Skip to main content
Log in

Epithelioid sarcoma in children and adolescents

An immunohistochemical study

  • Published:
Virchows Archiv A Aims and scope Submit manuscript

Summary

Six cases of epithelioid sarcoma were studied by conventional light microscopy and immunohistochemistry. The six cases account for 1.4% of the 417 cases of soft tissue sarcoma collected at the Paediatric Tumor Registry, Kiel. The average age of the five male and one female patient was 10.8 years (median: 13 years). Particular clinical findings included the location of the tumours; three were found in the pelvis, two in the head and neck, and one in the hand. Four patients are living without disease, and one patient died of disease three years after diagnosis.

Histologically, four of the six tumours revealed multinucleated giant cells. Immunohistochemically using a panel of mono- and polyclonal antibodies all cases stained positively for vimentin, cytokeratin, epithelial membrane antigen (EMA), and human milk fat globulin (HMFG-2). Five cases were positive for neuron specific enolase (NSE), and three stained positively for protein S-100. A positive reaction for alpha-1-antichymotrypsin was noted in two cases. These immunohistochemical findings attest to the multidirectional differentiating capabilities of epithelioid sarcoma and support the concept of derivation from a multipotent mesenchymal stem cell.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Altmannsberger M, Osborn M, Schauer A, Weber K (1981) Antibodies to different intermediate filament proteins. Cell type-specific markers on paraffin-embedded human tissues. Lab Invest 45:427–434

    Google Scholar 

  • Blewitt RW, Aparicio SGR, Bird CC (1983) Epithelioid sarcoma: a tumour of myofibroblasts. Histopathology 7:573–584

    Google Scholar 

  • Bloustein PA, Silverberg SG, Waddell WR (1976) Epithelioid sarcoma. Case report with ultrastructural review, histogenetic discussion, and chemotherapeutic data. Cancer 38:2390–2400

    Google Scholar 

  • Burchell J, Durbin H, Taylor-Papadimitriou J (1983) Complexity of expression of antigenic determinants, recognized by monoclonal antibodies HMFG-1 and HMFG-2, in normal and malignant human mammary epithelial cells. J Immunol 131:508–513

    Google Scholar 

  • Chase DR, Enzinger FM (1985) Epithelioid sarcoma. Diagnosis, prognostic indicators, and treatment. Am J Surg Pathol 9:241–263

    Google Scholar 

  • Chase DR, Enzinger FM, Weiss SW, Langloss JM (1984) Keratin in epithelioid sarcoma. An immunohistochemical study. Am J Surg Pathol 8:435–441

    Google Scholar 

  • Cooney TP, Hwang WS, Robertson DI, Hoogstraten J (1982) Monophasic synovial sarcoma, epithelioid sarcoma and chordoid sarcoma: ultrastructural evidence for a common histogenesis, despite light microscopic diversity. Histopathology 6:163–190

    Google Scholar 

  • Enjoji M, Hashimoto H (1984) Diagnosis of soft tissue sarcomas. Pathol Res Practice 178:215–226

    Google Scholar 

  • Frable WJ, Kay S, Lawrence W, Schatzki PF (1973) Epithelioid sarcoma - An electron microscopic study. Arch Pathol 95:8–12

    Google Scholar 

  • Fu Y-S Gabbiani G, Kaye GI, Lattes RI (1975) Malignant soft tissue tumors of probable histiocytic origin (malignant fibrous histiocytomas): General considerations and electron microscopic and tissue culture studies. Cancer 35:176–198

    Google Scholar 

  • Gabbiani G, Fu Y-S, Kaye GI, Lattes R, Majno G (1972) Epithelioid sarcoma. A light and electron microscopic study suggesting a synovial origin. Cancer 30:486–499

    Google Scholar 

  • Gatter KC, Dunnill MS, Van Muijen GNP, Mason DY (1986) Human lung tumours may coexpress different classes of intermediate filaments. J Clin Pathol 39:950–954

    Google Scholar 

  • Ghadially FN (1982) Ultrastructural Pathology of the Cell and Matrix, 2nd edition, London, Butterworths

    Google Scholar 

  • Gould VE (1986) Histogenesis and differentiation: A reevaluation of these concepts as criteria for the classification of tumors. Hum Pathol 17:212–214

    Google Scholar 

  • Gown AM, Vogel AM (1985) Monoclonal antibodies to human intermediate filament proteins. III. Analysis of tumors. Am J Clin Pathol 84:413–424

    Google Scholar 

  • Hajdu SI, Shin MH, Fortner JG (1977) Tendosynovial sarcoma. A clinicopathological study of 136 cases. Cancer 39:1201–1217

    Google Scholar 

  • Isaacson P, Jones DB, Millword-Sadler GH, Judd MA, Payne S (1981) Alpha-1-antitrypsin in human macrophages. J Clin Pathol 34:982–990

    Google Scholar 

  • Katenkamp D, Raikhlin NT (1985) Stem cell concept and heterogeneity of malignant soft tissue tumor - a challenge to reconsider diagnostics and therapy? Exp Pathol 28:3–11

    Google Scholar 

  • Küchemann K (1975) Epithelioid sarcoma. Beitr Pathol 155:84–89

    Google Scholar 

  • Lombardi L, Rilke F (1984) Ultrastructural similarities and differences of synovial sarcoma, epithelioid sarcoma, and clear cell sarcoma of the tendons and aponeuroses. Ultrastruct Pathol 6:209–219

    Google Scholar 

  • Machinami R, Kikuchi F, Matsushita H (1982) Epithelioid sarcoma. Enzyme histochemical and ultrastructural study. Virchows Arch [Pathol Anat] 397:109–120

    Google Scholar 

  • Mackay B (1977) Electron microscopy of soft tissue tumors. In: Management of primary bone and soft tissue tumors. Year Book Medical Publ., Chicago, pp 259–269

    Google Scholar 

  • Meister P (1984) Immunhistochemische Methoden bei der Diagnostik von Weichgewebstumoren. Pathologe 5:90–98

    Google Scholar 

  • Meister P, Nathrath W (1980) Immunohistochemical markers of histiocytic tumors. Hum Pathol 11:300–301

    Google Scholar 

  • Miettinen M, Lehto V-J, Badley RA, Virtanen I (1982a) Expression of intermediate filaments in soft-tissue sarcomas. Int J Cancer 30:541–546

    Google Scholar 

  • Miettinen M, Lehto V-P, Vartio T, Virtanen J (1982b) Epithelioid sarcoma. Ultrastructural and immunohistologic features suggesting a synovial origin. Arch Pathol Lab Med 106:620–623

    Google Scholar 

  • Miettinen M, Lehto V-P, Virtanen I (1982c) Keratin in the epitheliallike cells of classical biphasic synovial sarcoma. Virchows Arch [Cell Pathol] 40:157–161

    Google Scholar 

  • Mills SE, Fechner RE, Bruns DE, Bruns ME, O'Hara MF (1981) Intermediate filaments in eosinophilic cells of epithelioid sarcoma. A light-microscopic, ultrastructural, and electrophoretic study. Am J Surg Pathol 5:195–202

    Google Scholar 

  • Molenaar WM, Oosterhuis JW, Oosterhuis AM, Ramaekers FCS (1985) Mesenchymal and muscle-specific intermediate filaments (vimentin and desmin) in relation to differentiation in childhood rhabdomyosarcoma. Hum Pathol 16:838–843

    Google Scholar 

  • Mukai M, Torikata C, Iri H, Hanaoka H, Kawai T, Yakamaru K, Shimoda T, Mikata A, Kageyama K (1985) Cellular differentiation of epithelioid sarcoma: An electron-microscopic, enzyme-histochemical, and immunohistochemical study. Am J Pathol 119:44–56

    Google Scholar 

  • Nadji M, Morales AR (1984) Immunoperoxidase: Part II. Practical applications. Lab Med 15:33–37

    Google Scholar 

  • Osborn M, Weber K (1983) Biology of disease. Tumor diagnosis by intermediate filament typing: A novel tool for surgical pathology. Lab Invest 48:372–394

    Google Scholar 

  • Padilla RS, Flynn K, Headington JT, Arbor A (1985) Epithelioid sarcoma: enzymatic histochemical and electron microscopic evidence of histiocytic differentiation. Arch Dermatol 121:389–393

    Google Scholar 

  • Patchefsky AS, Soriano R, Kostianovsky M (1977) Epithelioid sarcoma. Ultrastructural similarity to nodular synovitis. Cancer 39:143–152

    Google Scholar 

  • Ramaekers FCS, Puts JJG, Moesker O, Kant A, Huysmans A, Haag D, Jap PHK, Herman CJ, Vooijs GP (1983) Antibodies to intermediate filament proteins in the immunohistochemical identification of human tumors: an overview. Histochem J 15:692–713

    Google Scholar 

  • Roholl PJM, De Jong ASH, Ramaekers FCS (1985) Application of markers in the diagnosis of soft tissue tumours. Histopathology 9:1019–1035

    Google Scholar 

  • Santiago H, Feinerman LK, Lattes R (1972) Epithelioid sarcoma. A clinical and pathologic study of nine cases. Hum Pathol 3:133–147

    Google Scholar 

  • Schmechel DE, Marangos PJ, Brightman MW (1979) Neuronspecific enolase is a marker for peripheral and central neuroendocrine cells. Nature 276:834–836

    Google Scholar 

  • Schmidt D, Reimann O, Treuner J, Harms D (1986) Cellular differentiation and prognosis in embryonal rhabdomyosarcoma. Virchows Arch [Pathol Anat] 409:183–194

    Google Scholar 

  • Seemayer TA, Dionne PG, Tabah EJ (1974) Epithelioid sarcoma. Can J Surg 17:37–41

    Google Scholar 

  • Sloane JP, Ormerod MG (1981) Distribution of epithelial membrane antigen in normal and neoplastic tissues and its value in diagnostic tumor pathology. Cancer 47:1786–1795

    Google Scholar 

  • Soule EH, Enriquez P (1972) Atypical fibrous histiocytoma, malignant fibrous histiocytoma, malignant histiocytoma, and epithelioid sarcoma: A comparative study of 65 cases. Cancer 30:128–143

    Google Scholar 

  • Sternberger LA, Hardy PH, Cuculis JJ, Meyer HG (1970) The unlabeled antibody - enzyme method of immunohistochemistry. Preparation of properties of soluble antigen-antibody complex (horseradish peroxidase-antihorseradish peroxidase) and its use in identification of spirochetes. J Histochem Cytochem 18:315–333

    Google Scholar 

  • Takahashi K, Yamaguchi H, Ishizaki J, Nakajima T, Nakazato Y (1981) Immunohistochemical and immunoelectron microscopic localization of S100 protein in the interdigitating reticulum cells of the human lymph node. Virchows Arch [Cell Pathol] 37:125–135

    Google Scholar 

  • Tsuneyoshi M, Enjoji M, Shinohara N (1980) Epithelioid sarcoma: A clinicopathologic and electron microscopic study. Acta Pathol Jpn 30:411–420

    Google Scholar 

  • Viac J, Reano A, Brochier J, Staquet M-J, Thivolet J (1983) Reactivity pattern of a monoclonal antikeratin antibody (KL 1). J Invest Dermatol 81:351–354

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Additional information

This study was supported in part by a grant from the Bundesminister für Arbeit und Sozialordnung and the Deutsche Forschungsgemeinschaft (Schm 613/1-1)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Schmidt, D., Harms, D. Epithelioid sarcoma in children and adolescents. Vichows Archiv A Pathol Anat 410, 423–431 (1987). https://doi.org/10.1007/BF00712762

Download citation

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00712762

Key words

Navigation