A subset of solitary fibrous tumors express nuclear PAX8 and PAX2: a potential diagnostic pitfall.
A subset of solitary fibrous tumors express nuclear PAX8 and PAX2: a potential diagnostic pitfall.
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孤立性纤维瘤的一个子集表达核 PAX8 和 PAX2：一个潜在的诊断陷阱。
DOI：
10.14670/hh-11-670
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发表时间：
2016
影响因子：
2
通讯作者：
L. Kunju
中科院分区：
文献类型：
--
作者：
A. McDaniel;N. Palanisamy;Steven C. Smith;D. Robinson;Yi;A. Chinnaiyan;J. Mchugh;J. Greenson;L. Kunju
孤立性纤维性肿瘤(SFT)是一种解剖分布广泛的间叶性肿瘤，在有限的样本中诊断具有挑战性。我们最近遇到一个胰腺肿块的吸入物，被免疫组织化学(IHC)错误地解释为转移性肾细胞癌，因为PAX8表达很强。切除后，形态特征加上额外的IHC(CD34阳性)，正确地将该病变确定为SFT。Pax8和PAX2通常被用作肾脏肿瘤标记物；然而，还没有系列研究PAX8或PAX2在SFT中的表达。对来自不同部位的41例SFT(活检和切除)进行了PAX8和PAX2的IHC检查。8例为组织学恶性，8例为既往切除的复发。Pax8在26.8%(11/41)的SFT中至少有局限性表达，而PAX2在12.2%(5/41)的SFT中呈阳性表达。PAX8和PAX2阳性病例弥漫性表达分别为45.6%和40%。未发现PAX8/PAX2阳性与年龄、肿瘤大小、部位、恶性程度或复发相关。总之，相当少数的SFT通过IHC表达PAX8和PAX2。在评估肾脏转移的可能性时，这是一个诊断陷阱，特别是当原发肿瘤表现为肉瘤样或梭形细胞形态时。
Solitary fibrous tumor (SFT), a mesenchymal neoplasm with widespread anatomic distribution, can be diagnostically challenging in limited samples. We recently encountered an aspirate of a pancreatic mass, incorrectly interpreted as metastatic renal cell carcinoma based on strong PAX8 expression by immunohistochemistry (IHC). After resection, morphologic features with additional IHC (CD34 positivity) correctly identified this lesion as a SFT. PAX8 and PAX2 are commonly used as renal tumor markers; however, no series has investigated PAX8 or PAX2 expression in SFT. IHC for PAX8 and PAX2 was performed on 41 SFTs (biopsy and resections) from varying sites. Eight were histologically malignant and eight were recurrences of previous resections. PAX8 staining was observed at least focally in 26.8% (11 of 41) SFT cases; additionally, PAX2 was positive in 12.2% (5 of 41 cases) of SFTs. For PAX8 and PAX2 positive cases 45.6% and 40%, respectively, showed diffuse expression. No correlation was found between PAX8/PAX2 positivity and age, tumor size, site, malignancy, or recurrence. In conclusion, a substantial minority of SFTs express PAX8 and PAX2 via IHC. This presents a diagnostic pitfall when evaluating possible metastases from the kidney, particularly when primary tumors show sarcomatoid or spindle cell morphologies.