Reactivity with TdT in Merkel cell carcinoma: A potential diagnostic pitfall

被引：47

作者：

Buresh, Cary J. ^{[1
]}

Oliai, Bahrant Robert ^{[1
]}

Miller, Rodney T. ^{[1
]}

机构：

[1] ProPath Lab, Immunohistochem Div, Dallas, TX 75247 USA

来源：

AMERICAN JOURNAL OF CLINICAL PATHOLOGY | 2008年 / 129卷 / 06期

关键词：

terminal deoxynucleotidyl transferase; TdT; Merkel cell carcinoma; immunohistochemistry; immunoperoxidase; lymphoblastic lymphoma;

D O I：

10.1309/R494HQ9VRDJWDY30

中图分类号：

R36 [病理学];

学科分类号：

100104 ;

摘要：

Merkel cell carcinoma (MCC) is a high-grade neuroendocrine carcinoma of skin characterized by cells with a "blastic" appearance, scant cytoplasm, and fine, evenly distributed chromatin. Terminal deoxynucleotidyl transferase (TdT) is a DNA polymerase present in thymic T cells, lymphoblastic lymphomal/leukemia, and some cases of acute myeloid leukemia. After observing TdT immunoreactivity in a case of MCC, we analyzed 26 tumors by immunohistochemical analysis to determine their spectrum of reactivity with TdT and identified TdT in 19 (73%) of 26 MCCs. Staining intensity was variable but was often moderate to strong and present in a significant percentage of cells. Because MCC has cytomorphologic features similar to those of lymphoblastic lymphoma and may manifest as metastatic disease, reactivity with TdT in MCC could represent a diagnostic pitfall in the differential diagnosis with lymphoblastic lymphoma, particularly because the latter may lack CD45 and/or CD20, yet both neoplasms may express PAX-5, a B-cell-associated marker.

引用

页码：894 / 898

页数：5

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