Benign ve malign meme lezyonlarının ayırıcı tanısında SMA ve TIVC kullanımı

Amaç: Memenin ayırıcı tanısında güçlük çekilen benign ve malign lezyonlarının smooth muscle actin (SMA) ve type IV collogene (TIVC) immünohistokimyasal boyaları kullanılarak ayırt edilmeleri ve bu yöntemin yararlılığının gösterilmesidir. Yöntem: Yaşları 17-75 arasında değişen 50 kadın hastanın parafin bloklarından alınan kesitler öncelikle H.E ile boyandıktan sonra değerlendirildi. Olgulardaki meme lezyonları tanımlandı. Daha sonra bu olgulara immünohistokimyasal olarak SMA ve TIVC uygulandı. Bulgular: 50 olgu tanısal olarak tiplendirildi ve boyanma özellikleri saptandı. Benign lezyonlarda SMA ve TIVC ile % 53,7 oranında eş zamanlı pozitiflik saptanırken, in situ lezyonlarda % 47,3 oranında eş zamanlı pozitiflik tespit edildi. İnvaziv tümörlerin hiç birinde SMA ve TIVC ile eş zamanlı pozitiflik gözlenmedi. Sonuç: SMA ve TIVC ile eşzamanlı pozitiflik saptanan olgularda invazyonun ekarte edilebileceği, her iki markerin negatif olduğu durumlarda invaziv tümör tanısının kesinleşeceği ve sadece bir markerin pozitif olduğu durumlarda yardımcı klinik bilgi ve immün boyaların kullanılması gerektiği sonucu elde edildi.

SMA and TIVC usage in the differential diagnosis of benign and malign breast lesions

Objective: The aim of this study was to differentiate malignant and benign lesions of the breast which we have difficulties in differential diagnosis by using Smooth Muscle Actin (SMA), and type IV collogen (TIVC) immunohistochemical stains and to show the usage of this method. Methods: 50 cases aged between 17-75 yrs of benign breast lesions and in situ and invasive carsinoma of the breast were included in this study. Sections from parafine blocks of these cases were firstly stained by H.E and were differentiated. Breast lesions were diagnosed and stained immunohistochemically by SMA, and TIVC. Results: 50 cases were diagnostically typed and staining pattern were fixed. Benign lesions showed 53.7%, and in situ lesions showed 47.3% positivity with both SMA and TIVC. None of the invasive tumors were both SMA and TIVC positive. Conclusion: In cases positive with both SMA and TIVC, invasion can exactly be ruled out. A diagnosis of invasive tumor is certain if both markers are negative. If only one marker is positive, correlation of clinical and histopathological findings together with using conventional and immunohistochemical stains are needed in order to make a true diagnosis.

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