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Decisive role of immunocytochemistry in aspiration cytology of chordoma of the clivus: A case report with review of the literature

Published online by Cambridge University Press:  29 June 2007

Giorgio Gherardi ,
Cristina Marveggio ,
Claudio Cola  and
Gianantonio Redaelli
Giorgio Gherardi*
Affiliation:
Department of Pathology, City Hospital of Sondrio, Sondrio, Italy.
Cristina Marveggio
Affiliation:
Department of Pathology, City Hospital of Sondrio, Sondrio, Italy.
Claudio Cola
Affiliation:
Department of Otolaryngology, City Hospital of Sondrio, Sondrio, Italy.
Gianantonio Redaelli
Affiliation:
Department of Otolaryngology, City Hospital of Sondrio, Sondrio, Italy.
*
Dr Giorgio Gherardi, Istituto di Anatomia e Istologia Patologica, Ospedale Civile, 25, Via Stelvio, 23100 Sondrio, Italy.
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Abstract

Immunocytochemistry (ICC) proved to be an essential adjunct in the fine-needle aspiration (FNA) cytological diagnosis of chordoma of the clivus in a 62-year-old woman. The cytological picture in routinely stained smears was not entirely diagnostic for chordoma due to the paucity of typical ‘physalipherous’ cells. To exclude other primary or metastatic neoplasms of the skull base possibly sharing the same cytological picture, additional direct smears were immunostained with antibodies specific for cytokeratin (CK), vimentin (VIM), SI00 protein (SIOOP), carcinoembrionic antigen (CEA), epithelial membrane antigen (EMA), glial fibrillary acidic protein (GFAP), CD68 antigen (KP1) and with the ‘panepithelial’ antibodies B72.3 and Ber-EP4. Chordoma cells showed the following immunoprofile: CK+/VIM−/S100P+/CEA−/EMA+/GFAP−/B72.3−/Ber-EP4−/CD68+. The pattern of immunoreactivity for CK, S100P and CEA confirms previously reported data, while the B72.3−/Ber-EP4−/CD68+ staining profile represents a novel observation. The etection of a CK+/S100+/CEA−/B72.3−/Ber-EP4− immunocytological profile of chordoma cells in aspirates is a basic requirement to exclude pertinent diagnostic differentials, such as metastatic carcinoma, ependymoma and sarcoma, and permits a reliable pre-operative diagnosis of the tumour by aspiration cytology.

Keywords

ImmunohistochemistryBiopsy, needleHead and neck neoplasmsChordoma
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 108 , Issue 5 , May 1994 , pp. 426 - 430
Copyright
Copyright © JLO (1984) Limited 1994

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