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Related Experiment Videos

Gliosarcoma: a histologic and immunohistochemical reaffirmation.

J M Meis1, K L Ho, J S Nelson

  • 1Henry Ford Hospital, Department of Pathology, Detroit, Michigan 48202.

Modern Pathology : an Official Journal of the United States and Canadian Academy of Pathology, Inc
|January 1, 1990
PubMed
Summary

Gliosarcoma (GS) and spindled glioblastoma multiforme (GBM) are often indistinguishable on routine histology. Immunohistochemistry, particularly glial fibrillary acidic protein (GFAP) staining, is crucial for differentiating these glial tumors.

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Area of Science:

  • Neuropathology
  • Oncology
  • Immunohistochemistry

Background:

  • Gliosarcoma (GS) is a rare, aggressive brain tumor characterized by a biphasic pattern of glial and sarcomatous elements.
  • Distinguishing GS from glioblastoma multiforme (GBM) with prominent spindle cell components can be challenging using standard histological stains like hematoxylin and eosin (H&E) and reticulin.

Purpose of the Study:

  • To investigate the utility of a panel of antibodies in differentiating GS from spindled GBM.
  • To elucidate the immunophenotypic characteristics of the glial and sarcomatous components in GS and GBM.

Main Methods:

  • A panel of ten antibodies was used with the avidin-biotin-peroxidase complex (ABC) method.
  • Thirteen cases, including seven GS and six spindled GBM, were analyzed.

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  • Immunohistochemical staining was performed on formalin-fixed, paraffin-embedded tissue sections.

    • Main Results:

    • GS exhibited a characteristic bimorphic staining pattern for glial fibrillary acidic protein (GFAP) and S-100 protein, with glial areas positive and sarcomatous areas negative.
    • Spindled GBM showed diffuse GFAP and S-100 protein staining.
    • Vimentin was detected in both neoplastic glial and sarcomatous components of GS, as well as in neoplastic glia of GBM.
    • Specific markers for sarcoma (cytokeratins, Factor VIII, desmin, neurofilament) were negative in both GS and GBM.

    Conclusions:

    • GS is a true biphasic neoplasm that is frequently difficult to distinguish from spindled GBM on routine histology.
    • Immunohistochemical staining, especially for GFAP, is essential for confirming the biphasic nature of GS and aids in differentiating it from GBM.
    • Tumor invasion into surrounding structures and vascular proliferation can complicate histological diagnosis, highlighting the importance of immunohistochemistry.