Sensitivity and Specificity of Antibodies on Necrotic Tumor Tissue

Judkins, Alexander R.; Montone, Kathleen T.; LiVolsi, Virginia A.; Rijn, Matt van de

doi:10.1093/ajcp/110.5.641

Cited by 34 publications

(14 citation statements)

References 5 publications

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“…Immunohistochemistry can be used to determine the lineage of the necrotic tumors. Judkins et al 16,17 in our institution applied a panel of antibodies to various necrotic tumors to determine the sensitivity and specificity of immunohistochemical stains. These authors found that keratin markers showed the highest sensitivity, whereas the usefulness of S100 and LCA was of limited value.…”

Section: Discussionmentioning

confidence: 99%

Clinical implications and value of immunohistochemical staining in the evaluation of lymph node infarction after fine‐needle aspiration

Nasuti

Gupta

Baloch

2001

Diagnostic Cytopathology

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We report on a series of 3 patients who underwent fine-needle aspiration (FNA) for clinically apparent lymphadenopathy. In all 3 cases, a diagnosis of malignancy was rendered based on cytologic findings (two metastatic squamous-cell carcinomas and one melanoma). However, initial follow-up surgical pathology reported only "extensive coagulative necrosis, no viable tumor seen." Subsequent immunohistochemical stains (cytokeratins (AE1/AE3), HMB45, S100, and Melan A) demonstrated the presence of metastatic tumor in the area of infarction in each case, thus establishing the presence of metastatic tumor and correct interpretation of the initial FNA. We conclude, based on our own experience and a few previously reported cases, that total infarction of the lymph nodes following FNA can occur, and immunohistochemistry can be helpful in clinical management.

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Section: Discussionmentioning

confidence: 99%

Clinical implications and value of immunohistochemical staining in the evaluation of lymph node infarction after fine‐needle aspiration

Nasuti

Gupta

Baloch

2001

Diagnostic Cytopathology

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“…Unfortunately, the ability to predict sensitivity and specificity of immunoreactivity in necrotic tissues is unpredictable, depending on whether the necrotic tissue contains immunoreactive epitopes . Study demonstrates that cytokeratin markers are relatively well preserved in necrotic tumor tissue, but highlights the lack of specificity of other commonly used tumor markers . CD20 is seen retained in necrotic lymphoid cells, but specificity of the stain in necrotic tissues has not been fully investigated .…”

Section: Work‐up Of Bone Marrow Necrosismentioning

confidence: 99%

“…33 Study demonstrates that cytokeratin markers are relatively well preserved in necrotic tumor tissue, but highlights the lack of specificity of other commonly used tumor markers. 34,35 CD20 is seen retained in necrotic lymphoid cells, but specificity of the stain in necrotic tissues has not been fully investigated. 36 Nuclear stains show much worse preservation of staining as compared to cytoplasmic/membrane stains.…”

Section: Malignancymentioning

confidence: 99%

How I investigate bone marrow necrosis

Deucher

Wool

2019

Int J Lab Hematology

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Hematopathologists encounter bone marrow biopsy specimens with marrow necrosis relatively infrequently; when necrosis is seen, determining the clinical significance can be challenging. While bone marrow necrosis is not uncommon in site‐directed biopsy specimens or autopsy material, substantial necrosis is much less common in nondirected bone marrow biopsy specimens. Retrospective review showed the prevalence of bone marrow necrosis to vary between 0.3% and 2% antemortem, depending on the patient population. Numerous causes of bone marrow necrosis have been identified, including malignancy, radiation/chemotherapy, medication, infection, autoimmune disease, disseminated intravascular coagulation, antiphospholipid syndrome and other thrombotic disorders, granulocyte‐colony stimulating factor (G‐CSF) exposure, and hemoglobinopathies. Clinical findings associated with bone marrow necrosis include bone pain and fever, cytopenias, elevated LDH and ferritin, and leukoerythroblastosis. Rarely, such as in fat embolization syndrome (FES), bone marrow necrosis can be associated with thrombotic microangiopathy, neurologic dysfunction, and multiorgan failure. A thorough review of the patient's clinical record (including medical history, clinical presentation, and other laboratory findings), a thorough morphologic review of the bone marrow with appropriate ancillary stains, and an appreciation of the causes of bone marrow necrosis in different patient populations are required to determine the underlying cause of bone marrow necrosis. The purpose of this review is to present a strategy for evaluation of bone marrow necrosis found in an antemortem biopsy specimen.

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“…1,2 The usefulness of immunohistochemical study for the diagnosis of necrotic melanoma has not been extensively investigated. 2,3 Therefore, we evaluated the diagnostic usefulness of 6 immunohistochemical markers of melanocytic differentiation by applying them to 35 melanoma specimens with extensive necrosis.…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical Evaluation of Necrotic Malignant Melanomas

Nonaka¹,

Laser²,

Tucker³

et al. 2007

Am J Clin Pathol

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We evaluated 35 cases of malignant melanomas with substantial necrosis immunostained with S-100, HMB-45, Melan-A, tyrosinase, PNL2, and microphthalmia transcription factor (MITF). Staining patterns were evaluated in viable and necrotic areas of the tumors. S-100 was the most sensitive marker (97%) in the viable tumors, but necrotic areas demonstrated nonspecific staining. Viable tumors stained variably for HMB-45 (25 [71%]), Melan-A (28 [80%]), tyrosinase (30 [86%]), and PNL2 (23 [66%]). Necrotic areas focally reacted to the same antibodies. The necrotic areas that retained immunoreactivity for these markers corresponded to areas where the outline of the tumor cells could still be recognized as ghost cells on the H&E-stained section. Areas that showed complete coagulative necrosis were negative for melanoma markers. MITF variably stained in the viable tumors but was completely negative in necrotic areas. Our study demonstrated that a combination of antibodies to HMB-45, tyrosinase, and PNL2 detected melanocytic differentiation in necrotic areas in 80% of cases.

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Sensitivity and Specificity of Antibodies on Necrotic Tumor Tissue

Cited by 34 publications

References 5 publications

Clinical implications and value of immunohistochemical staining in the evaluation of lymph node infarction after fine‐needle aspiration

Clinical implications and value of immunohistochemical staining in the evaluation of lymph node infarction after fine‐needle aspiration

How I investigate bone marrow necrosis

Immunohistochemical Evaluation of Necrotic Malignant Melanomas

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