TY - JOUR
T1 - Insulinoma-associated protein 1 (INSM-1) expression in medullary thyroid carcinoma FNA
T2 - a multi-institutional study
AU - Maleki, Zahra
AU - Abram, Mikk
AU - Dell'Aquila, Marco
AU - Kilic, Irem
AU - Lu, Ryan
AU - Musarra, Teresa
AU - Barkan, Guliz
AU - Rajakorpi, Erja
AU - Rossi, Esther Diana
AU - Kholová, Ivana
N1 - Funding Information:
This study was supported by the State Research Funding (VTR grant, ID: X5211) and a Tampere Tuberculosis Foundation grant (ID: 2018) in Finland and the primary founder for both grants is Dr. Ivana Kholva. Ms. Eini Eskola is thanked for excellent technical help in the laboratory.
Publisher Copyright:
© 2020
PY - 2020/5/1
Y1 - 2020/5/1
N2 - Introduction: Insulinoma-associated protein 1 (INSM-1) is expressed in both normal tissues and neoplasms with neuroendocrine differentiation such as small cell lung carcinoma and pancreatic neuroendocrine tumors. The aim of this study was to evaluate the INSM-1 expression in medullary thyroid carcinoma (MTC) in the aspirated material and its preoperative diagnostic value. Materials and methods: MTC cases with available cytological material from 5 institutions were retrospectively identified. INSM-1 expression was analyzed in 48 cell blocks prepared from fine-needle aspiration samples from histologically confirmed cases of MTC. Twenty-nine samples were aspirates from primary thyroid lesions and 19 from secondary lesions lymph node or liver lesions. INSM-1 immunostain was done using the Ventana Automatic System (Ventana Medical Systems, Tucson, AZ). The control group consisted of 20 samples from histologically confirmed cases of papillary, follicular, and anaplastic thyroid carcinomas and secondary thyroid malignancies (squamous cell carcinoma, malignant melanoma). Results: The male to female (M:F) ratio in MTC group was 1:1.5 and the average age was 55.6 years (range: 24-84 years). INSM-1 nuclear staining in at least 5% of cells was considered positive. Forty-five (93.75%) MTC samples were positive including all primary tumor aspirates. All control samples were negative. Conclusions: INSM-1 nuclear positivity is a reliable marker of MTC neuroendocrine differentiation on cytology material from both primary tumor and metastases. INSM-1 can also discriminate MTC from other primary and secondary thyroid carcinomas when there are cytomorphologic overlaps.
AB - Introduction: Insulinoma-associated protein 1 (INSM-1) is expressed in both normal tissues and neoplasms with neuroendocrine differentiation such as small cell lung carcinoma and pancreatic neuroendocrine tumors. The aim of this study was to evaluate the INSM-1 expression in medullary thyroid carcinoma (MTC) in the aspirated material and its preoperative diagnostic value. Materials and methods: MTC cases with available cytological material from 5 institutions were retrospectively identified. INSM-1 expression was analyzed in 48 cell blocks prepared from fine-needle aspiration samples from histologically confirmed cases of MTC. Twenty-nine samples were aspirates from primary thyroid lesions and 19 from secondary lesions lymph node or liver lesions. INSM-1 immunostain was done using the Ventana Automatic System (Ventana Medical Systems, Tucson, AZ). The control group consisted of 20 samples from histologically confirmed cases of papillary, follicular, and anaplastic thyroid carcinomas and secondary thyroid malignancies (squamous cell carcinoma, malignant melanoma). Results: The male to female (M:F) ratio in MTC group was 1:1.5 and the average age was 55.6 years (range: 24-84 years). INSM-1 nuclear staining in at least 5% of cells was considered positive. Forty-five (93.75%) MTC samples were positive including all primary tumor aspirates. All control samples were negative. Conclusions: INSM-1 nuclear positivity is a reliable marker of MTC neuroendocrine differentiation on cytology material from both primary tumor and metastases. INSM-1 can also discriminate MTC from other primary and secondary thyroid carcinomas when there are cytomorphologic overlaps.
KW - FNA
KW - Fine-needle aspiration
KW - INSM-1
KW - Immunohistochemistry
KW - Insulinoma-associated protein 1
KW - Medullary thyroid carcinoma
KW - Thyroid
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U2 - 10.1016/j.jasc.2020.01.005
DO - 10.1016/j.jasc.2020.01.005
M3 - Article
C2 - 32197966
AN - SCOPUS:85081938012
SN - 2213-2945
VL - 9
SP - 185
EP - 190
JO - Journal of the American Society of Cytopathology
JF - Journal of the American Society of Cytopathology
IS - 3
ER -