Background
Lymphoid enhancer binding factor 1 (LEF-1) has recently been reported
as a potential immunohistochemical (IHC) marker for basal cell adenoma (BCA)
and other salivary gland tumors, which may contribute to an increased
accuracy in differentiating basaloid salivary gland neoplasms. We evaluated
the utility of LEF-1 in fine needle aspiration (FNA) and resection specimens
to distinguish pleomorphic adenoma (PA), BCA, basal cell adenocarcinoma
(BCAC) and adenoid cystic carcinoma (ACC) as well as in non-neoplastic
salivary gland (NNSG).
Methods
Cases including 66 PA (35 FNA, 31 resections), 12 BCA (5 FNA, 7
resections), 42 ACC (11 FNA, 31 resections), 1 BCAC FNA and 10 NNSG (5 FNA,
5 resections) were obtained and stained for LEF-1.
Results
On cell block (CB), 51% of PA and 60% of BCA were
LEF-1 positive while 91% of ACC were LEF-1 negative. Among
resections, there was a higher percentage of LEF-1 positive PA (84%)
and BCA (86%), and a higher percentage of LEF-1 negative ACC
(97%). LEF-1 staining had a low to moderate sensitivity for
detecting benign basaloid neoplasms on FNA CB and resection specimens
(92% and 97%, respectively), but a higher specificity
(92% and 97% respectively), and positive predictive value
(95% and 97% respectively).
Conclusion
When comparing benign (PA and BCA) and the most common malignant
basaloid salivary gland tumor (ACC) lesion, positive LEF-1 favors a benign
neoplasm. Additional studies with LEF-1, specifically including other rare
basaloid salivary gland neoplasms are needed to further clarify the role of
LEF-1 in diagnosing these lesions on FNA.