Is CD1 a Dendritic Cell Immunolocalization in Cell Block Preparations Useful in the Differentiation of Papillary Carcinoma from Benign thyroid

nodules?

Background: A recent study showed (Pusztaszeri et al 2012) that increased presence of CD1-a positive DC in aspiration smears of Papillary thyroid carcinoma may serve as useful diagnostic adjunct. The aim of the present study was to evaluate the CD-1a positive DC in cell block material obtained during fine needle aspiration (FNA) procedure, in differentiating Papillary Carcinoma from benign thyroid nodules. Methods: The authors quantitatively assessed the presence of CD1a positive Dendritic cells in paraffin embedded cell blocks of histologically confirmed papillary carcinoma (n=15)and in a control group of benign thyroid nodules (BTNs) (n =19) using immunocytochemical staining with antibody against CD1a. The total number of DCs was counted in 5 separate high power fields-power
fields at 400 magnification from the areas in which they were the most numerous and a mean value from these 5 fields was calculated. The staining reaction in each case was graded on the basis of number

of dendritic cells staining per high power field (0 or negative <5, , 1+ 5- 10, 2+ 11 to 15, 3+ >15). Results six (33%) of 15 cases with an unequivocal diagnosis of PTC showed CD 1-a positive dendritic cells with a mean score of 11.67.1. However based on staining characteristic of 1+ or > only 5 of these 6 cases were considered positive for CD 1a dendritic cells. Tissue follow-up confirmed PTC in all 15 cases. All cases were negative for CD1a dendritic cells with the mean staining score of 1.05 .68 that showed some staining of DC. The mean scores of Dendritic cells in papillary carcinoma and benign thyroid nodules was statistically significant ( p<.005). The sensitivity and specificity of of CD1a positive dendritic cells for detecting cases of papillary carcinoma on cell block material was 33% and 100% respectively.

Conclusions: CD1 a positive Dendritic cells are more numerous in cell block section of papillary carcinoma than benign thyroid nodules. However low sensitivity of CD 1a positive dendritic cells for detecting papillary carcinoma on cell block sections makes it less effective for distinguishing it from benign thyroid nodules.

Citation: Pusztaszeri MP, Sadow PM, Faquin WC. Association of CD1a-positive dendritic cells with papillary thyroid carcinoma in thyroid fine-needle aspirations. Cancer Cytopathology. 2013.; 4: 206-213.