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Aanchal Kakkar
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P1.05 - Interventional Diagnostics/Pulmonology (Not CME Accredited Session) (ID 937)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.05-11 - Role of EBUS-TBNA in Evaluation of Mediastinal Lymphadenopathy and Masses in Patients with Known or Suspected Extra-Pulmonary Malignancies (ID 11907)
16:45 - 18:00 | Author(s): Aanchal Kakkar
- Abstract
Background
Endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) has recently emerged as a minimally invasive and safe modality for the evaluation of mediastinal lymphadenopathy, particularly in staging of lung carcinoma patients. Our aim was to evaluate its utility in patients with non-pulmonary malignancies presenting with mediastinal lymphadenopathy.
a9ded1e5ce5d75814730bb4caaf49419 Method
A computerized database search was performed for all EBUS-TBNA aspirations performed from 2015 to 2017 on patients with known or suspected extra-pulmonary malignancy and presence of mediastinal lymphadenopathy and/or masses on imaging. All archived cytology material was reviewed and categorized as positive, negative and unsatisfactory. Follow-up histology samples served as comparison standard.
4c3880bb027f159e801041b1021e88e8 Result
One-hundred-twenty-one patients were included. In 99 patients with known malignancy, primary sites were in the head and neck (25%), breast (22%), female genital tract (9%), lower gastrointestinal (GI)-tract (8%), genitourinary tract (7%), and upper GI-tract (5%). Six patients had history of hematolymphoid malignancy while primary site or type of malignancy was unknown in the remaining (18%). EBUS-TBNA diagnosed metastases or lymphoma relapse in 48 (40%), identified new malignancy in 18 (15%), granulomatous inflammation in 15 (12%), tuberculosis in 2 (1%), reactive lymphadenitis in 21 (17%) patients and was inadequate in 17 (14%) patients. Cell block was adequate in 43% (23/53) cases and was indispensible for diagnosis in 13% (7/53) cases. Subcarinal and right paratracheal lymphnodes were most commonly aspirated (77%) while hilar and paratracheal masses of non-lymphnode origin were assessed in 10% cases. Follow-up histology samples (available only in 13 cases) showed 100% concordance with EBUS-TBNA results (no false positive or false negative cases). Two cases unsatisfactory on EBUS-TBNA were positive for malignancy on histology.
8eea62084ca7e541d918e823422bd82e Conclusion
EBUS-TBNA is a highly efficient modality for the evaluation of mediastinal lymphnodes and masses in patients with extra-pulmonary malignancies with an overall diagnostic yield of 86%.
6f8b794f3246b0c1e1780bb4d4d5dc53
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P1.09 - Pathology (Not CME Accredited Session) (ID 941)
- Event: WCLC 2018
- Type: Poster Viewing in the Exhibit Hall
- Track:
- Presentations: 1
- Moderators:
- Coordinates: 9/24/2018, 16:45 - 18:00, Exhibit Hall
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P1.09-11 - Immunohistochemical Assessment of BRCA1 Associated Protein-1 (BAP1) in Pulmonary Mucoepidermoid Carcinomas (ID 11322)
16:45 - 18:00 | Author(s): Aanchal Kakkar
- Abstract
Background
Primary pulmonary mucoepidermoid carcinomas (PMEC) are rare tumors that account for <1% of all lung carcinomas. They are presumed to originate from the minor salivary glands lining the tracheobronchial tree. PMEC are the most common malignant salivary gland tumors of tracheobronchial tree. Despite recent advances in diagnosis and treatment, there has not been much improvement in the outcome of patients with MECs, thus necessitating the identification of novel targeted therapeutic agents. Comprehensive genomic profiling has recently revealed genomic aberrations in BRCA1 associated protein-1 (BAP1) gene in a subset of their non-pulmonary salivary gland counterparts. We conducted this study to identify loss of BAP1 by immunohistochemistry (IHC) in a cohort of PMECs.
a9ded1e5ce5d75814730bb4caaf49419 Method
Cases of PMECs were retrieved from the departmental archives. Hematoxylin and eosin stained sections were reviewed. Immunohistochemistry for BAP1 was performed on formalin fixed paraffin-embedded tumor sections.
4c3880bb027f159e801041b1021e88e8 Result
Twenty-five PMEC cases were retrieved, out of which sufficient tumor tissue for IHC was available only in 15 PMECs. Thirteen (86.7%) tumors were tracheobronchial in location, while two (13.3%) were intraparenchymal. All were low grade MECs. On immunohistochemistry, BAP1 nuclear staining was retained in all cases (100%), irrespective of tumor location or grade.
8eea62084ca7e541d918e823422bd82e Conclusion
Identification of easily applicable techniques to detect BAP1 loss in PMECs is needed for therapeutic decisions. Using IHC, loss of BAP1 staining was not seen in any of our cases, suggesting either the extreme rarity of BAP1 loss in PMEC or insensitivity of BAP1 IHC to detect aberrations at genomic level. Analysis of aberrations in BAP1 gene by genomic approaches in PMECs may be done before excluding the possibility of BAP1 gene as a predictive biomarker for targeted therapies.
6f8b794f3246b0c1e1780bb4d4d5dc53
