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.
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.
This is a preview of subscription content, log in via an institution to check access.
Literatur
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, Lyon
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 18:453–458
Aubertine CL, Flieder DB (2004) Primary paraganglioma of the lung. Ann Diagn Pathol 8:237–241
Barbareschi M, Detassis C, Dalla Palma P et al (1991) Atypical bronchial carcinoids lack S-100 positive sustentacular cells. Pathol Res Pract 187:856
Barbareschi M, Ferrero S, Frigo B et al (1988) Bronchial carcinoid with S-100 positive sustentacular cells. Tumori 74:705–711
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 186:212–222
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 381:313–329
Gosney JR, Denley H, Resl M (1999) Sustentacular cells in pulmonary neuroendocrine tumours. Histopathology 34:211–215
Hagemeyer O, Gabius HJ, Kayser K (1994) Paraganglioma of the lung – developed after exposure to nuclear radiation by the Tschernobyl atomic reactor accident? Respiration 61:236–239
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 25:688–693
Kim KN, Lee KN, Roh MS et al (2008) Pulmonary paraganglioma manifesting as an endobronchial mass. Korean J Radiol 9:87–90
Kliewer KE, Cochran AJ (1989) A review of the histology, ultrastructure, immunohistology, and molecular biology of extra-adrenal paragangliomas. Arch Pathol Lab Med 113:1209–1218
Lamy AL, Fradet GJ, Luoma A et al (1994) Anterior and middle mediastinum paraganglioma: complete resection is the treatment of choice. Ann Thorac Surg 57:249–252
Min KW (1998) Diagnostic usefulness of sustentacular cells in paragangliomas: immunocytochemical and ultrastructural investigation. Ultrastruct Pathol 22:369–376
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 25:207–217
Moran CA, Albores-Saavedra J, Wenig BM et al (1997) Pigmented extraadrenal paragangliomas. A clinicopathologic and immunohistochemical study of five cases. Cancer 79:398–402
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 6:715–727
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 116:1167–1174
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 192:414–417
Schroder HD, Johannsen L (1986) Demonstration of S-100 protein in sustentacular cells of phaeochromocytomas and paragangliomas. Histopathology 10:1023–1033
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 28:825–829
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 41:349–353
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 2:21
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 85:1336–1346
Interessenkonflikt
Der korrespondierende Autor gibt an, dass kein Interessenkonflikt besteht.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Warth, A., Krysa, S., Zahel, T. et al. S100-Protein-positive Sustentakularzellen in pulmonalen Karzinoiden und thorakalen Paragangliomen. Pathologe 31, 379–384 (2010). https://doi.org/10.1007/s00292-010-1293-2
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00292-010-1293-2