Morphometric analysis of "pancitokeratin-positive" neoplastic lesions of the lymph nodes of the neck

Authors

  • O. V. Poslavska State Establishment “Dnipropetrovsk Medical Academy of Health Ministry of Ukraine”, Dnipro, Ukraine,
  • I. S. Shponka State Establishment “Dnipropetrovsk Medical Academy of Health Ministry of Ukraine”, Dnipro, Ukraine,
  • P. A. Hritsenko State Establishment “Dnipropetrovsk Medical Academy of Health Ministry of Ukraine”, Dnipro, Ukraine,
  • O. A. Alekseenko State Establishment “Dnipropetrovsk Medical Academy of Health Ministry of Ukraine”, Dnipro, Ukraine,

DOI:

https://doi.org/10.14739/2310-1237.2017.3.118730

Keywords:

neoplasms, lymph nodes, ImageJ

Abstract

Cancer metastasis to the lymph nodes of the neck from an unknown primary source is a histological diagnosis of metastatic carcinoma without another clinical manifestation of the malignant process. In addition to the oropharynx and nasopharynx, metastasis to the lymph nodes of the neck can come from anywhere in the head and neck, as well as another organ. Such cancers are more often diagnosed between the fifth and seventh decades with a peak incidence in the sixth and remain an actual diagnostic problem.

The aim of the work was to investigate the complex of morphological, morphometric and immunohistochemical characteristics of elements of pancitokeratin-positive tumor tissue of metastatic origin in the lymph nodes of the neck for the improvement of diagnostic algorithms.

Materials and methods. A retrospective analysis of 41 cases of neoplastic lesions of the lymph nodes of the neck was made without other clinical manifestations of primary localization during the period August 2016 - July 2017. The mean age of the patients was 47.68 ± 16.41 years (median 46).

Results. Squamous cell carcinomas of the head and neck have an accessible visualization and rare phenotypes that produce metastatic cells before the increase in the primary focus (only 2 of 41), therefore should not fall under the ciphers of cancers of unknown primary localization. But the number of observations of metastatic lesions of the lymph nodes in the neck of category 3 "confirmed cancer of unknown primary localization" of our region is much higher than the world statistics, as a result of incomplete examination of patients at the "pre-biopsy stage".

Conclusions. In the diagnosis of Cytokeratin, PAN AE1 / AE3 (+) metastatic lesions of the lymph nodes, it is advisable to use objective parameters of the nuclei of tumor cells (area, perimeter, roundness coefficient) along with the primary panel of IGH markers (Cytokeratin, PAN AE1 / AE3, Vimentin, CD45, S100), comparing them with the size of conventional lymphocytes. This reduces the subjectivity of the evaluation and significantly helps to determine the diagnostic algorithm of the second stage of the IHC study.

References

Carollo, A., Rosenkranz, T., & Smith, D. J. (2017) Cancer of unknown primary (CUP) presenting as a Spigelian hernia: a case report. J Surg Case Rep, 2017(4), rjw218. doi: 10.1093/jscr/rjw218.

Greco, F. A., Lennington, W. J., Spigel, D. R., Varadhachary, G. R., & Hainsworth, J. D. (2012) Carcinoma of Unknown Primary Site: Outcomes in Patients with a Colorectal Molecular Profile Treated with Site Specific Chemotherapy. Journal of Cancer Therapy, 3, 37–43. doi: 10.4236/jct.2012.31005.

Vajdic, C. M., Schaffer, A. L., Dobbins, T. A., Ward, R. L., Er, C. C., & Pearson, S. A. (2015) Health service utilisation and investigations before diagnosis of cancer of unknown primary (CUP): A population-based nested case-control study in Australian Government Department of Veterans' Affairs clients. Cancer Epidemiol, 39(4), 585–592. doi: 10.1016/j.canep.2015.02.006.

Lin, F., & Haiyan, Liu. (2014) Immunohistochemistry in Undifferentiated Neoplasm / Tumor of Uncertain Origin. Arch Pathol Lab Med., 138, 1583–1610. doi: 10.5858/arpa.2014-0061-RA.

Pentheroudakis, G., Greco, F. A., & Pavlidis, N. (2009) Molecular assignment of tissue of origin in cancer of unknown primary may not predict response to therapy or outcome: a systematic literature review. Cancer Treat Rev., 35(3), 221–227. doi: 10.1016/j.ctrv.2008.10.003.

Erlander, M. G., Ma, X. J., Kesty, N. C., Bao, L., Salunga, R., & Schnabel, C. A. (2011) Performance and clinical evaluation of the 92-gene real-time PCR assay for tumor classification. The Journal of Molecular Diagnostics, 13(5), 493–502. doi: 10.1016/j.jmoldx.2011.04.004.

Vajdic, C. M., & Goldstein, D. (2015) Cancer of unknown primary site. Aust Fam Physician, 44(9), 640–643.

Varadhachary, G. R., & Raber, M. N. (2014) Cancer of unknown primary site. N. engl. J. Med., 371, 757–765. doi: 10.1056/NEJMra1303917.

Poslavskaya, O. V. (2015) Metodolohiia vykorystannia prohramnoho zabezpechennia dlia analizu tsyfrovykh mikrofotohrafii na bazi kursu patomorfolohii z metoiu pidvyshchennia profesiinoho rivnia studentiv i naukovtsiv [Methodology for the use of software for the analysis of digital micrographs on the base of pathomorphology course in order to increase the professional level of students and scientists]. Morpholohiia, 9(3), 122–6. [in Ukrainian].

Poslavskaya, O. V. (2016) Vyznachennia liniinykh rozmiriv ta ploshch okremykh morfolohichnykh obiektiv na mikrofotohrafiiakh za dopomohoiu prohramy ImageJ [Determination of linear dimensions and square surfaces areas of morphological objects on micrographs using ImageJ software]. Morpholohiia, 10(3), 377–81. [in Ukrainian].

How to Cite

1.
Poslavska OV, Shponka IS, Hritsenko PA, Alekseenko OA. Morphometric analysis of "pancitokeratin-positive" neoplastic lesions of the lymph nodes of the neck. Pathologia [Internet]. 2017Dec.22 [cited 2024Mar.2];(3). Available from: http://pat.zsmu.edu.ua/article/view/118730

Issue

Section

Original research