Undifferentiated head and neck tumors: the contribution of immunohistochemical technique to differential diagnosis

Bianchini, Walter Adriano; Altemani, Albina; Paschoal, Jorge Rizzato

doi:10.1590/s1516-31802003000600005

Cited by 9 publications

(13 citation statements)

References 11 publications

(11 reference statements)

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“…Similar observations regarding the head and neck region malignancy is predominant in male subjects also observed by Mandalet al 12 In our study it was observed that over one-third patients had cervical lymphadenopathy, one-third had neck mass and one-tenth had mass in nasal/sinonasal region. Almost similar findings was reported Bianchini et al 13 who obtained the lymph nodes (20.9%), pharynx and neck mass (16.3%), paranasal sinus (14.0%) and nose (11.6%) constituted the majority of sites.…”

Section: Discussionsupporting

confidence: 88%

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The role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region

Hossain¹,

Alam

Islam

et al. 2019

Birdem Med J

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Background: Undifferentiated tumours in the head and neck region are not uncommon. They can arise from different sites like in mucosa as well as in salivary glands, soft tissues or lymph nodes. Histopathological examination plays a central role in the diagnosis but difficulties arise with some tumours which are poorlydifferentiated due to their high inter- and intra-observer variability. In those cases, immunohistochemistry has greatly assisted to diagnose the tumours that cannot be accurately identified using routine histopathological procedures. The correct histopathological diagnosis is essential especially in case of malignant tumourwhere subsequent specific therapy is required. The aim of this study was to determine the role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region. Methods: This cross-sectional study was conducted during July 2014 to June 2015. A total of 35 Bangladeshi patient’s specimens of head and neck swelling were collected from two renowned laboratories in Dhaka city.These cases were diagnosed as undifferentiated tumour in histopathological examination.Standard protocol was followed for immunohistochemistry.Then primary immunohistochemical panel which included the markers for Epithelial CK (AE1/AE3),mesenchymal marker (Vimentin) and lymphoid marker (LCA) were used.The cases which were not resolved by primary immunohistochemistry panel, the second panel was applied for further sub classification (Desmin, Chromogranin, CK20, CEA, CD20, CD30, HMB45, NSE). Based on interpretation of immunohistochemical findings final diagnoses were made.Data analysis was performed using the Statistical Package for the Social Sciences for Windows version 22.0 (SPSS, Chicago, Illinois, USA). Results: A total of 35 undifferentiated tumorsof head-neck region were studied.The mean age was 46.3±17.6 years and male to female ratio was 4.8:1. The majority 13 (37.1%) patient had cervical lymphadenopathy, 11 (31.4%) had neck mass and 4(11.4%) had in nasal/sinonasal mass.Regarding histopathologicalcell types, round cell was 21 (60.0%), spindle cell 6 (17.1%), pleomorphic cells 6(17.1%) and epithelioid cells 2(5.7%). In initial histopathological examination, majority 25(71.4%) were undifferentiated malignant neoplasm, 8(22.8%) were metastatic undifferentiated carcinoma, 1(2.9%) was pleomorphic sarcoma and the remaining 1(2.9%) had malignant adnexal tumour. By application of immunohistochemistry, most (33, 94.3%) of the cases were resolved and the two cases remained unresolved. Among the resolved cases majority (15, 45.5%) were lymphoma, 4(12.1%) were metastatic carcinoma, 3(9.1%) were Ewing’s sarcoma and malignant melanoma were found in 3(9.1%) cases. Conclusion: This study supports that the immunohistochemical technique has a fundamental role in the investigation of undifferentiated tumour origin, to determine the correct guidance for treatment and improving the prognosis for head and neck tumour patients. Birdem Med J 2020; 10(1): 48-53

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Section: Discussionsupporting

confidence: 88%

“…It was not possible in 2 patients (5.7%) of cases. Bianchini et al 13 reported 18.6% and Gatter et al 5 reported 6.7% inconclusive results. This could be due to technique differences, different antigen retrieval methods or the unavailability of the antigen suspected.…”

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confidence: 96%

The role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region

Hossain¹,

Alam

Islam

et al. 2019

Birdem Med J

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“…This proportion is higher than the 27.9% confirmation rate of carcinomas in a study by Bianchini et al in Italy [9]. Lesions that were confused with carcinomas included 8 (12.9%) sarcomas, 8 (12.9%) lymphomas, 6 (9.7%) neuroendocrine tumors and 1 carcinosarcoma.…”

Section: Discussionmentioning

confidence: 61%

Immunohistochemical analysis of undifferentiated and poorly-differentiated head and neck malignancies at a tertiary hospital in Nigeria

et al. 2010

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AbsractThis is a retrospective analysis of poorly-differentiated head and neck malignancies at University College Hospital, Ibadan.Eighty-six poorly-differentiated neoplasms were categorized as carcinomas, sarcomas, lymphomas or neuroendocrine cancers with a panel of 7 antibodies (cytokeratin AE1/AE3, vimentin, desmin, myogenin, leukocyte common antigen and neuron-specific enolase). Immunohistochemical and original hematoxylin-eosin diagnoses were contrasted.The male: female ratio was 2.5:1, with mean age of 38.9 years. Nasopharynx, nose and maxillofacial bones were the most common locations. Immunohistochemistry confirmed 54.8% of carcinomas, 70.6% of sarcomas and 80% of lymphomas.Hematoxylin-eosin was able to distinguish between sarcoma and lymphoma but differentiation between a carcinoma and neuroendocrine lesion was poor. Further studies are required to maximize the role of immunohistochemistry as an ancillary diagnostic tool in the West African sub-region.

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“…In this regard, Bhagat et al could categorize 98.65%, Vege DS et al could categorize 85.5%, 7 Coindre JM et al (1986) could categorize 90%, while Michie et al (1987) could arrive at a diagnosis in 86% of undifferentiated tumours, by immunohistochemistry. In the study by Bianchini et al, immunohistochemistry allowed a conclusive diagnosis for 60.5% of tumours, 8 and was suggestive for 20.9%.…”

Section: Discussionmentioning

confidence: 94%

“…There were 7 cases of small cell (14%), 1 case of spindle cell (2%) and no case of pleomorphic (0%) category. Bianchini et al (2003) divided the undifferentiated tumours morphologically into round cell, epithelioid cell, spindle cells, myxoid pattern and pleomorphic, and found that round cell was the most prevalent pattern (51.2%). There were other authors who did not categorize the tumours morphologically and applied a complete panel of antibodies to all tumours.…”

Section: Diagnosis On Immunohistochemistrymentioning

confidence: 99%

Immuno Histochemical Approach to the Diagnosis of Undifferentiated Tumours- An Institutional Study

Gouda¹,

Harankhedkar²,

Das³

et al. 2018

jebmh

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Undifferentiated head and neck tumors: the contribution of immunohistochemical technique to differential diagnosis

Abstract: Our results demonstrate the fundamental role of the immunohistochemical technique for conclusive diagnosis of undifferentiated tumors.

Cited by 9 publications

References 11 publications

The role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region

The role of immunohistochemistry for diagnosing undifferentiated malignancy in the head and neck region

Immunohistochemical analysis of undifferentiated and poorly-differentiated head and neck malignancies at a tertiary hospital in Nigeria

Immuno Histochemical Approach to the Diagnosis of Undifferentiated Tumours- An Institutional Study

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