Immunohistochemical Approach to the Differential Diagnosis of Meningiomas and Their Mimics.
The differential diagnosis between meningioma and others tumors can be challenging. This study aimed to evaluate different immunohistochemical markers for the differential diagnosis between meningioma and their morphological mimics. Immunohistochemistry was performed on tissue microarray with antiepithelial membrane antigen (EMA), progesterone receptor, somatostatin receptor 2A (SSTR2A), CD34, STAT6, S100, SOX10, HMB45, MelanA, GFAP, inhibin, and BCL2 antibodies. One hundred and twenty-seven meningiomas, 26 solitary fibrous tumor/hemangiopericytomas (SFT/HPC), 39 schwannomas, 17 hemangioblastomas, 21 melanomas, 9 gliosarcomas, 5 neurofibromas, 9 peripheral primitive neuroectodermal tumors, 7 synovial sarcomas, and 5 malignant peripheral nerve sheath tumors were included in the microarray. SSTR2A was the most sensitive (95.2%) and specific (92%) marker of meningiomas. In combination, SSTR2A and/or EMA positivity reached maximal sensitivity (100%). Coexpression of SSTR2A and EMA was the most specific (94.8%) for the diagnosis of meningioma, regardless of the grade or subtype, with the exception of the differential diagnosis with synovial sarcoma. All synovial sarcomas were EMA-positive and 6/7 SSTR2A-positive. STAT6 showed optimum sensitivity and specificity (100%) for SFT/HPC. SOX10 was the most sensitive (94.3%) and specific (100%) marker to discriminate meningiomas from schwannomas. In conclusion, SSTR2A, STAT6, and SOX10 were the most sensitive and specific markers to distinguish meningiomas from their morphological mimics.
Pathology Department, Academic Hospital and Medicine University, Reims, France.
Camille
C
Boulagnon-Rombi
Pathology Department, Academic Hospital and Medicine University, Reims, France.
Clémence
C
Fleury
Pathology Department, Academic Hospital and Medicine University, Reims, France.
Caroline
C
Fichel
Neurology Department, Academic Hospital, Reims, France.
Sophie
S
Lefour
Pathology Department, Academic Hospital and Medicine University, Reims, France.
Aude
A
Marchal Bressenot
Pathology Department, Academic Hospital and Medicine University, INSERM U954, Université de Lorraine, Nancy, France
Guillaume
G
Gauchotte
D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D006393:Hemangiopericytoma / Q000235:genetics / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods*; D008579:Meningioma / Q000175:diagnosis* / Q000473:pathology*; D009363:Neoplasm Proteins / Q000235:genetics / Q000378:metabolism; D018317:Nerve Sheath Neoplasms / Q000175:diagnosis; D009442:Neurilemmoma / Q000175:diagnosis / Q000473:pathology; D015588:Observer Variation; D017481:Receptors, Somatostatin / Q000235:genetics; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D054364:Solitary Fibrous Tumors / Q000235:genetics / Q000473:pathology
D009363:Neoplasm Proteins; D017481:Receptors, Somatostatin; C093733:somatostatin receptor 2
Epithelial membrane antigen; Immunohistochemistry; Meningioma; SOX10; SSTR2A; STAT6; Schwannoma; Solitary fibrous tumor