PAX 8 positive synovial sarcoma

In this report, we describe a case of a biphasic tumour which presented as an incidental lump on the wrist of a 78 year old female. The epithelioid component predominated and was strikingly “gland-like”, and in an elderly female raised concerns of a primary soft tissue tumour as well as a metastatic mixed Müllerian tumour. The unusual “gland” lining cells and odd central secretion did not fit classical glands and raised our suspicions of synovial sarcoma. We employed a panel of immunoperoxidase stains to consider synovial sarcoma as well as metastases, and included PAX8, ER and PR for possible gynaecologic and breast malignancies. Paired Box (PAX) 8 is a tissue-specific transcription factor protein, and immunohistochemical stains using antibodies raised against PAX 8 are frequently used in staining panels to help identify the origin of primary or metastatic malignancies, and in particular where tumours from the female genital tract, kidney, thyroid and thymus are included in the differential diagnosis. Our research into PAX8 revealed that it has been little studied in soft tissue sarcomas and there is limited published data in the English language literature regarding PAX8 staining particularly in primary extremity soft tissue synovial sarcomas. Unexpectedly, our panel of immunohistochemical stains showed PAX8 positivity for both the epithelioid and spindle cell components of our case, and again raised concerns of a gynaecological malignancy. The components showed differential PAX8 staining patterns, which is of note, and highlights the possible variability in staining of synovial sarcoma. Definitive diagnosis of biphasic synovial sarcoma was confirmed by fluorescent in situ hybridisation studies. This case report therefore documents PAX8 positive staining in biphasic primary soft tissue synovial sarcoma, demonstrating important considerations in its use, enabling the diagnosis of this infrequent and potentially aggressive soft tissue tumour. The relevant literature is highlighted. The variable range of appearances of this potentially aggressive tumour is further illustrated by our case which showed striking epithelial-rich morphology, and presented important diagnostic considerations. Careful morphologic examination together with immunohistochemical and molecular studies in our case enabled a definitive diagnosis of this histologically striking variant, with unexpected PAX8 positive staining. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Miriam Fewtrell [verfasserIn] Patricia Symons [verfasserIn] Angela M. Hong [verfasserIn] Peter Luk [verfasserIn] Roland Jiang [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2021

Schlagwörter:	PAX 8 Synovial sarcoma Biphasic synovial sarcoma Immunostaining of sarcomas

Übergeordnetes Werk:	In: Human Pathology: Case Reports - Elsevier, 2016, 24(2021), Seite 200502-
Übergeordnetes Werk:	volume:24 ; year:2021 ; pages:200502-

Links:	Link aufrufen Link aufrufen Link aufrufen Journal toc

DOI / URN:	10.1016/j.ehpc.2021.200502

Katalog-ID:	DOAJ057748985

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allfields	10.1016/j.ehpc.2021.200502 doi (DE-627)DOAJ057748985 (DE-599)DOAJ6beca396d66848068d05a1586b106d40 DE-627 ger DE-627 rakwb eng RB1-214 Miriam Fewtrell verfasserin aut PAX 8 positive synovial sarcoma 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In this report, we describe a case of a biphasic tumour which presented as an incidental lump on the wrist of a 78 year old female. The epithelioid component predominated and was strikingly “gland-like”, and in an elderly female raised concerns of a primary soft tissue tumour as well as a metastatic mixed Müllerian tumour. The unusual “gland” lining cells and odd central secretion did not fit classical glands and raised our suspicions of synovial sarcoma. We employed a panel of immunoperoxidase stains to consider synovial sarcoma as well as metastases, and included PAX8, ER and PR for possible gynaecologic and breast malignancies. Paired Box (PAX) 8 is a tissue-specific transcription factor protein, and immunohistochemical stains using antibodies raised against PAX 8 are frequently used in staining panels to help identify the origin of primary or metastatic malignancies, and in particular where tumours from the female genital tract, kidney, thyroid and thymus are included in the differential diagnosis. Our research into PAX8 revealed that it has been little studied in soft tissue sarcomas and there is limited published data in the English language literature regarding PAX8 staining particularly in primary extremity soft tissue synovial sarcomas. Unexpectedly, our panel of immunohistochemical stains showed PAX8 positivity for both the epithelioid and spindle cell components of our case, and again raised concerns of a gynaecological malignancy. The components showed differential PAX8 staining patterns, which is of note, and highlights the possible variability in staining of synovial sarcoma. Definitive diagnosis of biphasic synovial sarcoma was confirmed by fluorescent in situ hybridisation studies. This case report therefore documents PAX8 positive staining in biphasic primary soft tissue synovial sarcoma, demonstrating important considerations in its use, enabling the diagnosis of this infrequent and potentially aggressive soft tissue tumour. The relevant literature is highlighted. The variable range of appearances of this potentially aggressive tumour is further illustrated by our case which showed striking epithelial-rich morphology, and presented important diagnostic considerations. Careful morphologic examination together with immunohistochemical and molecular studies in our case enabled a definitive diagnosis of this histologically striking variant, with unexpected PAX8 positive staining. PAX 8 Synovial sarcoma Biphasic synovial sarcoma Immunostaining of sarcomas Pathology Patricia Symons verfasserin aut Angela M. Hong verfasserin aut Peter Luk verfasserin aut Roland Jiang verfasserin aut In Human Pathology: Case Reports Elsevier, 2016 24(2021), Seite 200502- (DE-627)835590143 (DE-600)2834872-2 22143300 nnns volume:24 year:2021 pages:200502- https://doi.org/10.1016/j.ehpc.2021.200502 kostenfrei https://doaj.org/article/6beca396d66848068d05a1586b106d40 kostenfrei http://www.sciencedirect.com/science/article/pii/S2214330021000316 kostenfrei https://doaj.org/toc/2214-3300 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2021 200502-
spelling	10.1016/j.ehpc.2021.200502 doi (DE-627)DOAJ057748985 (DE-599)DOAJ6beca396d66848068d05a1586b106d40 DE-627 ger DE-627 rakwb eng RB1-214 Miriam Fewtrell verfasserin aut PAX 8 positive synovial sarcoma 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In this report, we describe a case of a biphasic tumour which presented as an incidental lump on the wrist of a 78 year old female. The epithelioid component predominated and was strikingly “gland-like”, and in an elderly female raised concerns of a primary soft tissue tumour as well as a metastatic mixed Müllerian tumour. The unusual “gland” lining cells and odd central secretion did not fit classical glands and raised our suspicions of synovial sarcoma. We employed a panel of immunoperoxidase stains to consider synovial sarcoma as well as metastases, and included PAX8, ER and PR for possible gynaecologic and breast malignancies. Paired Box (PAX) 8 is a tissue-specific transcription factor protein, and immunohistochemical stains using antibodies raised against PAX 8 are frequently used in staining panels to help identify the origin of primary or metastatic malignancies, and in particular where tumours from the female genital tract, kidney, thyroid and thymus are included in the differential diagnosis. Our research into PAX8 revealed that it has been little studied in soft tissue sarcomas and there is limited published data in the English language literature regarding PAX8 staining particularly in primary extremity soft tissue synovial sarcomas. Unexpectedly, our panel of immunohistochemical stains showed PAX8 positivity for both the epithelioid and spindle cell components of our case, and again raised concerns of a gynaecological malignancy. The components showed differential PAX8 staining patterns, which is of note, and highlights the possible variability in staining of synovial sarcoma. Definitive diagnosis of biphasic synovial sarcoma was confirmed by fluorescent in situ hybridisation studies. This case report therefore documents PAX8 positive staining in biphasic primary soft tissue synovial sarcoma, demonstrating important considerations in its use, enabling the diagnosis of this infrequent and potentially aggressive soft tissue tumour. The relevant literature is highlighted. The variable range of appearances of this potentially aggressive tumour is further illustrated by our case which showed striking epithelial-rich morphology, and presented important diagnostic considerations. Careful morphologic examination together with immunohistochemical and molecular studies in our case enabled a definitive diagnosis of this histologically striking variant, with unexpected PAX8 positive staining. PAX 8 Synovial sarcoma Biphasic synovial sarcoma Immunostaining of sarcomas Pathology Patricia Symons verfasserin aut Angela M. Hong verfasserin aut Peter Luk verfasserin aut Roland Jiang verfasserin aut In Human Pathology: Case Reports Elsevier, 2016 24(2021), Seite 200502- (DE-627)835590143 (DE-600)2834872-2 22143300 nnns volume:24 year:2021 pages:200502- https://doi.org/10.1016/j.ehpc.2021.200502 kostenfrei https://doaj.org/article/6beca396d66848068d05a1586b106d40 kostenfrei http://www.sciencedirect.com/science/article/pii/S2214330021000316 kostenfrei https://doaj.org/toc/2214-3300 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2021 200502-
allfields_unstemmed	10.1016/j.ehpc.2021.200502 doi (DE-627)DOAJ057748985 (DE-599)DOAJ6beca396d66848068d05a1586b106d40 DE-627 ger DE-627 rakwb eng RB1-214 Miriam Fewtrell verfasserin aut PAX 8 positive synovial sarcoma 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In this report, we describe a case of a biphasic tumour which presented as an incidental lump on the wrist of a 78 year old female. The epithelioid component predominated and was strikingly “gland-like”, and in an elderly female raised concerns of a primary soft tissue tumour as well as a metastatic mixed Müllerian tumour. The unusual “gland” lining cells and odd central secretion did not fit classical glands and raised our suspicions of synovial sarcoma. We employed a panel of immunoperoxidase stains to consider synovial sarcoma as well as metastases, and included PAX8, ER and PR for possible gynaecologic and breast malignancies. Paired Box (PAX) 8 is a tissue-specific transcription factor protein, and immunohistochemical stains using antibodies raised against PAX 8 are frequently used in staining panels to help identify the origin of primary or metastatic malignancies, and in particular where tumours from the female genital tract, kidney, thyroid and thymus are included in the differential diagnosis. Our research into PAX8 revealed that it has been little studied in soft tissue sarcomas and there is limited published data in the English language literature regarding PAX8 staining particularly in primary extremity soft tissue synovial sarcomas. Unexpectedly, our panel of immunohistochemical stains showed PAX8 positivity for both the epithelioid and spindle cell components of our case, and again raised concerns of a gynaecological malignancy. The components showed differential PAX8 staining patterns, which is of note, and highlights the possible variability in staining of synovial sarcoma. Definitive diagnosis of biphasic synovial sarcoma was confirmed by fluorescent in situ hybridisation studies. This case report therefore documents PAX8 positive staining in biphasic primary soft tissue synovial sarcoma, demonstrating important considerations in its use, enabling the diagnosis of this infrequent and potentially aggressive soft tissue tumour. The relevant literature is highlighted. The variable range of appearances of this potentially aggressive tumour is further illustrated by our case which showed striking epithelial-rich morphology, and presented important diagnostic considerations. Careful morphologic examination together with immunohistochemical and molecular studies in our case enabled a definitive diagnosis of this histologically striking variant, with unexpected PAX8 positive staining. PAX 8 Synovial sarcoma Biphasic synovial sarcoma Immunostaining of sarcomas Pathology Patricia Symons verfasserin aut Angela M. Hong verfasserin aut Peter Luk verfasserin aut Roland Jiang verfasserin aut In Human Pathology: Case Reports Elsevier, 2016 24(2021), Seite 200502- (DE-627)835590143 (DE-600)2834872-2 22143300 nnns volume:24 year:2021 pages:200502- https://doi.org/10.1016/j.ehpc.2021.200502 kostenfrei https://doaj.org/article/6beca396d66848068d05a1586b106d40 kostenfrei http://www.sciencedirect.com/science/article/pii/S2214330021000316 kostenfrei https://doaj.org/toc/2214-3300 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2021 200502-
allfieldsGer	10.1016/j.ehpc.2021.200502 doi (DE-627)DOAJ057748985 (DE-599)DOAJ6beca396d66848068d05a1586b106d40 DE-627 ger DE-627 rakwb eng RB1-214 Miriam Fewtrell verfasserin aut PAX 8 positive synovial sarcoma 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In this report, we describe a case of a biphasic tumour which presented as an incidental lump on the wrist of a 78 year old female. The epithelioid component predominated and was strikingly “gland-like”, and in an elderly female raised concerns of a primary soft tissue tumour as well as a metastatic mixed Müllerian tumour. The unusual “gland” lining cells and odd central secretion did not fit classical glands and raised our suspicions of synovial sarcoma. We employed a panel of immunoperoxidase stains to consider synovial sarcoma as well as metastases, and included PAX8, ER and PR for possible gynaecologic and breast malignancies. Paired Box (PAX) 8 is a tissue-specific transcription factor protein, and immunohistochemical stains using antibodies raised against PAX 8 are frequently used in staining panels to help identify the origin of primary or metastatic malignancies, and in particular where tumours from the female genital tract, kidney, thyroid and thymus are included in the differential diagnosis. Our research into PAX8 revealed that it has been little studied in soft tissue sarcomas and there is limited published data in the English language literature regarding PAX8 staining particularly in primary extremity soft tissue synovial sarcomas. Unexpectedly, our panel of immunohistochemical stains showed PAX8 positivity for both the epithelioid and spindle cell components of our case, and again raised concerns of a gynaecological malignancy. The components showed differential PAX8 staining patterns, which is of note, and highlights the possible variability in staining of synovial sarcoma. Definitive diagnosis of biphasic synovial sarcoma was confirmed by fluorescent in situ hybridisation studies. This case report therefore documents PAX8 positive staining in biphasic primary soft tissue synovial sarcoma, demonstrating important considerations in its use, enabling the diagnosis of this infrequent and potentially aggressive soft tissue tumour. The relevant literature is highlighted. The variable range of appearances of this potentially aggressive tumour is further illustrated by our case which showed striking epithelial-rich morphology, and presented important diagnostic considerations. Careful morphologic examination together with immunohistochemical and molecular studies in our case enabled a definitive diagnosis of this histologically striking variant, with unexpected PAX8 positive staining. PAX 8 Synovial sarcoma Biphasic synovial sarcoma Immunostaining of sarcomas Pathology Patricia Symons verfasserin aut Angela M. Hong verfasserin aut Peter Luk verfasserin aut Roland Jiang verfasserin aut In Human Pathology: Case Reports Elsevier, 2016 24(2021), Seite 200502- (DE-627)835590143 (DE-600)2834872-2 22143300 nnns volume:24 year:2021 pages:200502- https://doi.org/10.1016/j.ehpc.2021.200502 kostenfrei https://doaj.org/article/6beca396d66848068d05a1586b106d40 kostenfrei http://www.sciencedirect.com/science/article/pii/S2214330021000316 kostenfrei https://doaj.org/toc/2214-3300 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2021 200502-
allfieldsSound	10.1016/j.ehpc.2021.200502 doi (DE-627)DOAJ057748985 (DE-599)DOAJ6beca396d66848068d05a1586b106d40 DE-627 ger DE-627 rakwb eng RB1-214 Miriam Fewtrell verfasserin aut PAX 8 positive synovial sarcoma 2021 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier In this report, we describe a case of a biphasic tumour which presented as an incidental lump on the wrist of a 78 year old female. The epithelioid component predominated and was strikingly “gland-like”, and in an elderly female raised concerns of a primary soft tissue tumour as well as a metastatic mixed Müllerian tumour. The unusual “gland” lining cells and odd central secretion did not fit classical glands and raised our suspicions of synovial sarcoma. We employed a panel of immunoperoxidase stains to consider synovial sarcoma as well as metastases, and included PAX8, ER and PR for possible gynaecologic and breast malignancies. Paired Box (PAX) 8 is a tissue-specific transcription factor protein, and immunohistochemical stains using antibodies raised against PAX 8 are frequently used in staining panels to help identify the origin of primary or metastatic malignancies, and in particular where tumours from the female genital tract, kidney, thyroid and thymus are included in the differential diagnosis. Our research into PAX8 revealed that it has been little studied in soft tissue sarcomas and there is limited published data in the English language literature regarding PAX8 staining particularly in primary extremity soft tissue synovial sarcomas. Unexpectedly, our panel of immunohistochemical stains showed PAX8 positivity for both the epithelioid and spindle cell components of our case, and again raised concerns of a gynaecological malignancy. The components showed differential PAX8 staining patterns, which is of note, and highlights the possible variability in staining of synovial sarcoma. Definitive diagnosis of biphasic synovial sarcoma was confirmed by fluorescent in situ hybridisation studies. This case report therefore documents PAX8 positive staining in biphasic primary soft tissue synovial sarcoma, demonstrating important considerations in its use, enabling the diagnosis of this infrequent and potentially aggressive soft tissue tumour. The relevant literature is highlighted. The variable range of appearances of this potentially aggressive tumour is further illustrated by our case which showed striking epithelial-rich morphology, and presented important diagnostic considerations. Careful morphologic examination together with immunohistochemical and molecular studies in our case enabled a definitive diagnosis of this histologically striking variant, with unexpected PAX8 positive staining. PAX 8 Synovial sarcoma Biphasic synovial sarcoma Immunostaining of sarcomas Pathology Patricia Symons verfasserin aut Angela M. Hong verfasserin aut Peter Luk verfasserin aut Roland Jiang verfasserin aut In Human Pathology: Case Reports Elsevier, 2016 24(2021), Seite 200502- (DE-627)835590143 (DE-600)2834872-2 22143300 nnns volume:24 year:2021 pages:200502- https://doi.org/10.1016/j.ehpc.2021.200502 kostenfrei https://doaj.org/article/6beca396d66848068d05a1586b106d40 kostenfrei http://www.sciencedirect.com/science/article/pii/S2214330021000316 kostenfrei https://doaj.org/toc/2214-3300 Journal toc kostenfrei GBV_USEFLAG_A SYSFLAG_A GBV_DOAJ GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 24 2021 200502-
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title_sort	pax 8 positive synovial sarcoma
callnumber	RB1-214
title_auth	PAX 8 positive synovial sarcoma
abstract	In this report, we describe a case of a biphasic tumour which presented as an incidental lump on the wrist of a 78 year old female. The epithelioid component predominated and was strikingly “gland-like”, and in an elderly female raised concerns of a primary soft tissue tumour as well as a metastatic mixed Müllerian tumour. The unusual “gland” lining cells and odd central secretion did not fit classical glands and raised our suspicions of synovial sarcoma. We employed a panel of immunoperoxidase stains to consider synovial sarcoma as well as metastases, and included PAX8, ER and PR for possible gynaecologic and breast malignancies. Paired Box (PAX) 8 is a tissue-specific transcription factor protein, and immunohistochemical stains using antibodies raised against PAX 8 are frequently used in staining panels to help identify the origin of primary or metastatic malignancies, and in particular where tumours from the female genital tract, kidney, thyroid and thymus are included in the differential diagnosis. Our research into PAX8 revealed that it has been little studied in soft tissue sarcomas and there is limited published data in the English language literature regarding PAX8 staining particularly in primary extremity soft tissue synovial sarcomas. Unexpectedly, our panel of immunohistochemical stains showed PAX8 positivity for both the epithelioid and spindle cell components of our case, and again raised concerns of a gynaecological malignancy. The components showed differential PAX8 staining patterns, which is of note, and highlights the possible variability in staining of synovial sarcoma. Definitive diagnosis of biphasic synovial sarcoma was confirmed by fluorescent in situ hybridisation studies. This case report therefore documents PAX8 positive staining in biphasic primary soft tissue synovial sarcoma, demonstrating important considerations in its use, enabling the diagnosis of this infrequent and potentially aggressive soft tissue tumour. The relevant literature is highlighted. The variable range of appearances of this potentially aggressive tumour is further illustrated by our case which showed striking epithelial-rich morphology, and presented important diagnostic considerations. Careful morphologic examination together with immunohistochemical and molecular studies in our case enabled a definitive diagnosis of this histologically striking variant, with unexpected PAX8 positive staining.
abstractGer	In this report, we describe a case of a biphasic tumour which presented as an incidental lump on the wrist of a 78 year old female. The epithelioid component predominated and was strikingly “gland-like”, and in an elderly female raised concerns of a primary soft tissue tumour as well as a metastatic mixed Müllerian tumour. The unusual “gland” lining cells and odd central secretion did not fit classical glands and raised our suspicions of synovial sarcoma. We employed a panel of immunoperoxidase stains to consider synovial sarcoma as well as metastases, and included PAX8, ER and PR for possible gynaecologic and breast malignancies. Paired Box (PAX) 8 is a tissue-specific transcription factor protein, and immunohistochemical stains using antibodies raised against PAX 8 are frequently used in staining panels to help identify the origin of primary or metastatic malignancies, and in particular where tumours from the female genital tract, kidney, thyroid and thymus are included in the differential diagnosis. Our research into PAX8 revealed that it has been little studied in soft tissue sarcomas and there is limited published data in the English language literature regarding PAX8 staining particularly in primary extremity soft tissue synovial sarcomas. Unexpectedly, our panel of immunohistochemical stains showed PAX8 positivity for both the epithelioid and spindle cell components of our case, and again raised concerns of a gynaecological malignancy. The components showed differential PAX8 staining patterns, which is of note, and highlights the possible variability in staining of synovial sarcoma. Definitive diagnosis of biphasic synovial sarcoma was confirmed by fluorescent in situ hybridisation studies. This case report therefore documents PAX8 positive staining in biphasic primary soft tissue synovial sarcoma, demonstrating important considerations in its use, enabling the diagnosis of this infrequent and potentially aggressive soft tissue tumour. The relevant literature is highlighted. The variable range of appearances of this potentially aggressive tumour is further illustrated by our case which showed striking epithelial-rich morphology, and presented important diagnostic considerations. Careful morphologic examination together with immunohistochemical and molecular studies in our case enabled a definitive diagnosis of this histologically striking variant, with unexpected PAX8 positive staining.
abstract_unstemmed	In this report, we describe a case of a biphasic tumour which presented as an incidental lump on the wrist of a 78 year old female. The epithelioid component predominated and was strikingly “gland-like”, and in an elderly female raised concerns of a primary soft tissue tumour as well as a metastatic mixed Müllerian tumour. The unusual “gland” lining cells and odd central secretion did not fit classical glands and raised our suspicions of synovial sarcoma. We employed a panel of immunoperoxidase stains to consider synovial sarcoma as well as metastases, and included PAX8, ER and PR for possible gynaecologic and breast malignancies. Paired Box (PAX) 8 is a tissue-specific transcription factor protein, and immunohistochemical stains using antibodies raised against PAX 8 are frequently used in staining panels to help identify the origin of primary or metastatic malignancies, and in particular where tumours from the female genital tract, kidney, thyroid and thymus are included in the differential diagnosis. Our research into PAX8 revealed that it has been little studied in soft tissue sarcomas and there is limited published data in the English language literature regarding PAX8 staining particularly in primary extremity soft tissue synovial sarcomas. Unexpectedly, our panel of immunohistochemical stains showed PAX8 positivity for both the epithelioid and spindle cell components of our case, and again raised concerns of a gynaecological malignancy. The components showed differential PAX8 staining patterns, which is of note, and highlights the possible variability in staining of synovial sarcoma. Definitive diagnosis of biphasic synovial sarcoma was confirmed by fluorescent in situ hybridisation studies. This case report therefore documents PAX8 positive staining in biphasic primary soft tissue synovial sarcoma, demonstrating important considerations in its use, enabling the diagnosis of this infrequent and potentially aggressive soft tissue tumour. The relevant literature is highlighted. The variable range of appearances of this potentially aggressive tumour is further illustrated by our case which showed striking epithelial-rich morphology, and presented important diagnostic considerations. Careful morphologic examination together with immunohistochemical and molecular studies in our case enabled a definitive diagnosis of this histologically striking variant, with unexpected PAX8 positive staining.
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title_short	PAX 8 positive synovial sarcoma
url	https://doi.org/10.1016/j.ehpc.2021.200502 https://doaj.org/article/6beca396d66848068d05a1586b106d40 http://www.sciencedirect.com/science/article/pii/S2214330021000316 https://doaj.org/toc/2214-3300
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author2	Patricia Symons Angela M. Hong Peter Luk Roland Jiang
author2Str	Patricia Symons Angela M. Hong Peter Luk Roland Jiang
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doi_str	10.1016/j.ehpc.2021.200502
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up_date	2024-07-03T13:52:28.876Z
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