The diagnostic utility of Merkel cell polyoma virus immunohistochemistry in cytology specimens

IF 1.2 4区医学 Q4 CELL BIOLOGY Cytopathology Pub Date : 2024-02-14 DOI:10.1111/cyt.13366

Aysha Mubeen, Jeffrey K. Mito

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Abstract

Objective

Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine neoplasm that predominantly affects elderly and immunocompromised patients. Merkel cell polyoma virus (MCPyV) is clonally integrated into the majority of MCCs and has been linked to patient outcomes, playing a central role in the pathogenesis of the disease. We aimed to assess the utility of MCPyV immunohistochemistry (IHC) in the diagnosis of MCC in cytology cell block specimens and correlating with clinicopathologic features.

Methods

Fifty-three cytology samples of MCC with sufficient cell block material were stained for MCPyV by IHC and scored semi-quantitatively in extent and intensity. Morphologic mimics of MCC including small cell lung carcinoma (n = 10), non-Hodgkin lymphoma (n = 10), basaloid squamous cell carcinoma (n = 6) and other neuroendocrine carcinomas (n = 8) were stained in parallel. Positive staining was defined as >1% of the tumour cells showing at least moderate staining intensity.

Results

The cytologic features of MCC were characterized by high nuclear-cytoplasmic ratios, hyperchromatic nuclei with ‘salt and pepper’ chromatin, and nuclear moulding. MCPyV was detected in 24 of 53 cases (45%). Staining was strong and diffuse in roughly half of the positive samples. Of the morphologic mimics, one follicular lymphoma showed strong and diffuse staining. In contrast to prior studies, we saw no association between MCPyV status and patient outcomes.

Conclusion

Merkel cell polyoma virus IHC is highly specific (97%) for the diagnosis of MCC in our cohort, and can serve as a useful diagnostic tool for distinguishing MCC for morphologic mimics.

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细胞学标本中梅克尔细胞多瘤病毒免疫组化的诊断作用。

目的：梅克尔细胞癌（MCC）是一种侵袭性皮肤神经内分泌肿瘤，主要影响老年和免疫力低下的患者。梅克尔细胞多瘤病毒（MCPyV）克隆整合到大多数梅克尔细胞癌中，并与患者的预后有关，在该病的发病机制中起着核心作用。我们的目的是评估 MCPyV 免疫组织化学（IHC）在细胞学细胞块标本中诊断 MCC 的效用以及与临床病理特征的相关性：方法：用 IHC 对 53 份有足够细胞块材料的 MCC 细胞学样本进行 MCPyV 染色，并对其范围和强度进行半定量评分。同时对 MCC 的形态学模拟物进行染色，包括小细胞肺癌（10 例）、非霍奇金淋巴瘤（10 例）、基底鳞状细胞癌（6 例）和其他神经内分泌癌（8 例）。大于 1% 的肿瘤细胞显示至少中等程度的染色强度即为阳性染色：MCC的细胞学特征为高核-胞质比率、染色质为 "盐和胡椒 "的高色素核以及核模塑。53 例病例中有 24 例（45%）检测到 MCPyV。大约一半的阳性样本染色较强，呈弥漫性。在形态学拟态样本中，有一个滤泡淋巴瘤出现了强烈的弥漫性染色。与之前的研究不同，我们发现 MCPyV 状态与患者预后之间没有关联：梅克尔细胞多瘤病毒 IHC 对我们队列中 MCC 的诊断具有高度特异性（97%），可作为一种有用的诊断工具，用于区分 MCC 与形态学拟态。

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来源期刊

Cytopathology 生物-病理学

CiteScore

2.30

自引率

15.40%

发文量

107

审稿时长

6-12 weeks

期刊介绍： The aim of Cytopathology is to publish articles relating to those aspects of cytology which will increase our knowledge and understanding of the aetiology, diagnosis and management of human disease. It contains original articles and critical reviews on all aspects of clinical cytology in its broadest sense, including: gynaecological and non-gynaecological cytology; fine needle aspiration and screening strategy. Cytopathology welcomes papers and articles on: ultrastructural, histochemical and immunocytochemical studies of the cell; quantitative cytology and DNA hybridization as applied to cytological material.