Undifferentiated Melanoma Resembling Undifferentiated Round Cell Sarcoma: The Diagnostic Power of Molecular Melanoma Signature

Melanomas presenting in primary or metastatic sites with a poorly differentiated histology comprise dedifferentiated (DM) and undifferentiated melanomas (UM), the latter consisting purely of undifferentiated cells and totally lacking immunophenotypic features of melanoma. These entities have a wide morphological spectrum including round cell sarcoma-like features which pose a significant diagnostic challenge. Here we present a case of UM with morphological and immunohistochemical features resembling undifferentiated round cell sarcoma, whose diagnosis could only be established after proper integration of clinical and molecular data. This diagnostically challenging case, fulfilling the previously proposed diagnostic criteria by Agaimy et al, expands the clinicopathological spectrum of DM/UM, highlights the essence of molecular signature, and further emphasizes the importance of patient’s history in any morphological setting.

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Immunohistochemical Labeling of Multiple Myeloma Oncogene 1/Interferon Regulatory Factor 4 (MUM1/IRF-4) in Canine Cutaneous Histiocytoma

Veterinary Pathology ◽

10.1177/0300985818759770 ◽

2018 ◽

Vol 55 (4) ◽

pp. 517-520 ◽

Cited By ~ 4

Author(s):

Justin M. Stilwell ◽

Daniel R. Rissi

Keyword(s):

Multiple Myeloma ◽

Plasma Cell ◽

Interferon Regulatory Factor ◽

Round Cell ◽

Regulatory Factor ◽

Diagnostic Challenge ◽

Poorly Differentiated ◽

Interferon Regulatory Factor 4 ◽

Round Cell Tumors

Multiple myeloma oncogene 1/interferon regulatory factor 4 (MUM1/IRF-4) immunohistochemistry (IHC) is mainly used for diagnostic confirmation of plasma cell tumors (PCTs) in dogs and cats. This article describes MUM1/IRF-4 IHC expression in 20 cases of canine cutaneous histiocytoma (CH) and compares it with 10 cutaneous or mucocutaneous PCTs and 5 cutaneous histiocytic sarcomas (HSs) submitted to the same IHC protocol. All histiocytomas had strong nuclear and variable cytoplasmic immunolabeling for MUM1/IRF-4, whereas all PCTs had strong nuclear and moderate cytoplasmic immunolabeling for MUM1/IRF-4. No MUM1/IRF-4 immunolabeling was detected in the HSs. Although not typically a diagnostic challenge, MUM1/IRF-4 expression may have to be used with caution or in conjunction with additional immunomarkers to differentiate among poorly differentiated round cell tumors, especially when a histiocytic or plasma cell origin is suspected.

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CIC-DUX4 rearranged uterine cervix round-cell sarcoma exhibiting near-complete pathologic response following radiation and neoadjuvant chemotherapy: A case report

Gynecologic Oncology Reports ◽

10.1016/j.gore.2021.100745 ◽

2021 ◽

Vol 36 ◽

pp. 100745

Author(s):

Aline Cristini Vieira ◽

Camila Bragança Xavier ◽

Thiago Dieb Vieira ◽

Filomena Marino Carvalho ◽

Mariana Scaranti ◽

...

Keyword(s):

Case Report ◽

Neoadjuvant Chemotherapy ◽

Uterine Cervix ◽

Pathologic Response ◽

Complete Pathologic Response ◽

Round Cell ◽

Cell Sarcoma

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Ovarian Involvement by Desmoplastic Small Round Cell Tumor With Leydig Cell Hyperplasia Showing an Unusual Immunophenotype (Cytokeratin Negative, Calretinin and Inhibin Positive) Mimicking Poorly Differentiated Sertoli Leydig Cell Tumor

International Journal of Gynecological Pathology ◽

10.1097/pgp.0b013e3181aae8dc ◽

2009 ◽

Vol 28 (6) ◽

pp. 579-583 ◽

Cited By ~ 6

Author(s):

Corinne Engohan-Aloghe ◽

Nicolas de Saint Aubain Sommerhausen ◽

Jean-Christophe Noël

Keyword(s):

Leydig Cell ◽

Leydig Cell Tumor ◽

Cell Tumor ◽

Round Cell ◽

Cell Hyperplasia ◽

Round Cell Tumor ◽

Small Round Cell Tumor ◽

Small Round Cell ◽

Poorly Differentiated ◽

Ovarian Involvement

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Parasitic hypereosinophilia in childhood: a diagnostic challenge

Mediterranean Journal of Hematology and Infectious Diseases ◽

10.4084/mjhid.2018.034 ◽

2018 ◽

Vol 10 (1) ◽

pp. 2018034

Author(s):

Roberto Antonucci ◽

Nadia Vacca ◽

Giulia Boz ◽

Cristian Locci ◽

Rosanna Mannazzu ◽

...

Keyword(s):

Eosinophil Count ◽

Hypereosinophilic Syndrome ◽

Igg Antibodies ◽

Diagnostic Challenge ◽

Etiological Diagnosis ◽

Maximum Value ◽

History Of ◽

Diagnostic Work ◽

Patient’S History ◽

Work Up

Severe hypereosinophilia (HE) in children is rare, and its etiological diagnosis is challenging. We describe a case of a 30-month-old boy, living in a rural area, who was admitted to our Clinic with a 7-day history of fever and severe hypereosinophilia. A comprehensive diagnostic work-up could not identify the cause of this condition. On day 6, the rapidly increasing eosinophil count (maximum value of 56,000/mm3), the risk of developing hypereosinophilic syndrome, and the patient’s history prompted us to undertake an empiric treatment with albendazole.The eosinophil count progressively decreased following treatment. On day 13, clinical condition and hematological data were satisfactory, therefore the treatment was discontinued and the patient was discharged. Three months later, anti-nematode IgG antibodies were detected in patient serum, thus establishing the etiological diagnosis. In conclusion, an empiric anthelmintic treatment seems to be justified when parasitic hypereosinophilia is strongly suspected, and other causes have been excluded.

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BCOR-CCNB3-positive soft tissue sarcoma with round-cell and spindle-cell histology: a series of four cases highlighting the pitfall of mimicking poorly differentiated synovial sarcoma

Histopathology ◽

10.1111/his.13001 ◽

2016 ◽

Vol 69 (5) ◽

pp. 792-801 ◽

Cited By ~ 25

Author(s):

Wan-Shan Li ◽

I-Chuang Liao ◽

Mei-Chin Wen ◽

Howard Haw-Chang Lan ◽

Shih-Chen Yu ◽

...

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Synovial Sarcoma ◽

Spindle Cell ◽

Round Cell ◽

Poorly Differentiated

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Uterine Epithelioid Trophoblastic Tumor in a 44-Year-Old Woman: A Diagnostic Dilemma

Clinics and Practice ◽

10.3390/clinpract11030078 ◽

2021 ◽

Vol 11 (3) ◽

pp. 631-639

Author(s):

Maria-Gabriela Aniţei ◽

Diana-Elena Lazăr ◽

Raluca Alina Pleşca ◽

Cristina Terinte ◽

Radu Iulian ◽

...

Keyword(s):

Reproductive Age ◽

Diagnostic Challenge ◽

Diagnostic Dilemma ◽

Natural Childbirth ◽

Trophoblastic Tumor ◽

Epithelioid Trophoblastic Tumor ◽

Uterine Curettage ◽

Normal Human ◽

Poorly Differentiated ◽

Β Hcg

Background: Epithelioid trophoblastic tumor (ETT) is a rare and newly defined disease, which most commonly occurs in women of reproductive age and can be a sequela of any gestational event. ETT can be present in both intrauterine and extrauterine sites. Case report: A woman of reproductive age, without specific comorbidities and with a single pregnancy and natural childbirth eight years ago, was diagnosed initially with poorly differentiated pleomorphic leiomyosarcoma on the hemostatic uterine curettage. Conclusion: Our case highlights that ETT presents a diagnostic challenge due to its rarity and histologic resemblance to other pathologies. Misdiagnosis delays effective treatment and affects survival. To date, only 8 cases of ETT of the uterus without previous gestational event and normal human chorionic gonadotropin (β-HCG) levels in a 60-year literature survey have been reported.

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Undifferentiated Small Round Cell Sarcoma of the Postcricoid Region of the Hypopharynx: A Rare Case Report and Review of the Literature

OncoTargets and Therapy ◽

10.2147/ott.s320335 ◽

2021 ◽

Vol Volume 14 ◽

pp. 4537-4544

Author(s):

Jiao Zhu ◽

Bo Li ◽

Juan Juan Hu ◽

Weiping Liu ◽

Dan Lu ◽

...

Keyword(s):

Case Report ◽

Rare Case ◽

Round Cell ◽

Review Of The Literature ◽

Cell Sarcoma ◽

Small Round Cell ◽

Rare Case Report

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Epithelial-Type and Neural-Type Cadherin Expression in Malignant Noncarcinomatous Neoplasms With Epithelioid Features That Involve the Soft Tissues

Archives of Pathology & Laboratory Medicine ◽

10.5858/2002-126-0425-etantc ◽

2002 ◽

Vol 126 (4) ◽

pp. 425-431 ◽

Cited By ~ 4

Author(s):

William B. Laskin ◽

Markku Miettinen

Keyword(s):

Malignant Melanoma ◽

Synovial Sarcoma ◽

Soft Tissues ◽

Clear Cell ◽

Epithelioid Sarcoma ◽

Clear Cell Sarcoma ◽

Extraskeletal Myxoid Chondrosarcoma ◽

Cell Sarcoma ◽

Myxoid Chondrosarcoma ◽

Poorly Differentiated

Abstract Context.—Transmembrane adhesion molecules, epithelial-type cadherin (ECAD) and neural-type cadherin (NCAD), help in regulating transformations between epithelial and mesenchymal cells in the developing embryo and in maintaining the epithelioid phenotype. Consequently, the presence of epithelioid cells in certain malignant noncarcinomatous neoplasms raises speculation that the expression of ECAD and NCAD in these neoplasms may have diagnostic significance. Objective.—To investigate the utility of ECAD and NCAD immunoexpression in distinguishing malignant (noncarcinomatous) neoplasms with epithelioid features that involve the soft tissues. Design.—Membranous immunoreactivity of anti-ECAD and anti-NCAD was evaluated on archived cases selected from the files of the Armed Forces Institute of Pathology. Results.—Epithelial-type cadherin was found in biphasic synovial sarcoma (35 of 35 cases), malignant melanoma (13/21), monophasic fibrous synovial sarcoma (13/26), clear cell sarcoma (4/9), poorly differentiated synovial sarcoma (3/13), diffuse mesothelioma (4/20), malignant epithelioid peripheral nerve sheath tumor (1/6), and epithelioid sarcoma (5/62). Neural-type cadherin was observed in chordoma (11/11), biphasic synovial sarcoma (30/35), diffuse mesothelioma (14/20), malignant melanoma (14/25), epithelioid sarcoma (24/63), epithelioid angiosarcoma (1/4), poorly differentiated synovial sarcoma (2/13), clear cell sarcoma (1/10), and monophasic fibrous synovial sarcoma (1/26). Eighteen cases of primary cutaneous squamous cell carcinomas all tested positive for ECAD, whereas NCAD was focally observed in 5 cases. No expression of either molecule was observed in cases of epithelioid hemangioendothelioma (n = 9), alveolar soft part sarcoma (n = 8), and extraskeletal myxoid chondrosarcoma (n = 7). Conclusions.—Epithelial-type and neural-type cadherins are found in a variety of noncarcinomatous neoplasms with epithelioid features that involve the soft tissues and can be utilized, in association with other immunomarkers, in distinguishing chordoma (100% NCAD) from extraskeletal myxoid chondrosarcoma and conventional chondrosarcoma of bone (0% NCAD), squamous cell carcinoma (100% ECAD) from epithelioid sarcoma (8% ECAD), and biphasic synovial sarcoma (100% ECAD) from diffuse mesothelioma (20% ECAD).

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Problems and Controversies in the Histopathology of Thyroid Carcinomas of Follicular Cell Origin

Archives of Pathology & Laboratory Medicine ◽

10.5858/133.5.683 ◽

2009 ◽

Vol 133 (5) ◽

pp. 683-691

Author(s):

Ronald Ghossein

Keyword(s):

Thyroid Carcinoma ◽

English Language ◽

Follicular Carcinoma ◽

Molecular Data ◽

Follicular Cell ◽

Clinical Value ◽

Thyroid Carcinomas ◽

Poorly Differentiated ◽

Disease Entities

Abstract Context.—Despite past and recent efforts, many problems and controversies remain in the classification of thyroid carcinomas of follicular cell origin. These controversies have an impact on the prognosis and therapy of patients with thyroid carcinoma as well as on the development of robust cutting-edge research aimed at better outcome and quality of life. Objective.—To focus on 3 contentious areas with significant clinical value: the follicular variant of papillary thyroid carcinoma, the extent of invasion in follicular carcinoma, and the poorly differentiated thyroid carcinomas. Data Sources.—The published English language literature was reviewed. Conclusions.—Recent data show that prognosis and therapy for many disease entities can be better delineated if a meticulous microscopic examination is performed. An accurate assessment of the extent of invasion (especially vascular) is crucial. Proliferative grading (ie, mitosis and necrosis) is of high prognostic value and should be looked for in every specimen. In addition, molecular data gathered to date can help reassess these tumors at the histologic level. Classification proposals based on personal experience rather than adequate and careful clinical follow-up should be discouraged.

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