| ObjectiveSynovial sarcoma is a clinically and histologically well - defined entity. This tumor accounts for up to 10% of all soft tissue sarcomas. Synovial sarcoma occur especially in young adults, primarily in the periarticular regions, usually in close association with tendon sheaths, bursal and joint capsules. The tumor usually present as deep - seated palpable swelling in the previously mentioned sites. Pain or tenderness is experienced by approximately 50% of patients.A specific chromosomal translocation t(X;18) (p11.2;q11. 2) ,has been demonstrated in synovial sarcoma, which results in the fusion of the SYT gene on chromosome 18 and SSX1 or SSX2 gene on chromosome X. The chimeric gene transcripts have been detected by reverse trandcriptase - polymerase chain reaction ( RT - PCR) in more than 90% of cases. Therefore, detection of this spicefic translocation by chromosome analysis and of SYT - SSX trabscruots by RT -PCR are helpful in the diagnosis of synovial sarcoma.The histogenesis of synovial sarcoma has raised a great deal of discussion in the last few years. In the present WHO classification of soft tissue tumors, synovial sarcoma are included in the group of miscellaneous malignant neoplasms, and in major pathology textbooks, they are included in tumors of uncertain histogenesis. So we ditect expression of CD68, CD34 and C - kit to discuss relation between synovial sarcoma and hemorrhagic stem cell.Materials and Methods1. Tissue samplesA total of thirty - eight synovial sarcoma were obtained from patients underwent surgical resection in the First Affiliated hospital of China Medical University between 1998 and 2002. Fresh tissue samples were obtained from the same place.2. ReagentsThe primary antibodies including CD34, CD68 and c - kit were monoclonal antibodies, the Ultro - sensitive S - P Kit and DAB agent kit were bought from FUJIAN Maixin Biological Company. RT - PCR kit, Trizol are bought from DALIAN BAO Biological Company.3. Methods 3.1 RT-PCRThe microdissected tissue samples were homogenized and RNA was isolated using a Trizol reagent. Whole volume of total RNA was reverse transcribed. The resulting samples of complementary DNA were amplified by PCR. Two microliter cDNA were initially amplified for 40 cycles. Anhesling temperature for all reactions was 55℃. The molecular size of the final PCR products was 98 bp. The PCR products were fractionated on 3% agarose gels and visualized by ethidium bromide staining and ultraviolet illumination.3. 2 Immunohistochemistry for CD68, c - kit and CD34Immunohistochemical staining was performed using an Ultro - sensitive S -P kit according to the instructions provided by the manufacturer. Color was developed using DAB solution. After the reas of tumor tissue has been chosen by random under low power,one hundred cells within tumors were counted in each of 10 fields at 200 magnification. Cases defined as positive were regarded by both staining intensity and the percentage of immunoreactive tumor cells.3. 3 Electron MicroscopySmall fragments of tissue were fixed in Karnovsky 's fluid, postfixed in 1 percent osmium tetroxide, dehydrated and embedded in Araldite Semithin sections were stained with toluidine blue to confirm the presence of tumour and ultrathin sections were mounted on copper grids and stained with uranyl acetate and lead citrate and examined and photographed in an electron microscope.Result1. Clinical pathologic dataThere were seventeen men and nineteen women, with age from 13 to 79 years. Thirty of the tumors involved the lower and higher timb,five in the thigh and one metastasis in the kidney.Tumors with any discrete epithelial component were regarded as biphasic. There were twenty such cases, with the epithelial component forming solid cords and islands in ten, solid and glandular foci in six, and glandular foci in four. In one case there were also small foci of rounded, plump cells with distinct boundaries suggestive of squamous differentiation. In one case the tumor was monopha-sic at first presention but recurred as a biphasic tumor, and then again as a tumor with a predominantly glandular composition. The epithelial component was usually distinct, although in most tumors apparently continuous merging of epithelial and spindle cell areas was seen in sections stained with hematoxylin - eosin, reti-culin staining showed the demarcation.The remaining 16 tumors were monophasic, composed of closely packed, short,uniform spindle cells with little cytoplasm and oval or rounded nuclei, which were sometimes vacuolated. Little intercellular collagen was observed in the highly cellular areas, but in other areas there were variable amounts of fibro-sis, sometimes diffuse, with scattered single tumor cells, in these areas the clls tended to be more rounded, whereas in myxoid areas the cells, although separated, had retained their spindle shape. Stromal calcification, a characteristic fea-ture of synovial sarcoma,was present in two monoplasic tumors. One tumor, in the upper arm, recurred two years later with a pattern resembling epithelioid sarcoma.2. RT - PCR FindingsSYT - SSX fusion transcripts was detected in 36 of the 41 synovial sarcoma specimens. SYT - SSX mRNA expression rate reached 88. 9% (36/41) in synovial sarcoma.3. Immunohistochemical Findings...
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