말초신경초 종양의 특징을 지닌 개 신경종의 조직병리학적 및 면역조직화학적 진단 Canine nervous-tissue tumors with features of peripheral nerve sheath tumor: histopathological and immunohistochemical findings원문보기
Canine peripheral nerve sheath tumors (PNSTs) are spindle cell tumors that arise from Schwann cells, perineural cells, fibroblasts or all of them. Based on the morphology and biologic behavior, PNSTs are divided into benign PNST (BPNST) and malignant PNST (MPNST) forms. The aim of this study is to d...
Canine peripheral nerve sheath tumors (PNSTs) are spindle cell tumors that arise from Schwann cells, perineural cells, fibroblasts or all of them. Based on the morphology and biologic behavior, PNSTs are divided into benign PNST (BPNST) and malignant PNST (MPNST) forms. The aim of this study is to diagnose the two cases of neoplastic tissue samples with features of PNSTs by the histopathology and immunohistochemistry. The study was performed using two specimens from small animal clinic. The first case, A was a mass, 3~4 cm in diameter, extruded from vaginal mucosa of 10-year-old spayed female mixed-breed dog. And the second case, B was a subcutaneous mass, 1.5 cm in diameter, which is originated from right hind leg of 9-year-old castrated male mixed-breed dog. Two cases were stained with hematoxylin and eosin (H&E) for histopathological examination. And also immunohistochemistry (IHC) was performed by the avidin-biotin peroxidase complex (ABC) method with antibodies specific for the following proteins: S-100 protein, smooth muscle actin (SMA) and epidermal growth factor receptor (EGFR). In results, Antoni B schwannoma pattern characterized by pleomorphic, round and fusiform polygonal cells was seen in A. In B, Antoni A pattern, densely packed spindle cells arranged in interlacing bundles was seen in addition to Antoni B pattern. In IHC, cytoplasms of neoplastic cells were diffusely labeled for S-100 expression in A and B. For SMA, both A and B show negative expression. And for EGFR, A shows negative expression but B shows partially positive expression in areas of Antoni B schwannoma pattern. The histopathologic features of two cases coupled with the S-100 immunoreactivity led to a diagnosis of PNST. For SMA, both A and B show negative expression. The diagnosis of A will be a BPNST with the negative result and B will be a MPNST with the positive result for EGFR.
Canine peripheral nerve sheath tumors (PNSTs) are spindle cell tumors that arise from Schwann cells, perineural cells, fibroblasts or all of them. Based on the morphology and biologic behavior, PNSTs are divided into benign PNST (BPNST) and malignant PNST (MPNST) forms. The aim of this study is to diagnose the two cases of neoplastic tissue samples with features of PNSTs by the histopathology and immunohistochemistry. The study was performed using two specimens from small animal clinic. The first case, A was a mass, 3~4 cm in diameter, extruded from vaginal mucosa of 10-year-old spayed female mixed-breed dog. And the second case, B was a subcutaneous mass, 1.5 cm in diameter, which is originated from right hind leg of 9-year-old castrated male mixed-breed dog. Two cases were stained with hematoxylin and eosin (H&E) for histopathological examination. And also immunohistochemistry (IHC) was performed by the avidin-biotin peroxidase complex (ABC) method with antibodies specific for the following proteins: S-100 protein, smooth muscle actin (SMA) and epidermal growth factor receptor (EGFR). In results, Antoni B schwannoma pattern characterized by pleomorphic, round and fusiform polygonal cells was seen in A. In B, Antoni A pattern, densely packed spindle cells arranged in interlacing bundles was seen in addition to Antoni B pattern. In IHC, cytoplasms of neoplastic cells were diffusely labeled for S-100 expression in A and B. For SMA, both A and B show negative expression. And for EGFR, A shows negative expression but B shows partially positive expression in areas of Antoni B schwannoma pattern. The histopathologic features of two cases coupled with the S-100 immunoreactivity led to a diagnosis of PNST. For SMA, both A and B show negative expression. The diagnosis of A will be a BPNST with the negative result and B will be a MPNST with the positive result for EGFR.
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문제 정의
본 연구의 목적은 PNST의 특징을 갖는 신경종양의 2예를 조직병리학적 및 면역염색학적 방법을 이용하여 진단함으로써 소동물 임상에 도움을 주고자 보고하는 바이다.
제안 방법
B예의 Antoni B 영역에서 EGFR에 양성발현을 보이므로 악성의 PNST로 진단하였다. A예는 PNST이지만 면역염색과 조직병리학적 결과를 기초로 하여 양성종양으로 진단하였다.
조직병리학적 소견을 통해 증례 1과 2 모두에서 schwannoma pattern이 관찰되었으며 면역염색 소견에서 S-100 protein에 양성을 나타냈다. 따라서 두 증례 모두 PNST로 진단하였다. S-100 protein은 신경집세포, 멜라닌세포, 신경아교세포로 구성된 신경릉세포, 연골세포, 근상피세포, 지방세포, 대식세포 등에서 유래되는 산성(acidic)의 단백질로서 vimentin과 함께PNST에서 높은 양성율을 나타내는 것으로 알려져 있기 때문이다(Chijiwa 등, 2004; Franziska 등, 2015; Silvia 등, 2016; Sirri 등, 2016).
대상 데이터
병리조직학적 소견으로 증례 1은 Antoni B schwannoma pattern으로 관찰되었다. 느슨하게 짜여진 다형태의 둥글고, 방추형의 세포들이 관찰되었으며, 이들 방추형 세포는 점액성 혹은 유리질화된 기질 또는 아교질 등에 의해 임의적으로 배열되어 있었다(Fig.
본 연구는 경기도 고양시 소재 동물병원에서 의뢰받은 2예를 대상으로 진행하였다. 첫번째 예(증례 1)는 10년령의 중성화된 잡종 암컷의 질점막으로부터 돌출된 약 3 cm 직경의 종괴였으며, 두번째 예(증례 2)는 9년령의 중성화된 잡종 수컷의 뒷다리에 생긴 약 1.
이론/모형
면역염색은, tri-ethoxysilyl propylamin이 처리된 slide glass에 올려서 진행하였다. ABC법(avidin-biotin peroxidase complex method)을 사용하였으며 발색제로는 3,30 diaminobenzidine (DAB)를 선택하였다. 또한 sodium citrate 용액을 약 90∼100℃로 가열하여 pH 9로 항원복구과정을 수행하였다.
성능/효과
조직병리학적 소견을 통해 증례 1과 2 모두에서 schwannoma pattern이 관찰되었으며 면역염색 소견에서 S-100 protein에 양성을 나타냈다. 따라서 두 증례 모두 PNST로 진단하였다.
질의응답
핵심어
질문
논문에서 추출한 답변
신경종양은 어떻게 분류되는가?
이에 따라 ‘개 연부조직의 방추형 세포종양’(spindle cell tumor)이라고도 사용되어 왔다(McColl과 Middleton, 1998). 신경종양은 신경초종(schwannoma), 신경섬유종(neurofibroma), 혈관주위세포종(hemangiopericytoma)으로 분류된다. 악성종양은 병변부가 희고 단단한 결절로 구성된 경우가 많으며 침습성이 강한 특징이 있다.
악성종양의 특징은 어떠한가?
신경종양은 신경초종(schwannoma), 신경섬유종(neurofibroma), 혈관주위세포종(hemangiopericytoma)으로 분류된다. 악성종양은 병변부가 희고 단단한 결절로 구성된 경우가 많으며 침습성이 강한 특징이 있다. 이들 말초신경초 종양(peripheral nerve sheath tumors, PNST)은 림프계로는 전이되지 않는 특징을 지니며 노령의 개에서 주로 발생한다(Koestner와 Higgins, 2002).
말초신경초 종양의 일반적인 임상증상으로는 무엇이 있는가?
신경집세포(Schwann cell)는 손상을 받은 조직이나 세포가 정상기능을 회복하는데 도움을 주는데, 이 과정에서 종양으로 발전하는 것으로 추정되지만 규명한 연구결과는 아직 없다(Sughrue 등, 2008). PNST의 일반적인 임상증상으로는 원인불명의 앞다리나 뒷다리의 심한 통증, 만성적인 파행, 근육위축, 운동실조, 불완전 단일마비, 고유수용감각이상, 자가절단, 근긴장저하, 반사저하 등이 있다(Koestner와 Higgins, 2002). 척수가 종양에 의해 압박을 받는 경우에는 Honer 증후군이나 마비를 보이기도 한다.
참고문헌 (14)
Abbas T, Javad J, Fariba K, Ehsan H, Alimohammad B, Mehdi AH , Mohammadmehdi M. 2013. Ulnar malignant peripheral nerve sheath tumour diagnosis in a mixed-breed dog as a model to study human: histologic, immunohistochemical and clinicopathologic study. Diagn Pathol 8: 86.
Chijiwa K, Uchida K, Tateyama S. 2004. Immuno- histochemical evaluation of canine peripheral nerve sheath tumors and other soft tissue sarcomas. Vet Pathol 41: 307-318.
Franziska H, Gwendolyna R, Kershaw O, Corinna EJ. 2015. Malignant peripheral nerve sheath tumor of the third eyelid in a 3-year-old Rhodesian Ridgeback. Clin Case Rep 3: 50-56.
Gisele S, Daniele M, Fabiana W, Neusa B, Tatiane TN, Gustavo S, Luciana S, David D. 2015. Retrospective canine skin peripheral nerve sheath tumors data with emphasis on histologic, immuno-histochemical and prognostic factors. Pesq Vet Bras 35: 965-974.
Jianqiang W, Deanna M, Edwin J, David W, Kimberly B, Ami V, Eric B, James R, Timothy P, Anat O, Nancy R. 2014. EGFR-STAT3 signaling promotes formation of malignant peripheral nerve sheath tumors. Oncogene 33: 173-180.
Klopfleisch R, Meyer A, Lenze D, Hummel M, Gruber AD. 2013. Canine cutaneous peripheral nerve sheath tumours versus fibrosarcomas can be differentiated by neuroectodermal marker genes in their transcriptome. J Comp Patho 148: 197-205.
Sawamoto O, Yamate J, Kuwamura M, Hagiwara R, Kurisu K. 1999. A canine peripheral nerve sheath tumor including peripheral nerve fibers. J Vet Med Sci 61: 1335-1338.
Silvia T, Irina A, Alexandra R, Fatima F, Fatima G. 2016. Molecular heterogeneity of canine cutaneous peripheral nerve sheath tumors: a drawback in the diagnosis refinement. In Vivo 30: 819-828.
Sirri R, Sabattini S, Bettini G, Mandrioli L. 2016. Reclassification of 21 presumptive canine peripheral nerve sheath tumors (PNST) using a literature-based immuno- histochemical panel. Acta Vet Beograd 66: 455-465.
Sughrue ME, Jon L, Barbarol NM. 2008. Pain as a symptom of peripheral nerve sheath tumors: clinical significance and future therapeutic directions. J Brachial Plex Peripher Nerve Inj 3: 6.
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