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IMMUNOCYTOCHEMICAL STUDY OF SMOOTH MUSCLE ACTIN (SMA) IN FINE NEEDLE ASPIRATION CYTOLOGY (FNAC) OF BENIGN AND MALIGNANT BREAST TUMORS

Author: Methaq M Najem ميثاق معين نجم
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2012 Volume: 10 Issue: 1 Pages: 87-92
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

BackgroundMyoepithelial cells play an important role in the interpretation of breast fine needle aspiration cytology, since these cells are believed to be a component of the benign process in the breast lesion. Myoepithelial cells distinction may be difficult occasionally, so their demonstration by immunocytochemistry method through myoepithelial cell marker like smooth muscle actin is a useful diagnostic tool to differentiate between benign and invasive malignant lesions.ObjectiveTo study the role of smooth muscle actin as immunocytochemical marker in the demonstration of myoepithelial cell as an aid in the diagnosis of benign breast lesions in fine needle aspiration cytolog of breast.MethodsForty five cases of fine needle aspiration cytology of palpable female breast lesions were selected. 25 out of these 45 cases comprised 20 invasive breast carcinoma and 5 fibrocystic diseases with atypia stained with smooth muscle actin by immunocytochemistry method directly and 20 cases comprised of 10 fibroadenoma and 10 fibrocystic disease stained with smooth muscle actin after destaining from H&E stain. All of these cases had a confirmatory histological diagnosis. ResultsSmooth muscle actin staining consistently highlighted the myoepithelial cells in smears of all histologically proven benign lesions such as fibroadenomas and fibrocystic changes. In contrast, invasive breast cancers demonstrated absence of staining with smooth muscle actin that seen in benign breast lesions.ConclusionApplication of smooth muscle actin immunostaining in breast fine-needle aspirates is feasible and practical. The use of destained H&E smears provides an effective means to directly examine any atypical cluster of cells for the presence of MEC differentiation. The demonstration of presence or absence of MEC differentiation in atypical cases can provide sufficient evidence to decrease error in diagnosis (false positive) of breast fine-needle aspirates.KeywordsSmooth muscle actin, fine needle aspiration cytology, breast lesions


Article
EVALUATION OF IMMUNOHISTOCHEMICAL EXPRESSION OF CK19 IN PAPILLARY THYROID CARCINOMA AND GRAVE'S DISEASE WITH PAPILLARY CHANGES

Authors: Ikram A. Hasan اكرام عبد اللطيف حسن --- Methaq M. Najem ميثاق معين نجم --- Thair J. Kadem ثائر جواد كاظم
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2013 Volume: 11 Issue: 3 Pages: 225-229
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background:Immunohistochemistry seems to be important method for differentiation between papillary thyroid carcinoma which is the commonest thyroid cancer and Grave's disease which may be challenging by light microscopic features only.Objectives:The aim of the study was to evaluate the immunohistochemical expression of CK 19 antibody that is considered a marker of malignancy in papillary thyroid carcinoma and in Grave's disease and to determine whether CK19 is effective in the discrimination between these two pathological conditions.Methods:In this retrospective study paraffin embedded archival materials from 40 cases including 20 papillary thyroid carcinoma and 10 Grave's disease in addition to ten normal thyroid tissue were used as a control group, collected from the department of pathology of Al-Yarmook Teaching Hospital for the period between Jan 2009 to Jan 2011. The immunohistochemical expression of CK19 markers was assessed for intensity and extent of staining in semiquantative method.Results:Sixteen of the 20 papillary carcinomas showed diffuse and intense cytoplasmic staining with CK19 (80%), 4 cases showing diffuse faint staining (20%). Seven of the 10 Grave's cases (70%) are completely negative. The remaining 3 cases showing focal weak staining with CK19 (30%). There was a significant difference in the extent of staining between papillary thyroid carcinoma and Grave's disease and there was highly significant difference in intensity of staining between them.Conclusions:The staining features of CK19 may be helpful in the differential diagnosis between papillary carcinoma and Grave's disease with papillary carcinoma like structures. This immunoreactivity should be evaluated with histopathological findings in order to prevent over diagnosis of papillary carcinoma.Keywords:CK19 immunohistochemical expression, papillary thyroid carcinoma, Grave's disease.

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