Cytomorphological spectrum, including immunohistochemical results of 16 cases of clear cell sarcoma of soft tissue, along with positive EWSR1 gene rearrangement result in two cases

© 2020 John Wiley & Sons Ltd..

OBJECTIVES: To describe the cytopathological features of clear cell sarcomas (CCSs), including immunohistochemical and molecular results, the latter in selected cases.

METHODS: Sixteen consecutively diagnosed cases of CCS of soft tissue, over 6-year duration were included. Fine needle aspiration cytology was performed for primary diagnosis in three and for recurrent/metastatic lesions in 12 cases. Cytopathological features in 16 cases (conventional Papanicolaou- and May-Grünwald Giemsa-stained smears) were critically analysed. Corresponding histopathological and immunostained sections were available in 15 cases. Two cases were tested for EWSR1 gene rearrangement by fluorescence in-situ hybridisation.

RESULTS: Sixteen tumours occurred in patients with age ranging from 18 to 56 years (median = 33.5); M: F ratio = 1:1; in deep soft tissues, mostly in extremities. Primary cytopathological diagnosis (3 cases) was CCS with a differential diagnosis of melanoma (1 case) and poorly differentiated malignant tumour (2 cases). On review, smears were predominantly hypercellular (n = 14), invariably composed of monomorphic appearing epithelioid/polygonal cells (n = 16), including spindle cells (n = 6); mostly singly scattered (n = 16), in loose clusters (n = 12); with prominent nucleolisation (n = 16); granular to vacuolated, well-defined cytoplasm (n = 12), binucleation/multinucleation (n = 9); mitoses (n = 6); sudden anisonucleosis; racquet-shaped cells (n = 3), against a tigroid background (n = 2), along with focal intracytoplasmic pigment deposition (n = 2). Immunohistochemically, tumour cells were positive for S-100P (15/15), HMB-45 (15/15) and melan-A(6/12). Two cases tested for EWSR1 rearrangement displayed red-green split signals.

CONCLUSIONS: This constitutes one of the largest series describing the cytomorphological spectrum of CCS of soft tissue. Certain features, such as singly scattered monomorphic, epithelioid cells with prominent nucleolisation are useful diagnostic clues. Immunohistochemical stains are necessary and molecular testing is further helpful in reinforcing a diagnosis in certain cases. A correct diagnosis has crucial treatment implications.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:31

Enthalten in:

Cytopathology : official journal of the British Society for Clinical Cytology - 31(2020), 4 vom: 01. Juli, Seite 280-287

Sprache:

Englisch

Beteiligte Personen:

Rao, Vidya [VerfasserIn]
Rekhi, Bharat [VerfasserIn]

Links:

Volltext

Themen:

Biomarkers, Tumor
Cytology of soft tissue tumours
EWSR1 gene rearrangement
EWSR1 protein, human
FNAC of clear cell sarcoma of soft parts
FNAC of melanoma of soft parts
Gp100 Melanoma Antigen
Journal Article
MART-1 Antigen
Melanoma-Specific Antigens
PMEL protein, human
RNA-Binding Protein EWS
S100 Proteins

Anmerkungen:

Date Completed 04.08.2021

Date Revised 04.12.2021

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1111/cyt.12845

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM309400597