Biphenotypic sinonasal sarcoma: A series of six cases with evaluation of role of β-catenin immunohistochemistry iii differential diagnosis
Biphenotypic sinonasal sarcoma: A series of six cases with evaluation of role of β-catenin immunohistochemistry iii differential diagnosis
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DOI：
10.1016/j.anndiagpath.2017.11.005
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发表时间：
2018-04-01
影响因子：
2
通讯作者：
Sharm, Suresh C.
中科院分区：
文献类型：
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作者：
Kakkar, Aanchal;Rajeshwari, Madhu;Sharm, Suresh C.
前言：双表型鼻腔鼻窦肉瘤(BSNs)是近年来发现的一种鼻窦区的间叶性肿瘤。这是一种低级别肉瘤，表现为肌源性和神经分化的证据。β-连环蛋白免疫组织化学在区分它与其形态模拟的作用方面的作用还没有得到很好的证实。我们进行这项研究是为了从我们的档案中鉴定出BSNs的病例，并检测其中的β-连环素的免疫阳性情况以及在其密切的鉴别诊断中的作用。并对其组织病理学特点进行复习。4例平滑肌肌动蛋白和S-100免疫阳性，形态典型，重新分类为BSNs。结果：共检出21例间叶性肿瘤，其中鼻窦血管外皮细胞瘤12例，孤立性纤维瘤5例，骨桥蛋白3例，滑膜肉瘤1例。3例SNHPC重新分类为BSNs。BSNS患者包括1名男性和5名女性，平均年龄51岁。5例(83.3%)BSNs核β-连环素免疫阳性。结论：BSNs是一种罕见的鼻腔鼻窦肿瘤，常被误诊为SNHPC和SFT。β-连环蛋白免疫阳性见于大多数病例，提示在发病机制中起一定作用。然而，由于在其他肿瘤中呈阳性，如SNHPC，它在鉴别诊断中的作用有限。
Introduction: Biphenotypic sinonasal sarcoma (BSNS) is a recently described mesenchymal tumor exclusive to the sinonasal region. It is a low grade sarcoma, displaying evidence of myogenic and neural differentiation. Role of beta-catenin immunohistochemistry in distinguishing it from its morphological mimics is not well-established. We conducted this study to identify cases of BSNS from our archives, and to examine immunopositivity for beta-catenin in them as well as in its close differential diagnosis.Methods: All cases of nasal cavity and paranasal sinus mesenchymal neoplasms were identified. Histopathological features were reviewed. Cases showing smooth muscle actin (SMA) and S-100 immunopositivity, and typical morphology were reclassified as BSNS. beta-catenin immunoexpression was assessed.Results: Twenty-one mesenchymal tumors, including 12 sinonasal hemangiopericytoma (SNHPC), five solitary fibrous tumors (SFT), three BSNS, and one synovial sarcoma were identified. Three SNHPC cases were reclassified as BSNS. BSNS patients included one male and five females, with mean age of 51 years. Five BSNS cases (83.3%) showed nuclear beta-catenin immunopositivity. SNHPC cases also were beta-catenin positive (60%).Conclusion: BSNS is a rare sinonasal neoplasm, frequently misdiagnosed as SNHPC and SFT. beta-catenin immunopositivity is seen in majority of cases, indicating a role in pathogenesis. However, due to positivity in other tumors like SNHPC, it has limited role in differential diagnosis.