Gliosarcoma: report of four cases with immunohistochemical findings

Abstract

-Gliosarcoma (GSa) is a rare primary central nervous system neoplasm (CNS) characterized by biphasic histological pattern with both glial and sarcomatous components. Our objective is to describe the clinical, morphological and immunohistochemical features of four cases of GSa and to discuss its pathogenetic mechanisms. The male:female ratio was 3:1. The mean age was 39 years, ranging from 19 to 48. Headache was the commonest clinical symptom. All patients underwent craniotomy with microsurgery and total resection of the tumor. Diagnosis was suspected due to microscopic architecture and confirmed by detection of reticulin fibers through histochemical techniques. Immunohistochemical analysis was positive for p53 in both glial and sarcomatous cells in all four cases. EGFR was focally positive in glial cells in one case. Our findings support monoclonal origin of GSa involving the TP53 tumor-suppressor gene. However, alternative pathways cannot be ruled out.KEY WORDS: brain neoplasms, gliosarcoma, immunohistochemistry. Gliossarcoma: relato de quatro casos com achados imuno-histoquímicosRESUMO -Gliossarcoma (GSa) é uma neoplasia primária rara do sistema nervoso central, caracterizada por padrão histológico bifásico incluindo componentes tanto glial como sarcomatoso. São discutidos os aspectos clínicos, morfológicos e imunohistoquímicos de quatro casos de GSa e seus mecanismos patogêneticos. A relação masculino/feminino foi 3:1. A média de idade foi 39 anos, variando de 19 a 48. Cefaléia foi a manifestação predominante. Todos os pacientes foram submetidos a craniotomia com microcirurgia e ressecção total do tumor. O diagnostico foi suspeitado devido à arquitetura microscópica e foi confirmada por presença de fibras de reticulina através de técnicas de histoquímica. A análise imuno-histoquímica foi positiva para p53 tanto em células gliais como em células sarcomatosas nos quatro casos. EGFR foi localmente positivo em células gliais em apenas um caso. Esses achados apoiam uma origem monoclonal do GSa relacionada com alteração no Tp53, gene supressor de tumor. No entanto, outras vias alternativas na gênese desses tumores não podem ser afastadas. PALAVRAS-CHAVE: neoplasias cerebrais, gliossarcoma, imuno-histoquímica.genetic studies failed to support this theory, suggesting a monoclonal origin for both histological components 1 . GSa corresponds to less than 2% of all glioblastomas 1 , with a peak of incidence from the fourth to the sixth decades of life, mean age 53 years. Male: female ratio is 1.8:1 and the clinical presentation, natural history and radiologic profile are similar to those of primary glioblastoma 1,3 . We studied four cases of gliosarcoma aiming to

Gliosarcomas: magnetic resonance imaging findings

“…Gliosarcomas are rare CNS primary tumors that occur in ~4% of all malignant gliomas and affect mainly adults (especially in the fifth and sixth decades of life) 34 and males (male:female frequency ratio of 1.8:1) 35 . The clinical course is frequently associated with a poor prognosis, including a survival of less than three months in more than half of the cases 36 (a faster evolution compared to that observed in the present study, in which the survival varied from three to eight months after diagnosis).…”

Fatores que interferem na qualidade do DNA extraído de amostras biológicas armazenadas em blocos de parafina

“…As blocotecas dos setores de patologia, primeiro banco estruturado de tecidos patológicos estabelecido em grande escala, foram e continuarão sendo valiosas fontes de pesquisa de doenças (23,46) . Todos os dias, amostras de biópsias do corpo humano são retiradas para análises diagnósticas de doenças, sendo as amostras estocadas nos laboratórios de setores de patologia.…”

Gliosarcoma Protein - Protein Interaction Network Analysis and Gene Ontology

“…TP53 mutations accompanied with the other genes such as CDKN2A is reported in GS and it is discussed in details (31). In the another report, the role of TP53 mutation beside CD34 in the GS patients was studied and its significant role in the disease was emphasized (32). In addition, the amplification of EGFR in correlation with 2…”