Differential diagnosis of papillary thyroid carcinoma: Immunocytochemical study of 112 cases

Abstract

Abstract. Papillary carcinoma is diagnosed mainly by its classical papillary structures and nuclear changes. However similar structural and cytological features may also be seen in other lesions of thyroid. Immunohistochemical staining methods help in these circumstances that cytological features do not suffice for differential diagnosis. In this study we stained 112 parafin-embedded blocks with thyroidal lesions (60 papillary carcinoma and 52 other benign or malignant thyroidal lesions) with HBME-1, CK-19, S-100 and EMA. Papillary carcinomas were stained 8.3% weakly, 90% moderately  and strongly with HBME-1; 11.7% weakly, 88.3% moderately and strongly with CK-19; 50% weakly, 50% moderately and strongly with EMA; 26.6% weakly, 48.4% moderately and strongly with S-100. Other thyroid lesions were stained 36.5% weakly, 5.8% moderately with CK-19; 26.6% weakly, 15.4% moderately with EMA; 7.7% weakly, 1.9% moderately with S-100. None of the thyroid lesions, but papillary carcinoma, were stained with HBME-1. Papillary carcinoma cases had significantly higher staining with all four markers. However, HBME-1 and CK-19 were considered more valuable in differential diagnosis for papillary carcinomas, since they showed moderate and strong staining. Also high sensitivity and specificity of HBME-1 makes it a good marker for the diagnosis of papillary thyroid cancer.

Keywords: Papillary thyroid carcinoma, HBME-1, CK-19, S-100, EMA

Keywords

• Papillary thyroid carcinoma, HBME-1, CK-19, S-100, EMA

Kaynakça

1. Mc Laren KM, Cossar DW. The immunohistochemical localization of S-100 in the diagnosis of papillary carcinoma of the thyroid. Human Pathol 1996; 27: 633-636.
2. Benninton JL. Papillary lesions of the thyroid. In: Surgical Pathology of the Thyroid WB Saunders Company, Philadelphia 1990, pp 136-195.
3. Carcangiu ML, DeLellis RA. Thyroid gland. In: Anderson’s Pathology Mosby Year Book, St. Louis, 1999, pp:1943-1995.
4. Canda MŞ. A new histopathological feature in thyroid papillary carcinoma: Hyalin bodies. Türk Patoloji Dergisi 1989;5:11-17.
5. LiVolsi VA, Montone K, Sack M. Pathology of thyroid disease. In: Diagnostic Surgical pathology, Third Ed. Lippincott Williams&Wilkins, Philadelphia, 1999, pp: 529-570.
6. Merino MJ, Sidawy MK. The thyroid gland. In: Surgical Pathology and Cytopathology, Third Ed. Churchill Livingstone, New York, 1997, pp:2665- 2744.
7. Miettinen M, Kovatich AJ, Karkkainen P. Keratin subsets in papillary and follicular thyroid lesions. Virchows Arch A Pathol Anat 1997; 431:407-420.
8. Yamamoto Y, Izumi K, Otsuka H. An immunohistochemical study of EMA, cytokeratin and vimentin in papillary carcinoma: Recognition of lethal and favorable prognostic types. Cancer 1992; 70:2326-2629.

9. Özer E, Bilezikçi B, Çaydere M, Üstün H. Benign ve Malign papiller tiroid lizyonlarının değerlendirilmesinde EMA ve S-100 protein kullanımı. Patoloji Bülteni 1998; 15:29-31.
10. Altaner S, Yalçın O, Özdil A, Kutlu K. Tiroidin papiller karsinomu ile papiller hiperplazinin ayırıcı tanısında S-100 ve EMA’nın önemi. Türk Neoplazi Dergisi 2000; 8:15-19.
11. Kilicarslan B, Pesterelli EH, Oren N, Sargin FC, Kapuzoglu P. EMA and S-100 protein expression in benign and malignant papillary thyroid neoplasms. Adv Clin Path. 2000; 4:155-158.
12. Damiani S, Fratamico f, Lapertosa G, Dina R. Alcian blue and EMA are useful markers in differentiating benign from malignant papillae in thyroidal lesions. Virchows Archiv A Pathol Anat 1991; 419 :131-136.
13. Nishimura R, Yokesa T, Mukai K. S-100 protein is a differentiation marker in thyroid carcinoma of follicular cell origin: An immunohistochemical study. Pathol Int 1997; 47:673-682.
14. Baloch ZW, Abraham S, Roberts S, LiVolsi VA. Differential expression of cytokeratins in follicular variant immunohistochemical study and its diagnostic utility. Hum. Pathol 1999; 30:1166-1233. carcinoma: an
15. thyroid carcinoma. Mod. Pathol 2001; 14:338-380.
16. Rigau V, Martel B, Evrard C, Rousselot P, Galateau-Salle F. HBME-1 immunostaining in thyroid pathology. Ann Pathol 2001; 21:15-20.