Differential diagnosis of mesenchymal neoplasms of the digestive tract by cell block and immunohistochemistry

Autor:	Péttala Rigon, Claudio Galleano Zettler, Antônio Atalíbio Hartmann, César Vivian Lopes
Rok vydání:	2018
Předmět:	Adult Male Leiomyosarcoma Pathology medicine.medical_specialty Histology Adolescent Gastrointestinal Stromal Tumors Pathology and Forensic Medicine Diagnosis Differential Mesoderm Lesion Young Adult 03 medical and health sciences 0302 clinical medicine medicine Humans Endoscopic Ultrasound-Guided Fine Needle Aspiration Aged Aged 80 and over GiST biology business.industry CD117 General Medicine Middle Aged medicine.disease Immunohistochemistry digestive system diseases Gastrointestinal Tract Leiomyoma Needles Cytopathology 030220 oncology & carcinogenesis biology.protein Female 030211 gastroenterology & hepatology Differential diagnosis medicine.symptom business
Zdroj:	Cytopathology. 29:531-536
ISSN:	0956-5507
DOI:	10.1111/cyt.12630
Popis:	Objectives To evaluate the diagnostic yield of the cell block (CB) technique with immunohistochemistry in patients with mesenchymal neoplasms of the gastrointestinal tract collected by endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA). Methods Tissue samples from consecutive patients with subepithelial lesions collected by EUS-FNA, without analysis by on-site cytopathology, were evaluated by the same pathologist only using CBs in AAF fixative. Sections were stained with haematoxylin-eosin and underwent complementary immunohistochemical staining for SMA, CD117, DOG-1 and S100 in the presence of mesenchymal neoplasms. Specimens were defined as diagnostic when sufficient tissue was present for histopathological evaluation and immunohistochemistry analysis. If they were insufficient for complete evaluation, the specimens were considered nondiagnostic. Results Between September 2012 and December 2016, a total of 158 patients (median age: 57 years, 64.5% women) underwent EUS-FNA with an average of three needle passes for every lesion. The median lesion size was 17 mm. There were 113 mesenchymal neoplasms confirmed by immunohistochemistry (66 leiomyomas, 44 GISTs, two schwannomas, one leiomyosarcoma). The overall diagnostic yield of CBs was 84.17%. However, diagnosis was obtained in 98.5% (133/135) of the cases after exclusion of 23 cases in which EUS-FNA sampling was insufficient or without tumoural tissue. Only two mesenchymal neoplasms were not confirmed by CBs even after immunohistochemistry. Conclusions CBs collected by EUS-FNA and analysed by immunohistochemistry showed a high diagnostic yield in patients with mesenchymal neoplasms, even without on-site cytopathology.
Databáze:	OpenAIRE
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