Document Detail

An immunohistochemical study comparing clear cell sarcoma of the kidney and Wilms' tumor.
MedLine Citation:
PMID:  8396229     Owner:  NLM     Status:  MEDLINE    
This study explores immunohistochemical characteristics that may be of diagnostic value in differentiating clear cell sarcoma of the kidney (CCSK) from Wilms' tumor (WT) and may provide some insight into the histogenesis of CCSK. Formalin-fixed, paraffin-embedded sections of 8 CCSK and 9 WT were stained, using the standard avidin-biotin peroxidase complex method, for vimentin (VIM), Factor-8 related antigen (F8A), epithelial membrane antigen (EMA), desmin (DES), S-100 protein and Mac 387. CCSK cells consistently exhibited moderate to strong diffuse cytoplasmic positivity for VIM and were negative for F8A, EMA, DES, S-100 and Mac 387. In contrast, only patchy groups of stromal cells and primitive glomeruloid structures in WT exhibited VIM-positivity. Blastemal cells were VIM-negative. Stromal cells with rhabdomyomatous differentiation exhibited cytoplasmic positivity for DES. Epithelial cells of maturing tubular structures showed EMA-positivity whereas immature tubular structures were EMA-negative. Neither blastemal, stromal nor epithelial elements in WT were positive for F8A, S-100 or Mac 387. Podocytes and mesangial cells of glomeruli in 3 mid-trimester human abortuses (controls) exhibited moderate to strong VIM-positivity. The importance of differentiating CCSK from WT has been repeatedly emphasized because of its poorer prognosis and the necessity of adding Adriamycin to the chemotherapeutic regime. The consistent VIM-positivity of CCSK cells can be a useful feature in differentiating it from "blastemal-predominant" WT, with which it is often confused. Although vimentin expression by CCSK cells is consistent with a mesenchymal character, the possibility of a histogenetic link with glomerular podocytes or mesangial cells should also be considered.
L M Looi; P L Cheah
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pathology     Volume:  25     ISSN:  0031-3025     ISO Abbreviation:  Pathology     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-10-07     Completed Date:  1993-10-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0175411     Medline TA:  Pathology     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  106-9     Citation Subset:  IM    
Department of Pathology, Faculty of Medicine, University of Malaya, Kuala Lumpur.
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MeSH Terms
Child, Preschool
Diagnosis, Differential
Intermediate Filament Proteins / analysis*
Kidney Neoplasms / chemistry,  pathology*
Sarcoma / chemistry,  pathology*
Wilms Tumor / chemistry,  pathology*
Reg. No./Substance:
0/Intermediate Filament Proteins

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