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Related Experiment Videos

Ewing sarcoma vs lymphoblastic lymphoma. A comparative immunohistochemical study.

D R Lucas1, G Bentley, M E Dan

  • 1Department of Pathology, Wayne State University School of Medicine, Harper, Hutzel, and Children's Hospitals, and Karmanos Cancer Institute, Detroit, MI, USA.

American Journal of Clinical Pathology
|February 24, 2001
PubMed
Summary

An immunohistochemistry panel using CD99 and terminal deoxynucleotidyl transferase (TdT) antibodies effectively distinguishes lymphoblastic lymphoma from Ewing sarcoma. This diagnostic approach enhances accuracy in differentiating these challenging hematologic malignancies.

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Area of Science:

  • Oncology
  • Pathology
  • Immunohistochemistry

Background:

  • Distinguishing lymphoblastic lymphoma from Ewing sarcoma is critical for appropriate patient treatment.
  • Immunohistochemistry plays a key role in the differential diagnosis of small round blue cell tumors.

Observation:

  • A panel of antibodies including CD99, TdT, LCA, CD43, CD79a, CD20, CD3, vimentin, and NSE was tested on 17 Ewing sarcoma and 27 lymphoblastic lymphoma/leukemia cases.
  • All cases were CD99 positive.
  • Lymphomas and leukemias were TdT positive, while Ewing sarcoma cases were TdT negative.

Findings:

  • Ewing sarcoma cases (88%) showed strong, diffuse vimentin positivity, unlike lymphoblastic lymphoma/leukemia cases (23%).
  • Lymphocytic markers (CD43, LCA, CD79a, CD3, CD20) were inconsistently expressed in lymphomas and leukemias and absent in Ewing sarcoma.

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  • The combination of CD99 and TdT antibodies proved highly sensitive and specific for differentiating the two entities.

    • Implications:

    • An immunohistochemistry panel including CD99 and TdT is practical and valuable for differentiating lymphoblastic lymphoma from Ewing sarcoma.
    • These markers are well-preserved in fixed and decalcified tissues, facilitating their use in routine diagnostics.
    • Combining CD99, TdT, vimentin, and lymphocytic markers offers a robust diagnostic strategy for challenging cases.