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Related Experiment Videos

Synovial sarcoma: an immunohistochemical and ultrastructural study.

N G Ordóñez1, S M Mahfouz, B Mackay

  • 1Department of Pathology, University of Texas M.D. Anderson Cancer Center, Houston 77030.

Human Pathology
|July 1, 1990
PubMed
Summary

This study highlights keratin and epithelial membrane antigen (EMA) as key markers for identifying synovial sarcoma, aiding diagnosis. Electron microscopy is valuable when these markers are absent, differentiating subtypes.

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Area of Science:

  • Surgical Pathology
  • Oncology
  • Immunohistochemistry

Background:

  • Synovial sarcoma is a challenging soft tissue sarcoma to diagnose.
  • Distinguishing between biphasic and monophasic synovial sarcoma is crucial for prognosis and treatment.
  • Immunohistochemistry and electron microscopy are essential tools in sarcoma diagnosis.

Purpose of the Study:

  • To evaluate the utility of various antibodies in diagnosing primary and metastatic synovial sarcomas.
  • To determine the most effective epithelial markers for identifying synovial sarcoma components.
  • To assess the role of electron microscopy in challenging diagnostic cases.

Main Methods:

  • Immunohistochemical analysis of 39 primary and 19 metastatic synovial sarcomas using a panel of antibodies.

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  • Examination of 22 primary and 18 metastatic synovial sarcomas by electron microscopy.
  • Specific antibodies included keratin, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), and vimentin.

    • Main Results:

    • Keratin and EMA were consistently expressed in epithelial and/or spindle cells of biphasic synovial sarcomas.
    • Keratin was the most frequent epithelial marker in monophasic synovial sarcomas (63% primary, 25% metastatic).
    • Electron microscopy aided diagnosis in cases lacking clear epithelial marker expression.

    Conclusions:

    • Keratin is the most reliable epithelial marker for synovial sarcoma diagnosis.
    • EMA and CEA can also be useful, particularly in biphasic tumors.
    • Immunohistochemistry combined with electron microscopy provides comprehensive diagnostic capability for synovial sarcomas.