The association between nm23 gene expression and survival in patients with sarcomas
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Metastasis Suppressor Gene
Synovial Sarcoma
Clinical Significance
Synovial Sarcoma
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The authors report an unusual spindle cell sarcoma that arose in the lung of a 12-year-old girl. This tumor had histologic, immunophenotypic, and ultrastructural features consistent with monophasic fibrous synovial sarcoma. These features included a growth pattern of densely packed spindle cells in irregularly intersecting, broad fascicles, diffuse vimentin immunoreactivity, and focal expression of epithelial membrane antigen and S100 protein. This diagnosis was further supported by cytogenetic studies showing the specific t(X;18) chromosomal translocation associated with synovial sarcoma. This balanced translocation appears to be an essentially universal characteristic of these sarcomas, regardless of histologic subtype or site of origin. The constellation of morphologic and cytogenetic findings in this case firmly establishes synovial sarcoma as a subtype of pulmonary spindle cell sarcomas. The distinctive features of these neoplasms allow them to be distinguished from a variety of primary and metastatic malignancies in the lung.
Synovial Sarcoma
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Seven cases of synovial sarcoma (SS), two with biphasic and five with monophasic histology, were studied immunohistochemically using monoclonal antibodies to intermediate filaments, keratin, and vlmentin. Slender spindle cells and plump cells were constant components of all the tumors. Epithelioid cells were present only in biphasic SS. Epithelioid cells and plump cells were positively stained by both keratin and vimentin. Slender spindle cells were stained positive for vlmentin and negative for keratin. Staining manner of each cell type was similar irrespective of monophasic or biphasic pattern. Present immunohistochemical studies suggested that monophasic or biphasic patterns in SS should be regarded as a different expression of the same disease. In addition, immunohistochemistry proved to be a useful tool to detect plump cells which were difficult to find on routine staining.
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EWS-FLI1 and EWS-ERG Gene Fusions Are Associated With Similar Clinical Phenotypes in Ewing's Sarcoma
PURPOSE: There are a variety of solid tumors in which alternative chromosomal translocations generate related fusion products. In alveolar rhabdomyosarcoma and synovial sarcoma, these variant fusions have been found to have major clinical significance. We investigated whether the two alternative gene fusion products, EWS-FLI1 and EWS-ERG, define different clinical subsets within the Ewing's sarcoma family of tumors. PATIENTS AND METHODS: We selected 30 cases of Ewing's sarcoma with the EWS-ERG gene fusion and 106 cases with the EWS-FLI1 fusion. Clinical data were obtained for each case and compared with the molecular diagnostic findings. RESULTS: There were no significant clinical differences observed between the two groups in age of diagnosis, sex, metastasis at diagnosis, primary site, event-free survival, or overall survival. CONCLUSION: Differences in the C-terminal partner in the Ewing's sarcoma family gene fusions are not associated with significant phenotypic differences.
FLI1
Ewing's sarcoma
Synovial Sarcoma
Clinical Significance
Erg
Alveolar rhabdomyosarcoma
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Synovial Sarcoma
Immunostaining
Epithelioid sarcoma
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Purpose . The histological diagnosis of Mycobacterium tuberculosis (MTB) remains a diagnostic challenge despite different methods. Immunohistochemistry (IHC) not only could confirm granulomatous tissue involvement but also can demonstrate MTB antigen immunolocalization. This study tries to clarify the details of immunohistochemical staining for MTB with pAbBCG. Materials/Methods . Twenty-three confirmed TB granulomatous tissue samples were studied by Ziehl-Neelsen and immunohistochemistry (IHC) staining with pAbBCG. Samples were selected from the archive of the Department of Pathology, National Research Institute of Tuberculosis and Lung Disease, Tehran, Iran. Results . IHC staining was positive in all samples, whereas Ziehl-Neelsen was positive in 9 cases out of 23 (39.1%). Tissue types used were pleural tissue, lymph nodes, and lung tissue. IHC showed positive coarse granular cytoplasmic and round, fragmented bacillary staining. In this study, epithelioid cells clearly showed more positive staining at the periphery of the granuloma rather than the center of granuloma. There is also positive staining in endothelial cells, fibroblasts, plasma cells, lymphocytes, and macrophages outside the granuloma. Conclusion . Considering the criteria of positive immunohistochemical staining of TB granulomatous reactions, this stain not only highlights the presence of mycobacterial antigens for tissue diagnosis, but also could morphologically localize its distribution in different cells.
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Ziehl–Neelsen stain
Periodic acid–Schiff stain
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Histology
Synovial Sarcoma
Tissue microarray
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Background: Synovial sarcoma is the common adult soft tissue sarcomas affects the lower extremities. In poor resource settings, characterization by molecular methods may not be feasible always. This study is aimed to evaluate Sensitivity and Specificity of Transducin-like enhancer of split 1 (TLE1) immunohistochemical expression in Synovial sarcomas (SS) and its histological mimics and to study the clinicopathological features of Synovial sarcoma.
Method: A prospective study of two years duration from September 2013 to September 2015 conducted at the Department of Pathology, MNJ Institute of Oncology and Regional Cancer Centre, Redhills, Hyderabad. Total number of Synovial sarcomas was 30. All original H & E section of the tumor are reviewed and Immunohistochemistry (IHC) analysis was carried out on TLE1 mouse monoclonal antibody (TMA) blocks using TLE1 Antibody.
Results: The Median age was 30 years. The most common site of involvement was lower limbs. The most common mode of presentation was painless swelling. The most common variant of Synovial sarcoma was monophasic Spindle in 19 cases. Total number of TLE1 positive cases of Synovial sarcoma was 93.3%. Total number of SS mimics showing TLE1 positivity was30%. TLE1 showed Sensitivity 93.3% and Specificity- 73.3%. In the present study negative predictive value is 91.6% and the positive predictive value is 77.7%.
Conclusion: All small round blue cell tumors should be kept in mind while diagnosing poorly differentiated SS. TLE1 is a very sensitive marker for synovial sarcoma.TLE 1 is a highly sensitive marker for synovial sarcoma, but is less specific because of its positive expression in other mesenchymal tumors.
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Abstract The immunohistochemical staining pattern of 18 cases of synovial sarcoma with two epithelial‐specific monoclonal antibodies is described. This is compared with normal synovium, cases of giant cell tumour of tendon sheath (benign synovioma) and a variety of spindle celled sarcomas. Sixteen cases of synovial sarcoma showed staining of the epithelial component with at least one antibody. No staining was seen in normal synovium or in giant cell tumours of tendon sheath. A small number of malignant schwannomas contained groups of cells which stained positively whilst other spindle cell sarcomas either did not stain or showed ‘cross‐reaction’ type staining only. These results add weight to the proposition that synovial sarcomas do not arise from normal synovium, despite their morphological similarities, but from mesenchymal connective tissue. It is also shown that immunohistochemical staining with anti‐epithelial antibodies will emphasize the biphasic pattern of synovial sarcomas allowing their distinction from other sarcomas.
Synovial Sarcoma
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Molecular analysis is gold standard for diagnosis of synovial sarcoma (SS) but use of these ancillary techniques is limited by many practical issues like cost and limited resources. Several studies analyzed TLE1 as a diagnostic immunohistochemical marker for synovial sarcoma and few studies disagreed. The objective of the study was to evaluate immunohistochemical expression of TLE1 in synovial sarcoma and its histological mimics.The study included a total of 63 cases; of which 28 were synovial sarcomas (SS) and 35 its histologic mimics. A tissue microarray was constructed from these cases and subjected to TLE immunostaining. Nuclear immunoreactivity of TLE1 was graded as 0, 1+, 2+ and 3+ based on intensity and percentage of cells.All SS except one (27/28; 96.4%) were positive for TLE 1. These included 18 of monophasic spindle cell type (94.7%), 5 biphasic type (100%), followed by two each (100%) of poorly differentiated and calcifying type of SS. Of the other tumours 2 GISTs (50%), 2 haemangiopericytoma (66.7%), 2 schwannomas (50%) and one mesenchymal chondrosarcoma (33.3%) were positive for TLE1.TLE 1 is a highly sensitive marker with reasonable specificity for synovial sarcoma. Awareness of TLE1 expression in other tumours, is important to avoid misdiagnosis.
Synovial Sarcoma
Tissue microarray
Immunostaining
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