Franquemont D W, Mills S E, Lack E E
Department of Pathology, University of Virginia Health Sciences Center, Charlottesville.
Am J Clin Pathol. 1994 Aug;102(2):163-70. doi: 10.1093/ajcp/102.2.163.
To determine if immunohistochemistry might aid in the identification of neuroblastomatous foci in composite adrenal tumors, the authors analyzed two examples of composite adrenal pheochromocytoma-neuroblastoma, 18 pure pheochromocytomas, and six pure neuroblastomas using peanut agglutinin and a panel of antibodies directed against neuroendocrine and neural-associated antigens. Pure pheochromocytoma had the following immunopositivity: vimentin 14/18, chromogranin 18/18, synaptophysin 18/18, S100 protein 0/18 (tumor cells), neurofilament 14/18, J1 beta-tubulin (J1) 18/18, microtubule-associated protein-2 13/18, glial fibrillary acidic protein 13/18, and peanut agglutinin 17/18. Pure neuroblastoma reacted positively as follows: vimentin 0/6, chromogranin 5/6, synaptophysin 4/6, S100 protein 0/6 (tumor cells), neurofilament 5/6, J1 6/6, microtubule-associated protein-2 6/6, glial fibrillary acidic protein 1/6, and peanut agglutinin 6/6. Each component of both composite tumors reacted similarly to the pure neoplasms. Although the frequency of positive staining was similar for pheochromocytoma and neuroblastoma, the intensity and pattern differed for several antigens. Pheochromocytoma was diffusely positive for synaptophysin and chromogranin, whereas staining was focal and punctate in neuroblastoma. Microtubule-associated protein-2, J1, and neurofilament antibodies highlighted the fibrillar background of neuroblastoma, which pheochromocytoma lacked. Pheochromocytoma contained focal, ball-like immunoreactivity for glial fibrillary acidic protein and vimentin, which was absent in neuroblastoma. These immunohistochemical distinctions can assist the clinically important recognition of neuroblastomatous foci in composite adrenal pheochromocytoma-neuroblastoma.
为了确定免疫组织化学是否有助于识别复合性肾上腺肿瘤中的神经母细胞瘤灶，作者使用花生凝集素以及一组针对神经内分泌和神经相关抗原的抗体，分析了两例复合性肾上腺嗜铬细胞瘤-神经母细胞瘤、18例纯嗜铬细胞瘤和6例纯神经母细胞瘤。纯嗜铬细胞瘤具有以下免疫阳性结果：波形蛋白14/18、嗜铬粒蛋白18/18、突触素18/18、S100蛋白0/18（肿瘤细胞）、神经丝14/18、J1β-微管蛋白（J1）18/18、微管相关蛋白-2 13/18、胶质纤维酸性蛋白13/18以及花生凝集素17/18。纯神经母细胞瘤的阳性反应如下：波形蛋白0/6、嗜铬粒蛋白5/6、突触素4/6、S100蛋白0/6（肿瘤细胞）、神经丝5/6、J1 6/6、微管相关蛋白-2 6/6、胶质纤维酸性蛋白1/6以及花生凝集素6/6。两例复合性肿瘤的每个成分与纯肿瘤的反应相似。尽管嗜铬细胞瘤和神经母细胞瘤的阳性染色频率相似，但几种抗原的强度和模式有所不同。嗜铬细胞瘤的突触素和嗜铬粒蛋白呈弥漫性阳性，而神经母细胞瘤的染色为局灶性和点状。微管相关蛋白-2、J1和神经丝抗体突出了神经母细胞瘤的纤维状背景，而嗜铬细胞瘤缺乏这种背景。嗜铬细胞瘤含有局灶性、球状的胶质纤维酸性蛋白和波形蛋白免疫反应性，而神经母细胞瘤中不存在这种反应性。这些免疫组织化学差异有助于在临床上重要地识别复合性肾上腺嗜铬细胞瘤-神经母细胞瘤中的神经母细胞瘤灶。
