Highlighting nuclear membrane staining in thyroid neoplasms with emerin: Review and diagnostic utility

Immunohistochemical staining (IHC) with emerin, an integral inner nuclear membrane protein, highlights nuclear membrane details in papillary thyroid carcinoma (PTC). We evaluated emerin for highlighting nuclear shape, grooves, inclusions, circumferential nuclear membrane irregularities (“garlands”),...

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Bibliographic Details
Published in:Diagnostic cytopathology 2013-06, Vol.41 (6), p.497-504
Main Authors: Kinsella, Mary D., Hinrichs, Benjamin, Cohen, Cynthia, Siddiqui, Momin T.
Format: Article
Language:English
Subjects:
Carcinoma, Papillary - ultrastructure
cell blocks
Cell Nucleus - ultrastructure
Emerin
FNA
Humans
Membrane Proteins - analysis
Nuclear Envelope - chemistry
Nuclear Envelope - ultrastructure
Nuclear Proteins - analysis
papillary thyroid carcinoma
Thyroid Neoplasms - ultrastructure
TMA
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Summary:Immunohistochemical staining (IHC) with emerin, an integral inner nuclear membrane protein, highlights nuclear membrane details in papillary thyroid carcinoma (PTC). We evaluated emerin for highlighting nuclear shape, grooves, inclusions, circumferential nuclear membrane irregularities (“garlands”), deep “stellate” membrane invaginations, and crescents in 34 fine‐needle aspiration (FNA) cell blocks, PTC (n = 24) and follicular neoplasms (FN) (n = 10). Tissue microarrays were also examined for 182 cases, PTC (n = 95) and non‐PTC (n = 87). Emerin IHC of PTC revealed a predominantly oval nuclear shape in the majority of cases, with FN demonstrating round nuclei and FV of PTC showing a roughly equal distribution of round and oval shapes. In addition to oval nuclear shape, the presence of emerin‐positive nuclear grooves, circumferential emerin nuclear “garlands,” nuclear crescent shapes, and chromatin clearing on cell block H&E staining were significant predictors of PTC by regression analysis. Emerin IHC of thyroid FNA and surgical specimens serves as a useful adjunct to conventional H&E staining in the diagnosis of PTC and its distinction from FN by delineating diagnostic nuclear membrane irregularities (“garlands” and crescents), nuclear grooves, and a characteristic oval nuclear shape. In diagnostically challenging cases with limited cellularity, emerin staining can help to provide a more definitive diagnosis of PTC. Diagn. Cytopathol. 2013. © 2012 Wiley Periodicals, Inc.
ISSN:8755-1039
1097-0339
DOI:10.1002/dc.22870