ackerman’s Surgical Pathology. 9th Edition, Vol 1,
Elsevier Inc. 45-63.
Delellis RA, Dayal Y. The role of immunohistochemistry in
the diagnosis of poorly differentiated malignant neoplasms.
Semin Oncol 1987; 14: 173-192,
Gatter KC, Alcock C, Heryet A, Pulford KA, Heyderman E,
Taylor – Papadimitriou J, Stein H, Mason DY. The
differential diagnosis of routinely processed anaplastic
tumors using monoclonal antibodies. Am J Clin Pathol 1984;
:33-43.
Chan JK. Advances in Immunohistochemistry: impact on
surgical pathology practice, Semin. Diagn. Pathol. 2000; 17:
-177.
Larsson L. Tissue preparation methods for light microscopic
immunohistochemistry. Appl Immunohistochem 1993; 1: 2-
Ahmed Z, Yaqoob N, Muzaffar S, Kayani N, Pervez S,
Hasan SH. Diagnostic Surgical Pathology: the importance of
second opinion in a developing country. JPMA 2004; 54:
-311.
Chan JKC, Banks PM, Cleary ML, Delsol G, De WolfPeeters C, Falini B, Gatter KC, et al. A revised European –
American Classification of lymphoid neoplasms proposed by
the International Lymphoma Study Group. A summary
version. Am J Clin Pathol 1995; 103: 543-560.
Jaffe ES, Harris NL, Stein H, Vardiman JW. Tumors of
hematopoitic and lymphoid tissues, pathology and genetics.
World Health Organization classification of tumors, Lyon
IARC Press, 2001
Delsol G, al Saati T, Gatter KC, Gerdes J, Schwarting R,
Caveriviere P, etal. Coexpression of epithelial membrane
antigen (EMA), Ki-1, and interleukin-2 receptor by
anaplastic large cell lymphomas. Dignostic value in so-called
malignant histiocytosis. Am J Pathol 1988; 130: 59-70
Delsol G, Ralfkiaer E, Stein H, Wright D, Jaffe ES.
Anaplastic large cell lymphoma. In World Health
Organization classification of tumors. Pathology and genetics
of tumors of Hematopoietic and lymphoid tissues. Jaffe ES,
Harris NL, Stein H, Vardiman JW, eds. International Agency
for Research on Cancer. 2001: 230-235.
Veloso JD, Rezuke WN, Cartun RW, Abernathy EC.
Immunohistochemical distinction of follicular lymphoma
from follicular hyperplasia in formalin fixed tissues using
monoclonal antibodies. MT2 and bcl-2. Appl
Immunohistochem 1995; 3: 153-159.
Almasri NM, Iturraspe JA, Braylan RC. CD10 expression in
follicular lymphoma is different from that of reactive lymph
node follicles. Arch Pathol Lab Med 1998; 122: 539-544.
Rubin BP, Singer S, Tsao C, Duensing A, Lux ML, Ruiz R,
et al. KIT activation is a ubiquitous feature of gastrointestinal
stromal tumors. Cancer Res 2001; 61: 8118-8121.
Miettinem M, Sobin LH, Sarloma-Rikala M.
Immunohistochemical spectrum of GISTs at different sites
and their differential diagnosis with a reference to CD 117
(KIT). Mod Pathol 2000; 13:1138-1142.
Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J,
Longley BJ, Miettinen M, et al. Diagnosis of gastrointestinal
stromal tumors: a consensus approach. Hum Pathol 2002; 33:
-465.
Yaziji H, Gown AM. Immunohistochemical markers of
melanocytic tumors. Int J Surg Pathol 2003; 11: 11-15.
Ordonez NG. Value of calretinin immunostaining in
differentiating epithelial mesothelioma from lung
adenocarcinoma. Mod Pathol 1998; 11: 929-933.
Ordonez NG. Value of cytokeratin 5/6 immunostaining in
distinguishing epithelial mesothelioma of the pleura from
lung adenocarcinoma. Am J Surg Pathol 1998; 22:1215-
Ordonez NG. Value of the Ber EP4 antibody in
differentiating epithelial pleural mesothelioma from
adenocarcinoma: the M.D. Anderson experience and a
critical review of the literature. Am J Clin Pathol 1998;
:85-89.
Suster S, Fisher C, Moran CA. Expression of bcl-2
oncoprotein in benign and malignant spindle cell tumors of
soft tissue, skin, serosal surfaces, and gastrointestinal tract.
Am J Surg Pathol 1998; 22: 863-872.24. Folpe AL, Schmidt RA, Chapman D, Gown AM. Poorly
differentiated synovial sarcoma: immunohistochemical
distinction from primitive neuroectodermal tumors and high
grade peripheral nerve sheath tumors. Am J Surg Pathol
; 22: 673-682.
Johnson DE, Herndier BG, Medeiros LJ, Warnke RA, Rouse
RV. The diagnostic utility of the keratin profiles of
hepatocellular carcinoma and cholangiocarcinoma. Am J
Surg Pathol 1988; 12: 187-197.
Papsidero LD, Croghan CA, Asirwattham J, Gaeta J,
Abenoza P, Englander L, Valenzuela L.
Immunohistochemical demonstration of Prostate Specific
Antigen in metastases with the use of monoclonal antibody.
Am J Pathol 1985; 121:451-454.
Kleihues P, Davis RL, Ohgaki H, Burger PC, Westphal MM,
Cavanee WK. Diffuse astrocytoma. In Kleihues P, Cavanee
W (eds): World Health Organization classification of tumors.
Pathology and genetics – tumors of the nervous system 2000;
lyon, IARC Press, 22-26
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