96. Jahrestagung der Deutschen Gesellschaft für Pathologie e. V ...

FR-P-098
Immunohistological staining with the monoclonal antibody
Em2G11 is highly specific and sensitive for Echinococcus multilocularis
larvae in human tissue
T .S . Herrmann 1 , D . Tappe 2 , L . Stark 1 , B . Grüner 3 , K . Buttenschön 4 , D . Henne-
Bruns 5 , P . Kern 6 , P . Möller 1 , P . Kern 3 , P . Deplazes 7 , T .F .E . Barth 1
1 University of Ulm, Institute of Pathology, Ulm, 2 University of Würzburg,
3 University Hospital and Medical Center Ulm, Division of Infectious Diseases,
Ulm, 4 University of Alberta, Department of Surgery, Edmonton, Canada,
5 University Hospital of Ulm, Department of General, Visceral, and Transplantation
Surgery, Ulm, 6 University of Ulm, Institute of Epidemiology
and Medical Biometry, Ulm, 7 University of Zurich, Institute of Parasitology,
Zürich, Switzerland
Aims. Alveolar echinococcosis (AE) and cystic echinococcosis (CE) are
two parasitic diseases in humans caused by the metacestode stages of
Echinococcus multilocularis and Echinococcus granulosus, respectively.
Differential diagnosis is fundamental for the choice of specific therapy
strategies and prognosis.
Methods. We have analyzed 96 archived formalin-fixed, paraffin-embedded
tissue samples, including 5 cutting needle biopsies and 3 fine
needle aspirates from patients with AE or CE with the monoclonal antibody
MAbG11, specific for the antigen Em2G11 in the laminated layer of
the metacestode of E. multilocularis.
Results. We show that, in human tissue, staining with MAbG11 is highly
specific for the laminated layer and the calcareous corpuscles of the
E. multilocularis metacestode while no staining was observed in the metacestode
stage of E. granulosus. Furthermore, the antibody marks small
particles of E. multilocularis (Spems) of less than 1 µM in the necrotic
tissue surrounding the main lesion. Spems are also detected in the liver
sinusoids and lymphatic tissue outside the main lesion, most probably
due to shedding from the laminated layer. In 6 of 96 samples, the conventional
histological diagnosis based on haematoxylin and eosin and PAS
stainings alone had to be adjusted when revised by immunohistology
with MAbG11. The specific staining was proved on bioptic material fixed
for more than 60 years in formalin.
Conclusions. We conclude that the MAbG11-antibody is a highly specific
tool in the diagnostic algorithm of AE also on long-time archived formalin-fixed
or paraffin-embedded tissue. The staining modality with small
particles outside the main lesion of E. multilocularis sheds new light on
the interaction of the parasite with the human host and suggests a systemic
effect.
FR-P-099
Chronic HEV hepatitis after liver transplantation: a clinicopathological
follow up over 3 years with implications for the differential
diagnosis of chronic hepatitis
J . Friemel1 , F . Böhm1 , M . Bawohl1 , E . Marques-Maggio1 , J . Seebach2 , P . Dutkowski3
, B . Müllhaupt4 , U . Protzer2 , A . Weber1 1 2 University of Zurich, Pathology, Zürich, Switzerland, Technical University
(TU) Munich, Institute of Virology, München, 3University of Zurich, Visceraland
Transplant Surgery, Zürich, Switzerland, 4University of Zurich, Hepatology
and Gastroenterology, Zürich, Switzerland
Aims. Hepatitis E virus (HEV) infection usually manifests as an acute
and self-limiting hepatitis. Recently, cases of chronic HEV infection following
(solid) organ transplantation have been reported. Here, we present
the case of a 57-year-old man who de novo developed a chronic HEV
infection following liver transplantation (LTX).
Methods. The formalin-fixed and paraffin-embedded (FFPE) tissues
of the explant liver and six liver biopsies (taken 1 day to >3 years after
LTX) were routinely processed for histology. In addition, immunostains
(CMV and ADV) and in situ hybridisation (EBV) were performed as
well as RT-PCR testing on FFPE material for HEV, targeting the HEV
ORF2 gene region. Liver enzymes and viral infections were serologically
monitored.
Results. The patient developed elevated liver enzymes eight months after
LTX. Liver biopsy by that time showed spotty eosinophilic necrosis,
but no inflammation. After 8 month, HEV-RNA was detected serologically
and in the liver biopsy. Follow-up biopsies revealed a chronic
hepatitis with mild portal and lobular inflammation, ductular reaction
and portal fibrosis. No other viruses (hepatitis viruses A, B, C and D;
EBV, ADV, cmV) were detectable. Whereas retrospective testing of the
explanted liver and day 1 biopsy were negative, follow-up biopsies were
HEV-positive for now more than 3 years.
Conclusions. The case presented illustrates that HEV infection is an upcoming
cause of chronic hepatitis in particular in immunosuppressed
patients. The histologic pattern is similar to the chronic hepatitis C infection.
Histologic diagnosis is challenging in cases of unusual histology,
e.g. with little inflammation. Molecular testing is helpful in such cases.
FR-P-100
eIF3a as a putative gall bladder cancer target
A .K . Mehta1 , R . Spilka2 , C . Lackner1 , H . Müller1 , S . Lax3 , P . Obrist2 , J . Haybaeck1 1 2 Institute of Pathology, Medical University of Graz, Austria, Pathologylab
Dr . Obrist & Dr . Brunhuber OG, Zams, Austria, 3Department of Pathology,
General Hospital Graz West, Graz, Austria
Aims. Gallbladder carcinoma (GBC) is the most common type of biliary
tree carcinomas. GBC is an aggressive and often lethal cancer which is
usually diagnosed at advanced stage with a 5-year survival rate