IMAGE CYTOMETRIC NUCLEAR-DNA QUANTITATION OF PARAGANGLIOMAS IN TISSUE-SECTIONS - PROGNOSTIC-SIGNIFICANCE

OBJECTIVE: Image cytometric quantitation of nuclear DNA of paraganglio mas may provide prognostic information that cannot be obtained from hi stopathologic study. Flow cytometry has demonstrated DNA aneuploid tum ors to have a higher risk of progression than diploid neoplasms. STUDY DESIGN: DNA ploidy of 56 paragangliomas was assessed by image cytomet ry of 5-mu m, Feulgen-stained, formalin-fixed, paraffin-embedded tissu e sections.RESULTS: Thirty-three (59%) paragangliomas were diploid and 23 (41%) aneuploid. Of the 30 adrenal pheochromocytomas, 15 (50%) wer e diploid. Thirteen (93%) of the 14 carotid body tumors were diploid. Five of seven (71%) glomus jugulare tumors and two of five (40%) extra adrenal paragangliomas were aneuploid. During a mean follow-up of 57 m onths (range, 1 month to 36 years) of 44 patients with 47 paragangliom as, 33 (75%) were alive and without disease; 7 (16%), including 1 glom us jugulare, 2 carotid body and 4 pheochromocytoma patients, developed recurrences/metastases. By multivariate analysis, image cytometric DN A ploidy was predictive of disease-free survival for adrenal pheochrom ocytomas. No significant differences in overall survival, disease-free survival or recurrence/metastasis rate were noted between other diplo id and aneuploid tumors. CONCLUSION: Aneuploidy suggests a risk of ear ly recurrence for adrenal pheochromocytomas.