Synovial sarcoma

AE1/AE3 Boehringer- Mannheim 1 150 MWER Recognition of epithelioid sarcoma, synovial sarcoma, and divergent... 

Clear cell sarcoma, adenoid cystic carcinoma, small cell lung carcinoma, Ewing sarcoma, synovial sarcoma, osteosarcoma, angiosarcoma, AML,... 

A H- - -H- H- - Carcinoma Carcinoma breast, salivary, sweat gland Mesothelioma Synovial sarcoma Epithelioid sarcoma Chordoma Mixed tumor... 

Some sarcomas besides epithelioid sarcoma or synovial sarcoma show coexpression of vimentin and keratin (18). Examining these tumors for the expression of other epithelial markers will help clarify their true nature. 

Le Marchadour F, Peoch M, Pasquier B, et al. 1994. Cardiac synovial sarcoma with translocation (X 18) associated with asbestos exposure [Letter]. Cancer 74 986. 

Kuhnen, C., Tolnay, E., Steinau, H. U., Voss, B. and Muller, K. M. (1998). Expression of c-met receptor and hepatocyte growth factor/scatter factor in synovial sarcoma and epithelioid sarcoma. Virchows Arch. 432, 337-342. 

A + Carcinoma Mesothelioma Synovial sarcoma Epithelioid sarcoma... 

Antibodies to these PEMs are directed to the apical membrane portions of secretory mammary cells surrounding milk fat globules (mol wt >250 kDa). They react with a variety of epithelial tumors, including mesotheliomas. Like keratin, these antibodies are also expressed on synovial sarcomas, epithelioid sarcomas, and chordomas. They are not as reactive with as wide a variety of tumors as antikeratins. For instance, they do not react with many endocrine tumors. However, they may recognize some renal-cell carcinomas and small-cell anaplastic carcinomas... 

Mune T, Yasuda K, Ishii M, Matsunaga T, Miura K. Tetany due to hypomagnesemia induced by cisplatin and doxorubicin treatment for synovial sarcoma. Intern Med 1993 32(5) 434-7. 

Hyalm onate is produced both by animals and bacteria. It was first obtained by Meyer and Palmer from the vitreous humor of cattle eyes. Since then, it has been isolated from many sources, such as Wharton s jellyconnective tissue, skin, cock s comb, synovial fluid, Rous sarcoma, myxoedemal fluids, and encapsulated strains of hemolytic streptococci. Aerobacter aerogenes may also produce hyaluronate. Group A streptococci have been principally used for the investigation of the biosynthesis of hyaluronic acid. 

Nikiforova MN, Groen P, Mutema G, et al. Detection of SYT-SSX rearrangements in synovial sarcomas by real-time one-step RT-PCR. Pediatr Dev Pathol. 2005 8 162-167. 

Anti-CD99 (M) Dako 1 20 MWER Recognition of virtually all primitive neuroectodermal tumors and Ewing s sarcomas labels roughly 50% of synovial sarcomas and malignant peripheral nerve sheath tumors also present in lymphoblastic lymphomas/ leukemias presenting in soft tissue... 

Keratins 7, 1 3, and 19 are seen in 45% to 50% of cases of small cell synovial sarcoma, but less than 10% of differential diagnostic alternatives. 

KER, keratin, detected by a mixture of GAMS.2, MAK-6, and AEl /AE3 EMA, epithelial membrane antigen VIM, vimentin DES, desmin MSA, muscle-specific actin SMA, smooth muscle (alpha isoform) actin GALD, h-caldesmon S-IOOP, S-100 protein OCN, osteocalcin LM, laminin UL, Ulex europaeus I lectin binding FS, fibrosarcoma SGRMS, spindle cell rhabdomyosarcoma LMS, leiomyosarcoma MPNST, malignant peripheral nerve sheath tumor MSS, monophasic spindle cell synovial sarcoma SCAS, spindle cell angiosarcoma KS, Kaposi s sarcoma FOS, fibroblastic osteosarcoma. 

It must be stressed that CD56 and CD57 are not restricted to nerve sheath cells or neuroectodermal elements among all soft tissue tumors, but rather are most often observed in those cell types. Synovial sarcomas, LMSs, and some metastatic carcinomas also... 

The Wilms tumor-1 (WTl) gene is located on the short arm of chromosome 11 (llpl3). It encodes a protein that is a critical determinant of urogenital development and is expressed in >80% of nephroblastomas. With regard to osseous and soft tissue tumors, WTl protein is not a specific marker and is potentially present in angiosarcoma, malignant peripheral nerve sheath tumor, synovial sarcoma, osteosarcoma, myxoid liposarcoma, and clear-cell sarcoma.Nevertheless, it is most often utilized (in a structured panel with other immunodeter-minants) as an adjunctive indicator of endothelial differentiation in diagnostic practice. ... 

TEE1 expression is prominent in synovial sarcoma, but not mimics such as MPNST and SFT. 

Keratins are regularly found in synovial sarcoma, chordoma, parachordoma, epithelioid sarcoma, and adamantinoma. They are seen less commonly in leiomyosarcoma, malignant peripheral nerve sheath tumors, epithelioid angiosarcoma, and polyphenotypic tumors such as PNET. 

EMA regularly decorates synovial sarcoma, epithelioid sarcoma, perineuriomas, neurothekeomas, chordoma/ parachordoma, and plasmacytomas. 

POORLY DIFFERENTIATED SMALL-CELL SYNOVIAL SARCOMA... 

Leiomyosarcomas are most commonly found in the retroperitoneum in adults. They uncommonly occur in the deep soft tissues of the extremities but may be seen in more superficial sites, particularly in the dermis and subcutis. The differential diagnosis of LMS traditionally includes other sarcomas composed of intersecting spindle-cell fascicles, including fibrosarcoma, MPNST, synovial sarcoma, and spindle cell rhabdomyosarcoma. Additional conditions such as IMT (inflammatory pseudotumor), neurofibroma, and hemangiopericytoma (see Fig. 4.5) are also considerations. 

Another spindle cell tumor that shares immunophe-notypic features with MPNST is monophasic synovial sarcoma (MSS). Roughly 40% of cases of MSS show SlOO staining, and approximately 30% are CD57-positive. " Cytokeratin subset analysis may be useful in difficult cases, because most synovial sarcomas are reactive for CK7 or CK19, or both. " In contrast, MPNSTs typically lack those proteins. CD 10-reactivity also favors a diagnosis of MPNST, whereas TLEl-positivity typifies MSS. 

MPNSTs are negative for CK7 (which is positive in synovial sarcoma). 

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