Role of Alcian blue (pH 2.5) histochemical stain in diagnostic thyroid pathology: how far is it helpful?

Authors

  • Seetu Palo Department of Pathology, Maharajah Institute of Medical Sciences, Vizianagram, Andhra Pradesh
  • Dayananda S. Biligi Department of Pathology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka

DOI:

https://doi.org/10.18203/2320-6012.ijrms20151438

Keywords:

Alcian blue, Histochemical, Thyroid, Glycoprotein

Abstract

Background: Controversies and pitfalls are well-known in diagnostic thyroid pathology. Since, the luminal surface of  neoplastic thyroid follicular cells is said to be covered by a glycoproteinaceous material, there is a need  to  investigate the efficacy of  mucin stains like Alcian blue (pH 2.5), which can be used as an adjunctive tool in difficult cases.

Methods: 60 thyroidectomy specimens, received at Department of Pathology, were included in this retrospective analytical study. Alcian blue histochemical (pH 2.5) staining was done on representative sections and assessed for positivity.

Results: Of the 60 cases analysed, all cases of papillary/nodular hyperplasia (n=10), follicular adenoma (n=14), follicular carcinoma (n=4) and medullary carcinoma (n=1) were negative for Alcian blue. Only 3/16 (18.7 %) cases of classical papillary carcinoma and 2/15 (13.3%) cases of follicular variant of papillary carcinoma showed positivity.

Conclusions: We got statistically insignificant results with Alcian blue (pH 2.5) staining, making it unreliable in diagnostic thyroid pathology.

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References

DeLellis RA, Williams ED. Tumours of thyroid and parathyroid. In: DeLellis RA, Lloyd RV, Heitz PU, Eng C, edts. Pathology And Genetics. Tumors of Endocrine Organs. World Health Organization Classification of Tumors. Lyon,France: IARC Press; 2004:49-56.

Rosai J, Tallini G. Thyroid gland in Rosai and Ackerman’s surgical pathology. 10th ed. Elseiver Mosby; 2011;1:487-539.

Baloch ZW, LiVolsi VA. Follicular-patterned lesions of the thyroid: the bane of the pathologist. Am J Clin Pathol. 2002;117:143–50.

Rydlovaa M, Ludvikovab M, Stankovac I. Potential Diagnostic Markers In Nodular Lesions Of The Thyroid Gland: An Immunohistochemical Study. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2008, 152(1):53–60.

Erkilic S, Kocer NE. The role of cytokeratin 19 in the differential diagnosis of true papillary carcinoma of thyroid and papillary carcinoma like changes in Grave's disease. Endocr Pathol. 2005;16: 63-6.

Mustafa Kosem, Sabriye Polat, Mustafa Ozturk, et al. Differential diagnosis of papillary thyroid carcinoma: Immunohistochemical study of 112 cases. Eastern Jr Of Med 2005;10:15-9.

LiVolsi VA. Papillary thyroid carcinoma: an update. Mod Pathol. 2011;24:S1–S9.

Rosai J, Kuhn E, Carcangiu ML. Pitfalls in thyroid tumour pathology. Histopathology. 2006;49: 107-20.

Fischer S, Asa SL. Application of Immunohistochemistry to Thyroid Neoplasms. Arch Pathol Lab Med. 2008;132:359–72.

Baloch ZW , LiVolsi VA. Pathologic diagnosis of papillary thyroid carcinoma: today and tomorrow. Expert Rev Mol Diagn. 2005;5:573–84.

Papale F, Cafiero G, Grimaldi A, et al. Galectin-3 expression in thyroid fine needle cytology uncertain cases: validation of molecular markers and technology innovation. J Cell Physiol. 2013;228: 968–74.

Mc Laren KM, Cossar DW. The immunohistochemical localization of S-100 in the diagnosis of papillary carcinoma of the thyroid. Human Pathol. 1996; 27:633-6.

Miettinen M, Kovatich AJ, Karkkainen P. Keratin subsets in papillary and follicular thyroid lesions. Virchows Arch A Pathol Anat. 1997;431:407-20.

Yamamoto Y, Izumi K, Otsuka H. An immunohistochemical study of EMA, cytokeratin and vimentin in papillary carcinoma: Recognition of lethal and favorable prognostic types. Cancer. 1992; 70:2326-629.

de Matos P S, Ferreira A P, de Oliveira Facuri F, et al. Usefulness of HBME-1, cytokeratin 19 and galectin-3 immunostaining in the diagnosis of thyroid malignancy. Histopathology. 2005;47:391–40.

Elsheikh TM, Asa SL, Chan JK, et al. Interobserver and intraobserver variation among experts in the diagnosis of thyroid follicular lesions with borderline nuclear features of papillary carcinoma. Am J Clin Pathol. 2008;130(5): 736–44.

Hirokawa M, Carney JA, Goellner JR, et al. Observer variation of encapsulated follicular lesions of the thyroid gland. Am J Surg Pathol. 2002; 26(11):1508–14.

Lloyd RV, Erickson LA, Casey MB, et al. Observer variation in the diagnosis of follicular variant of papillary thyroid carcinoma. Am J Surg Pathol. 2004;28:1336–40.

Damiani S, Fratamico F, Lepertosa G, Dina R, Eusebi V. Alcian blue and epithelial membrane antigen are useful markers in differentiating benign from malignant papillae in thyroid lesions. Virchows Arch A Pathol Anat Histopathol. 1991:419(2):131-5.

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Published

2017-01-17

How to Cite

Palo, S., & Biligi, D. S. (2017). Role of Alcian blue (pH 2.5) histochemical stain in diagnostic thyroid pathology: how far is it helpful?. International Journal of Research in Medical Sciences, 3(12), 3766–3769. https://doi.org/10.18203/2320-6012.ijrms20151438

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Original Research Articles