Immunohistochemical Profile of Lung Tumors in Image Guided Biopsies

Authors

  • Pavithra Thandavarayan Department of Pathology, Coimbatore Medical College, Tamilnadu, India
  • Dhanalakshmi Arumugam Department of Pathology, Coimbatore Medical College, Tamilnadu, India
  • Lalitha Chidambaram
  • Lavanya Krishnagiri Balan
  • Shifa Seyed Ibrahim Department of Pathology, Madurai Medical College, Tamilnadu, India

Keywords:

Lung tumor, Non-small cell lung carcinoma, Small cell lung carcinoma, Cytokeratin, TTF-1, p63.

Abstract

Background: Lung  cancer  is  the  leading  cause  of  cancer  related  mortality  in  both  men  and women  worldwide.  Establishing  the  histological  type  and  grade  of  pulmonary  carcinoma  is  very  important  especially  for  the  therapy  and  prognosis.  Study  design:  cross-sectional  descriptive  study. The  study  analyses  various  histomorphological  patterns of  lung  tumors  in correlation  with  immunohistochemical  profile.

Methods: All  the  bronchoscopic  and  CT  guided  needle  biopsy specimens  (50  biopsy  specimens)    received  in  the  Pathology  department  of  Coimbatore  medical  college  hospital  over  a   period  of  one  year  were  analysed.  Both  H&E  and  immunohistochemical  sections  were studied  with  panel  of  markers-  CK7,  CK20,  TTF-1,  chromogranin,  synaptophysin, CD45,  vimentin,  smooth  muscle  actin.

Result: The  most  common  histological  type  was  squamous  cell  carcinoma (48%),  followed  by adenocarcinoma (28%)  and  small  cell  lung  carcinoma (18%).  Large  cell  neuroendocrine carcinoma  and  metastatic  deposit  constituted  2%  each.  Out of 50  cases,  24 cases  were squamous cell carcinoma  which  showed  positivity  with  HMWCK  (20  cases)  and  P63  (22  cases)  (p<0.001).  Fourteen  cases  reported  as  adenocarcinoma  showed  positivity  with  CK7  (14 cases)  and  TTF-1  (13 cases)  (p<0.001).  All  the  nine  cases  of  small  cell carcinomas  showed  positivity  with  both  TTF-1  and  Ki 67.  One  case  of  large  cell carcinoma  with  neuroendocrine  features  showed  immunopositivity  with  neuroendocrine markers.

Conclusion: Integration  of  conventional  histomorphological  diagnosis  with  panel  of  immunohistochemical  markers  allows  more  accurate  identification  of  histological  type, which  has  significant  treatment  implications.

 

DOI: 10.21276/APALM.1342

References

1. Thilagavathy SN, et al. Correlation between CT scan Findings, Histopathology and Demographic variables Associated with lung carcinoma. Int J Recent Sci Res.2016 7(8), pp.13041-13046.
2. Bordoni A et al. Impact of histopathological diagnosis with ancillary immunohistochemical studies on lung cancer subtypes Incidence and Survival: A Population-based study. Journal of Cancer Epidemiology.2011;
3. Ridge CA, McErlean AM, Ginsberg MS. Epidemiology of lung cancer Semin Intervent Radiol.2013 Jun;30(2):93-98.
4. Lohinai Z et al. KRAS mutation and incidence and prognostic value are metastatic site specific in lung adenocarcinoma; poor prognosis in patients with KRAS mutation and bone metastasis. Int J Recent Sci.Rep.2017; (7):39721.
5. Assche KV, Liesbeth F, Yolande F, Katrien V, Veerle S. EGFR mutation positive stage IV non-small cell lung cancer: Treatment beyond progression. Front Oncol. 2014; 4:350.

6. Travis WD; World Health Organization; International Agency for Research on Cancer; International Association for the Study of Lung Cancer; International Academy of Pathology; et al. WHO classification of tumours of the lung, pleura, thymus, and heart. Lyon: IARC Press, 2015.
7. Sheikh S, Shah A et al. Histological patterns of Primary Malignant Tumors Diagnosed in a Tertiary Care Hospital, Asian Pacific Journal of Cancer Prevention 2010; (2):1341-46.
8. Hans B, Leif J, Karin J, Mats J, Per J, Maria P. Immunohistochemistry in the Differential Diagnostics of Primary Lung Cancer: An Investigation Within the Southern Swedish Lung Cancer Study.Am J Clin Pathol2013;140(1):37-46.

9. Occque R, Tochigi N. Usefulness of Immunohistochemical and Histochemical Studies in the Classification of Lung Adenocarcinoma and Squamous Cell Carcinoma in Cytologic Specimens.Am J ClinPathol.2011;136:81-87.

10. Kalhor N, Zander DS, Liu J. TTF-1 and p63 for distinguishing pulmonarysmall-cell carcinoma from poorly differentiated squamous cell carcinoma in previously pap-stained cytologic material. Modern Pathology (2006) 19, 1117–1123.

11.Vera L Capelozzi, Role of immunohistochemistry in the diagnosis of lung cancer. J.bras.pneumol. 2009;35(4).

12. Siddiqui MT. TTF-1 and Napsin a Double Staining in Diagnosing Lung Adenocarcinoma. J Cytol Histol 2012;3:e 103.

13. Yatabe Y, Mitsudomi T, Takahashi T. TTF-1 expression in pulmonary adenocarcinomas.Am J SurgPathol.2002; 26: 767- 773.

14. Brunnstrom H, Johansson L et al. Immunohistochemistry in the differential diagnosis of primary lung cancer.An investigation within the Southern Swedish lung cancer study. Am J Clin Pathol. 2013;140: 37-46.

15. Y.C Su, Y.C. Hsu, and C.Y Chai. Role of TTF-1, CK20, AND CK7 Immunohistochemistry for diagnosis of primary And secondary lung adenocarcinoma. Kaohsiung J Med SciJanuary 2006;22 :14-18.

16. Nicholson SA, Beasley MB, Brambilla E, Hasleton PS, Colby TV, Sheppard MN, Falk R, Travis WD. Small cell lung carcinoma (SCLC): a clinicopathologic study of 100 cases with surgical specimens. Am J SurgPathol.2002; 26: 1184-1197.

17. Aslan DL, Gulbahce HE et al. Ki-67 Immunoreactivity in the Differential Diagnosis of Pulmonary Neuroendocrine Neoplasms in Specimens With Extensive Crush Artifact. Am J ClinPathol 2005;123:874-878.

18. Laurine V, Marianna A, Patricia L, Jean C, Myriam D, Myriam R et al. TTF-1 positive small cell cancers: Don’t think they’re always primary pulmonary! World J Gastrointest Oncol.2011.3(10): 144-47.

19.Viberti L, Bongiovanni M, Bussolati G. 34betaE12 cytokeratin immunodetection in the differential diagnosis of small cell tumors of lung. Int J SurgPathol. 2000;8:317–322.

20. Travis WD. Update on small cell carcinoma and its differentiation from squamous cell carcinoma and other non-small cell carcinomas. Modern Pathology. 2012;25:S18-30.

Downloads

Published

01-11-2017

How to Cite

1.
Thandavarayan P, Arumugam D, Chidambaram L, Balan LK, Ibrahim SS. Immunohistochemical Profile of Lung Tumors in Image Guided Biopsies. Ann of Pathol and Lab Med [Internet]. 2017 Nov. 1 [cited 2024 Nov. 19];4(5):A604-609. Available from: https://pacificejournals.com/journal/index.php/apalm/article/view/apalm1342

Issue

Vol. 4 No. 5 (2017)

Section

Original Article

License

Copyright (c) 2017 Pavithra Thandavarayan, Dhanalakshmi Arumugam, Lalitha Chidambaram, Lavanya Krishnagiri Balan, Shifa Seyed Ibrahim

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish with this journal agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access at http://opcit.eprints.org/oacitation-biblio.html).