THE DIAGNOSTIC ROLE OF CHOLINE TRANSPORTER AND CALRETININ IMMUNOHISTOCHEMISTRY IN HIRSCHSPRUNG DISEASE: A COMPARATIVE STUDY

Document Type : Preliminary preprint short reports of original research

Authors

1 Department of Pathology, Faculty of Medicine, Alexandria University.

2 pathology department, faculty of medicine, Alexandria university, Egypt

3 Department of Surgery, Armed Forces Medical Academy

Abstract

Hirschsprung’s disease is an ENS malformation, with absence of intrinsic gangliain the distal rectum and a variable length of proximal bowel. Microscopic picture in H&E stained slides include absence of ganglion cells in muscularispropria and submucosa, and hyperplasia of cholinergic nerves & neurites. Diagnosis is challenging as, it needs hard boring examination of numerous sections of the tiny suction biopsy which lake the deep submucosa & muscularispropria where the ganglion cells are abundant, searching for ganglion cells which has a normal sparse nature in the distal 1-2 cm of the rectum. So we need ancillary techniques to help in diagnosis and make it easier, previously it was used AChE EHC which needs fresh frozen sample & CR IHC. Here we study Choline Transporter IHC to be a surrogate for AChE EHC with the advantage of being used with FFPE tissue sections, and to help in cases with misleading calretinin results.

Keywords