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Ultrastructural and immunohistochemical studies of synovial sarcoma [monophasic type]
Bulletin of Alexandria Faculty of Medicine. 1999; 35 (4): 521-529
in English | IMEMR | ID: emr-105154
ABSTRACT
The present work was carried out on 20 cases of monophasic pattern of synovial sarcoma to speculate on their histogenesis as well as to highlight the important histologic parameters of prognostic value of such tumours. The use of combined immunohistochemistry, as cytokeratin, epithelial membrane antigen [EMA] and vimentin, together with electron microscopy conveyed away the origin of these tumours from the normal synovial lining of joints. The cytokeratins and Epithelial membrane antigen [EMA] were positive epithelial markers in 75% and 45% of the cases respectively, whereas the vimentin mesenchymal marker was positive in 80% of cases. Five negative cases for epithelial markers were examined by electron microscopy, where two cases showed prominent epithelial features in the form of a well defined basal lamina and desmosomal attachments. The other 3 cases were diagnosed as poorly differentiated synovial sarcomas. The histologic features of monophasic pattern with large size tumours of more than 4 cm in diameter showing areas of necrosis exceeding 4mm, with high mitotic rates of more than 15 mitoses / 10 high power fields +/- recurrences or vascular invasion were considered as signs of poor prognosis and unfavorable outcome. There was a significant direct relation between the size of the tumour and the occurrence of recurrences [t = 2.92, P=0.009]. There was also a significant direct relation between the size and the presence of vascular invasion [t=4.54. P mitosis and the presence of recurrences [P= 0.00231, X[2] = 9.28571]. Similarly, there was also a linear significant relation between the number of mitosis and the presence of vascular invasion [X[2]=6.55462, P = 0.01]. Prognosis of monophasic pattern of synovial sarcoma depended mainly on the size of the tumour as well as the number of mitosis / 10 high power fields [HPF]. The scores of intensity of staining by different epithelial and mesenchymal markers used in this study had a little impact on the prognosis
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Index: IMEMR (Eastern Mediterranean) Main subject: Prognosis / Immunohistochemistry / Microscopy, Electron / Sarcoma, Synovial Limits: Humans Language: English Journal: Bull. Alex. Fac. Med. Year: 1999

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Index: IMEMR (Eastern Mediterranean) Main subject: Prognosis / Immunohistochemistry / Microscopy, Electron / Sarcoma, Synovial Limits: Humans Language: English Journal: Bull. Alex. Fac. Med. Year: 1999