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Molecular analysis distinguishes synovial sarcoma from mesothelioma
Klebe S et al. Pathology; published online 28 August 2018 https://doi.org/10.1016/j.pathol.2018.06.001
- Key clinical point: Molecular analysis is mandatory for distinguishing cases of pleural malignant mesothelioma versus synovial sarcoma. Clear discrimination between pleural sarcomatoid mesothelioma and synovial sarcoma can be impossible from H&E-stained sections and conventional immunohistochemical markers for mesothelioma, and on TLE1 immunolabelling.
- Major finding: A comparative analysis by transducin-like enhancer of split 1 (TLE1) immunohistochemistry and molecular analysis of SYT-SSX distinguished 16 pleural predominantly sarcomatoid mesotheliomas and six cases of pleuropulmonary synovial sarcoma (five pleural in distribution only, with one case of a predominantly subpleural upper lobe synovial sarcoma), all of which were solely or predominantly monophasic. The synovial sarcomas were diagnosed in patients significantly younger on average than the sarcomatoid mesotheliomas. The synovial sarcoma patients had significantly longer survivals than the predominantly sarcomatoid mesotheliomas.
- Study details: In line with current approaches to diagnosis, mesotheliomas were defined according to their negative SYT-SSX status, versus a positive result by fluorescence in situ hybridisation (FISH) or by reverse transcriptase PCR (RT-PCR) for synovial sarcoma.
- In this series, predominantly sarcomatoid mesotheliomas out-numbered the synovial sarcomas in a ratio of nearly 3:1.
- Disclosures: This study was supported by Flinders University. The authors state that there are no conflicts of interest to disclose.
- Source: Klebe S et al. Pathology; published online 28 August 2018 https://doi.org/10.1016/j.pathol.2018.06.001
Citation:
Klebe S et al. Pathology; published online 28 August 2018 https://doi.org/10.1016/j.pathol.2018.06.001