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 On-Line KMU Student Bulletin

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 Alveolar soft part sarcoma of the tongue Oral Oncology Extra 42, 241-243(2006)

 

 

 

   Jeane de Fa
tima Correia-Silvaet al.

                  Universidade de Sa˜o Paulo, Sa˜o Paulo, Brazil

   

   

   

          Intern E^{   }

   

   

   

   


 

 

 

 

• Alveolar soft part sarcoma (ASPS) ^{           }

  

• ASPS^{      ! " # $} 25%^{% & ! '(}15⁾35^{*+  , -}

• ^{. / 0 12 3  4 5 6 7}

• ^{8 9 (: # ;< # = > ! ?  '@ $ 8 9 A B C  D 7}

Case Report Chief complaint

• ^{ %} 17^{*+  'E  F ? GH I J K L M & !  N OP} Odilon Berhens

Hospital^{Q R  S T 8 U O 7} Clinical examination

• ^{Q V W X Y # 1Z [ O" # \ ] ^ 1 N _ ` 7}

• ^{Q a W X b  )& c 0 $  d e} 2cm^{1f g h ij k}nodular^{lGm n o}

p q r ;s t uv w  x y z 7a { | } U $ ~  kelastic consistency^l

• ^{ ! €  ‚ ƒ „ $ … † 7}

• ^{‡ ˆ }benign mesenchymal neoplasm (neurofibroma, schwannoma and lipoma)

• ^{‰ Š} LA^‹excisional biopsy^{'3 (}10% neutral phosphatebuffered Formalin

Œ  7.

Microscopic findings

• ^{Ž  V  ?} large round or polygonal cell^‘nests^{’ “ '3 ”}fibrous stroma

• – —  7

• Granular cell^{a { ˜ ™ š }granular eosinophilic ^{Ž  s u$ › h œ }

vesicular (^{ž g lŽ  œ 7Ÿ   ¡} Mitosis^{u¢ £ - ¤  œ 3 „ $  _ 7}

• Periodic acid-Schiff (PAS) with and without diastase digestion ^{¥ ¦ $} intracellular glycogen and rhomboid shaped crystals^{§ 7}

• ^{¨ } phosphotungstic acid-hematoxylin ^©Masson tricrome stain^{x 1ª  _} Cross striations⁷

Immunohistochemistry

• Tumor cell^{« (‹$ ¬  ­ ®}

- Muscle specific actin (Clone HHF-35, diluted 1:100, DAKO Corporation) - Cytoplasmic MyoD1 (5-BA, diluted 1:100, DAKO Corporation)







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- Myogenin (Clone F5D, diluted 1:100, DAKO Corporation) - Desmin (Clone A0611, diluted 1:50, DAKO Corporation)

- Neuron specific enolase protein (NSE) (Clone A0587, diluted 1:100, Dako Corporation)

• Tumor cell^{« (‹x 1­ ®}

- Vimentin (Clone Vim 3B4, diluted 1:100, DAKO Corporation) - S-100 (Z0311, diluted 1:75, DAKO Corporation)

- Cytokeratin AE1/ AE (Clone AE1 & AE3, diluted 1:50, DAKO Corporation) - Antigen retrieval with citrate buffer (0.01 M, pH 6.0, 95_,30 min)

(0 i¯ ° ± S-100^{'b (² ³ ?} solid type^ASPS⁷ Diagnosis

• Alveolar soft-part sarcoma of tongue

Discussion

ASPS^{´ µ ¶ $ ·    } 1^{¸¹     7‹º » ¼ z ½ ¾ t ¿ 'O}

! " # À µ ± 2^{Á¸' ! " #  à $ Ä Å ¸% & ! 7  & ! 0 Æ Ç È Ç É}

Ê Ë z Ì Í Î Ï 'Ð A 0  Ñ Ò Ä Ó*7+    Ô Õ ? Ö  × Ø 7² Ù Ú ‹Û

Ü; Ý Þ uß à  Ý Þ « á Æ Ç È Ç U â ¡ ã ä N 'ä  m å Gæ

Óç  è é ê intracellular glycogen Ä ç PAS (+)

ë ç Diastase-resistant rhomboid or rod-shaped crystals

ì í î ï ð ñ b ( ) _ G

1. PAS(+)

2. Diastase-resistant crystals

ò ó  _ b ( 8^{ô¸ ð  õ )' ”ö ? ÷} rhabdomyoma^{• ø ä  ù ú 7} Rhabdomyoma ^{ _ ® û G}

1. PAS(-)

2. Intracitoplasmatic glycogen granules ^{ü ý} diastase^{þ C
}

3. Phosphotungstic acid-hematoxylin and Masson tricrome staining^{þ C
¦ _} cross-striations

ASPS^{   ”  ¦  þ C  d )  ') E      }

neuroectodermal^;endocrine ^© myogenic^{'  ß à  Ý Þ Ì Í   » } myogenic^{'¨  d 1E »  I  _ 7 » Ž  1ª (}cytokeratin^{ † ;} epithelial membrane antigen^;neurofilaments^;glial fibrillary acidic protein^; serotonin^; synaptophysin^;met-enkephalin and leu-enkephalin^{£ r ' $   $} S-100^uNSE^{kì í ð ñ $} NSE¹S-100^l7 Muscle markers^{¿ ƒ   Ì Í}

   '   ? vimentin, musclespecific actin and desmin^{b ( ¦  '} desmin^{Ë z ­ ® Í  ² ¨ }vimentin^{A $ „  _   7   } myogenous







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differentiation^{Û   ! '}myoglobin ^umyogenin^{i¯  "  y 7}

 ó  Þ  # $  atypia^;cellularity^;necrosis^unumber of mitosis^{b (ý }

% &   ' ( 7b ò Ë z Ì Í  )  #  { * + ‘U â 0 | 7, - 0

ASPS^{4 . 6  /
0  ' Ò 1 2 z { * 8 9 ): # ;< u> ! 7@ }

 & ! 0 ASPS^{'E ”  8 9 ©0  Ô x $} 3^{ô¸'E  ´ $ Óôø þ Ó8}

9 ): # 7¶ (& # Æ Ç È Ç Ÿ  4 ! 3 4 5 7Æ Ç È Ç 6 7 (8 ° ?  '  9 : ; < = > < 7? ú - é   i¯ '& # Æ Ç È Ç @  0  ©(8 9 ð ñ b (. @ 8 ° ! ; < = > < 3  A  7 „ $ 8 9 B ú  É'C Î ;D Î uE D Î § F Ô ø G 60.0%^;38.0% ^u15.0%^{'  À u ÉÎ H ;  N h}

u8 9 ÷  $ I 7i J  „ $ 8 9 uK C  Î „ $ 0  & # ASPS ^«

á E » # %   $ Í @ B C 7



 





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