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Penegakan diagnosis pseudotumor dan limfoma maligna adneksa mata dengan metode imunohistokimia = The reliability of haematoxylin eosin staining and immunohistochemistry panelin differentiating ocular adnexal lymphoma and pseudotumor

Tujuan Untuk mengetahui reliabilitas pemeriksaan hematoksilin eosin (HE) dan panel imunohistokimia (IHK) dalam membedakan pseudotumor dan limfoma maligna di mata dengan menilai intraobserver agreement Metode Deskriptif analitik. Peneliti yang tersamar meninjau ulang sediaan HE dan kombinasi HE dengan panel IHK yang terdiri dari CD20, CD3, CD43, Ki67, Bcl2 . Evaluasi HE dilakukan 3 kali, sedangkan evaluasi IHK dilakukan 2 kali dengan interval 2 minggu. Intraobserver agreement dihitung dengan nilai kappa. Ekspresi masing masing penanda akan dideskripsikan secara kuantitatif. Predominansi limfosit dihitung dengan rasio CD20 terhadap CD3 dan CD43. Hasil Nilai kappa evaluasi HE adalah moderate (! = 0.59-0.80), sedangkan kombinasi HE dan panel imunohistokimia adalah excellent (! = 0.93). Median (kisaran) CD20 lebih tinggi pada limfoma [97.41 (80-100)] dibandingkan pseudotumor [80.79 (1-94.49)]. Median (kisaran) CD3 lebih tinggi pada pseudotumor [48.84 (2.32-64.27)] dibandingkan limfoma [36.19 (0.01-82.13)]. Median (kisaran) CD 43 relatif sama pada limfoma [73.81 (9.28-100)] dan pseudotumor [72.36 (46.55100)]. Median (kisaran) Bcl2 relatif sama pada limfoma [85.22(0.37-99.54)] dan pseudotumor [78.95 (64.24-91.73)]. Median (kisaran) Ki67 relatif sama rendah pada limfoma [11.13 (1.89-93.54)] dan pseudotumor [6.59 (0.05-49.60)]. Median rasio CD20:CD3 limfoma [2.75 (1.12-8766)] lebih tinggi dibandingkan pseudotumor [1.60 (0.43-2.74)]. Kesimpulan Kombinasi evaluasi HE dan panel imunohistokimia memiliki reliabilitas yang lebih tinggi dibandingkan HE dalam membedakan limfoma adneksa mata dan pseudotumor


Objective To investigate the reliability of haematoxylin eosin (HE) staining and immunohistochemistry (IHC) panel in differentiating ocular adnexal lymphoma and pseudotumor by measuring intra observer agreement. Methods A descriptive analytical study. Haematoxylin eosin staining and IHC panels (CD20, CD3, CD43, Ki67, Bcl-2) of 32 cases (15 lymphoma and 17 pseudotumor) were reviewed by a pathologist whose blinded to its previous diagnosis. The review was performed twice in two weeks apart. The intra observer agreement was analyzed using ! statistics. IHC markers were analyzed quantitatively. Lymphocytes predominance was indicated by CD20 ratio to CD3 or CD43. Results The ! statistics of HE stainings evaluation was moderate (! = 0.59-0.80), while that of HE and IHC panel was excellent (! = 0.93). Median (range) of CD20 was higher in lymphoma [97.41 (80-100)] compared to that of pseudotumor [80.79 (194.49)]. Median (range) of CD3 was higher in pseudotumor [48.84 (2.32-64.27)] compared to that of lymphoma [36.19 (0.01-82.13)]. Median (range) of CD 43 was comparable in lymphoma [73.81 (9.28-100)] and that of pseudotumor [72.36 (46.55-100)]. Median (range) of Bcl2 was comparable in lymphoma [85.22(0.3799.54)] and that of pseudotumor [78.95 (64.24-91.73)]. Median (range) of Ki67 was comparably low both in lymphoma [11.13 (1.89-93.54)] and pseudotumor [6.59 (0.05-49.60)]. Median (range) of CD20:CD3 ratio of lymphoma [2.75 (1.128766)] was higher than that of pseudotumor [1.60 (0.43-2.74)]. Conclusions The combination of HE and IHC panel have a higher reliability compared to HE alone in differentiating ocular adnexal lymphoma and pseudotumor