FNA diagnosis of CD99 positive neuroblastoma: A diagnostic dilemma

Kaur, Gagandeep; Bakshi, Pooja; Verma, Kusum

doi:10.4103/0970-9371.97162

Cited by 5 publications

(5 citation statements)

References 9 publications

(16 reference statements)

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“…However, the same cases did not show positive staining for CD99 on histopathology. This differential staining has been attributed to technical problems like cytological sample processing and immunocytochemical protocols 7 . In our case, the tumor was strongly immunoreactive for CD99 on both cytology and histopathology as well as primary and metastatic site.…”

Section: Discussionmentioning

confidence: 58%

CD99 and NKX2.2 positive neuroblastoma diagnosed on cytology: A potential diagnostic pitfall and necessity of pathological evaluation of the primary site

Devi

Alashetty

Champaka

et al. 2023

Diagnostic Cytopathology

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Immunohistochemistry plays a vital role in the diagnosis of small round cell tumors. CD99 immunonegativity is one of the features, which helps in distinguishing neuroblastoma from other small round cell tumors. NKX2.2 is a specific marker of Ewing sarcoma, which is a differential for poorly differentiated neuroblastoma. Here, we present a case of metastatic neuroblastoma showing immunoreactivity for both CD99 and NKX2.2 on cytology of the metastatic site causing diagnostic dilemma. Biopsy study of the adrenal lesion revealed presence of differentiating cells and neuropil, highlighting the importance of evaluation of the primary site and limitation of cytology.

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Section: Discussionmentioning

confidence: 58%

CD99 and NKX2.2 positive neuroblastoma diagnosed on cytology: A potential diagnostic pitfall and necessity of pathological evaluation of the primary site

Devi

Alashetty

Champaka

et al. 2023

Diagnostic Cytopathology

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“…Although CD99 expression differentiates a poorly differentiated synovial sarcoma from neuroblastoma in majority of cases, positive CD99 staining can rarely be observed in neuroblastoma. 34 Miettinen et al 22 reported GATA3 expression in 5 of 24 synovial sarcoma which included 4 biphasic and 1 monophasic spindle cell synovial sarcoma; the positivity was seen in the epithelial component of biphasic and spindle cells of the monophasic components. Haraguchi et al 39 also reported GATA3 expression in 3/3 synovial sarcoma, but they did not comment on the histologic subtypes.…”

Section: Discussionmentioning

confidence: 98%

“…[6][7][8] Nevertheless, not uncommonly, even the above-mentioned panel does not assist to render a correct diagnosis because of considerable infidelity among the transcriptional factors. [30][31][32][33][34][35][36][37] Also, there is a lack of specificity of these IHC markers to confirm a neuroblastic lineage in a small round blue cell tumor, calling for a specific and sensitive marker for neuroblastoma.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Utility of GATA3 and ISL1 in Differentiating Neuroblastoma From Other Pediatric Malignant Small Round Blue Cell Tumors

Mohanty,

Diwaker,

Mishra

et al. 2023

Int J Surg Pathol

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Accurate diagnosis of neuroblastoma may be challenging, especially with limited or inadequate specimen and at the metastatic sites due to overlapping imaging, histopathologic, and immunohistochemical (immunohistochemistry [IHC]; infidelity among various lineage-associated transcription factors eg FLI1, transducin-like enhancer 1, etc) features. GATA3 and ISL1 have recently been described as markers of neuroblastic differentiation. This study aims at determining the diagnostic utility of GATA3 and ISL1 in differentiating neuroblastoma from other pediatric malignant small round blue cell tumors. We evaluated GATA3 and ISL1 expression in 74 pediatric small round blue cell tumors that included 23 NMYC-amplified neuroblastomas, 11 EWSR1-rearranged round cell sarcomas, 7 SYT::SSX1-rearranged synovial sarcomas, 5 embryonal rhabdomyosarcomas, 10 Wilms tumors (nephroblastomas), 7 lymphoblastic lymphoma, 7 medulloblastoma, and 4 desmoplastic small round cell tumor. All 23 neuroblastomas (moderate to strong staining in >50% of the tumor cells), 5 T-lymphoblastic lymphomas (moderate to strong staining in 40%-90% of the tumor cells), and 2 desmoplastic small round cell tumors (weak to moderate staining in 20%-30% of the tumor cells) expressed GATA3, while other tumors were negative. ISL1 immunoreactivity was observed in 22 (96%) neuroblastomas (strong staining in in >50% of the tumor cells, n = 17; moderate to strong staining in 26%-50% of the tumor cells, n = 5), 3 embryonal rhabdomyosarcoma (moderate to strong staining in 30%-85% of the tumor cells), 1 synovial sarcoma (weak staining in 20% of the tumor cells), and 7 medulloblastoma (strong staining in 60%-90% of the tumor cells). Other tumors were negative. Overall, GATA3 showed 86% specificity, 100% sensitivity, and 90% accuracy for neuroblastoma, with a positive predictive value (PPV) and negative predictive value (NPV) of 77% and 100%, respectively. ISLI showed 72% specificity, 96% sensitivity, and 81% accuracy for neuroblastoma, with a PPV and NPV of 67% and 97%, respectively. After the exclusion of T-lymphoblastic lymphoma and desmoplastic small round cell tumors, GATA3 had 100% specificity, sensitivity, accuracy, and PPV and NPV for neuroblastoma. Similarly, in pediatric small round blue cell tumors, ISL1 had 100% specificity, sensitivity, accuracy, PPV, and NPV for neuroblastoma, after embryonal rhabdomyosarcoma, synovial sarcoma, and medulloblastoma were excluded. Conclusions GATA3 and ISL1 may be valuable in the diagnostic work-up of neuroblastoma and may reliably be used to support the neuroblastic lineage of pediatric small round blue cell tumors. Furthermore, dual positivity helps in challenging scenarios, when there is equivocal imaging, overlapping IHC features, limited specimen, and the lack of facility for a molecular work up.

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“…The antibody sensitized ferrocene microcapsules were used as a probe in the proposed system (Viswanathan and Ho, 2007). Kaur and Verma (2012) compared their insulin biosensor response with ELISA for reliability test. And they found that their developed biosensor is reliable.…”

Section: Amperometric Biosensors For Hormonesmentioning

confidence: 99%