DIAGNOSTIC UTILITY OF CD34 MARKER IN DISTINGUISHING PRIMARY VERSUS SECONDARY HEPATIC CARCINOMAS: A RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL.

DR. ROHINI DHANYA C S; DR. ANURADHA C K RAO

Volume : VIII, Issue : III, March - 2019

DIAGNOSTIC UTILITY OF CD34 MARKER IN DISTINGUISHING PRIMARY VERSUS SECONDARY HEPATIC CARCINOMAS: A RETROSPECTIVE STUDY IN A TERTIARY CARE HOSPITAL.

Dr. Rohini Dhanya C S, Dr. Anuradha C K Rao

Abstract :

Distinguishing hepatocellular carcinoma (HCC) from metastatic carcinomas in malignant liver lesions is a well recognized problem in cytology and histopathology. Pathologic evaluation of biopsy samples plays a key role in establishing an accurate diagnosis for patient management. Morphologic features and a wide variety of immunohistochemistry (IHC) studies are used to solve multiple diagnostic dilemmas. In this study, we assess the role of CD34 in thin core biopsy material in malignant liver lesions for differentiating primary from secondary malignancies of liver. OBJECTIVE: The objective of the study was to assess the diagnostic utility of CD34 IHC stain on liver biopsies of clinicoradiologically/cytologically suspected malignant liver tumours to differentiate primary from metastatic malignancies. MATERIAL AND METHODS: Formalin fixed, paraffin embedded tissue sections of thin core biopsies were assessed from 21 cases of malignant hepatocytic lesions. HCC were scored for nuclear grade. Sections were immunostained using monoclonal antibody against CD34 antigen and scored semi–quantitatively. RESULTS: A higher percentage of HCC were CD34 positive (92%) as compared to metastatic carcinomas (75%); predominantly showing complete staining (54%) with endothelial rimming (92.3%). Cholangiocarcinoma showed no reaction to CD34 while metastatic carcinomas showed mostly incomplete positivity (50%). In contrast to metastatic carcinomas, 8(53.8%) cases of HCC showed grade 3 and 4, 4(30.8%) cases grade 1 and 2. CONCLUSION: CD34 as an IHC marker for endothelial staining is not specific for HCC, but the rimming pattern of staining seen in HCC is absent in metastasis and can be considered to be diagnostic