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Glioblastomda TTF-1 Klon SPT24 ve CD 99 Pozitifliği: Tanısal İkilem

Yıl 2015, Cilt: 1 Sayı: 1, 64 - 67, 01.01.2015

Öz

Nadir bir varyant olan küçük hücre morfolojisine sahip glioblastom olgusunu dikkat çekici immünoprofili ile tanımladık. Glioblastoma multiforme morfolojik olarak oldukça heterojen bir gruptur. Bununla birlikte, glioblastom heterojen profili ayırıcı tanıda karışıklığa yol açabilir. 64 yaşında erkek hasta hastanemize başvurdu, magnetik rezonans incelemede temporal kitle tespit edildi ve cerrahi uygulandı. Tümör monomorfik sıkışık gruplar yapan, mitotik olarak aktif küçük astrositlerden oluşmaktaydı. Tümöral alanlarda prolifere küçük damarlar, palizatlanan nekroz izlendi. İmmünohistokimyasal analiz yapıldı, tümör hücreleri GFAP, CD56, NSE, CD99 VE TTF-1 klon SPT24 ekprese ederken TTF-1, klon 8G7G3/1 ile ekspresyon izlenmedi. Glioblastomlarda TTF-1 ekspresyonu diffüz ve güçlü olsa bile santral sinir sisteminin primer tümörünü dışlayamaz. Tanı için klinik ve histopatolojik parametrelerin birlikte değerlendirilmesi gerekmektedir

Kaynakça

  • 1. Central Brain Tumor Registry of the United States. Statistical Report. Primary Brain Tumors in the United States, 1998-2002. Hinsdale, Ill: Central Brain Tumor Registry of the United States; 2006.
  • 2. Miller CR, Perry A. Glioblastoma. Arch Pathol Lab Med 2007;131:397-406.
  • 3. Bari KU, Danish R, Azher Q, Karim AS. Glioblastoma multiforme in a patient with a small cell lung cancer: Case report. Clin Neurol Neurosurg 2011;113:78-9.
  • 4. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007;114:97-109.
  • 5. Kristensen MH, Nielsen S, Vyberg M. Thyroid transcription factor-1 in primary CNS tumors. Appl Immunohistochem Mol Morphol 2011;19:437-43.
  • 6 Matoso A, Resnick MB, Wang LJ. Comparison of 2 monoclonal TTF-1 antibodies. Appl Immunohistochem Mol Morphol 2011;19:384.
  • 7. Dettmer M, Kim TE, Jung CK, Jung ES, Lee KY, Kang CS. Thyroid transcription factor-1 expression in colorectal adenocarcinomas. Pathol Res Pract 2011;207:686-90.
  • 8. Bisceglia M, Galliani C, Rosai J. TTF-1 expression in breast carcinoma-the chosen clone matters. Am J Surg Pathol 2011;35:1087-8.
  • 9. Zamecnik J, Chanova M, Kodet R. Expression of thyroid transcription factor 1 in primary brain tumours. J Clin Pathol 2004;57:1111-3.
  • 10. Galloway M, Sim R. TTF-1 staining in glioblastoma multiforme. Virchows Arch 2007;451:109-11.
  • 11. Lee EB, Tihan T, Scheithauer BW, Zhang PJ, Gonatas NK. Thyroid transcription factor 1 expression in sellar tumors: A histogenetic marker? J Neuropathol Exp Neurol 2009;68:482-8.
  • 12. Robens J, Goldstein L, Gown AM, Schnitt SJ. Thyroid transcription factor-1 expression in breast carcinomas. Am J Surg Pathol 2010;34:1881-5.
  • 13. Compérat E, Zhang F, Perrotin C, Molina T, Magdeleinat P, Marmey B, Régnard JF, Audouin J, Camilleri-Broët S. Variable sensitivity and specificity of TTF-1 antibodies in lung metastatic adenocarcinoma of colorectal origin. Mod Pathol 2005;18:1371-6.
  • 14. Penman D, Downie I, Roberts F. Positive immunostaining for thyroid transcription factor-1 in primary and metastatic colonic adenocarcinoma: A note of caution. J Clin Pathol 2006;59:663-4.
  • 15. Scotlandi K. Targeted therapies in Ewing’s sarcoma. Adv Exp Med Biol 2006;587:13-22.
  • 16. Visée S, Soltner C, Rialland X, Machet MC, Loussouarn D, Milinkevitch S, Pasco-Papon A, Mercier P, Rousselet MC. Supratentorial primitive neuroectodermal tumours of the brain: Multidirectional differentiation does not influence prognosis. A clinicopathological report of 18 patients. Histopathology 2005;46:403-12.
  • 17. Choi YL, Chi JG, Suh YL. CD99 immunoreactivity in ependymoma. Appl Immunohistochem Mol Morphol 2001;9:125-9.
  • 18. Ishizawa K, Komori T, Shimada S, Hirose T. Olig2 and CD99 are useful negative markers for the diagnosis of brain tumors. Clin Neuropathol 2008;27:118-28.

TTF-1 Clone SPT24 and CD 99 Positivity in Glioblastoma: A Diagnostic Dilemma

Yıl 2015, Cilt: 1 Sayı: 1, 64 - 67, 01.01.2015

Öz

We describe an unusual variant of glioblastoma with small cell morphology and discuss its remarkable immunoprofile. Glioblastoma multiforme comprises a morphologically highly heterogeneous neoplasm. However, this heterogeneous immunoprofile of glioblastoma can lead to confusion in the differential diagnosis. A 64-year-old male presented to our hospital. A temporal mass was detected on magnetic resonance examination and surgery was performed. The tumor was composed of a monomorphic collection of densely packed and mitotically active small astrocytes. Proliferated microvessels and palisading necrosis were seen in tumoral areas. Immunohistochemical analysis revealed that the tumor cells expressed GFAP, CD56, NSE, CD99 and TTF-1 clone SPT24 but there was no expression of clone 8G7G3/1 of TTF1. TTF-1 expression in glioblastomas cannot rule out primary tumor of the central nervous system even when there is diffuse and strong staining. The clinical and histopathological parameters should be evaluated together for the diagnosis

Kaynakça

  • 1. Central Brain Tumor Registry of the United States. Statistical Report. Primary Brain Tumors in the United States, 1998-2002. Hinsdale, Ill: Central Brain Tumor Registry of the United States; 2006.
  • 2. Miller CR, Perry A. Glioblastoma. Arch Pathol Lab Med 2007;131:397-406.
  • 3. Bari KU, Danish R, Azher Q, Karim AS. Glioblastoma multiforme in a patient with a small cell lung cancer: Case report. Clin Neurol Neurosurg 2011;113:78-9.
  • 4. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, Scheithauer BW, Kleihues P. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol 2007;114:97-109.
  • 5. Kristensen MH, Nielsen S, Vyberg M. Thyroid transcription factor-1 in primary CNS tumors. Appl Immunohistochem Mol Morphol 2011;19:437-43.
  • 6 Matoso A, Resnick MB, Wang LJ. Comparison of 2 monoclonal TTF-1 antibodies. Appl Immunohistochem Mol Morphol 2011;19:384.
  • 7. Dettmer M, Kim TE, Jung CK, Jung ES, Lee KY, Kang CS. Thyroid transcription factor-1 expression in colorectal adenocarcinomas. Pathol Res Pract 2011;207:686-90.
  • 8. Bisceglia M, Galliani C, Rosai J. TTF-1 expression in breast carcinoma-the chosen clone matters. Am J Surg Pathol 2011;35:1087-8.
  • 9. Zamecnik J, Chanova M, Kodet R. Expression of thyroid transcription factor 1 in primary brain tumours. J Clin Pathol 2004;57:1111-3.
  • 10. Galloway M, Sim R. TTF-1 staining in glioblastoma multiforme. Virchows Arch 2007;451:109-11.
  • 11. Lee EB, Tihan T, Scheithauer BW, Zhang PJ, Gonatas NK. Thyroid transcription factor 1 expression in sellar tumors: A histogenetic marker? J Neuropathol Exp Neurol 2009;68:482-8.
  • 12. Robens J, Goldstein L, Gown AM, Schnitt SJ. Thyroid transcription factor-1 expression in breast carcinomas. Am J Surg Pathol 2010;34:1881-5.
  • 13. Compérat E, Zhang F, Perrotin C, Molina T, Magdeleinat P, Marmey B, Régnard JF, Audouin J, Camilleri-Broët S. Variable sensitivity and specificity of TTF-1 antibodies in lung metastatic adenocarcinoma of colorectal origin. Mod Pathol 2005;18:1371-6.
  • 14. Penman D, Downie I, Roberts F. Positive immunostaining for thyroid transcription factor-1 in primary and metastatic colonic adenocarcinoma: A note of caution. J Clin Pathol 2006;59:663-4.
  • 15. Scotlandi K. Targeted therapies in Ewing’s sarcoma. Adv Exp Med Biol 2006;587:13-22.
  • 16. Visée S, Soltner C, Rialland X, Machet MC, Loussouarn D, Milinkevitch S, Pasco-Papon A, Mercier P, Rousselet MC. Supratentorial primitive neuroectodermal tumours of the brain: Multidirectional differentiation does not influence prognosis. A clinicopathological report of 18 patients. Histopathology 2005;46:403-12.
  • 17. Choi YL, Chi JG, Suh YL. CD99 immunoreactivity in ependymoma. Appl Immunohistochem Mol Morphol 2001;9:125-9.
  • 18. Ishizawa K, Komori T, Shimada S, Hirose T. Olig2 and CD99 are useful negative markers for the diagnosis of brain tumors. Clin Neuropathol 2008;27:118-28.
Toplam 18 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Olgu Sunumu
Yazarlar

Betül Ünal Bu kişi benim

Cezmi Çağrı Türk Bu kişi benim

Cumhur İbrahim Başsorgun Bu kişi benim

Elif İnanç Gürer Bu kişi benim

Yayımlanma Tarihi 1 Ocak 2015
Yayımlandığı Sayı Yıl 2015 Cilt: 1 Sayı: 1

Kaynak Göster

Vancouver Ünal B, Türk CÇ, Başsorgun Cİ, Gürer Eİ. TTF-1 Clone SPT24 and CD 99 Positivity in Glioblastoma: A Diagnostic Dilemma. Akd Tıp D. 2015;1(1):64-7.