Validation of tissue microarray technology in malignant peripheral nerve sheath tumours

BACKGROUND

It has been suggested that the donor tissue cores used in tissue microarrays (TMAs) may not be representative of the whole tissue section.

AIM

To validate the use of TMA technology in the study of malignant peripheral nerve sheath tumours (MPNSTs).

METHODS

A TMA was constructed containing five independent core biopsy samples of 14 formalin-fixed, paraffin-embedded MPNSTs. The immunohistochemical (IHC) results of the five cores from the same tissue block on TMA were compared with readings from whole sections using two antibodies: anti-Ki-67 and anti-S-100. Digital image analysis was performed to calculate the percentage of positive stain areas. The agreement between IHC results obtained with TMA cores and whole sections was assessed using the kappa statistic.

RESULTS

There was good to very good agreement between IHC results for whole and TMA sections from MPNSTs. In relation to S-100, very good agreement (92% agreement; kappa = 0.77) was observed using a minimum of four TMA cores. Staining results for Ki-67 from at least four readable TMA cores were the same as those for the whole section in 86% of cases, with good agreement, using weighted kappa statistics (kappa = 0.63).

CONCLUSIONS

This study indicates that the TMA technique can be used in the IHC study of MPNSTs, even with the use of heterogeneous markers such as S-100 protein.

Neurofibromatosis type I with periodontal manifestation. A case report and literature review

The term neurofibromatosis (NF) is used for a group of genetic disorders that primarily affect the cell growth of neural tissues. Neurofibromatosis type 1 (NF1), also known as von Recklinghausen's disease, is the most common type of NF and accounts for about 90% of all cases. It is one of the most frequent human genetic diseases, with a prevalence of one case in 3,000 births. The expressivity of NF1 is extremely variable, with manifestations ranging from mild lesions to several complications and functional impairment. Oral manifestations can be found in almost 72% of NF1 patients. A case of a NF1 patient with a gingival neurofibroma in the attached gingiva of the lingual aspect of the lower central incisors is presented. The lesion was nodular, with sessile base, non-ulcerated, non-painful, with normal colour and measured 1 cm in diameter. An excisional biopsy of the oral lesion was performed. Histopathological and immunohistochemical analysis confirmed the clinical hypothesis of neurofibroma. Because NF1 is one of the most common genetic diseases and oral manifestations are very common, dentists should be aware of the characteristics of this disease.

Identification of growth hormone receptor in localised neurofibromas of patients with neurofibromatosis type 1

BACKGROUND

The hallmark of neurofibromatosis type 1 (NF1) is the development of multiple neurofibromas. Solitary neurofibroma may occur in an individual who does not have NF1, but multiple neurofibromas tend to develop only in those with NF1. It has been suggested that hormones may influence the neurofibromas of patients with NF1. The evidence that hormones may influence the growth of neurofibromas comes mainly from the observation that localised neurofibromas of patients with NF1 commonly grow during puberty and pregnancy. Because growth hormone (GH) concentrations increase during puberty, it is possible that GH influences the growth of these tumours.

AIMS

To investigate the presence of GH receptors (GHRs) in neurofibromas.

METHODS

By means of immunohistochemistry, the presence of GHRs was investigated in two groups of patients: 16 patients without NF1 with solitary neurofibromas (group A) and 10 patients with NF1 with localised neurofibromas (group B).

RESULTS

Six of the 16 patients in group A had neurofibromas that were immunopositive for GHR, whereas nine of the 10 patients in group B were immunopositive.

CONCLUSIONS

Most patients with NF1 have localised neurofibromas that express GHR. This suggests that GH may play some role in the development of localised neurofibromas in patients with NF1.