Patterns of keratin polypeptides in 110 biphasic, monophasic, and poorly differentiated synovial sarcomas

Miettinen, Markku; Limon, Janusz; Niezabitowski, A; Lasota, Jerzy

doi:10.1007/s004280000238

Cited by 77 publications

(42 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1 However, when molecular genetic analysis is not available and immunoreactivities for epithelial membrane antigen and cytokeratins are inconspicuous, differential diagnosis from other spindle cell sarcomas might be difficult. 27 Poorly differentiated synovial sarcoma cells show even more limited expression of cytokeratin. 28,29 In this study, cases with reduced expression were recognized more frequently among monophasic fibrous-type tumors (63%) than among tumors resembling spindle cell sarcomas (0/30: 0%).…”

Section: Discussionmentioning

confidence: 99%

Reduced expression of SMARCB1/INI1 protein in synovial sarcoma

et al. 2010

View full text Add to dashboard Cite

Synovial sarcoma is classified as a tumor of uncertain differentiation, and some synovial sarcomas have rhabdoid cells. In previous studies, all malignant rhabdoid tumors and renal medullary carcinomas, some extraskeletal myxoid chondrosarcomas, almost all epithelioid sarcomas and half of epithelioid malignant peripheral nerve sheath tumors showed a loss of SMARCB1/INI1 protein expression in tumor cells and all of these tumors are also known to have rhabdoid cells. We analyzed the immunohistochemical and mRNA expression of SMARCB1/INI1 in 95 synovial sarcomas (73 monophasic fibrous type, 18 biphasic type and 4 poorly differentiated type) and 30 spindle cell sarcomas (3 adult fibrosarcomas, 7 fibrosarcomas arising in dermatofibrosarcoma protuberans, 10 leiomyosarcomas and 10 malignant peripheral nerve sheath tumors) resembling monophasic fibrous synovial sarcoma. The results have shown that 66 of the 95 synovial sarcoma cases (69%) had reduced SMARCB1/INI1 protein expression, whereas the remaining 29 cases (31%) and all 30 spindle cell sarcomas showed preserved this protein expression. No case with a complete loss of SMARCB1/INI1 protein expression was recognized. The median values of SMARCB1/INI1 mRNA expression in non-tumor skeletal muscle and synovial sarcoma with reduced protein expression were 12.86 and 134.01, respectively, and a statistically significant difference was detected between these two groups (P ¼ 0.0000004). However, there was no statistically significant difference of prognosis between the synovial sarcoma group with reduced and that with preserved SMARCB1/INI1 protein expression (P ¼ 0.46). Therefore, it was suggested that there is a post-transcriptional SMARCB1/INI1 regulatory mechanism in the tumor cells of synovial sarcoma.

show abstract

Section: Discussionmentioning

confidence: 99%

Reduced expression of SMARCB1/INI1 protein in synovial sarcoma

et al. 2010

View full text Add to dashboard Cite

show abstract

“…For example, cytokeratin, although positive in most biphasic synovial sarcomas, is less likely to stain monophasic and poorly differentiated synovial sarcomas in small samples. [1][2][3] In addition, cytokeratin can be found in a minority of malignant peripheral nerve sheath tumors 4 and Ewing sarcomas. 5,6 S100 protein is positive in only around half of malignant peripheral nerve sheath tumors, 7 however, can also stain synovial sarcoma 4,8 and Ewing sarcoma, 9 and thus lacks sufficient sensitivity and specificity to be a very reliable marker.…”

mentioning

confidence: 99%

Cluster analysis of immunohistochemical profiles in synovial sarcoma, malignant peripheral nerve sheath tumor, and Ewing sarcoma

2006

View full text Add to dashboard Cite

As a result of overlapping morphologic and immunohistochemical features, it can be difficult to distinguish synovial sarcoma, malignant peripheral nerve sheath tumor, and Ewing sarcoma/primitive neuroectodermal tumor in core biopsies. To analyze and compare immunohistochemical profiles, we stained tissue microarrays of 23 synovial sarcomas, 23 malignant peripheral nerve sheath tumors, and 27 Ewing sarcomas with 22 antibodies potentially useful in the differential diagnosis, and analyzed the data with cluster analysis. Stain intensity was scored as none, weak, or strong. For CD99, tumors with membranous accentuation were independently categorized. Cluster analysis sorted five groups, with like tumors clustering together. Synovial sarcoma clustered into two groups: one cytokeratin and EMA positive (n ¼ 11), the other mostly cytokeratin negative, EMA positive, bcl-2 positive and mostly CD56 positive (n ¼ 9). Malignant peripheral nerve sheath tumor clustered into two groups: one S100 positive, with nestin and NGFR positivity in most (n ¼ 10), the other mostly S100 negative, and variably but mostly weakly positive for nestin and NGFR (n ¼ 11). Ewing sarcomas clustered into a single group driven by membranous CD99 staining. Thirteen cases failed to cluster (outliers), while three Ewing sarcomas clustered into groups of other tumor types. Paired antibodies for each tumor type determined by visual assessment of cluster analysis data and statistical calculations of specificity, sensitivity, and predictive values showed that EMA/CK7 for synovial sarcoma, nestin/S100 for malignant peripheral nerve sheath tumor, and membranous CD99/Fli-1 for Ewing sarcoma yielded high specificity and positive predictive values. Cluster analysis also highlighted aberrant staining reactions and diagnostic pitfalls in these tumors. Hierarchical cluster analysis is an effective method for analyzing high-volume immunohistochemical data.

show abstract

“…Even poorly differentiated SS cases show immunostaining of EMA and CK in 95% and 42%, respectively [19]. Among CKs, CK7 and CK19 are expressed in spindle cells of SS, in contrast to other spindle cell sarcoma [20,21]. As shown in Table 2, the present cases with granular features expressed EMA and CKs, with a higher intensity and a larger proportion in the epithelioid granular component than in spindle cell component, like most biphasic SS cases.…”

Section: Discussionmentioning

confidence: 69%