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BSND 免疫组化在涎腺嗜酸细胞性和沃辛样黏液表皮样癌鉴别诊断中的应用。

The Utility of BSND Immunohistochemistry in the Differential Diagnosis of Oncocytic and Warthin-like Mucoepidermoid Carcinoma of Salivary Gland.

机构信息

Department of Pathology and Laboratory Medicine, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.

出版信息

Head Neck Pathol. 2024 Nov 26;18(1):123. doi: 10.1007/s12105-024-01728-0.

Abstract

PURPOSE

BSND is a chloride channel subunit that is expressed in the normal salivary gland. We aimed to validate the utility of BSND immunohistochemistry in the differential diagnosis of oncocytic salivary gland neoplasms.

METHODS

BSND immunohistochemistry was performed in a retrospective cohort of 93 salivary gland lesions, enriched with tumors with oncocytic features and histologic variants of mucoepidermoid carcinoma (MEC).

RESULTS

All oncocytomas (n = 18) showed diffuse membranous BSND immunopositivity. Warthin tumors (n = 18) were also positive for BSND, but the staining pattern was patchy cytoplasmic and membranous in 10-25% of tumor cells. Using a threshold of 10% BSND-positive cells, all Warthin tumors were positive, while none of Warthin-like MECs or non-MEC salivary tumors were positive. Applying the same 10% positivity criterion, two oncocytic MECs were positive for BSND. The percentage of BSND staining in oncocytic MECs was up to 20%. In contrast, BSND was diffusely positive in oncocytomas with a median percentage of positivity of 95% (range: 40 - 100%). Therefore, a higher threshold of > 20% BSND-positive cells may be considered when differentiating between oncocytoma and oncocytic MEC.

CONCLUSION

BSND immunohistochemistry is a potentially useful diagnostic marker for salivary gland neoplasms, especially oncocytic and Warthin-like MECs. A threshold of ≥ 10% positivity can differentiate Warthin tumors from Warthin-like MECs, whereas > 20% positivity can be effective for separating oncocytomas from oncocytic MECs.

摘要

目的

BSND 是一种氯离子通道亚基,在正常唾液腺中表达。我们旨在验证 BSND 免疫组织化学在鉴别嗜酸性细胞唾液腺肿瘤中的作用。

方法

在富含具有嗜酸性细胞特征和黏液表皮样癌(MEC)组织学变异的肿瘤的 93 例唾液腺病变的回顾性队列中进行 BSND 免疫组织化学检测。

结果

所有的嗜酸细胞瘤(n=18)均显示弥漫性膜 BSND 免疫阳性。Warthin 肿瘤(n=18)也为 BSND 阳性,但在 10%-25%的肿瘤细胞中染色模式为斑片状细胞质和膜性。使用 10%BSND 阳性细胞的阈值,所有的 Warthin 肿瘤均为阳性,而没有 Warthin 样 MEC 或非 MEC 唾液肿瘤阳性。应用相同的 10%阳性标准,2 例嗜酸细胞 MEC 为 BSND 阳性。嗜酸细胞 MEC 中 BSND 的染色百分比高达 20%。相比之下,BSND 在嗜酸性细胞瘤中呈弥漫性阳性,阳性百分比中位数为 95%(范围:40-100%)。因此,在鉴别嗜酸细胞瘤和嗜酸细胞 MEC 时,可能需要考虑更高的>20%BSND 阳性细胞阈值。

结论

BSND 免疫组织化学是一种用于唾液腺肿瘤,特别是嗜酸性和 Warthin 样 MEC 的有潜在应用价值的诊断标志物。≥10%的阳性率可将 Warthin 肿瘤与 Warthin 样 MEC 区分开来,而>20%的阳性率可有效区分嗜酸细胞瘤与嗜酸细胞 MEC。

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