Diagnostic Utility of Pax8, Pax2, and NGFR Immunohistochemical Expression in Pediatric Renal Tumors

被引:13
|
作者
Arva, Nicoleta C. [1 ]
Bonadio, Jeffrey [2 ]
Perlman, Elizabeth J. [1 ]
Cajaiba, Mariana M. [1 ]
机构
[1] Ann & Robert H Lurie Childrens Hosp Chicago, Dept Pathol & Lab Med, 225 E Chicago Ave, Chicago, IL 60611 USA
[2] Univ Pittsburgh, Med Ctr, Dept Pathol, Pittsburgh, PA USA
关键词
pediatric renal tumor; Pax8; Pax2; nerve growth factor receptor; Wilms tumor; clear cell sarcoma of the kidney; CLEAR-CELL SARCOMA; LINEAGE SPECIFICATION; KIDNEY; GENES; IMMUNOREACTIVITY; MORPHOGENESIS; TISSUES; MARKER; LIM1;
D O I
10.1097/PAI.0000000000000520
中图分类号
R602 [外科病理学、解剖学]; R32 [人体形态学];
学科分类号
100101 ;
摘要
Pediatric renal tumors (PRT) with small round blue or spindle cell morphology can be diagnostically challenging and only a limited number of immunohistochemical markers have been documented to help in the diagnosis: paired box (Pax) 2 and nerve growth factor receptor (NGFR) positivity have been demonstrated in Wilms tumor (WT) and clear cell sarcoma of the kidney (CCSK), respectively. However, the immunohistochemical expression of these markers in other PRT remains unknown. This study investigated Pax8, Pax2, and NGFR immunophenotype in a large series of PRT. Pax8 and Pax2 showed an identical staining pattern, and were expressed in all (100%) WT while most CCSK were negative. All congenital mesoblastic nephromas, metanephric stromal tumors, primitive neuroectodermal tumors, desmoplastic small round blue cell tumors, most rhabdoid tumors, and synovial sarcomas were negative for Pax8. NGFR was expressed in 96% of CCSK (diffuse expression in 91%). Only a minority of WT stained for NGFR: 16% showed expression in the blastemal and 25% in the mesenchymal components. NGFR expression was noted in synovial sarcomas (67%, with diffuse expression seen in only 1 case, 8%), rhabdoid tumors (19%), cellular congenital mesoblastic nephromas (13%) and metanephric stromal tumors (12.5%). Primitive neuroectodermal tumors and desmoplastic small round blue cell tumors were negative for NGFR. In conclusion, Pax8/Pax2 and NGFR are sensitive markers for the diagnosis of WT and CCSK, respectively. However, their specificity is limited by variable reactivity within a subset of other renal neoplasms.
引用
收藏
页码:721 / 726
页数:6
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