Optimized immunohistochemical panel to differentiate myeloid sarcoma from blastic plasmacytoid dendritic cell neoplasm

Nikhil A. Sangle, Robert L. Schmidt, Jay L. Patel, L. Jeffrey Medeiros, Archana M. Agarwal, Sherrie L. Perkins, Mohamed Salama

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Myeloid sarcoma (MS) and blastic plasmacytoid dendritic cell neoplasm (BPDCN) can be difficult to distinguish morphologically, even with the use of extensive immunohistochemical studies. Three new research markers, myxovirus A (MxA), CLA/CD162, and CD303/BDCA-2, have been reported to be positive in BPDCN, but their clinical utility has never been tested. We compared these markers to other antibodies that have been used traditionally to distinguish MS from BPDCN to assess the utility of these newer antibodies in differential diagnosis. Formalin-fixed, paraffin-embedded tissue sections of 23 MS and 17 BPDCN cases were assessed using immunohistochemical analysis for CD4, CD14, CD33, CD43, CD56, CD68, CD123, CD163, myeloperoxidase, lysozyme, terminal deoxynucleotidyl transferase (TdT), T-cell leukemia 1 (TCL-1), MxA, cutaneous lymphocyte-associated antigen (CLA)/CD162, and blood dendritic cell antigen 2 (BDCA2)/CD303. We identified antibodies with a high predictive value of ≥90% and used these markers to develop an approach to classification using specific staining criteria. Diagnostic classification criteria were based on staining patterns of one or more of the seven markers. BPDCN was associated with positive staining for CD56, TdT, or TCL1, or negative staining for lysozyme. MS was associated with positive staining for lysozyme or myeloperoxidase, or negative staining for CD56, CD123, myxovirus, or TCL1. The immunohistochemical staining patterns observed using a panel that includes MPO, CD56, CD123, TCL1, TdT, and MxA, are predictive of MS or BPDCN. In this study, neither CD162 nor CD303 had good predictive value in distinguishing MS from BPDCN.

Original languageEnglish (US)
Pages (from-to)1137-1143
Number of pages7
JournalModern Pathology
Volume27
Issue number8
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

Fingerprint

Myeloid Sarcoma
Dendritic Cells
Orthomyxoviridae
DNA Nucleotidylexotransferase
Staining and Labeling
Neoplasms
Muramidase
Negative Staining
Peroxidase
Antibodies
Lymphocytes
T-Cell Leukemia
Skin
Paraffin
Formaldehyde
Blood Cells
Differential Diagnosis
Antigens

Keywords

  • Myeloid sarcoma BPDCN immunohistochemical panel

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Sangle, N. A., Schmidt, R. L., Patel, J. L., Jeffrey Medeiros, L., Agarwal, A. M., Perkins, S. L., & Salama, M. (2014). Optimized immunohistochemical panel to differentiate myeloid sarcoma from blastic plasmacytoid dendritic cell neoplasm. Modern Pathology, 27(8), 1137-1143. https://doi.org/10.1038/modpathol.2013.238

Optimized immunohistochemical panel to differentiate myeloid sarcoma from blastic plasmacytoid dendritic cell neoplasm. / Sangle, Nikhil A.; Schmidt, Robert L.; Patel, Jay L.; Jeffrey Medeiros, L.; Agarwal, Archana M.; Perkins, Sherrie L.; Salama, Mohamed.

In: Modern Pathology, Vol. 27, No. 8, 01.01.2014, p. 1137-1143.

Research output: Contribution to journalArticle

Sangle, Nikhil A. ; Schmidt, Robert L. ; Patel, Jay L. ; Jeffrey Medeiros, L. ; Agarwal, Archana M. ; Perkins, Sherrie L. ; Salama, Mohamed. / Optimized immunohistochemical panel to differentiate myeloid sarcoma from blastic plasmacytoid dendritic cell neoplasm. In: Modern Pathology. 2014 ; Vol. 27, No. 8. pp. 1137-1143.
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