Primary renal synovial sarcoma: Molecular and morphologic delineation of an entity previously included among embryonal sarcomas of the kidney Journal Article
| Authors: | Argani, P.; Faria, P. A.; Epstein, J. I.; Reuter, V. E.; Perlman, E. J.; Beckwith, J. B.; Ladanyi, M. |
| Article Title: | Primary renal synovial sarcoma: Molecular and morphologic delineation of an entity previously included among embryonal sarcomas of the kidney |
| Abstract: | We report 15 primary renal neoplasms with morphologic, immunohistochemical, and molecular features identical to those of synovial sarcoma. These tumors form a distinct subset of the entity previously designated as embryonal sarcoma of the kidney. Most were diagnosed between the ages of 20 and 50 years. On gross examination, tumors are large, partially necrotic, and usually contain smooth-walled cysts. Microscopically, tumors are characterized by mitotically active, monomorphic plump spindle cells with indistinct cell borders growing in short, intersecting fascicles. Grossly identified cysts are lined by mitotically inactive polygonal eosinophilic cells with apically oriented nuclei ('hobnailed epithelium'). The spindle cells are immunoreactive for vimentin, often immunoreactive for EMA, but typically non-immunoreactive for desmin, actin, S100, or cytokeratins, whereas the cyst epithelium is cytokeratin-positive. These findings are consistent with monophasic, spindled synovial sarcoma encircling dilated native renal collecting ducts. The presence of an SYT-SSX gene fusion resulting from the t(X;18) characteristic of synovial sarcoma was demonstrated by reverse transcriptase polymerase chain reaction in three of three tumors in which adequate RNA could be obtained from paraffin blocks. An additional case demonstrated the characteristic t(X;18) translocation on cytogenetic analysis, but adequate material to perform molecular studies was not available in this case or the remaining 11 cases. Primary renal synovial sarcoma is a distinctive clinicopathologic entity confirmed by molecular detection of SYT-SSX fusion transcripts. |
| Keywords: | immunohistochemistry; adult; clinical article; middle aged; sequence analysis; histopathology; microscopy; reverse transcription polymerase chain reaction; diagnosis, differential; tumor markers, biological; morphology; kidney neoplasms; rna; reverse transcriptase polymerase chain reaction; rna, messenger; oncogene proteins, fusion; x chromosome; translocation, genetic; neoplasms, germ cell and embryonal; synovial sarcoma; sarcoma, synovial; kidney sarcoma; chromosomes, human, pair 18; embryonal sarcoma; humans; human; male; female; article; artificial gene fusion |
| Journal Title: | American Journal of Surgical Pathology |
| Volume: | 24 |
| Issue: | 8 |
| ISSN: | 0147-5185 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2000-08-01 |
| Start Page: | 1087 |
| End Page: | 1096 |
| Language: | English |
| DOI: | 10.1097/00000478-200008000-00006 |
| PUBMED: | 10935649 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Export Date: 18 November 2015 -- Source: Scopus |
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