CD 56 staining in liver biopsies does not help in differentiating extrahepatic biliary atresia from other causes of neonatal cholestasis

<p>Abstract</p> <p>Introduction</p> <p>Several conditions are considered in differential diagnosis of neonatal cholestasis. Of these the most important is extrahepatic biliary atresia (EHBA), while prompt diagnosis and surgical correction of obstruction can ameliorate c...

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Main Authors: Irvanloo Guiti, Sani Mehri, Khairkhah Reza, Mahjoub Fatemeh E, Monajemzadeh Maryam
Format: Article
Language:English
Published: BMC 2008-03-01
Series:Diagnostic Pathology
Online Access:http://www.diagnosticpathology.org/content/3/1/10
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author Irvanloo Guiti
Sani Mehri
Khairkhah Reza
Mahjoub Fatemeh E
Monajemzadeh Maryam
author_facet Irvanloo Guiti
Sani Mehri
Khairkhah Reza
Mahjoub Fatemeh E
Monajemzadeh Maryam
author_sort Irvanloo Guiti
collection DOAJ
description <p>Abstract</p> <p>Introduction</p> <p>Several conditions are considered in differential diagnosis of neonatal cholestasis. Of these the most important is extrahepatic biliary atresia (EHBA), while prompt diagnosis and surgical correction of obstruction can ameliorate clinical symptoms, provides long term survival for about one fourth of patients and serves as an important bridge to transplantation for many others. From histopathologic standpoint, features of EHBA overlaps with other diagnoses and so ancillary tests such as immunohistochemical staining for CD56 is suggested by some authors as a helpful tool in differential diagnosis.</p> <p>Hereby we wanted to examine this staining in our center which is a referral children hospital and to prove its efficacy in our problematic cases.</p> <p>Materials and Methods</p> <p>By retrospective review of pathology records during 2000 to 2006 in Markaze Tebbi Koodakan (children hospital related to Tehran University of Medical Sciences), we selected 17 cases of EHBA as patients and 12 cases with other diagnoses as controls, both with some degree of bile ductular proliferation in liver biopsies. EHBA cases were all proved by surgery. Four of control cases also underwent surgery but proved to have open ducts by intra-operative cholangiography. Long term follow up and other tests ruled out EHBA in other 8 cases. Hematoxylin-Eosin stains of paraffin blocks were studied again and freshly prepared sections were immunostained for CD56.</p> <p>Results</p> <p>Bile ducts and proliferating bile ductules were strongly positive for CD56 in 6 of 17 cases of EHBA. In 7 out of 17, positivity were seen in more than two thirds of portal tracts. In controls, one case showed strong positivity and 6 out of twelve showed positivity in more than two thirds of portal tracts. The intensity and distribution of CD56 staining did not differ significantly between two groups.</p> <p>Discussion</p> <p>Despite findings of previous studies, we have shown that CD56 staining can not help as an ancillary test in differential diagnosis of neonatal cholestasis and perhaps other markers should be tested in this regard.</p>
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spelling doaj.art-455252801e3e4d829a12f19ceccdc0cc2022-12-21T23:21:13ZengBMCDiagnostic Pathology1746-15962008-03-01311010.1186/1746-1596-3-10CD 56 staining in liver biopsies does not help in differentiating extrahepatic biliary atresia from other causes of neonatal cholestasisIrvanloo GuitiSani MehriKhairkhah RezaMahjoub Fatemeh EMonajemzadeh Maryam<p>Abstract</p> <p>Introduction</p> <p>Several conditions are considered in differential diagnosis of neonatal cholestasis. Of these the most important is extrahepatic biliary atresia (EHBA), while prompt diagnosis and surgical correction of obstruction can ameliorate clinical symptoms, provides long term survival for about one fourth of patients and serves as an important bridge to transplantation for many others. From histopathologic standpoint, features of EHBA overlaps with other diagnoses and so ancillary tests such as immunohistochemical staining for CD56 is suggested by some authors as a helpful tool in differential diagnosis.</p> <p>Hereby we wanted to examine this staining in our center which is a referral children hospital and to prove its efficacy in our problematic cases.</p> <p>Materials and Methods</p> <p>By retrospective review of pathology records during 2000 to 2006 in Markaze Tebbi Koodakan (children hospital related to Tehran University of Medical Sciences), we selected 17 cases of EHBA as patients and 12 cases with other diagnoses as controls, both with some degree of bile ductular proliferation in liver biopsies. EHBA cases were all proved by surgery. Four of control cases also underwent surgery but proved to have open ducts by intra-operative cholangiography. Long term follow up and other tests ruled out EHBA in other 8 cases. Hematoxylin-Eosin stains of paraffin blocks were studied again and freshly prepared sections were immunostained for CD56.</p> <p>Results</p> <p>Bile ducts and proliferating bile ductules were strongly positive for CD56 in 6 of 17 cases of EHBA. In 7 out of 17, positivity were seen in more than two thirds of portal tracts. In controls, one case showed strong positivity and 6 out of twelve showed positivity in more than two thirds of portal tracts. The intensity and distribution of CD56 staining did not differ significantly between two groups.</p> <p>Discussion</p> <p>Despite findings of previous studies, we have shown that CD56 staining can not help as an ancillary test in differential diagnosis of neonatal cholestasis and perhaps other markers should be tested in this regard.</p>http://www.diagnosticpathology.org/content/3/1/10
spellingShingle Irvanloo Guiti
Sani Mehri
Khairkhah Reza
Mahjoub Fatemeh E
Monajemzadeh Maryam
CD 56 staining in liver biopsies does not help in differentiating extrahepatic biliary atresia from other causes of neonatal cholestasis
Diagnostic Pathology
title CD 56 staining in liver biopsies does not help in differentiating extrahepatic biliary atresia from other causes of neonatal cholestasis
title_full CD 56 staining in liver biopsies does not help in differentiating extrahepatic biliary atresia from other causes of neonatal cholestasis
title_fullStr CD 56 staining in liver biopsies does not help in differentiating extrahepatic biliary atresia from other causes of neonatal cholestasis
title_full_unstemmed CD 56 staining in liver biopsies does not help in differentiating extrahepatic biliary atresia from other causes of neonatal cholestasis
title_short CD 56 staining in liver biopsies does not help in differentiating extrahepatic biliary atresia from other causes of neonatal cholestasis
title_sort cd 56 staining in liver biopsies does not help in differentiating extrahepatic biliary atresia from other causes of neonatal cholestasis
url http://www.diagnosticpathology.org/content/3/1/10
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AT khairkhahreza cd56staininginliverbiopsiesdoesnothelpindifferentiatingextrahepaticbiliaryatresiafromothercausesofneonatalcholestasis
AT mahjoubfatemehe cd56staininginliverbiopsiesdoesnothelpindifferentiatingextrahepaticbiliaryatresiafromothercausesofneonatalcholestasis
AT monajemzadehmaryam cd56staininginliverbiopsiesdoesnothelpindifferentiatingextrahepaticbiliaryatresiafromothercausesofneonatalcholestasis