Soft tissue sarcomas: Evaluation by immunohistochemistry

Abstract

Background: Soft tissue sarcomas (STS) are relatively rare tumors, representing less than 1% of adult malignancies based on report from American Cancer Society. The crude incidence rate in Iraq for soft tissue sarcomas was 219/ 100,000 populations during 2014 with a male: female ratio of 1.2:1, and the highest age peak falling between 30-34 years .The histological subtype and microscopic criteria are two parameters that influence the tumor grade which is the best predictor for aggressiveness. Objectives: A retrospective evaluation of soft tissue sarcomas, using immunohistochemical (IHC) study of Myosin, Desmin, Smooth muscle Actin (SMA) and Vimentin, aiming to review the primary diagnosis and whether IHC assessment in soft tissue sarcoma is mandatory to reach a final interpretation. Patients and methods: A total of 50 cases of soft tissue sarcomas were reviewed retrospectively from case archives of histopathology department/ Central Public Health Laboratory and Ghazi Al Hariri Hospital for Specialized Surgeries for the period (2011)(2012)(2013)(2014)(2015)(2016)(2017)(2018). Hematoxylin and Eosin (H&E) stain and IHC staining of unstained sections from formalin-fixed, paraffin-embedded tissue were performed using SMA, Vimentin, Desmin and Myosin. The staining intensity was assessed based on the percentage of positive cell expression of the four IHC monoclonal antibodies. Results: The staining interpretation of the four monoclonal antibodies were confirmatory for the original diagnosis in 40% of cases, while 60% of the final diagnoses were re-evaluated and a different interpretation was given supported by the IHC findings for Desmin, Myosin, SMA and vimentin, under the clinical and radiological context. Conclusions: The co-expression of SMA and Desmin helped in the diagnosis of leiomyosarcoma (LMS). Myosin expression was helpful in the diagnosis of rhabdomyosarcoma (RMS) and alveolar soft part sarcoma (ASPS). SMA and Vimentin were not specific for the diagnosis of malignant fibrous histiocytoma (MFH). By applying IHC markers, 60% of soft tissue sarcomas were found to be different from the preliminary diagnosis while 40% of cases were supportive of the original H&E diagnosis.

Effect of Iron Oxide Nanoparticles Prepared by Chemical Method on the Kidneys, Liver and Brain of Male Mice

“…Fe being a highly reactive and reductive transition metal, NPs made of Fe are safe and require further research. To investigate a poison, it is necessary to have clear adverse effects on physiology in in vivo studies [15]. Therefore, we tested the iron oxide NP's oral acute in vivo toxicity (Fe2O3) in male albino mice with special reference to the target biochemical parameters for the evaluation of the biomarkers used traditionally.…”