Immunocytochemistry in adrenocortical tumours: A clinicomorphological study of 72 neoplasms

Abstract

Surgical specimens of 72 adrenocortical tumours (ACTs) were investigated. Histologically, 57 tumours were classified as adenomas and 15 as carcinomas. In 9 of the latter cases, distant metastases and/or lethal outcome of disease was recorded. Immunocyto-chemistry showed only 2 ACTs to be positive for cytokeratin and 6 for vimentin. None of the 72 tumours showed argyrophilia or immunoreactivity for epithelial membrane antigen (EMA), S-100 protein, chromogranin A, Leu 7 or Leu-M1, while 31 cases exhibited positivity on immunostaining with a polyclonal antiserum against synaptophysin. All 72 ACTs were immunoreactive with the recently described antibody D11. Thus the panel of antibodies described here could not discriminate between adenomas and carcinomas or between carcinomas with aggressive and indolent behaviour. Immunostaining with D11 and for EMA and Leu-M1 may help to distinguish ACTs from phenotypically similar lesions of different histogenesis.

Immunohistochemical Characteristics of Adrenocortical Carcinoma: An Overview

“…The monoclonal antibody D11, was introduced as a marker for adrenal cortical neoplasms by Schroder et al [27]. The antibody recognizes several 59 kD proteins capable of binding apolipoprotein E. Schroder et al demonstrated nuclear positivity in 100% of benign (57 cases) and malignant (15 cases) adrenocortical tumors [27].…”

“…The antibody recognizes several 59 kD proteins capable of binding apolipoprotein E. Schroder et al demonstrated nuclear positivity in 100% of benign (57 cases) and malignant (15 cases) adrenocortical tumors [27]. A subsequent study by Tartour et al demonstrated nuclear positivity in 44% (8 of 18 cases) of carcinomas, all of which were well differentiated [29].…”

“…Lewis X) while adrenocortical carcinomas do not [5]. Most adenocarcinomas are positive for carcinoembryonic antigen, epithelial membrane antigen and CD15 while adrenocortical carcinomas are negative [7,27]. Adrenocortical carcinomas are also negative with the renal cell carcinoma (RCC) and hepatocyte antibodies [19,31] (Table 1).…”

Pathologic Features of Prognostic Significance for Adrenocortical Carcinoma After Curative Resection

“…Although protein expression of epidermal growth factors, p53, transforming growth factor ␣, and P-glycoprotein, may be useful in distinguishing benign adenomas from malignant adrenocortical carcinomas, none of these markers has been shown to be an independent prognostic factor for survival rates in patients with an adrenocortical carcinoma. [13][14][15][16] We demonstrated that tumor size (Ͼ12 cm), the number of mitotic figures (Ն6 per 10 high-power fields), and intratumoral hemorrhage can predict a lower survival rate in patients undergoing curative resection for adrenocortical carcinoma. The presence of tumor necrosis nearly reached significance (P=.06), and with additional numbers, may also be an independent predictor.…”

Expression of Proliferating Cell Nuclear Antigen (PCNA) in Human Parathyroid Adenoma.

“…The differential diagnosis between adrenal carcinoma and adenoma is mainly made by the rate of mitotic cells. The cut-off line is usually 5 mitoses per 50 high power fields (15). Moreover, anaplastic seminoma is also defined by the mitotic rate, which is more than thirty mitoses in a total of 10 high power fields (13).…”