Hacer HALTAŞ, Reyhan BAYRAK, Sibel YENİDÜNYA, Ümran YILDIRIM

Diagnostic value of cytokeratin 19, HBME-1, and galectin-3 immunostaining of cell block from fine-needle aspiration specimens in papillary carcinoma of the thyroid

To evaluate the utility of immunohistochemical staining of cytokeratin 19 (CK19), HBME-1, and galectin-3 in cell block preparations of fine-needle aspiration cytology specimens as ancillary techniques for the differential diagnosis of papillary thyroid carcinoma. Materials and methods: Immunohistochemical detection of CK19, HBME-1, and galectin-3 was completed in 45 thyroid aspiration cytology specimens fixed in paraffin-embedded blocks consisting of the following cytologic diagnoses: 1) 16 cases of papillary carcinoma, 2) 16 cases suspicious for papillary carcinoma, and 3) 13 cases involving nonneoplastic lesions. Results: The follicular cells in the cytologically unequivocal papillary carcinoma diagnosis group expressed diffusely positive (+++) CK19, HBME-1, and galectin-3 in 12/16, 12/16, and 14/16 cases, respectively. Diagnosis of papillary carcinoma was confirmed during follow-up in all 16 cases. Positive staining for CK19 or galectin-3 was not detected among the 13 cases of cytologic and histopathologic diagnosis of nonneoplastic lesions. CK19 (9/12) and galectin-3 (9/12) were diffusely positive (+++) in the majority of papillary carcinoma samples with initial cytologic diagnostics indicating suspicion of papillary carcinoma. Conclusion: The CK19, HBME-1, and galectin-3 immunostaining panel is a novel and informative adjunct for the diagnosis of papillary thyroid carcinoma from cell block material. Diffuse immunostaining for CK19 and galectin-3 contributes to improvements in accurate diagnosis of malignancy in cases of suspected papillary carcinoma.

Keywords:

thyroid, papillary carcinoma, cell block, immunohistochemistry cytokeratin 19, HBME-1, galectin-3, Fine-needle aspiration,

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DeMay R. Thyroid. In: DeMay R, editor. The Art and Science of Cytopathology. 1st ed. Chicago: ASCP Press; 1996. p.724–40. 2. Khurana KK, Truong LD, LiVolsi VA, Baloch ZW. Cytokeratin 19 immunolocalization in cell block preparation of thyroid aspirates. An adjunct to fine-needle aspiration diagnosis of papillary thyroid carcinoma. Arch Pathol Lab Med 2003; 127: 579–83.
Bartolazzi A, Orlandi F, Saggiorato E, Volante M, Arecco F, Rossetto R et al. Galectin-3-expression analysis in the surgical selection of follicular thyroid nodules with indeterminate fine- needle aspiration cytology: a prospective multicentre study. Lancet Oncol 2008; 9: 543–9.
Cheung CC, Ezzat S, Freeman JL, Rosen IB, Asa SL. Immunohistochemical diagnosis of papillary thyroid carcinoma. Mod Pathol 2001; 14: 338–42.
Van Hoeven KH, Kovatich AJ, Miettinen M. Immunocytochemical evaluation of HBME-1, CA 19-9, and CD-15 (Leu-M1) in fine- needle aspirates of thyroid nodules. Diagn Cytopathol 1998; 18: 93–7.
Nga ME, Lim GS, Soh CH, Kumarasinghe MP. HBME-1 and CK19 are highly discriminatory in the cytological diagnosis of papillary thyroid carcinoma. Diagn Cytopathol 2008; 36: 550–6.
Papotti M, Volante M, Saggiorato E, Deandreis D, Veltri A, Orlandi F. Role of galectin-3 immunodetection in the cytological diagnosis of thyroid cystic papillary carcinoma. Eur J Endocrinol 2002; 147: 515–21.
Carpi A, Rossi G, Mechanick JI, Nicolini A, Camici M, Russo MA et al. Large needle aspiration biopsy histology for preoperative selection of Hürthle cell thyroid nodules. Histopathology 2011; 59: 892–6.
El Demellawy D, Nasr A, Alowami S. Application of CD56, P63 and CK19 immunohistochemistry in the diagnosis of papillary carcinoma of the thyroid. Diagn Pathol 2008; 6: 3–5.
Stone MR, O’Neill A, Catino D, Bloch RJ. Specific interaction of the actin-binding domain of dystrophin with intermediate filaments containing keratin 19. Mol Biol Cell 2005; 16: 4280–93.
Miettinen M, Kovatich AJ, Kärkkäinen P. Keratin subsets in papillary and follicular thyroid lesions. A paraffin section analysis with diagnostic implications. Virchows Arch 1997; 431: 407–13.
Baloch ZW, Abraham S, Roberts S, Li Volsi VA. Differential expression of cytokeratins in follicular variant of papillary carcinoma: an immunohistochemical study and its diagnostic utility. Hum Pathol 1999; 30: 1166–71.
Miettinen M, Karkkainen P. Differential reactivity of HBME-1 and CD15 antibodies in benign and malignant thyroid tumours. Preferential reactivity with malignant tumours. Virchows Arch 1996; 429: 213–9.
Greenspan FS. The role of fine-needle aspiration biopsy in the management of palpable thyroid nodules. Am J Clin Pathol 2000; 108: 26–30.
Casey MB, Lohse CM, Lloyd RV. Distinction between papillary thyroid hyperplasia and papillary thyroid carcinoma by immunohistochemical staining for cytokeratin 19, galectin-3, and HBME-1. Endocrinol Pathol 2003; 14: 55–60.
Sack MJ, Astengo-Osuna C, Lin BT, Battifora H, LiVolsi VA. HBME-1 immunostaining in thyroid fine-needle aspirations: a useful marker in the diagnosis of carcinoma. Mod Pathol 1997; 10: 668–74.
Saggiorato E, Cappia S, De Giuli P, Mussa A, Pancani G, Caraci P et al. Galectin-3 as a presurgical immunocytodiagnostic marker of minimally invasive follicular thyroid carcinoma. J Clin Endocrinol Metab 2001; 86: 5152–8.
Papotti M, Rodriguez J, De Pompa R, Bartolazzi A, Rosai J. Galectin-3 and HBME-1 expression in well-differentiated thyroid tumors with follicular architecture of uncertain malignant potential. Mod Pathol 2005; 18: 541–6.
Seçkin S, Karagece Ü. Expression of CK-19, cErbB2, galectin-3, and p53 in papillary thyroid carcinomas. Turk J Med Sci 2010; 40: 207–12.
Domagala WM, Markiewski M, Tuziac T, Kram A, Weber K, Osborn M. Immunocytochemistry on fine needle aspirates in paraffin miniblocks. Acta Cytol 1990; 34: 291–6.
Rapheal SJ, McKeown-Eyssen G, Asa SL. High-molecular-weight cytokeratin and cytokeratin-19 in the diagnosis of thyroid tumors. Mod Pathol 1994; 7: 295–300.
De Matos PS, Ferreira AP, Facuri FO, Assumcao LVM, Metze K, Ward LS. Usefulness of HBME-1, cytokeratin 19 and galectin-3 immunostaining in the diagnosis of thyroid malignancy. Histopathology 2005; 47: 391–401.
Inohara H, Honjo Y, Yoshii T, Akahani S, Yoshida J, Hattoro K et al. Expression of galectin-3 in fine-needle aspirates as a diagnostic marker differentiating benign from malignant thyroid neoplasms. Cancer 1999; 85: 2475–84.
Cui W, Sang W, Zheng S, Ma Y, Liu X, Zhang W. Usefulness of cytokeratin-19, galectin-3, and Hector Battifora mesothelial-1 in the diagnosis of benign and malignant thyroid nodules. Clin Lab 2012; 58: 673–80.
Niedziela M, Maceluch J, Korman E. Galectin-3 is not an universal marker of malignancy in thyroid nodular disease in children and adolescents. J Clin Endocrinol Metabol 2002; 87: 4411–5.
Mehorotra P, Okpokam A, Bouhaidar R, Johnson SJ, Wilson JA, Davies BR et al. Galectin-3 does not reliably distinguish benign from malignant thyroid neoplasms. Histopathology 2004; 45: 493–500.