Diagnostic Utility of Epithelial Membrane Antigen (EMA) and Calretinin (CAL) in Effusion Cytology
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 5
Abstract
Introduction: Fluid cytology and subsequent utilization of immunocytology on cell block is being used commonly for increasing the diagnostic accuracy in effusion cytology. Aim: To do cytological analysis of fluids and evaluate the role of Epithelial Membrane Antigen (EMA) and Calretinin (CAL) to differentiate between reactive and malignant cell in pleural and peritoneal fluids. Materials and Methods: This was a prospective study carried out in Department of Pathology, Shri Guru Ram Rai Institue of Medical and Health Science, for a period of 18 months from January 2014 to June 2015. A total of 253 samples of pleural and peritoneal fluid were studied by May-Gruenwald-Giemsa (MGG) stain and Papanicolaou (Pap) staining. In 73 cases which were suspicious for malignancy, cell blocks were prepared and IHC was done using two immunomarkers- EMA and CAL. Results: A total of 253 cases of effusion cytology were studied out of which 73 were found positive for malignant cells. Maximum cases of malignant cells or atypical cells were seen in peritoneal fluid. A total of 34 cases were histologically positive for malignancy. All these cases showed strong membranous and cytoplasmic positivity for EMA. Most of cases also showed 2%-5% positivity for CAL. There were 38 cases categorized as atypical or reactive mesothelial cell hyperplasia. These cases showed nuclear and cytoplasmic staining for calretinin and none of these were positive for EMA, although 5 cases showed score 2-3, which was considered as negative. Conclusion: The distinction between reactive and malignant mesothelial cells in cytological specimens can be problematic. A combination of CAL and EMA may help in accurate diagnosis.
Authors and Affiliations
Neha Nautiyal, Aparna Bhardwaj, Seema Acharya, Sanjeev Kishore, Sandip Kudesia
Keywords
Related Articles
- EP ID EP341899
- DOI 10.7860/JCDR/2017/24339.9888
- Views 97
- Downloads 0
Evaluation of Analgesic and Anti-Inflammatory Activity of Ibuprofen-Pregabalin in Animal Models
ABSTRACT Introduction: Despite an enhanced recognition of the molecular mechanisms of nociception, existing analgesic drugs continue to remain restricted in terms of efficacy. Since all single analgesic drugs are not eff...
Expression of Oct4 Protein in Astrocytic Tumours-Histopathologic and Immunohistochemical Study
ABSTRACT Introduction: The majority of gliomas in adults are resistant to therapy. Therapy resistance has been attributed to the presence of cancer stem cells (CSCs). Oct4 is a transcription factor required for maintaini...
Orientation of Cut Angle in Distal Tibia Derotation Osteotomy Can Create Unintended Sagittal and Coronal Plane Deformity at the Ankle
ABSTRACT Introduction: Distal tibial osteotomy is commonly used for surgically correcting tibial torsion. While the effect of purposeful oblique osteotomies are well described, minimal data exists regarding how variation...
Assessing the Clinical Applicability of Population Specific Bolton’s Norms
ABSTRACT Introduction: Bolton’s norms are an essential parameter used in orthodontic diagnosis to evaluate the tooth size discrepancy. However, these norms have been established for Caucasian population and population va...
Elevation of Oxidative Stress and Decline in Endogenous Antioxidant Defense in Elderly Individuals with Hypertension
Introduction: Hypertension is becoming an important medical and public health problem all over the world and is the most common disorder of ageing. There is a growing evidence of involvement of vascular oxidative stress...