The analysis also showed reduced production of two proteins important for neuron-to-neuron communication at synapses: synaptophysin
and a glutamate receptor protein.
Mouse anti-human synaptophysin
, Dak-synap clone, Ready for use; Monocl.
Seven cases were positive for cytokeratin, 5 for chromogranin, 2 with CD56 and one each with synaptophysin
and neuron specific Enolase.
The most sensitive and specific immunohistochemical markers are synaptophysin
and chromogranin A.
Immunohistochemically, these tumors show positivity for neuron specific enolase (NSE), vimentin, CD10, progesterone receptor (PR) and [beta] catenin, variable positivity for synaptophysin
and cytokeratin and negativity for chromogranin4,8,11,12.
IHC wall removed OC reconstruction 1 Synaptophysin
, Up Incus, malleus Primary CD56, pancyt- okeratin, CK7 CK5 2 Synaptophysin
, Down Malleus, Primary S-100 protein, previously chromogranin placed prosthesis 3 CD31, CD34 Down Incus, malleus, Primary tympanic membrane 4 p63, SMA N/A None N/A 5 S-100 protein Up None N/A 6 EMA, PR Up Incus, malleus Secondary 7 N/A Up None N/A Key: IHC = immunohistochemistry; OC = ossicular chain; SMA = smooth-muscle actin; EMA = epithelial membrane antigen; PR = progesterone receptor; N/A = not applicable.
To confirm that the neoplasm derives from Schwann cells, the following markers were evaluated: neurofilament (table 1 and figure 2A), glial fibrillary acidic protein (table 1 and figure 2B), synaptophysin
(table 1 and figure 2C), Leu-7 (table 1 and figure 2D), protein S-100 (table 1 and figure 2E), dimentin (table 1 and figure 2F).
Right) Pheochromocytoma, paraganglioma, and lymph node metastasis; (A) pheochromocytoma primary adrenal medullary tumour with characteristic Zellballen pattern and low-risk histopathology (H&E); (B) synaptophysin
positivity in main tumour; (C) chromogranin positivity in main tumour; (D) paraaortic paraganglioma (H&E); (E) synaptophysin
positivity in para-aortic paraganglioma; and (F) lymph node metastasis (H&E).
Three cores of the right lobe and five cores of the light lobe of the prostate gland showed usual PA with neuroendocrine differentiation (positivity of CD 56, synaptophysin
, and NSE), with a high proliferative index (90%).
Hence, the diagnosis of ganglioglioma was considered, the synaptophysin
stain was carried out with no neuronal elements identified.
MTC areas were strongly positive for calcitonin, synaptophysin
and chromogranin and negative for thyroglobulin.
The tumor cells were positive for CD56 and synaptophysin
, AE1/AE3 and CAM 5 and negative for chromogranin.