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Immunohistochemical panel for the diagnosis of Hirschsprung's disease using antibodies to MAP 2, calretinin, GLUT 1 and S100
Author(s) -
Bachmann Leonhard,
Besendörfer Manuel,
Carbon Roman,
Lux Philipp,
Agaimy Abbas,
Hartmann Arndt,
Rau Tilman T
Publication year - 2015
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12527
Subject(s) - calretinin , pathology , medicine , perineurium , immunohistochemistry , submucosa , muscularis mucosae , ganglion , hirschsprung's disease , staining , disease , anatomy , peripheral nerve
Aims The diagnosis of Hirschsprung's disease is currently based on the identification of aganglionosis and the presence of an increase in acetylcholinesterase‐positive hypertrophic nerve fibres in the large bowel submucosa. However, acetylcholinesterase staining is laborious and requires a skilled technician. The aim of this study was to identify a method for diagnosing Hirschsprung's disease reliably using an immunohistochemical panel of recently proposed markers. Methods and results Sixty‐nine specimens from 37 patients were evaluated. MAP 2 and calretinin antibodies were shown to stain ganglia reliably in the submucosal and myenteric plexuses of normal tissue. By contrast, reduced staining of ganglia was observed in patients with Hirschsprung's disease. Staining for GLUT 1 and S100 was used to evaluate the number and thickness of nerve fibres. Gain of GLUT 1 and S100 expression was in contrast to the loss of calretinin and MAP 2. Hypertrophic submucosal nerve fibres in Hirschsprung's disease develop a perineurium with a ring‐like GLUT 1 staining pattern similar in size and intensity to that observed in deeper subserosal tissue. Conclusions The diagnosis of Hirschsprung's disease using immunohistochemical panels could be as accurate as with conventional frozen section techniques. In particular, the use of a combination of markers for ganglia and hypertrophic nerve fibres highlighting a prominent perineurium in Hirschsprung's disease could be an alternative method.