Cytokeratin immunoreactivity in Ewing's sarcoma: prevalence in 50 cases confirmed by molecular diagnostic studies

Am J Surg Pathol. 2000 Mar;24(3):410-6. doi: 10.1097/00000478-200003000-00010.

Abstract

Ewing's sarcoma (ES) and primitive neuroectodermal tumor (PNET) are characterized by the presence of the specific t(11;22)(q24;q12) or variants thereof, producing diagnostic EWS fusion transcripts. Cytokeratin has been reported sporadically to be expressed in some cases of ES/PNET. However, its prevalence has not been assessed systematically in a series of cases with confirmatory molecular or cytogenetic evidence of a diagnostic translocation. We present in detail three index patients in whom strong cytokeratin immunoreactivity was a confounding factor in the diagnosis. To establish further the prevalence of cytokeratin immunoreactivity in a series of well-characterized ES/PNET, we then performed immunohistochemical studies with antibodies CAM5.2 and AE1/AE3 on 50 cases of ES/PNET diagnosed at Memorial Sloan-Kettering Cancer Center in which molecular evidence of a specific ES/PNET-associated translocation were available. Immunoreactivity to cytokeratin was present in 10 cases (20%), in five diffusely and five focally. There was no significant association between cytokeratin expression and the following parameters: patient age, sex, skeletal and extraskeletal primary site, and the type of EWS fusion transcript. Cytokeratin expression, a manifestation of epithelial differentiation, is present in as many as 20% of ES/PNET in either a diffuse or focal pattern.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Child
  • Female
  • Humans
  • Immunohistochemistry
  • Keratins / biosynthesis
  • Keratins / immunology*
  • Male
  • Neoplasms, Multiple Primary / immunology*
  • Neoplasms, Multiple Primary / pathology
  • Neuroectodermal Tumors, Primitive / immunology*
  • Neuroectodermal Tumors, Primitive / pathology
  • Sarcoma, Ewing / immunology*
  • Sarcoma, Ewing / pathology

Substances

  • Keratins