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Der Pathologe

, Volume 31, Issue 5, pp 379–384 | Cite as

S100-Protein-positive Sustentakularzellen in pulmonalen Karzinoiden und thorakalen Paragangliomen

Differenzialdiagnostische und prognostische Bedeutung
  • A. WarthEmail author
  • S. Krysa
  • T. Zahel
  • H. Hoffmann
  • P. Schirmacher
  • P.A. Schnabel
  • E. Herpel
Originalien

Zusammenfassung

Die klassische Histomorphologie von Paragangliomen ist als so genanntes „Zellballenmuster“ beschrieben. Die nestartig angeordneten Zellverbände sind hierbei von S100-Protein-exprimierenden Sustentakularzellen (SZ) umgeben, welche mittels ihrer Zellfortsätze ein Netzwerk mit stacheldrahtähnlicher Morphologie ausbilden. In adrenalen und extraadrenalen Paragangliomen korreliert die Prävalenz von SZ invers mit der Prognose der Patienten. Um die Prävalenz sowie die bisher unklare differenzialdiagnostische und prognostische Relevanz S100-positiver Zellen in pulmonalen Karzinoiden zu analysieren, wurden 26 Tumorlets, 147 typische und atypische pulmonale Karzinoide und 10 thorakale Paragangliome immunhistochemisch untersucht. Dabei zeigte sich eine ähnliche Verteilung der Zellen in pulmonalen Karzinoiden und thorakalen Paragangliomen. Alle Patienten mit pulmonalen Karzinoiden und schlechtem klinischem Verlauf wiesen geringe Zahlen S100-positiver Zellen im Tumorgewebe auf, was analog zu Paragangliomen auf eine mögliche prognostische Relevanz hindeutet. Zusammenfassend erscheinen S100-positive Zellen in der Differenzialdiagnose thorakaler Paragangliome und pulmonaler Karzinoide kein verlässliches Kriterium zu sein, könnten jedoch bei der prognostischen Einordnung dieser Entität hilfreich sein.

Schlüsselwörter

S100-Protein Sustentakularzellen Tumorlets Karzinoide Paragangliome 

S100 protein positive sustentacular cells in pulmonary carcinoids and thoracic paragangliomas

Differential diagnostic and prognostic evaluation

Abstract

Paragangliomas have a classical histomorphology comprising a so-called “Zellballen” or nesting pattern with surrounding S100 protein positive sustentacular cells (SC) which form a meshwork with a wire-fence appearance. In adrenal and extra-adrenal paragangliomas the prevalence of SC is inversely associated with the patients’ outcome. In order to get more insight into the prevalence as well as the prognostic and differential diagnostic value of this cell population in pulmonary carcinoids, we investigated a panel of 26 tumorlets, 147 typical and atypical pulmonary carcinoids and ten thoracic paragangliomas immunohistochemically. We were able to demonstrate that S100 protein positive cells are similarly distributed in both thoracic paragangliomas and pulmonary carcinoids. Hence, the presence and distribution of these cells does not appear to represent a reliable criterion in differential diagnosis. Moreover, all pulmonary carcinoid patients with a worse outcome had low numbers of or no S100 protein positive cells in their tissue specimens. Thus, the prevalence of these cells may potentially aid in prognostic assessment of pulmonary carcinoids, especially in biopsies.

Keywords

S100 protein Sustentacular cells Tumorlets Carcinoids Paraganglioma 

Notes

Interessenkonflikt

Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.

Literatur

  1. 1.
    Travis WD, Brambilla E, Müller-Hermelink HK, Harris CC (eds) (2004) World Health Organization classification of tumors. Pathology and genetics of tumours of the lung, pleura, thymus and heart. IARC, LyonGoogle Scholar
  2. 2.
    Achilles E, Padberg BC, Holl K et al (1991) Immunocytochemistry of paragangliomas – value of staining for S-100 protein and glial fibrillary acid protein in diagnosis and prognosis. Histopathology 18:453–458CrossRefPubMedGoogle Scholar
  3. 3.
    Aubertine CL, Flieder DB (2004) Primary paraganglioma of the lung. Ann Diagn Pathol 8:237–241CrossRefPubMedGoogle Scholar
  4. 4.
    Barbareschi M, Detassis C, Dalla Palma P et al (1991) Atypical bronchial carcinoids lack S-100 positive sustentacular cells. Pathol Res Pract 187:856PubMedGoogle Scholar
  5. 5.
    Barbareschi M, Ferrero S, Frigo B et al (1988) Bronchial carcinoid with S-100 positive sustentacular cells. Tumori 74:705–711PubMedGoogle Scholar
  6. 6.
    Barbareschi M, Frigo B, Mosca L et al (1990) Bronchial carcinoids with S-100 positive sustentacular cells. A comparative study with gastrointestinal carcinoids, pheochromocytomas and paragangliomas. Pathol Res Pract 186:212–222PubMedGoogle Scholar
  7. 7.
    Capella C, Gabrielli M, Polak JM et al (1979) Ultrastructural and histological study of 11 bronchial carcinoids. Evidence for different types. Virchows Arch A Pathol Anat Histol 381:313–329CrossRefPubMedGoogle Scholar
  8. 8.
    Gosney JR, Denley H, Resl M (1999) Sustentacular cells in pulmonary neuroendocrine tumours. Histopathology 34:211–215CrossRefPubMedGoogle Scholar
  9. 9.
    Hagemeyer O, Gabius HJ, Kayser K (1994) Paraganglioma of the lung – developed after exposure to nuclear radiation by the Tschernobyl atomic reactor accident? Respiration 61:236–239CrossRefPubMedGoogle Scholar
  10. 10.
    Hironaka M, Fukayama M, Takayashiki N et al (2001) Pulmonary gangliocytic paraganglioma: case report and comparative immunohistochemical study of related neuroendocrine neoplasms. Am J Surg Pathol 25:688–693CrossRefPubMedGoogle Scholar
  11. 11.
    Kim KN, Lee KN, Roh MS et al (2008) Pulmonary paraganglioma manifesting as an endobronchial mass. Korean J Radiol 9:87–90CrossRefPubMedGoogle Scholar
  12. 12.
    Kliewer KE, Cochran AJ (1989) A review of the histology, ultrastructure, immunohistology, and molecular biology of extra-adrenal paragangliomas. Arch Pathol Lab Med 113:1209–1218PubMedGoogle Scholar
  13. 13.
    Lamy AL, Fradet GJ, Luoma A et al (1994) Anterior and middle mediastinum paraganglioma: complete resection is the treatment of choice. Ann Thorac Surg 57:249–252CrossRefPubMedGoogle Scholar
  14. 14.
    Min KW (1998) Diagnostic usefulness of sustentacular cells in paragangliomas: immunocytochemical and ultrastructural investigation. Ultrastruct Pathol 22:369–376CrossRefPubMedGoogle Scholar
  15. 15.
    Min KW (2001) Spindle cell carcinoids of the lung with paraganglioid features: a reappraisal of their histogenetic origin from paraganglia using immunohistochemical and electronmicroscopic techniques. Ultrastruct Pathol 25:207–217CrossRefPubMedGoogle Scholar
  16. 16.
    Moran CA, Albores-Saavedra J, Wenig BM et al (1997) Pigmented extraadrenal paragangliomas. A clinicopathologic and immunohistochemical study of five cases. Cancer 79:398–402CrossRefPubMedGoogle Scholar
  17. 17.
    Nakajima T, Watanabe S, Sato Y et al (1982) An immunoperoxidase study of S-100 protein distribution in normal and neoplastic tissues. Am J Surg Pathol 6:715–727CrossRefPubMedGoogle Scholar
  18. 18.
    Pelosi G, Zancanaro C, Sbabo L et al (1992) Development of innumerable neuroendocrine tumorlets in pulmonary lobe scarred by intralobar sequestration. Immunohistochemical and ultrastructural study of an unusual case. Arch Pathol Lab Med 116:1167–1174PubMedGoogle Scholar
  19. 19.
    Resl M, Kral B, Simek J et al (1996) S-100 protein positive (sustentacular) cells in pulmonary carcinoid tumorlets: a quantitative study of 24 cases. Pathol Res Pract 192:414–417PubMedGoogle Scholar
  20. 20.
    Schroder HD, Johannsen L (1986) Demonstration of S-100 protein in sustentacular cells of phaeochromocytomas and paragangliomas. Histopathology 10:1023–1033CrossRefPubMedGoogle Scholar
  21. 21.
    Shibahara J, Goto A, Niki T et al (2004) Primary pulmonary paraganglioma: report of a functioning case with immunohistochemical and ultrastructural study. Am J Surg Pathol 28:825–829CrossRefPubMedGoogle Scholar
  22. 22.
    Warth A, Herpel E, Krysa S et al (2009) Chromosomal instability is more frequent in metastasized than in non-metastasized pulmonary carcinoids but is not a reliable predictor of metastatic potential. Exp Mol Med 41:349–353CrossRefPubMedGoogle Scholar
  23. 23.
    Warth A, Herpel E, Schmahl A et al (2008) Diffuse idiopathic pulmonary neuroendocrine cell hyperplasia (DIPNECH) in association with an adenocarcinoma: a case report. J Med Case Reports 2:21CrossRefPubMedGoogle Scholar
  24. 24.
    Warth A, Simon P, Capper D et al (2007) Expression pattern of the water channel aquaporin-4 in human gliomas is associated with blood-brain barrier disturbance but not with patient survival. J Neurosci Res 85:1336–1346CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • A. Warth
    • 1
    Email author
  • S. Krysa
    • 2
  • T. Zahel
    • 1
  • H. Hoffmann
    • 2
  • P. Schirmacher
    • 1
  • P.A. Schnabel
    • 1
  • E. Herpel
    • 1
  1. 1.Institut für PathologieUniversitätsklinikum HeidelbergHeidelbergDeutschland
  2. 2.Abteilung für ThoraxchirurgieThoraxklinik HeidelbergHeidelbergDeutschland

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