Micronuclei and Nuclear Buds: Highlighting Overlooked Indicators of Increased Chromosomal Damage in Thyroid Lesions with Emerin Immunohistochemistry
Ipek Coban, Tuba Dilay Kokenek Unal, Asli Erdogan Cakir, Ayse Selcen Oguz, Murat Alper. Diskapi YB Training and Research Hospital, Ankara, Turkey; Corlu State Hospital, Corlu, Turkey
Background: Emerin immunohistochemistry provides detailed information about nuclear shape and irregularities in thyroid. We aimed to investigate the presence of micronuclei and nuclear buds, which are considered to be indicators of increased chromosomal damage, in well differentiated neoplastic and non-neoplastic follicular epithelial lesions of thyroid by using emerin immunohistochemistry.
Design: Tissue microarrays consisting of samples from well differentiated neoplastic (follicular/oncocytic adenoma (FA/OA), follicular/oncocytic carcinoma (FC/OC), papillary thyroid carcinoma (PTC)) and non- neoplastic (nodular hyperplasia (NH), Hashimoto's thyroiditis (HT), adenomatous nodule (AN)) epithelial lesions were stained with anti-emerin monoclonal antibody and evaluated for the presence of nuclear buds and micronuclei.
Results: Of the 340 cases examined 275 were diagnosed as neoplastic (77FA/OA, 48FC/ OC, 150 PTC) and 65 as non- neoplastic (10 NH, 21 HT, 34 AN). All malignant cases (FC/OC, PTC), 19 (25%) of 77 FA/OA, 2 (10%) of HT were positive for micronuclei and nuclear buds, whereas all of the NH an AN cases were negative. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the presence of nuclear buds and micronuclei (fig.) for neoplasia and malignancy are shown in table 1.