Ranan Gülhan AKTAŞ, Ebru DEMİRALAY, Şemsi YILDIZ

Primer Akciğer Kanserinde Histokimyasal ve Elektron Mikroskopik Sonuçların Çeşitliliği: 21 Olguluk Retrospektif Bir Çalışma

Amaç: Akciğer adenokarsinom olguları; kanserler arasında son derece değişken bir grup oluşturmaktadır. Bu değişkenlik bioyolojik ve klinik önemli farklılıklar ile ortaya çıkarmaktadır. Bu durum; patologları tanı aşamasında oldukça zorlamaktadır. Bu nedenle; adenokarsinoma vakalarının patolojik incelemeleri sırasında hastaların tanı ve tedavisi aşamasında daha çok bilgiye ihtiyaç duyulmaktadır. Bu çalışmada; primer akciğer adenokarsinoma tanısı almış 21 hastanın patolojik örneklerinin histokimyasal ve elektron mikroskopik düzeyde incelenmesi amaçlanmıştır. Gereç ve Yöntem: Arşivdeki parafin bloklar histokimyasal ve ince yapısal özelliklerinin değerlendirilmesi amacı ile yeniden incelenmiştir. Periyodik asit-Schiff, musikarmin ve alsiyan mavisi ile hücrelerin glikojen ve farklı tiplerdeki musin içeriği araştırılmıştır. Doku örneklerinde saptanan alanlar yeniden işlemlendirilerek elektron mikroskopik düzeyde değerlendirilmiştir. Bulgular: Bu çalışma; 21olgunun histokimyasal ve ince yapısal özelliklerini özetlemektedir. Adenokarsinoma hücrelerinin sekretuar granül yapısnın ve sitoplazmik özelliklerinin büyük bir değişkenlik gösterebildiği görülmüştür. Sonuçlar: Sonuçlar; sekretuar granüllerin içeriğinin histokimyasal ve elektron mikroskopik özelliklerinin çok değişken olabileceğini göstermiştir. Histokimyasal inceleme; tek başına hücrelerin salgısal özellikleri konusunda bilgi veremeyebilir. Bu aşamada; hücrelerin ince yapısal özelliklerinin electron mikroskopik düzeyde değerlendirilmesi oldukça faydalı olabilir. Akciğer adenokarsinoma vakalarının alt gruplara ayrılmasında; electron mikroskopi çok önemli bilgiler sağlayabilir.

Anahtar Kelimeler:

Akciğer, adenokarsinoma, histopatoloji, electron mikroskopi

Diversity of Histochemical and Electron Microscopic Results in Primary Lung Cancer: A Retrospective Study of 21 Cases

Aim: Pulmonary adenocarcinomas represent an incredibly diverse group of human malignancies. This diversity has considerable biological and clinical significance. It poses many diagnostic challenges for pathologists. With this has come a need for more information from the pathological examination of adenocarcinoma samples in order to determine patient management. The main aim of this study was to analyze histochemical and electron microscopic features of 21 primary human lung adenocarcinoma cases comparatively. Materials And Methods: Archival blocks were re-analysed to demonstrate their histochemical and ultrastructural features. Periodic acid-Schiff, mucicarmine and alcian blue were used for identification of the glycogen content and different types of mucins. Tissue specimens from the same regions were re-processed and re-examined under electron microscope. Results: The study reports histochemical features and the ultrastructural characteristics of 21 primary lung adenocarcinoma cases. These results reveal that the secretory cells in adenocarcinoma specimens have tremendous diversity according to the structure of secretory granules and cytoplasmic content. Conclusions: The data demonstrate not only the contents of the secretory granules according to their histochemical features, but also the differences in their electron microscopic appearance. Examination of the specimen at histochemical level may not be presenting its secretory nature and ultrastructural examination might be a useful tool for the observation of subcellular components. Electron microscopy might provide crucial information for subclassification of the lung adenocarcinoma cases.

Keywords:

Lung, adenocarcinoma, histopathology, electron microscopy,

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Kerr KM. Pulmonary adenocarcinomas: classification and reporting. Review 2009; 54: 12–27
Hirsch FR, Spreafico A, Novello S, Wood MD, Simms L, Papotti M. The prognostic and predictive role of histol- ogy in advanced non-small cell lung cancer: a literature review. J Thorac Oncol 2008; 3(12):1468-1481.
Langer CJ, Besse B, Gualberto A, Brambilla E, Soria JC. The Evolving Role of Histology in the Management of Advanced Non–Small-Cell Lung Cancer. J Clin Oncol 2010; 28 (36): 5311-5320.
Berg KK, Scheithauer, BW, Felix I, et al. Pituitary ade- nomas that produce adrenocorticotropic hormone and alpha-subunit: clinicopathological, immunohistochem- ical, ultrastructural, and immunoelectron microscopic studies in nine cases. Neurosurgery 1990; 6 (3): 397- 403.
Draper CE, Adeghate E, Lawrence PA, Pallot DJ, Garner A, Singh J:.Age related changes in morphology and se- cretory responses of male rat lacrimal gland. J Auton Nerv Syst 1998; 69 (2-3): 173-183.
Ikeda R , Aiyama S. Developmental changes in mucous cells of the early postnatal rat parotid gland: an ultra- structural and histochemical study. Arch Histol Cytol 1997; 60 (2): 185-93.
Kuo H, Ingram DK, Walker DC, Tian M, Hengemihle JM , Jucker M. Similarities in the age related hippocam- pal deposition of periodic acid-schiff-positive granules in the senescence-accelerated mouse P8 and C57BL/6 mouse strains. Neuroscience 1996,; 74 (3): 733-740.
Madrid JF, Hernandez F , Bellesta J. Characterization of glycoproteins in the epithelial cells of human and oth- er mammalian gallbladder. A review. Microsc Res Tech 1997; 38 (6): 616-630.
Mitsuno S, Takahashi M, Gondo T, et al. Immunohis- tochemical, conventional and immunoelectron micro- scopical characteristics of periodic acid-Schiff-positive granules in the mouse brain. Acta Neuropathol 1999,; 98 (1): 31-38.
Parshley MS, Cerreta JM, Mandl I, Fierer JA, Turino GM. Characteristics of a clone of endothelial cells derived from a line of normal adult rat lung cells. In Vitro 1979; 5 (9): 709-722.
Suzuki S, Mifune H, Nishida T, et al. Fine structure of the parotid gland in three shrew (Tupaia glis). Exp Anim 1995; 44 (4): 267-273.
Wattel W, Geuze JJ, de Rooij DG:. Ultrastructural and carbohydrate histochemical studies on the differentia- tion and renewal of mucous cells in the rat gastric fun- dus. Cell Tissue Res 1997; 176 (4): 445-462.
Bancroft JD. , Cook HC. Carbohydrates. In Manual of Histological Techniques and Their Diagnostic Applica- tion. Edited by Bancroft JD and Cook HC, Churchill Liv- ingstone; 1994; 131-173.
Filipe MI. The value of a study of the mucosubstances in rectal biopsies from patients with carcinoma of the rec- tum and lower sigmoidin the diagnosis of premalignant mucosa J Clin Pathol 1972; 25(2):123-128.
Mariassy AT, St George JA, Nishio SJ , Plopper CG. Tra- cheobronchial epithelium of the sheep: III. Carbohy- drate histochemical and cytochemical characterization of secretory epithelial cells. Anat Rec 1988; 221 (1): 540-549.
Ochiai A, Emura M, Riebe-Imre M, et al. Secretory dif- ferentiation and cell type identification of a human fetal bronchial epithelial cell line (HFBE). Virchows Arch B Cell Pathol Inc Mol Pathol 1991; 61 (3): 217-226.
Ochiai A, Emura M, Mohr U, Tahara E, Dungworth DL. Induction and characterization of secretory differentia- tion in human fetalbronchial epithelial cell line (HFBE) cultured on collagen gel in growth hormone and vita- min-A supplemented medium. Exp Pathol 1991; 41 (3): 157-168.
St George JA, Nishio SJ, Cranz DL , Plopper CG. Carbo- hydrate cytochemistry of rhesus monkey tracheal sub- mucosal glands. Anat Record 1986; 216 (1): 60-67.
Hoyt RF Jr, Sorokin SP, McDowell EM, Trump BF. Period- ic-acid-Schiff-lead hemaoxylin as a marker for the endo- crine phenotype in human lung tumors. Arch Pathol Lab Med 1986; 110(10): 943-951.
Pelosi G, Sonzogni A, Viale G. The classification of lung carcinoma: time to change the morphology-based ap- proach? Int J Surg Pathol, 2010; 18:161-172.
Ocque R, Tochigi N, Ohori NP, Dacic S. Usefulness of Immunohistochemical and Histochemical Studies in the Classification of Lung Adenocarcinoma and Squa- mous Cell Carcinoma in Cytologic Specimens . Am J Clin Pathol 2011; 136: 81-87.