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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
"broad range"
symptom
acute rheumatic fever
congenital toxoplasmosis
cowden syndrome
cystinuria
dystrophic epidermolysis bullosa
gm1 gangliosidosis
hereditary cerebral hemorrhage with amyloidosis
kallmann syndrome
neuralgic amyotrophy
severe combined immunodeficiency
typhoid
waldenström macroglobulinemia
well-differentiated liposarcoma
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