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EMA, vimentin, desmin, calretinin, e-cadherin on cell block to differentaite adenocarcinoma cells from benign reactive mesothelial cells.
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| Author:
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NEHA JAISWAL, JAYANT MAKRANDE, ARVIND BHAKE, A.V. BAPAT
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| Abstract:
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Introduction: The common difficulty encountered in cytology of fluids is the inefficacy to distinguish between the desquamated benign mesothelial cells with atypia from the metastatic cells of well-differentiated adenocarcinoma .1Cell blocks are particularly useful when the conventional cytological abnormalities are indetermined for definite diagnosis3.Such dicey situation of morphological interpretation can be resolved by immunocytochemistry on cell blocks. A panel of EMA, desmin, E-cadherin, Calretinin and vimentin has been reported to be useful at resolving the dilemma of well-differentiated adenocarcinoma versus atypical mesothelial cells.2,3,4,5.
Objectives1.To compare the morphological diagnosis of conventional cytology and cell block.2.To interpret the results of immunocytochemistry of Epithelial membrane antigen, calretinin, desmin, E-cadherin, vimentin on cell block at distinguishing well-differentiated adenocarcinoma from atypical mesothelial cells.
Methodology: Prospective study comprising of 75 cases. Fluids were conventionally processed and stained. Cytomorphology was assessed by standard text available on topic. Cell blocks of fluid were made by clot method. Immunocytochemistry was performed by standard protocol over cell blocks. Interpretation of immunostaining in mesothelial and adenocarcinoma cells were graded semi-quantitatively for Epithelial membrane antigen, Vimentin, Desmin, E-cadherin and Calretinin.
ResultsEpithelial membrane antigen has most sensitivity and specificity for adenocarcinoma while calretinin shows maximum sensitivity and specificity in reactive mesothelial cells. Desmin will show positivity in almost all cases of reactive mesothelial hyperplasia. Vimentin will be positivity in most case in reactive mesothelial cells while negligible in adenocarcinoma. E-cadherin will be equally sensitive for adenocarcinoma as epithelial membrane antigen.
Conclusion: The study concluded that morphological features are better appreciated in cell block than conventional smear. It can be concluded in the light of observation that improved immunomarkers are able to distinguish the reactive atypical benign mesothelial cells with atypia from well-differentiate adenocarcinoma cells if the combination of the ICC panels are used.
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| Keyword:
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Immunocytochemistry, Cell block, Epithelial Membrane Antigen, Vimentin, Desmin, E-cadherin, Calretinin.
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| EOI:
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| DOI:
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https://doi.org/10.31838/ijpr/2019.11.02.213
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| Download:
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