Sarcoma Awareness Month
Sarcomas arise from cells of the mesenchymal supporting tissue and are therefore not limited to one organ or part of the body. The most common subtypes include liposarcomas and leiomyosarcomas. (www.krebsdaten.de). Several risk factors can contribute to the development of sarcomas, including genetic predisposition, radiation, certain chemicals and viral infections such as human herpesvirus 8 (HHV-8) and Epstein-Barr virus (EBV). It is important to have regular screenings and minimize risk factors to reduce the risk of sarcoma.
The differentiation of well-differentiated liposarcomas (WDLPS) and dedifferentiated liposarcomas (DDLPS) from benign adipose tumors or other poorly differentiated sarcomas is often morphologically difficult.
Binh et al. [1, 2] describe the immunohistochemical detection of CDK4 and MDM2 overexpression as very helpful and reproducible in the diagnosis of ALT/WDLPS and dedifferentiated liposarcomas. According to Weaver et al. [3], MDM2 overexpression is also a sensitive marker for differentiating liposarcomas from sclerosing mesenteritis and retroperitoneal fibrosis.
MDM2 amplification in different tissues
| Tissue | Frequency of MDM2 Amplification |
|---|---|
| Atypical lipomatous tumors/well-differentiated liposarcomas (ALT/WDLS) | ~ 100 % |
| Dedifferentiated liposarcoma (DDLS) | ~ 100 % |
| Pleomorphic liposarcoma | ~ 40 % |
| Benign lipomatous lesions | 0 % |
Ki-67 clone K-2: marker for lipoblasts
Miller [4] describes the use of the Ki-67 antibody, clone K-2, as a marker for lipoblasts and liposarcomas. This antibody shows not only the usual Ki-67 reaction in the nuclei of proliferating cells but also a cytoplasmic reaction in lipoblasts. No reaction was observed in "pseudolipoblasts" in cases of inflammatory myxohyaline tumors and fat necrosis.
Zytomed Systems offers you this Ki-67 clone to complement your antibody panel for liposarcoma.
According to the Soft Tissue Sarcoma Guideline | Version 1.1 | June 2022, DKG, the following antibodies, among others, have proven their value for the initial diagnosis of soft tissue tumors:
| Broad spectrum keratins | Desmin | MelanA | ERG |
| EMA | Caldesmon or calponin | HMB45 | CD117 |
| Ki67 | Myogenin | ER/PR | DOG1 |
| S100 | WT1 | CD10 | NSE |
| CD45/PanLeu | Calretinin | Smooth muscle actin | CD56 |
| CD21 | BAP1 | Synaptophysin | SOX10 |
| CD23 | Podoplanin/D2-40 | Chromogranin | CD34 |
| CD99 |
For extended immunohistochemical diagnostics, there are a number of relatively specific markers that can also be used partly for screening underlying genetic alterations:
| beta-Catenin | e.g. desmoid fibromatosis |
| MDM2/CDK4 | highly differentiated/de-differentiated liposarcoma |
| BRAF V600E | malignant melanoma |
| TLE1 | Synovial sarcoma |
| STAT6 | solitary fibrous tumor SFT |
| MUC4 | low grade fibromyxoid sarcoma sclerosing epithelioid fibrosarcoma |
| TFE3 | alveolar soft tissue sarcoma |
| SDHB | SDH-mutated gastrointestinal stromal tumors GIST |
| HHV8 | Kaposi's sarcoma |
| c-MYC | Radiation-induced sarcomas, especially angiosarcomas |
| CAMTA1 | epithelioid hemangioendotheliomas |
| FOSB | pseudomyogenic hemangioendothelioma epithelioid hemangioma |
| INI-1 | malignant rhabdoid tumor epithelioid sarcoma, epithelioid malignant nerve sheath tumor |
| H3K27me | malignant peripheral nerve sheath tumor |
| Brachyury | Chordome |
| ALK | Chordome |
| NKX2.2 | Ewing sarcoma |
| WT1/ETV4 | CIC-rearranged small cell sarcomas |
| BCOR | BCOR-rearranged small cell sarcomas |
On our website you will find a large selection of CE/IVD compliant antibodies for your sarcoma diagnostics.
[1] Binh MB et al. Am J Surg Pathol, 29:1340-1347, 2005
[2] Binh MB et al. Am J Clin Pathol, 125:693-697, 2006
[3] Weaver J et al. Mod Pathol 22:66-70, 2009
[4] Miller RT. ProPath: The Focus Immunohisto-chemistry (Newsletter), February 2005
Further topics
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The new GATA antibody
A recently conducted study has shown that TRPS1 is expressed very highly in triple-negative breast cancer (TNBC). Expression was significantly higher than the GATA3 expression in metaplastic (85% vs. 21%) and non-metaplastic (86% vs. 51%) TNBC. Accordingly, TRPS1 has proven to be a highly specific and sensitive marker for all types of breast cancer, in particular TNBC. (Di Ai et al.; "TRPS1: a highly sensitive and specific marker for breast carcinoma, especially for triple-negative breast cancer. Mod Pathol 34: 710-719, 2021)
