Detection of Bone Marrow Metastases of Neuroblastoma With Immunohistochemical Staining of CD56, Chromogranin A, and Synaptophysin

摘要

Neuroblastoma is one of the most common solidtumors occurring in childhood. Bone marrow evaluation is animportant part of clinical staging in neuroblastoma patients. Inview of the difficulty of detecting neuroblastoma cells withconventional bone marrow aspirate smears and biopsy (BMB)and specimens in cases in which metastasis is not prominent, wepropose the use of immunohistochemistry (IHC) as a potentialdiagnostic tool. We examined 116 BMB and 115 bone marrowclot (BMC) specimens from 60 newly diagnosed neuroblastomapatients for tumor cells. Neuroendocrine IHC markers, suchas CD56, chromogranin A, and synaptophysin were appliedto diagnose neuroblastoma. Eighteen out of the 60 patients(25.4%) displayed BM metastasis, as observed with conven-tional hematoxylin and eosin staining. IHC staining of BMCsections was generally more sensitive than that of BMB sectionsfor tumor cell detection. We detected tumors in 5 and 7additional hematoxylin and eosin-negative BMB and BMCsections, respectively, using CD56. Overall, CD56 or a combina-tion of CD56 and chromogranin A was effective in detectingneuroblastoma cells. IHC analysis of BMB and BMC sections iswarranted as a routine component of the diagnostic work-up ofneuroblastoma to overcome discrepancies between routinesmears and IHC stains.