GATA3 Differential Expression in
We have read with great interest the report by Wiles et al,
published in Cancer Cytopathology, about the immunohis-
tochemical expression of the GATA3 antibody in cytolog-
ical material from neuroblastomas.
GATA3 immunohistochemical expression in neuroblas-
toma cytology and/or biopsy samples, and diffuse nuclear
positivity was found in all 30 specimens studied. Each
sample revealed either strong (n 5 26) or moderate
nuclear staining (n 5 4) in more than 75% of neuroblas-
toma cells, regardless of the presence or lack of stromata,
necrosis, or differentiation.
GATA3 is a relatively recent marker useful for diag-
nosing tumors of various epithelial and nonepithelial ori-
gins such as mammary tumors, urothelial tumors, renal
tumors, germ cell tumors, mesotheliomas, and paragan-
gliomas. Moreover, it is usually negative in round cell sar-
In contrast, little is known about GATA3
expression in blastemal or other small round cell pediatric
tumors. Nonaka et al
reported the presence of diffuse
GATA3 expression in the neuroblastoma family of tumors
and a lack of expression in other small round cell tumors.
The distinction between neuroblastomas and
nephroblastomas may be delicate because the clinical and
radiological presentation may be overlapping. Moreover,
we have previously encountered important difficulties in
the cytological differential diagnosis between poorly
differentiated neuroblastomas without neuropils or
differentiating cells from blastema-rich monophasic
We initiated this study to evaluate GATA3’s
immunohistochemical utility in the cytological differ-
ential diagnosis between neuroblastomas and nephro-
blastomas. Six cell blocks from the most recent
consecutive ultrasound-guided fine-needle aspirates
from neuroblastomas and 6 cell blocks from nephro-
blastomas were investigated.
Paraffin-embedded sections were stained with the
GATA3 antibody (clone L50-823; Biocare, Concord,
California). Immunostaining was scored as negative,
weakly positive, or strongly positive. The percentage of
positive cells was also estimated.
Nuclear staining was found in all 6 cases of neuro-
blastoma but in only 1 case of nephroblastoma. No
cytoplasmic staining was observed. The intensity varied
from weak (4 cases) to strong (2 cases; Figs. 1 and 2).
The percentage of positive cells varied from 5% to
100%. Only 1 of the 6 cases of nephroblastoma showed
weak nuclear positivity in 5% of tumor cells. The clini-
cal data and the results of immunohistochemistry are
presented in Table 1
On the basis of our results, we conclude that
GATA3 may be a useful marker for differentiating neuro-
blastomas from nephroblastomas, especially when it is
used with Phox2b and tyrosine-hydroxylase antibodies.
Moreover, in some cases, GATA3 may be not specific,
and positivity in a blastemal nephroblastoma may be a pit-
fall of a differential diagnosis with a poorly differentiated
Figure 2. Weak GATA3 nuclear positivity in nephroblastoma.
Figure 1. Strong GATA3 nuclear positivity in neuroblastoma.