Ki67 staining pattern as a diagnostic tool in the evaluation of lymphoproliferative disorders

• Published in: Histopathology 2006-04, Vol.48 (5), p.505-515
• Main Authors: Bryant, R J, Banks, P M, O'Malley, D P
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Castleman Disease - diagnosis; Castleman Disease - metabolism; Diagnosis, Differential; differential diagnosis; follicular; Hematologic and hematopoietic diseases; Humans; hyperplasia; Hyperplasia - diagnosis; Hyperplasia - metabolism; Immunohistochemistry; Investigative techniques, diagnostic techniques (general aspects); Ki-67 Antigen - analysis; Ki67; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoma, Follicular - diagnosis; Lymphoma, Follicular - metabolism; lymphoproliferative; Lymphoproliferative Disorders - diagnosis; Lymphoproliferative Disorders - metabolism; Medical sciences; Mib-1; Observer Variation; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Sensitivity and Specificity
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/j.1365-2559.2006.02378.x

Aims : To evaluate a group of lymphoid proliferations using only Ki67‐stained slides to determine the value of the pattern of proliferating cells in diagnosis. Ki67 immunohistochemistry allows evaluation of the distribution of proliferating cells in addition to simply determining the proliferation rate of cells. Methods and results : Three observers, using a Ki67‐stained slide only, studied 149 cases from five diagnostic groupings: follicular hyperplasia, mixed pattern hyperplasia, localized Castleman's disease, follicular lymphoma and marginal zone lymphoma. The sensitivity for benign lesions varied from 94% to 97% among the three observers. Follicular lymphomas were recognized as neoplastic with a sensitivity of 96% and 100% by two of the observers. Marginal zone lymphoma was recognized as neoplastic in 67–73% of cases. Conclusions : The Ki67 stain alone is a powerful tool for distinguishing benign from malignant proliferations within the selected groups. Nuances and pitfalls in the interpretation of Ki67 staining pattern are discussed.