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NY-ESO-1 is a sensitive and specific immunohistochemical marker for myxoid and round cell liposarcomas among related mesenchymal myxoid neoplasms.
[well-differentiated liposarcoma]
Myxoid
and
round
cell
liposarcomas
constitute
approximately
one
-
third
of
all
liposarcomas
,
a
relatively
common
group
of
fat-derived
soft
tissue
sarcomas
.
The
histomorphology
is
a
continuum
between
highly
differentiated
myxoid
and
poorly
differentiated
round
cell
components
.
The
gold
standard
of
diagnosis
is
dependent
on
histomorphology
and
/
or
identification
of
t
(
12
;
16
)
(
q
13
;
p
11
)
translocation
by
cytogenetics
or
demonstration
of
DDIT
3
rearrangements
by
fluorescence
in
situ
hybridization
.
There
are
currently
no
diagnostic
immunohistochemical
stains
available
.
The
broad
range
of
myxoid
neoplasms
in
the
differential
diagnosis
includes
a
variety
of
sarcomas
.
Given
the
notable
differences
in
disease
biology
among
myxoid
neoplasms
,
which
range
from
benign
to
aggressive
,
an
accurate
diagnosis
is
imperative
for
proper
treatment
and
prognostication
.
Prompted
by
our
recent
study
showing
frequent
expression
of
the
cancer
testis
antigen
NY
-ESO-
1
in
myxoid
and
round
cell
liposarcomas
,
we
sought
to
evaluate
the
utility
of
NY
-ESO-
1
as
an
immunohistochemical
marker
for
myxoid
and
round
cell
liposarcoma
among
mesenchymal
myxoid
neoplasms
within
the
differential
diagnosis
.
Formalin-fixed
,
paraffin-embedded
blocks
were
obtained
for
the
following
mesenchymal
myxoid
neoplasms
(
n
=
138
)
:
myxoid
and
round
cell
liposarcoma
(
n
=
38
)
;
well-differentiated
liposarcoma
(
n
=
12
)
;
lipoma
(
n
=
20
;
4
with
myxoid
change
)
;
extra
-
cardiac
soft
tissue
myxoma
(
n
=
39
)
;
extraskeletal
myxoid
chondrosarcoma
(
n
=
12
)
;
myxofibrosarcoma
(
n
=
10
:
5
low
grade
,
2
intermediate
grade
,
3
high
grade
)
;
and
low
-grade
fibromyxoid
sarcoma
(
n
=
7
)
.
Utilizing
standard
immunohistochemistry
protocols
,
full
sections
were
stained
with
NY
-ESO-
1
(
clone
E
978
)
,
and
staining
was
assessed
for
intensity
(
1
-
2
+
)
,
percentage
of
tumor
positivity
,
and
location
.
In
all
,
36
/
38
(
95
%
)
of
the
myxoid
and
round
cell
liposarcomas
demonstrated
NY
-ESO-
1
immunoreactivity
.
The
majority
of
the
positive
cases
(
34
/
36
;
94
%
)
showed
strong
,
homogenous
staining
(
>
50
%
tumor
positivity
)
,
and
two
cases
(
6
%
)
showed
weak
(
1
+
intensity
)
,
patchy
staining
(
20
-
30
%
tumor
positivity
)
.
Immunoreactivity
was
predominantly
cytoplasmic
.
All
the
other
neoplasms
evaluated
were
negative
for
NY
-ESO-
1
.
NY
-ESO-
1
appears
to
be
a
sensitive
and
a
specific
marker
for
myxoid
and
round
cell
liposarcoma
among
mesenchymal
myxoid
neoplasms
.
The
assessment
of
NY
-ESO-
1
expression
by
immunohistochemistry
in
the
appropriate
setting
provides
a
cheaper
,
faster
,
and
more
accessible
confirmatory
test
.
Diseases
Validation
Diseases presenting
"liposarcoma"
symptom
dedifferentiated liposarcoma
erdheim-chester disease
focal myositis
gm1 gangliosidosis
liposarcoma
pleomorphic liposarcoma
well-differentiated liposarcoma
This symptom has already been validated