Immunohistochemistry of MyoD1 in Adult Pleomorphic Soft Tissue Sarcomas

Wesche, W. A.; Fletcher, C. D. M.; Dias, Peter; Houghton, Peter J.; Parham, David M.

doi:10.1097/00000478-199503000-00003

Cited by 45 publications

(22 citation statements)

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“…Cytoplasmic positivity therefore should be used as a supportive but nonspecific finding for PRMS. The sensitivity of MyoD1 is as high as 90% in the literature, yet only ten cases have been tested (27,31). Myf4, myogenin, a supportive skeletal muscle marker, was only 53% sensitive for PRMS, in our experience.…”

Section: Figurementioning

confidence: 61%

“…With the exception of myoglobin, a protein found late in embryonic muscle development and requiring experienced interpretation, all other antibodies were found to be nonspecific for skeletal muscle phenotype. In the most recent decade, several series have used an immunohistochemical approach to identify PRMS (15,17,(27)(28)(29)(30)(31). In 1993, fast myosin, a skeletal muscle-specific marker, was added to the repertoire for PRMS (15).…”

Section: Discussionmentioning

confidence: 99%

“…15,21,29,31). However, with the exception of one group (29), who described a background of larger round cells, presumably rhabdomyoblasts, mainly only spindled and polygonal background cells have been previously recognized in the literature (15)(16)(17)(18)29).…”

Section: Figurementioning

confidence: 97%

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Pleomorphic Rhabdomyosarcoma in Adults: A Clinicopathologic Study of 38 Cases with Emphasis on Morphologic Variants and Recent Skeletal Muscle-Specific Markers

2001

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Pleomorphic rhabdomyosarcoma (PRMS) is a rare and controversial tumor of skeletal muscle phenotype. Diagnostic criteria for PRMS by combined histology and currently available immunohistochemistry have not been clearly defined. We report 38 pleomorphic rhabdomyosarcomas in adults, explore morphologic variants, and discuss our experience with both specific and nonspecific skeletal muscle markers in these tumors. Clinical data, morphology, and immunohistochemistry were reviewed. Electron microscopy was performed. Of 38 cases, there were 28 males and 10 females. Patient ages ranged from 21 to 81 years (median ‫؍‬ 54 y; mean ‫؍‬ 51 y). Tumors were located in the lower extremity (n ‫؍‬ 18), abdomen/retroperitoneum (n ‫؍‬ 6), chest/abdominal wall (n ‫؍‬ 5), spermatic cord/ testes (n ‫؍‬ 4), upper extremity (n ‫؍‬ 3), and one each in the mouth and orbit. Tumor sizes ranged from 1.5 to 15.0 cm (mean ‫؍‬ 7.3 cm; median ‫؍‬ 6.8 cm). The cases were divided into three variants, each with large, atypical, pleomorphic polygonal rhabdomyoblasts (PRMB) with abundant eosinophilic cytoplasm in varying numbers and different morphologic backgrounds of round or spindled rhabdomyoblasts (RMB). , fast skeletal muscle myosin, or myf4). In addition, all cases had some positivity for nonspecific muscle markers (desmin, MSA, SMA, myf3). Electron microscopy (EM), performed on eight selected cases from all three morphologic groups, demonstrated definitive skeletal muscle differentiation in all cases. Follow-up, available on 30 (79%) cases, revealed that 70% of patients died of disease (mean 20 months, range 1 month-108 months), 3% were alive with disease at 12 months (n ‫؍‬ 1); and 27% had no evidence of disease (mean, 83 mo; range, 18 to 108 mo). PRMS, a tumor of predominantly middle-aged adult males in the lower extremity, can be diagnosed by the morphologic presence of scattered PRMB with immunohistochemical evidence of at least one skeletal muscle-specific marker. There are three morphologic variants of PRMS. The appropriate diagnosis of PRMS is significant as it is a high-grade sarcoma, with an aggressive clinical course.

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Section: Figurementioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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Pleomorphic Rhabdomyosarcoma in Adults: A Clinicopathologic Study of 38 Cases with Emphasis on Morphologic Variants and Recent Skeletal Muscle-Specific Markers

2001

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“…5). (20) 20/20ϩ Spindle cell (1) 1/1ϩ Other pediatric sarcomas (50) 0/50ϩ ESFT (16) 0/14ϩ Nephroblastoma (6) 2/6ϩ a Ectomesenchymoma (2) 2/2ϩ DSRCT (6) 0/6ϩ Rhabdoid (5) 0/5ϩ Precursor hematopoeitic neoplasms (7) 0/7ϩ NB/GNB (4) 0/4ϩ Olfactory neuroblastoma (5) 0/5ϩ ESFT, Ewing's sarcoma family of tumors; DSRCT, desmoplastic small round cell tumor; NB/GNB, neuroblastoma/ganglioneuroblastoma. a These two nephroblastomas had myogenous differentiation.…”

Section: Resultsmentioning

confidence: 99%

“…The expression of markers specific for rhabdomyoblastic differentiation is particularly useful in defining lineage in some poorly differentiated/undifferentiated tumors and antibodies to MyoD1 and myogenin proteins have been found to be of most use in this regard (1)(2)(3)(4)(5). Although staining for MyoD1 was the first to be used in the diagnostic setting, nonspecific cytoplasmic staining often makes interpretation of results problematic when fixed tissue sections are used (3,6,7).…”

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confidence: 99%