D'cruze Lawrence, Dutta Ruma, Rao Shalinee, R Anuradha, Varadarajan Suresh, Kuruvilla Sarah
Assistant Professor, Department of Pathology, Sri Ramachandra Medical College and Research Institute , Porur, Chennai-602116, India .
J Clin Diagn Res. 2013 Jul;7(7):1377-82. doi: 10.7860/JCDR/2013/5127.3132. Epub 2013 Jul 1.
The term, "Small Round - Cell Tumours" (SRCT) describes a group of highly aggressive malignant neoplasms which are composed predominantly of small and monotonous undifferentiated cells with high nucleocytoplasmic ratios. Immunohistochemistry (IHC) plays a crucial role in catagorizing the small round - cell tumours.
This study was done to analyse the spectrum of small round cell tumours over a period of five years at a tertiary care centre and to study the relevance of immunohistochemistry in making precise diagnoses of the small round cell tumours.
Formalin - fixed, paraffin - embedded sections of tumours which were diagnosed as small round cell tumours on small biopsies and resected specimens were retrieved from the files of the Department of Pathology of Sri Ramachandra Medical College and Research institute, in the period from January 2005 to December 2009. This study was confined to the bone and the soft tissues. Decalcification was performed on the bony tissues before the routine processing was done. The patients belonging to all age groups were included in this study. The small round cell tumours of the bone marrow, the spleen and the lymph node was excluded from our study. Immunohistochemical stains were performed to differentiate and categorise the small round blue cell tumours. The immunomarkers which were utilised in this study included CD45/LCA (the lymphocyte common antigen), CD20, CD3, CD99 (cluster of differentiation 99 also known as MIC2), desmin, EMA (epithelial membrane antigen), CK(cytokeratin), synaptophysin, chromogranin and GFAP (Glial fibrillary acidic protein).
Forty three cases of small round cell tumours were analysed, which included 19 cases of NHL (non Hodgkin's lymphoma), 6 cases of Ewing/PNETs (primitive neuroectodermal tumours), 3 cases of atypical carcinoid, 3 cases of olfactory neuroblastoma, 2 cases each of rhabdomyosarcoma, Wilms tumour, neuroblastoma and synovial sarcoma and 1 case each of small cell osteosarcoma, small (oat) cell carcinoma, medulloblastoma and hepatoblastoma. By using a panel of monoclonal antibodies, we could arrive at a final diagnosis for all the 40 cases in which immunohistochemistry was performed.
Our study showed that the use of immunohistochemistry was extremely beneficial. A majority of the small round cell tumours occurred between the ages of 15-45 years and the most common small round cell tumour was Non-Hodgkins lymphoma (extra lymphoreticular).
术语“小圆细胞肿瘤”（SRCT）描述了一组高度侵袭性的恶性肿瘤，其主要由核质比高的小而单一的未分化细胞组成。免疫组织化学（IHC）在小圆细胞肿瘤的分类中起着关键作用。
本研究旨在分析一家三级医疗中心五年期间小圆细胞肿瘤的谱系，并研究免疫组织化学在精确诊断小圆细胞肿瘤中的相关性。
从2005年1月至2009年期间，从斯里兰卡拉马钱德拉医学院和研究所病理科的档案中检索小活检和切除标本中被诊断为小圆细胞肿瘤的福尔马林固定、石蜡包埋切片。本研究仅限于骨骼和软组织。在进行常规处理之前，对骨组织进行脱钙。本研究纳入了所有年龄组的患者。本研究排除了骨髓、脾脏和淋巴结的小圆细胞肿瘤。进行免疫组织化学染色以区分和分类小圆蓝细胞肿瘤。本研究中使用的免疫标志物包括CD45/LCA（淋巴细胞共同抗原）、CD20、CD3、CD99（分化簇99，也称为MIC2）、结蛋白、EMA（上皮膜抗原）、CK（细胞角蛋白）、突触素、嗜铬粒蛋白和GFAP（胶质纤维酸性蛋白）。
分析了43例小圆细胞肿瘤病例，其中包括19例非霍奇金淋巴瘤（NHL）、6例尤因/原始神经外胚层肿瘤（PNETs）、3例非典型类癌、3例嗅神经母细胞瘤、横纹肌肉瘤、肾母细胞瘤、神经母细胞瘤和滑膜肉瘤各2例，小细胞骨肉瘤、小（燕麦）细胞癌、髓母细胞瘤和肝母细胞瘤各1例。通过使用一组单克隆抗体，我们能够对进行免疫组织化学检测的所有40例病例做出最终诊断。
我们的研究表明，免疫组织化学的应用极其有益。大多数小圆细胞肿瘤发生在15至45岁之间，最常见的小圆细胞肿瘤是非霍奇金淋巴瘤（结外）。
