Table 3. - Immunohistochemical characteristics described in the literature.
| Author | Anatomopathology / Immunohistochemistry Characteristics |
|---|---|
| Souza et al. ( 12 ) | The immunohistochemical profile of MNTI is generally positive for cytokeratin and HMB45 and negative for S100. And Ki-67 and CD99 expressions are quite uncommon and may be related to more aggressive tumor growth. |
| Albuquerque et al. ( 13 ) | Small cells of neural origin are confirmed by positivity for NSE, synaptophysin and chromogranin. And cells of ectodermal origin can be confirmed by the positivity of EMA, CK, HMB-45. |
|
Cui; Mao; Liao
( 14 ) |
Smaller round cells were melanoma-associated antigen 45 (HMB45) / vimentin / epithelial membrane antigen (+), no significant glial fibrillary acid protein staining (GFAP) / neuron-specific enolase (NSE) / synaptophysin (+), and the largest cells were cytokeratin (CK) / S-100. Scattered cells exhibited desmin immunoreactivity and ~2% of cells were Ki-67 (+). |
| Batta et al. ( 7 ) | Larger epithelioid cells stain positively with cytokeratin, vimentin and HMB-45, reflecting epithelial and melanocytic differentiation, in addition to generally not reacting with S-100 protein, helping to differentiate tumors such as melanoma. Smaller cell nests in MNTI are often positive for neurogenic markers such as synaptophysin, neuron-specific, enolase, and glial fibrillary acidic protein. |
| Strieder et al. ( 15 ) | Larger cells express cytokeratins (CKs), epithelial membrane antigen (EMA), glial fibrillary acidic protein (GFAP), S100 and HMB45 protein, and smaller cells express CD56 and synaptophysin; both cells express neuron-specific enolase (NSE), PGP 9.5 and chromogranin A. |
| Wu et al. ( 10 ) | The epithelioid component of large cells shows a small to moderate amount of eosinophilic cytoplasm and is positive with pancytokeratin and HMB45 immunostaining. The small blue primitive cell component does not show appreciable cytoplasm and is positive for synaptophysin. |
| Moreau et al. ( 3 ) | In HE staining, a fibrocollagenous stroma surrounding an epithelioid and neuroblastic component organized in lobules or alveolar structures. And the neuroblastic component was discrete and masked by a large melanin-rich epithelioid component. Epithelioid cells expressed epithelial and melanocytic markers (AE1/AE3; and melan A, PS 100 and HMB 45, respectively). |
| Nicosia et al. ( 16 ) | They are usually positive for cytokeratin, vimentin, epithelial membrane antigen, HMB-45, glial fibrillary acidic protein, and specific neuronal enolase. |
| Unsal; Yalçin ( 9 ) | The largest fraction of epithelioid cells expressed a number of cytokeratins - in most patients HMB-45, but rarely S-100.8 protein. Neuroblast-like cells are positive for neuron-specific enolase, CD 56, glial fibrillary acidic protein and synaptophysin, and melanogenic cells are positive for HMB-45, epithelial antigen membrane antigen, cytokeratin and vimentin. |
| Emmerling; York; Caccanese ( 17 ) | There is identification of immunohistochemical markers, such as cell population frequently expressing cytokeratins, HMB-45 and vimentin, while S100 is much less common. And the small cell population usually expresses synaptophysin but is negative for another neuroendocrine marker, chromogranin A. |
| Santos et al. ( 2 ) | Other markers, such as HMB45, Melan A, cytokeratin, and neuroblastic markers, such as synaptophysin and neuron-specific enolase, can help in diagnosis. |
| Soles et al. ( 8 ) | The cells present are positive for vimentin and neuron-specific enolase and negative for S100. Larger melanogenic epithelioid cells are commonly positive for cytokeratins and some differentiating markers of melanocytes (HMB-45, dopamine b-hydroxylase, etc.). Smaller neurogenic cells are positive for synaptophysin and negative for cytokeratin, in addition to being positive for glial fibrillary acidic protein (GFAP), but rarely for neurofilament and CD99. |
| Atarbashi-Moghadam Et Al. ( 18 ) | Epithelioid cells are positive for cytokeratin, HMB-45 and NSE. Smaller cells are generally positive for NSE and CD56 and sometimes synaptophysin. Furthermore, MNTI are not expressed in the S-100 protein. Larger epithelioid cells express MDM-2, cyclin D1 and A. |
| Ebel et al. ( 1 ) | Immunohistochemically positive staining for markers such as HMB-45, synaptophysin and cytokeratin strengthens the diagnosis. A marker to differentiate between benign and malignant tumors does not exist so far. |
The table summarizes some histopathological and immunohistochemical characteristics of MNTI based on studies in the literature.
Source: Done by the authors.