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Wang GY, Nazarian RM, Zhao L, Hristov AC, Patel RM, Fullen DR, Chan MP. Protein gene product 9.5 (PGP9.5) expression in benign cutaneous mesenchymal, histiocytic, and melanocytic lesions: comparison with cellular neurothekeoma. Pathology 2016; 49:44-49. [PMID: 27914685 DOI: 10.1016/j.pathol.2016.09.061] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2016] [Revised: 09/07/2016] [Accepted: 09/09/2016] [Indexed: 10/20/2022]
Abstract
Cellular neurothekeoma (CNTK) frequently enters the differential diagnosis of a benign dermal cellular proliferation. Diagnosis often relies on immunohistochemistry including the use of protein gene product 9.5 (PGP9.5). A previous study demonstrated PGP9.5 expression across a wide variety of soft tissue neoplasms. We explored the utility of this antibody in distinguishing CNTK from other benign dermal-based lesions. A cohort of CNTK (n=7) and benign cutaneous lesions of neural (n=28), fibrohistiocytic (n=23), fibroblastic (n=25), histiocytic (n=18), myofibroblastic (n=7), smooth muscle (n=14), and melanocytic (n=12) differentiations were immunostained with PGP9.5. Staining was graded by H-score and compared with CNTK. A significantly higher H-score was found in CNTK compared with the fibrohistiocytic (p=0.0001), histiocytic (p=0.0016), myofibroblastic (p=0.0003), smooth muscle (p<0.0001), and melanocytic (p=0.0004) groups, with the exceptions of plexiform fibrohistiocytic tumour, xanthoma, and xanthogranuloma. No significant difference was found when comparing CNTK with fibroblastic and neural lesions, with the exceptions of neurofibroma and perineurioma. In conclusion, PGP9.5 is helpful in distinguishing CNTK from most benign cutaneous fibrohistiocytic, histiocytic, myofibroblastic, smooth muscle, and melanocytic lesions. In addition to CNTK and neural lesions, PGP9.5 is also expressed in benign fibroblastic lesions, and therefore distinction of these lesions should not be based on PGP9.5 positivity.
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Affiliation(s)
- Grace Y Wang
- Department of Pathology, University of Michigan, Ann Arbor, MI, United States
| | - Rosalynn M Nazarian
- Pathology Service, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Lili Zhao
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Alexandra C Hristov
- Department of Pathology, University of Michigan, Ann Arbor, MI, United States; Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Rajiv M Patel
- Department of Pathology, University of Michigan, Ann Arbor, MI, United States; Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - Douglas R Fullen
- Department of Pathology, University of Michigan, Ann Arbor, MI, United States; Department of Dermatology, University of Michigan, Ann Arbor, MI, United States
| | - May P Chan
- Department of Pathology, University of Michigan, Ann Arbor, MI, United States; Department of Dermatology, University of Michigan, Ann Arbor, MI, United States.
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Abstract
CONTEXT Immunohistochemistry is not a diagnostic test but a highly valuable tool that requires interpretation within a context. OBJECTIVE To review the current status and limitations of immunohistochemistry in dermatopathology. DATA SOURCES English-language literature published between 1980 and 2014. CONCLUSIONS Although immunohistochemistry is rarely completely specific or sensitive, it is an important adjunctive technique in dermatopathology and can be helpful in a series of diagnostic dilemmas.
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Affiliation(s)
- Tammie Ferringer
- From the Departments of Dermatology and Laboratory Medicine, Geisinger Medical Center, Danville, Pennsylvania
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