Elif İnanç GÜRER, Cezmi Çağrı TÜRK, Cumhur İbrahim BAŞSORGUN, Betül ÜNAL

TTF-1 (Clone SPT24) and CD 99 Positivity in Glioblastoma: A Diagnostic Dilemma

Nadir bir varyant olan küçük hücre morfolojisine sahip glioblastom olgusunu dikkat çekici immünoprofili ile tanımladık. Glioblastoma multiforme morfolojik olarak oldukça heterojen bir gruptur. Bununla birlikte, glioblastom heterojen profili ayırıcı tanıda karışıklığa yol açabilir. 64 yaşında erkek hasta hastanemize başvurdu, magnetik rezonans incelemede temporal kitle tespit edildi ve cerrahi uygulandı. Tümör monomorfik sıkışık gruplar yapan, mitotik olarak aktif küçük astrositlerden oluşmaktaydı. Tümöral alanlarda prolifere küçük damarlar, palizatlanan nekroz izlendi. İmmünohistokimyasal analiz yapıldı, tümör hücreleri GFAP, CD56, NSE, CD99 VE TTF-1 (klon SPT24) ekprese ederken TTF-1, klon 8G7G3/1 ile ekspresyon izlenmedi. Glioblastomlarda TTF-1 ekspresyonu diffüz ve güçlü olsa bile santral sinir sisteminin primer tümörünü dışlayamaz. Tanı için klinik ve histopatolojik parametrelerin birlikte değerlendirilmesi gerekmektedir

Glioblastomda TTF-1 (Klon SPT24) ve CD 99 Pozitifliği: Tanısal İkilem

We describe an unusual variant of glioblastoma with small cell morphology and discuss its remarkable immunoprofile. Glioblastoma multiforme comprises a morphologically highly heterogeneous neoplasm. However, this heterogeneous immunoprofile of glioblastoma can lead to confusion in the differential diagnosis. A 64-year-old male presented to our hospital. A temporal mass was detected on magnetic resonance examination and surgery was performed. The tumor was composed of a monomorphic collection of densely packed and mitotically active small astrocytes. Proliferated microvessels and palisading necrosis were seen in tumoral areas. Immunohistochemical analysis revealed that the tumor cells expressed GFAP, CD56, NSE, CD99 and TTF-1 (clone SPT24) but there was no expression of clone 8G7G3/1 of TTF1. TTF-1 expression in glioblastomas cannot rule out primary tumor of the central nervous system even when there is diffuse and strong staining. The clinical and histopathological parameters should be evaluated together for the diagnosis.

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