The diagnostic significance of reticulin stain in biopsy of adrenocortical carcinoma
Abstract
Aims
To investigate the diagnostic significance of reticulin stain in biopsy of adrenocortical carcinoma.
Methods and results
21 cases of adrenal mass biopsy specimens collected at Sun Yat-sen University Cancer Center from November 2008 to July 2021 which included 19 cases of adrenal cortical carcinoma (ACC) and 2 cases of normal adrenal cortical were evaluated for their histologic，immunohistochemical（IHC）and reticulin stain features, and relevant literature was reviewed. The nuclei of ACC cancer cells were deeply stained, varying in size. Varying degrees of nuclear atypia, mitotic figures, focal necrosis and tumor giant cells were visible in ACC. Most of the cytoplasm was eosinophilic, some of the cytoplasm was transparent and the ACC cancer cells were nested, cord-like or diffuse distribution. In contrast, 2 cases of normal adrenal cortex puncture tissues showed that the cytoplasm of adrenal cortex cells was partially transparent, partly eosinophilic, with small nuclei and no atypia. Among ACC patients, 4 cases (4/19) were positive for CK. 6 cases (6/19) were positive for Vimentin. 8 cases (8/19) were positive for Inhibin-a, and 7 cases (7/19) were Melan-A positive. 7 patients (7/19) were positive for SF-1. 11 patients (11/19) were Syn positive and 4 patients (4/19) were CD56 positive. The Ki-67 index of the patients ranged from 2% to 90%. The reticulin stain of 2 cases of normal adrenal cortex showed that the reticular fibers were arranged regularly and completely wrapped the adrenal cortex cell. In the reticulin stain, a complete reticular fiber appeared, and the thickness of the fiber was moderate and uniform. In 19 cases of ACC, the reticular fiber was incomplete and damaged (19/19), mainly manifested as discontinuity, breakage, disorder, sparseness or disappearance.
Conclusion
Reticulin stain was an effective method for accurate diagnosis of adrenal cortical carcinoma.
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References
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