Contributions of Immunohistochemistry to the Diagnosis of Soft Tissue Tumors

Wick, Mark R.; Manivel, J. Carlos; Swanson, Paul E.

doi:10.1007/978-3-662-12820-6_13

Cited by 12 publications

(4 citation statements)

References 258 publications

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“…Case 4 in this study serves to underscore this premise, since deep local invasion and distant metastases were evident within 24 months of diagnosis, with the patient ultimately dying of her disease. While ultrastructural confirmation of myogenic differetitiation was lacking in this example of dermal LMS, we feel that its histologic features, and the immunohistochemical demonstration of desmin (26)(27)(28)(29)(30) and muscle-specific actin (31) are sufllcient for a confident diagnosis of leiomyosarcoma.…”

Section: Discussionmentioning

confidence: 80%

“…Of course, caveats in diagnostic immunohistochemistry inevitably suffer from exceptions. For example, rare cases of neuroflbrosarcoma (NFS) may express both vimentin and desmin in spindle-cell foci, as well as S-100 or Leu 7 (30,35). NFS is much less common than LMS in cutaneous sites (2), however, and in our experience it is readily separated from the latter on the basis of ultrastructural analy-sis when light microscopic examination is not diagnostic.…”

Section: Discussionmentioning

confidence: 99%

“…For practical purposes, no other malignant cutaneous spitidle-cell tumor besides LMS co-expresses desmin and vimentin with a diffuse pattern of reactivity. "Fibrohistiocytic" neoplasms display vimentin (28)(29)(30) and cathepsin-B-positivity (39), and may rarely express desmin as well in a minor tumor cell population (28,29,38), but will not exhibit S-100 or Leu 7 (35). The presence of cathepsin-B in tumors of both fibrohistiocytic and myogenic differentiation probably reflects the normal tissue distribution of this enzyme, which may be a constituent of smooth muscle cells, myofibroblasts, and other mesenchymal elements (40)(41)(42).…”

Section: Discussionmentioning

confidence: 99%

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Primary cutaneous leiomyosarcoma. A histological and immunohistochemical study of 9 cases, with ultrastructural correlation

Swanson¹,

Stanley²,

Scheithauer³

et al. 1988

J Cutan Pathol

103

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Leiomyosarcoma (LMS) of dermal and subcutaneous tissues is an uncommon neoplasm. In order to analyze the specialized pathologic features of this tumor, we undertook a histological, ultrastructural, and immunohistochemical study of 9 superficial LMS, including 7 dermal lesions and 2 subcutaneous neoplasms. These were compared with 12 examples of "deep" extracutaneous LMS. Metastases to the skin from two of the latter neoplasms were also examined. Immunohistochemistry was found to be a useful diagnostic adjunct to light microscopic and ultrastructural studies in that all LMS coexpressed vimentin and desmin, regardless of site, and 90% also expressed muscle-specific actin. Variable expression of cathepsin B and myelin basic protein was noted in 8 and 10 tumors, respectively, whereas none contained cytokeratin. Weak cytoplasmic positivity for epithelial membrane antigen was seen in 1 dermal and 3 extracutaneous LMS. Of 7 dermal LMS, 4 contained S-100 protein, whereas this determinant was found in only 1 of 12 extracutaneous tumors. Conversely, Leu 7 reactivity was present in 7 of 12 extracutaneous LMS, but only 2 of 9 superficial lesions. Review of clinical features confirmed that subcutaneous LMS is capable of aggressive behaviour, whereas dermal LMS was more likely to behave in an indolent fashion. However, one example of dermal LMS exhibited aggressive local recurrences and distant metastasis, ultimately leading to the death of the patient. Therefore, careful clinical followup is indicated in all cases.

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Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Primary cutaneous leiomyosarcoma. A histological and immunohistochemical study of 9 cases, with ultrastructural correlation

Swanson¹,

Stanley²,

Scheithauer³

et al. 1988

J Cutan Pathol

103

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“…Malignant melanomas are typically vimentin, NSE, S100 protein, 88 –90 NKIC3 91 –93 and HMB‐45 positive 90 , 94 –96 . Recently anti‐Melan‐A 97 –102 and antityrosinase 103 antibodies have been introduced as two other melanocytic markers (Table 3).…”

Section: Immunophenotype Of Melanomasmentioning

confidence: 99%

Morphological and immunophenotypic variations in malignant melanoma

2000

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A variety of cytomorphological features, architectural patterns and stromal changes may be observed in malignant melanomas. Hence, melanomas may mimic carcinomas, sarcomas, benign stromal tumours, lymphomas, plasmacytomas and germ cell tumours. Melanomas may be composed of large pleomorphic cells, small cells, spindle cells and may contain clear, signet-ring, pseudolipoblastic, rhabdoid, plasmacytoid or balloon cells. Various inclusions and phagocytosed material may be present in their cytoplasm. Nuclei may show bi- or multi-nucleation, lobation, inclusions, grooving and angulation. Architectural variations include fasciculation, whorling, nesting, trabeculation, pseudoglandular/pseudopapillary/pseudofollicular, pseudorosetting and angiocentric patterns. Myxoid or desmoplastic changes and very rarely pseudoangiosarcomatous change, granulomatous inflammation or osteoclastic giant cell response may be seen in the stroma. The stromal blood vessels may exhibit a haemangiopericytomatous pattern, proliferation of glomeruloid blood vessels and perivascular hyalinization. Occasionally, differentiation to nonmelanocytic structures (Schwannian, fibro-/myofibroblastic, osteocartilaginous, smooth muscle, rhabdomyoblastic, ganglionic and ganglioneuroblastic) may be observed. Typically melanomas are S100 protein, NKIC3, HMB-45, Melan-A and tyrosinase positive but some melanomas may exhibit an aberrant immunophenotype and may express cytokeratins, desmin, smooth muscle actin, KP1 (CD68), CEA, EMA and VS38. Very rarely, neurofilament protein and GFAP positivity may be seen.

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Cutaneous epithelioid angiosarcoma: A potential diagnostic trap for cytopathologists

Collins

Law

et al. 1997

Diagn. Cytopathol.

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Contributions of Immunohistochemistry to the Diagnosis of Soft Tissue Tumors

Cited by 12 publications

References 258 publications

Primary cutaneous leiomyosarcoma. A histological and immunohistochemical study of 9 cases, with ultrastructural correlation

Primary cutaneous leiomyosarcoma. A histological and immunohistochemical study of 9 cases, with ultrastructural correlation

Morphological and immunophenotypic variations in malignant melanoma

Cutaneous epithelioid angiosarcoma: A potential diagnostic trap for cytopathologists

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