White opaque substance represents an intracytoplasmic accumulation of lipid droplets: Immunohistochemical and immunoelectron microscopic investigation of 26 cases

Ueo, Tetsuya; Yonemasu, Hirotoshi; Yada, Naomi; Yano, Shinji; Ishida, Tetsuya; Urabe, Masaki; Takahashi, Ken; Nagamatsu, Hideyasu; Narita, Ryoichi; Yao, Kenshi; Daa, Tsutomu; Yokoyama, Shigeo

doi:10.1111/j.1443-1661.2012.01364.x

Cited by 47 publications

(44 citation statements)

References 15 publications

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“…1) [11], the most commonly applied system in clinical practice [3,[12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Briefly, when we detect a mucosal lesion using C-WLI, we analyze the subsequent M-NBI findings.…”

Section: M-nbi Diagnostic Criteriamentioning

confidence: 99%

Diagnostic performance and limitations of magnifying narrow-band imaging in screening endoscopy of early gastric cancer: a prospective multicenter feasibility study

et al. 2014

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Background Curative treatment of patients with gastric cancer requires reliable detection of early gastric cancer. Magnifying endoscopy with narrow-band imaging (M-NBI) is useful for the accurate preoperative diagnosis of early gastric cancer. However, the role of M-NBI in screening endoscopy has not been established. The aims of this study were to determine the feasibility and limitations of M-NBI in screening endoscopy. Methods We conducted a multicenter prospective uncontrolled trial of patients undergoing routine screening endoscopy patients. We determined the diagnostic accuracy, sensitivity and specificity of M-NBI according to the degree of certainty and need for biopsy, as assessed using the VS (vessel plus surface) classification system. We analyzed the endoscopic and histopathological characteristics of both false negative and false positive high confidence M-NBI diagnoses. We then developed a provisional diagnostic strategy based on the diagnostic performance and limitations identified in this study. Results A total of 1097 patients were enrolled in the study. We analyzed 371 detected lesions (20 cancers and 351 noncancers). The accuracy, sensitivity and specificity of high confidence M-NBI diagnoses were 98.1, 85.7 and 99.4 %, respectively. The false negative case was a pale mucosal lesion with tissue diagnosis of signet-ring cell carcinoma. Exclusion of pale mucosal lesions increased the accuracy, sensitivity and specificity of high confidence M-NBI diagnoses to 99.4, 100 and 99.4 %, respectively. We therefore propose a practical strategy targeting non-pale mucosal lesions.

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Section: M-nbi Diagnostic Criteriamentioning

confidence: 99%

Diagnostic performance and limitations of magnifying narrow-band imaging in screening endoscopy of early gastric cancer: a prospective multicenter feasibility study

et al. 2014

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“…When we investigated histopathological findings carefully, dense accumulation of adipophilin underlying the epithelium was identified in most WOS-positive lesions, but sparse accumulation of adipophilin in deeper areas is present in most of the 5 WOS-negative lesions. Ueo et al [12] used immunoelectron microscopy to observe lipid vacuoles ranging from 0.1 to 4 μm in size in WOS-positive neoplastic cells. Minute lipid droplets may thus remain invisible under endoscopy when present at low density.…”

Section: Discussionmentioning

confidence: 99%

“…Immunohistochemical staining with monoclonal antibody to adipophilin (Acris Antibodies, San Diego, Calif., USA) as the primary antibody was performed as previously described [12] to specifically stain membrane proteins of lipid droplets and thereby demonstrate their presence. A pathologist (K.I.)…”

Section: Methodsmentioning

confidence: 99%

“…We used ME with NBI to identify white opaque substance (WOS) in gastric [9] and colorectal [10] epithelial neoplasms. Oil red O staining and immunohistochemical staining with the primary antibody of adipophilin were used to demonstrate that WOS represents minute lipid droplets accumulated in superficial parts in lesions [11,12]. Under endoscopic observation, WOS takes a white appearance because these minute lipid droplets cause strong backward scattering or reflection of the projected light, preventing the light from reaching the subepithelial microvessels.…”

Section: Introductionmentioning

confidence: 99%

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Novel Endoscopic Findings as Visualized by Magnifying Endoscopy with Narrow-Band Imaging: White Opaque Substance Is Present in Colorectal Hyperplastic Polyps

Hisabe

Yao²,

Imamura³

et al. 2015

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Background: Magnifying endoscopy (ME) with narrow-band imaging (NBI) can visualize a white opaque substance (WOS) in gastric epithelial neoplasms, gastric intestinal metaplasias, and colorectal epithelial neoplasms. Histological examination showed the WOS to be lipid droplets accumulated in the epithelium. The white appearance of colorectal hyperplastic polyps suggests that they may contain WOS, but this has not been investigated as yet. Aims: The purpose of this study was to determine whether WOS is present in colorectal hyperplastic polyps. Methods: We retrospectively evaluated endoscopic images of 26 consecutive lesions investigated by ME with NBI and subsequently endoscopically resected and confirmed to be hyperplastic polyps. Results: WOS was present in 21 of the 26 colorectal hyperplastic polyps (80.8%) based on the findings of ME with NBI. Adipophilin was present in 24 of the 26 colorectal hyperplastic polyps (92.3%). Conclusions: This study is the first to demonstrate that WOS (i.e. lipid droplets) accumulates in the epithelium of colorectal hyperplastic polyps.

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“…Recent advances have discovered a specific immunohistochemical marker localised to lipid droplets that can be carried out in FFPE tissue called adipocyte differentiation related protein (ADRP) or adipophilin [13]. The sub-cellular immunohistochemical expression of adipophilin has been found to be a useful marker of lipid accumulation in both tumours and non-neoplastic disease [4,[13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical staining of lipid droplets with adipophilin in paraffin-embedded glioma tissue identifies an association between lipid droplets and tumour grade

Kohe¹,

Colmenero²,

McConville³

et al. 2017

J Histol Histopathol

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Background: Cytoplasmic lipid droplets are important in cancer metabolism and a clear relationship has been established between their accumulation and increased tumour grade in glioma. The development of the novel immunohistochemical marker adipophilin has proven to be a useful method of detecting lipid droplets in paraffin embedded tissue from many diseases. Our aim was to assess the distribution of adipophilin stained lipid droplets in paraffin embedded glioma tissue and to evaluate whether it is a useful indicator of lipid droplets in brain tumours. Methods: Immunohistochemical staining for adipophilin was undertaken in a tissue microarray containing 65 paraffin embedded gliomas of varying grade. The number of tumour cells containing adipophilin positive lipid droplets was then quantified and statistically analysed. Results: We found a statistically significant accumulation of lipid droplets in high grade glioblastoma compared to low grade astrocytomas when we quantified the percentage of tumour cells containing adipophilin-positive lipid droplets (p<0.001). A significant positive correlation (rs=0.83) was detected between increasing tumour grade and the percentage of tumour cells containing lipid droplets, p=0.0001. Conclusions:We have determined that adipophilin is a useful immunohistochemical marker of lipid droplets in brain tumours. The ability to detect lipid droplets within paraffin embedded gliomas will greatly facilitate the evaluation of this tumour characteristic which is related to grade and prognosis.

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White opaque substance represents an intracytoplasmic accumulation of lipid droplets: Immunohistochemical and immunoelectron microscopic investigation of 26 cases

Abstract: The present study confirmed that the presence of WOS in gastric neoplasias was dependent upon intramucosal accumulation of lipid droplets using anti-adipophilin staining. Intraepithelial distribution and morphology of the lipid droplets differed between adenoma and adenocarcinoma.

Cited by 47 publications

References 15 publications

Diagnostic performance and limitations of magnifying narrow-band imaging in screening endoscopy of early gastric cancer: a prospective multicenter feasibility study

Diagnostic performance and limitations of magnifying narrow-band imaging in screening endoscopy of early gastric cancer: a prospective multicenter feasibility study

Novel Endoscopic Findings as Visualized by Magnifying Endoscopy with Narrow-Band Imaging: White Opaque Substance Is Present in Colorectal Hyperplastic Polyps

Immunohistochemical staining of lipid droplets with adipophilin in paraffin-embedded glioma tissue identifies an association between lipid droplets and tumour grade

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