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Emerin immunohistochemistry reveals diagnostic features of nuclear membrane arrangement in thyroid lesions.
No full textAIMS:
Objective appreciation of irregularities of the nuclear shape is a key parameter in the diagnosis of thyroid lesions, since foldings of the nuclear membrane (NM) featuring indentations, grooves and pseudoinclusions characterize papillary thyroid carcinomas (PTC). The aim was to focus on the immunohistochemistry of emerin, a protein of the NM whose decoration best demarcates the nuclear shape.
METHODS AND RESULTS:
Immunohistochemistry of the NM with emerin as well as three-dimensional reconstruction of the images (through deconvolution processing) performed on a series of 54 cases (processed following the tissue array procedure) revealed a uniform arrangement of the NM in non-neoplastic lesions (thyroiditis, microfollicular goitre, follicular adenoma) and normal thyroid as well as in follicular carcinoma. In contrast, irregular folding of the membrane and presence of curling and invaginations, eventually leading to the formation of nuclear pseudoinclusions, was observed in PTC cells.
CONCLUSIONS:
Decoration of the NM represents an original approach to identify PTC nuclear shape, highlights new structural features and might be helpful in the differential diagnosis between so-called nuclear pseudoinclusions and artefactual 'bubbles'
Presence of intra-mucosal smooth muscle cells in normal human and rat colon.
No full textIntramucosal smooth muscle cells surrounding the crypts and originating from the muscularis mucosae were observed in normal human and rat colon. Immunohistochemical techniques, using anti-desmin and anti-actin antibodies, along with ultrastructural procedures were employed to investigate the nature and distribution of these cells. Desmin-positive and actin-rich smooth muscle cells sprouting from the muscularis mucosae into the lamina propria and surrounding the crypts were observed both in rat and human colon. The intramucosal smooth muscle cells may play an important role in some pathophysiological conditions
[Histological sectioning of brush bristles allows an improved diagnosis of biliary tract lesions].
No full textBiliary tract brush cytology is increasingly being recognized as a favoured method for evaluating abnormalities of the biliary tract. In order to increase the diagnostic accuracy, we devise a new brush processing method finalized to the complete and ideal cytologic examination of the collected material. Small fragments of the mucosa, of inflammatory cell aggregates or of carcinomas are observed and the results are optimally fixed and allow a definitive histological diagnosis
Significance of the smooth muscle cell component in Peutz-Jeghers and juvenile polyps
No full textWe have previously reported the presence of smooth muscle cells (SMCs) in the lamina propria of both tubular and villous adenomatous polyps. In the current study, we investigated the presence and distribution of SMCs with immunohistochemical techniques using anti-alpha smooth muscle actin and anti- desmin antibodies on a series of hamartomatous polyps. In five Peutz-Jeghers polyps, large tree-like branches of SMCs were observed, while in 13 juvenile polyps, rare elongated SMCs were found in the lamina propria, partially surrounding cystically dilated glands. Apart from the quantitative differences, the SMC distribution was similar in the two types of hamartomatous polyps and not dissimilar from the pattern described in neoplastic polyps. These findings make the category 'juvenile polyp' less clear and its differentiation from other histologic types of polyp less sharp. Thus, the presence or absence of SMCs cannot form the basis of the differential diagnosis between adenomatous and hamartomatous polyps
Nuclear membrane decoration by emerin staining improves cytological detection of papillary thyroid carcinomas
No full textBackground. The diagnosis of follicular lesions is a grey zone in
thyroid fine-needle aspiration (FNA) cytology. Our study aims to
verify if staining with Emerin is a helpful marker of the follicular
variant of papillary thyroid carcinoma (FVPTC) in the differential
diagnosis of follicular-patterned lesions.
Methods. We designed both a prospective study on smears
and Thin Prep specimens to prove the feasibility of the procedure
and a retrospective study on 78 FNA cell-blocks from
cases which, after surgery, turned out to be either benign (34
cases) or malignant lesions (44, of which 31 PTC). From each
sample, we obtained two slides, one stained with Hematoxylin
and Eosin (H&E) and the other with immunohistochemistry
(IHC) for Emerin. In Thy3 cases, HBME-1 and Gal 3 stains
were also done. Two observers gave a judgement in Thy
categories (British Thyroid Association) on H&E, Emerin,
HBME-1 and Gal 3 stained slides.
Results. The prospective study demonstrated that Emerin staining
is an effective tool for nuclear membrane decoration and amplification of nuclear irregularities. In the retrospective study,
inter-observer agreement proved higher in Emerin-stained slides
(K of Cohen-Fleiss = 0.6890) than H&E-stained slides (K of
Cohen-Fleiss = 0.4878). Sensitivity and overall accuracy were
higher for Emerin (respectively, 77.27% and 84.61%) than H&Estained
slides (respectively, 36.36% and 62.82%). Emerin staining
proved able to identify all cases of PTC, including all cases
of FVPTC. In Thy3 cases, Emerin’s sensitivity and specificity
(64% and 96%) proved higher than HBME-1’s (60% and 88%),
and Gal3’s (61% and 68%).
Conclusions. Emerin stain, is a useful tool in the cytological
diagnosis of thyroid lesions. It enhances detection of nuclear
irregularities typical of PTC, thus helping to solve inconclusive
FNA cases, mainly in those cases of FVPTC with a reduced
expression of nuclear irregularities in the traditional stains
(H&E)
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