Risk Stratification in Paragangliomas with PASS (Pheochromocytoma of the Adrenal Gland Scaled Score) and Immunohistochemical Markers
Introduction: Paragangliomas (PGLs) are rare tumours that arise in sympathetic and parasympathetic paraganglia and are derived from neural crest cells. Presence of metastasis is the only absolute criterion for malignancy. There is no single histo-morphological feature indicating malignant potent...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2016-09-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/8419/20565_CE(RA1)_F(T)_PF1(AHAK)_PFA(AK)_PF2(P_PR).pdf |
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| author | Maithili Mandar Kulkarni Siddhi Gaurish Sinai Khandeparkar Sanjay D. Deshmukh R.R. Karekar Vandana L. Gaopande Avinash R. Joshi Mrunal V. Kesari R.R. Shelke |
| author_facet | Maithili Mandar Kulkarni Siddhi Gaurish Sinai Khandeparkar Sanjay D. Deshmukh R.R. Karekar Vandana L. Gaopande Avinash R. Joshi Mrunal V. Kesari R.R. Shelke |
| author_sort | Maithili Mandar Kulkarni |
| collection | DOAJ |
| description | Introduction: Paragangliomas (PGLs) are rare tumours that
arise in sympathetic and parasympathetic paraganglia and
are derived from neural crest cells. Presence of metastasis is
the only absolute criterion for malignancy. There is no single
histo-morphological feature indicating malignant potential and
multiple parameters have been proposed to prognosticate
the individual case. This includes studies conducted using
Pheochromocytoma of the Adrenal Gland Scaled Score (PASS)
and Immunohistochemical (IHC) markers.
Aim: We have studied ten cases of paraganglioma and attempted
to correlate the prognosis with multiple clinicopathological
variables.
Materials and Methods: This study was done in a tertiary care
general hospital over a period of five years. Available clinical
records and histopathology slides of all patients were reviewed.
Using Pheochromocytoma of the Adrenal Gland Scaled
Score (PASS), we divided the cases into two groups-tumours
showing high risk behaviour (PASS≥4) and tumours showing
benign behaviour (PASS<4). IHC analysis was done using
synaptophysin, chromogranin, S100 and Ki67. We correlated
S100 immunoreactivity and Ki67 proliferative index with PASS
score. Both PASS score and IHC markers were also correlated
with clinical outcome.
Results: There were six Pheochromocytomas (PHC) and
four Paragangliomas (PGL). Two paragangliomas were
retroperitoneal and one each was located in ear (HNPGL) and
broad ligament. PASS score was ≥4 in five cases and <4 in five
cases. Out of five cases in which PASS was ≥4, three cases
showed clinical evidence of malignancy and two cases were
benign. All the cases in which PASS was <4 were clinically
benign. S100 immunoreactivity was grade 1 in two cases,
grade 2 in six cases and grade 3 in two cases. The cases in
which S100 immunoreactivity was grade 1 were malignant.
One case in which S100 was grade 2 was clinically malignant.
Ki67 labeling index was raised (>3%) in two cases, which were
malignant correlated with malignant PASS score.
Conclusion: We conclude that the following clinicopathological
parameters should be taken into account for risk assessment of
malignant behaviour of paragangliomas- location, size, PASS
score, S100 immunoreactivity and Ki67 labeling index. |
| first_indexed | 2024-12-13T06:42:12Z |
| format | Article |
| id | doaj.art-196ef325c2314fae816ae641ec15c863 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-13T06:42:12Z |
| publishDate | 2016-09-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-196ef325c2314fae816ae641ec15c8632022-12-21T23:56:24ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2016-09-01109EC01EC0410.7860/JCDR/2016/20565.8419Risk Stratification in Paragangliomas with PASS (Pheochromocytoma of the Adrenal Gland Scaled Score) and Immunohistochemical MarkersMaithili Mandar Kulkarni0Siddhi Gaurish Sinai Khandeparkar1Sanjay D. Deshmukh2R.R. Karekar3Vandana L. Gaopande4Avinash R. Joshi5Mrunal V. Kesari6R.R. Shelke7Associate Professor, Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.Associate Professor, Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.Professor, Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.Associate professor, Department of Medicine, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.Professor, Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.Professor, Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.Assistant Professor, Department of Pathology, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.Professor, Department of Surgery, Shrimati Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India.Introduction: Paragangliomas (PGLs) are rare tumours that arise in sympathetic and parasympathetic paraganglia and are derived from neural crest cells. Presence of metastasis is the only absolute criterion for malignancy. There is no single histo-morphological feature indicating malignant potential and multiple parameters have been proposed to prognosticate the individual case. This includes studies conducted using Pheochromocytoma of the Adrenal Gland Scaled Score (PASS) and Immunohistochemical (IHC) markers. Aim: We have studied ten cases of paraganglioma and attempted to correlate the prognosis with multiple clinicopathological variables. Materials and Methods: This study was done in a tertiary care general hospital over a period of five years. Available clinical records and histopathology slides of all patients were reviewed. Using Pheochromocytoma of the Adrenal Gland Scaled Score (PASS), we divided the cases into two groups-tumours showing high risk behaviour (PASS≥4) and tumours showing benign behaviour (PASS<4). IHC analysis was done using synaptophysin, chromogranin, S100 and Ki67. We correlated S100 immunoreactivity and Ki67 proliferative index with PASS score. Both PASS score and IHC markers were also correlated with clinical outcome. Results: There were six Pheochromocytomas (PHC) and four Paragangliomas (PGL). Two paragangliomas were retroperitoneal and one each was located in ear (HNPGL) and broad ligament. PASS score was ≥4 in five cases and <4 in five cases. Out of five cases in which PASS was ≥4, three cases showed clinical evidence of malignancy and two cases were benign. All the cases in which PASS was <4 were clinically benign. S100 immunoreactivity was grade 1 in two cases, grade 2 in six cases and grade 3 in two cases. The cases in which S100 immunoreactivity was grade 1 were malignant. One case in which S100 was grade 2 was clinically malignant. Ki67 labeling index was raised (>3%) in two cases, which were malignant correlated with malignant PASS score. Conclusion: We conclude that the following clinicopathological parameters should be taken into account for risk assessment of malignant behaviour of paragangliomas- location, size, PASS score, S100 immunoreactivity and Ki67 labeling index.https://jcdr.net/articles/PDF/8419/20565_CE(RA1)_F(T)_PF1(AHAK)_PFA(AK)_PF2(P_PR).pdfparagangliomapass score pheochromocytomas100 immunoreactivity |
| spellingShingle | Maithili Mandar Kulkarni Siddhi Gaurish Sinai Khandeparkar Sanjay D. Deshmukh R.R. Karekar Vandana L. Gaopande Avinash R. Joshi Mrunal V. Kesari R.R. Shelke Risk Stratification in Paragangliomas with PASS (Pheochromocytoma of the Adrenal Gland Scaled Score) and Immunohistochemical Markers Journal of Clinical and Diagnostic Research paraganglioma pass score pheochromocytoma s100 immunoreactivity |
| title | Risk Stratification in Paragangliomas with PASS (Pheochromocytoma of the Adrenal Gland Scaled Score) and Immunohistochemical Markers |
| title_full | Risk Stratification in Paragangliomas with PASS (Pheochromocytoma of the Adrenal Gland Scaled Score) and Immunohistochemical Markers |
| title_fullStr | Risk Stratification in Paragangliomas with PASS (Pheochromocytoma of the Adrenal Gland Scaled Score) and Immunohistochemical Markers |
| title_full_unstemmed | Risk Stratification in Paragangliomas with PASS (Pheochromocytoma of the Adrenal Gland Scaled Score) and Immunohistochemical Markers |
| title_short | Risk Stratification in Paragangliomas with PASS (Pheochromocytoma of the Adrenal Gland Scaled Score) and Immunohistochemical Markers |
| title_sort | risk stratification in paragangliomas with pass pheochromocytoma of the adrenal gland scaled score and immunohistochemical markers |
| topic | paraganglioma pass score pheochromocytoma s100 immunoreactivity |
| url | https://jcdr.net/articles/PDF/8419/20565_CE(RA1)_F(T)_PF1(AHAK)_PFA(AK)_PF2(P_PR).pdf |
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