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Published on: January 9, 2019
Morphometric evaluation of nucleolar organiser regions in reactive and neoplastic lymph node lesions
B Arora1, Sanjay Kumar, Rahul Jain
1Department of Pathology, Postgraduate Institute of Medical Sciences, Rohtak 124001.
Insights
Argyrophilic nucleolar organiser regions (AgNORs) analysis in lymph nodes reveals significant differences between reactive lymphadenitis, non-Hodgkin's lymphoma (NHL), and metastatic carcinoma. AgNOR counts and morphometric parameters aid in differentiating these conditions.
Area of Science:
- Histopathology
- Oncology
- Cytopathology
Background:
- Argyrophilic nucleolar organiser regions (AgNORs) are established biomarkers for diagnosing and prognosing neoplastic lesions.
- Quantitative and morphometric analysis of AgNORs can provide objective diagnostic criteria.
Purpose of the Study:
- To perform a quantitative and morphometric analysis of AgNORs in various lymph node lesions.
- To evaluate the utility of AgNOR parameters in differentiating reactive lymphadenitis, non-Hodgkin's lymphoma (NHL), and metastatic carcinoma.
Main Methods:
- Studied 30 lymph node cases: 10 reactive lymphadenitis, 10 NHL (4 low-grade, 6 high-grade), and 10 metastatic carcinoma.
- Utilized an automatic image analyzer for quantifying AgNOR dots and evaluating their morphometry.
- Assessed AgNOR count, single AgNOR area, total AgNOR area, and their ratios to nuclear area.
Main Results:
- Mean AgNOR count was highest in metastatic lymph nodes (5.37), followed by high-grade NHL (5.12), low-grade NHL (4.61), and reactive lymphadenitis (2.45).
- Total AgNOR area was also highest in metastatic lymph nodes, followed by NHL and reactive lymphadenitis.
- The ratio of AgNOR area to nuclear area was highest in reactive lymphadenitis and lowest in metastatic lymph nodes.
Conclusions:
- AgNOR count and morphometric parameters show significant differences across reactive lymphadenitis, NHL, and metastatic lymph node lesions.
- These quantitative AgNOR features can assist in the differential diagnosis of challenging lymph node cases.
- AgNOR analysis offers a valuable tool for histopathological assessment of lymph node abnormalities.
Abstract:
Argyrophilic nucleolar organiser regions (AgNORs) have widely been used for making diagnostic as well as prognostic statements in neoplastic lesions. The present study was aimed at the quantitative and morphometric analysis of AgNORs in various lesions of lymph node. Thirty cases consisting 10 cases each of reactive lymphadenitis, non-Hodgkin's lymphoma (NHL) and metastatic deposits from carcinoma breast were included in the present study. Out of the ten cases of NHL, there were four cases of low grade and six cases of high grade lymphoma. The quantification of AgNOR dots and their morphometric evaluation were done using a specific programme of an automatic image analyser. The results revealed that mean AgNOR count was maximum in metastatic lymph nodes (5.37 +/- 0.35) when compared with NHL (high grade 5.12 +/- 0.27; low grade 4.61 +/- 0.13) and reactive lymphadenitis (2.45 +/- 0.49). The mean area of single AgNOR dot in metastatic lymph node, high grade lymphoma, low grade lymphoma and reactive lymphadenitis were 123.3 +/- 26.1, 95.3 +/- 12.2, 99.6 +/- 6.53 and 87.4 +/- 8.45 respectively. Similarly, the mean of total AgNOR area in metastatic lymph nodes was highest (668.4 +/- 169.9) followed by NHL (high grade 496.35 +/- 53.2; low grade 459.25 +/- 37.35) and reactive lymph node (215.0 +/- 37). However, the ratio of single AgNOR area to nuclear area was maximum in reactive lymphadenitis (0.132 +/- 0.001) followed by low grade NHL (0.083 +/- 0.0096), high grade NHL (0.073 +/- 0.0098) and metastatic lymph nodes (0.064 +/- 0.001). The ratio of total AgNOR area to nuclear area was also minimum in reactive lymph node when compared with other neoplastic lesions. Statistically, the p-value revealed a highly significant difference among all these lesions. Thus, it can be concluded from the present study that AgNOR count and other morphometric parameters are significantly altered in different lesions of lymph node which may aid in differentiation of problematic cases.
