Clear cell sarcoma of soft tissue: Diagnostic utility of fluorescence in situ hybridization and reverse transcriptase polymerase chain reaction

Choladda V. Curry, Megan K. Dishop, M. John Hicks, Rizwan C. Naeem, Jon A. Reed, Dolores H. López-Terrada

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

A 7-year-old girl presented with pain and progressive swelling on the left plantar surface. Biopsy of a 2.5 cm mass showed nests of large round to oval neoplastic cells with abundant amphophilic to clear cytoplasm, prominent nucleoli and high mitotic activity. Occasional cells showed spindled morphology. Infrequent melanin pigment was present. Melanocytic markers (HMB45, S-100) were diffusely positive. A diagnosis of clear cell sarcoma of soft tissue (CCSS) was made, and the mass was re-excised with negative margins. 28 months later, a 1.0 cm pulmonary nodule was identified and wedge excision showed metastatic CCSS. Cytogenetics showed a complex karyotype (unbalanced translocation der(12;14)(q10;q10), additional chromosome 22 material of unknown origin). Although the CCSS translocation t(12;22)(q13;q12) was not identified, EWSR1 gene rearrangement was detected by fluorescence in situ hybridization (FISH). Reverse transcription polymerase chain reaction (RT-PCR) showed an EWS-ATF1 fusion transcript, confirmed by direct sequencing. CCSS requires differentiation from malignant melanoma, because of overlapping clinical presentations, sites of involvement, histomorphology, immunocytochemical profiles and ultrastructure. In many circumstances, definitive diagnosis is only possible with confirmation of the CCSS-defining translocation.

Original languageEnglish (US)
Pages (from-to)411-417
Number of pages7
JournalJournal of Cutaneous Pathology
Volume35
Issue number4
DOIs
StatePublished - Apr 2008
Externally publishedYes

Fingerprint

Clear Cell Sarcoma
Reverse Transcriptase Polymerase Chain Reaction
Fluorescence In Situ Hybridization
Chromosomes, Human, Pair 22
Gene Rearrangement
Melanins
Karyotype
Cytogenetics
Reverse Transcription
Melanoma
Cytoplasm
Biopsy
Pain
Polymerase Chain Reaction
Lung

ASJC Scopus subject areas

  • Dermatology
  • Pathology and Forensic Medicine

Cite this

Clear cell sarcoma of soft tissue : Diagnostic utility of fluorescence in situ hybridization and reverse transcriptase polymerase chain reaction. / Curry, Choladda V.; Dishop, Megan K.; Hicks, M. John; Naeem, Rizwan C.; Reed, Jon A.; López-Terrada, Dolores H.

In: Journal of Cutaneous Pathology, Vol. 35, No. 4, 04.2008, p. 411-417.

Research output: Contribution to journalArticle

Curry, Choladda V. ; Dishop, Megan K. ; Hicks, M. John ; Naeem, Rizwan C. ; Reed, Jon A. ; López-Terrada, Dolores H. / Clear cell sarcoma of soft tissue : Diagnostic utility of fluorescence in situ hybridization and reverse transcriptase polymerase chain reaction. In: Journal of Cutaneous Pathology. 2008 ; Vol. 35, No. 4. pp. 411-417.
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