Utility of Nestin immunohistochemistry in the diagnosis of granular cell tumor

Year 2018, , 160 - 164, 30.11.2018

Hilal Erinanç , Hüseyin Savaş Göktürk , Gülhan Kanat Ünler Erdal Karagülle

https://doi.org/10.25000/acem.436429

Cited By: 1

Abstract

Aim: Granular cell tumors (GCTs) show neuroectodermal differentiation. Morphologically,
a wide variety of mesencymal tumors may have granular cell appearance. Nestin, which is an intermediate filament protein expressed in undifferentiated cells during
central nerves system development and its tumors. We aim to determine the diagnostic utility of Nestin in diagnosis of
GCTs. 

Methods:  Nestin
immunohistochemistry applied to GCT cases and other mesenchymal tumors which
may have granular cytoplasm and the major differential diagnostic consideration
of GCT.  A total of 21 GCT from different tissues (including 7 in the esophagus,
8 originating from skin tissues, 4 in the tongue, 2 in the vocal cord), 17 gastrointestinal stromal tumor  in the gastrointestinal tract,
8 leiomyoma (5 in the esophagus and 3 originating from skin tissues), 4
schwannoma (1 in the esophagus and 3 originating from skin tissues),  subcutaneous mesenchymal tumors ( including 7 neurofibroma, 5 fibroma, 15
dermatofibroma), 20 melanocytic nevi, 15 gastric xanthomas and 15 xanthalesma
of the skin were included the study.

Results: Nestin positivity was detected in all GCTs. Additionally,
strong Nestin positivity
was seen in all gastrointestinal stromal tumors,
schwannoma and neurofibroma cases. However, Nestin was
negative in all leiomyoma, fibroma, dermatofibroma, melanocytic nevi, gastric
xanthoma and xanthalesma cases. 

Conclusion:  The study showed that
Nestin immunohistochemistry has limitation in distinction of GCT from tumors
arising from neural cell lineage such as gastrointestinal stromal tumor, schwannoma and neurofibroma; however, Nestin
as a neural marker provides an evidence to neural origin of GCT and could be useful
in distinction GCT from other mesenchymal tumors with granular cytoplasm such
as leiomyoma, dermatofibroma and melanocytic nevi.

Keywords

Nestin, granular cell tumor, neural origin

Granüler hücreli tümör tanısında Nestin immunhistokimyasının kullanımı

Abstract

Amaç: Granüler
hücreli tümorler (GCTs) nöroektodermal diferansiasyon gösterirler. Morfolojik
olarak pek çok mezenkimal tümor, granüler hücreli görünüme sahip olabilir. Nestin,
santral sinir sistemi gelişimi boyunca undiferansiye hücrelerde ve santral
sinir sistemi tümörlerinde eksprese edilen bir intermediate filament
proteindir. Çalışmamızda Nestin proteininin granüler hücreli tümör ayırıcı
tanısında kullanılabilirliğinin belirlenmesi amaçlanmıştır.

Yöntemler: Çalışmamızda GCT tümör olguları ve
granüler sitoplazmaya sahip olabilecek ve granüler hücreli tümör ayırıcı tanısında
başlıca ele alınan mezenkimal tümörlere immunhistokimyasal olarak Nestin
antikoru uygulanmıştır.  Farklı
dokulardan köken alan 21 GCT (7’si
özofagus, 8’i deri,  4’ü dil,  2’si vokal korddan gelişen ) , 17 GIST (gastrointestinal stromal
tumor- gastrointestinal kanaldan gelişen) , 8 leiomyoma ( 5’i özofagus,  3’ü deriden gelişen), 4 schwannoma  (1’i özofagus, 3’ü deri yerleşimli) ve
subkutan yerleşimli mesenkimal tümörler (7 nörofibroma,
5 fibroma, 15 dermatofibroma)  ile 20
melanositik nevüs,  15 gastrik ksantom ve
15 ksantalezma olgusu çalışmamıza dahil edilmiştir.

Bulgular: GCT’lerin tamamında Nestin pozitifliği görüldü. Ayrıca
tüm GIST’ler,  schwannoma ve nörofibromada Nestin pozitif
olarak izlendi.   Bununla birlikte tüm
leiomyoma, fibroma,  dermatofibroma,  melanositik nevüs, gastrik ksantom ve  ksantalezmada  olgularında  Nestin ekspresyonu görülmedi.

Sonuç: Çalışmamız Nestin immunhistokimyasının GCT’ün ayırıcı tanısında
özellikle GIST, Schwannoma ve nörofibroma gibi nöral orijinli tümörlerde
sınırlı olduğunu göstermektedir. Bununla birlikte nöral bir marker olan Nestin
GCT’ün nöral kökenine dair bir kanıt sunmaktadır.  Nestin, GCT ‘ün granüler sitoplazmaya sahip leiomyoma,
dermatofibroma gibi diğer mezenkimal tümörler ve melanositik nevüsden
ayırımında kullanılabilir.

Keywords

nestin, granüler hücreli tümör, nöral orijin

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