muramidase and Soft-Tissue-Neoplasms

Elastofibroma dorsi is an uncommon benign fibroblastic pseudotumor that typically occurs in the subscapular region of middle-aged or older individuals. The pathogenesis is still unclear and a matter of debate. Magnetic resonance imaging can be used as a first-line investigation of the lesion and reveals a lenticular soft-tissue mass with a signal intensity similar to that of skeletal muscle interlaced with strands of fat. Biopsy is not necessary if all pathognomonic criteria are present. A conservative "wait and see" attitude is reasonable and immediate surgery is no more the standard treatment of elastofibroma dorsi. This review provides an updated overview of the diagnosis, management and pathogenesis of elastofibroma dorsi. We also discuss recent advances in our understanding of genomic alterations in elastofibroma dorsi.

Topics: Antigens, CD34; Chromosome Aberrations; DNA Copy Number Variations; Fibroma; Humans; Immunohistochemistry; Magnetic Resonance Imaging; Muramidase; Soft Tissue Neoplasms; Vimentin

To study the morphologic features, immunophenotypes, differential diagnoses and prognosis of histiocytic sarcoma (HS).. The clinical and pathologic findings of 6 cases of HS were reviewed. Immunohistochemical assay (Elivision staining) was also performed. Follow-up information was available in 4 patients.. There were altogether 3 males and 3 females. The age of patients ranged from 12 to 81 years old (median = 54.6 years). The sites of involvement included lymph node (number = 2 cases) and skin or soft tissue (number = 4 cases). The tumor was composed of sheets of large epithelioid cells with abundant eosinophilic cytoplasm, oval to irregular nuclei, vesicular chromatin and large nucleoli. Binucleated form was not uncommon. Two of the cases showed increased pleomorphism with multinucleated tumor giant cell formation. Focal cytoplasmic with foamy appearance was identified in 3 cases. One case demonstrated foci of spindly sarcomatoid appearance. Hemophagocytosis was identified in 2 cases. Mitotic figures were readily identified. The tumor cells were often accompanied by various numbers of inflammatory cells. Immunohistochemical study showed that all cases were diffusely positive for leukocyte common antigen, CD4, CD68 and CD163. Four of the 5 cases studied also expressed lysozyme. Amongst the 4 patients with follow-up information available, 3 died of the disease at 6 to 11 months interval after diagnosis. One patient, whose lesion was localized at the skin and soft tissue, survived for 3 years, with no evidence of tumor recurrence.. Accurate diagnosis of the HS is based on the combination of morphologic examination and immunohistochemical assay. HS often presents with clinically advanced disease and pursues an aggressive clinical course, with a poor response to therapy. However, a subset of cases presenting with clinically localized lesion may carry a relatively favorable long-term outcome.

Topics: Adult; Aged; Aged, 80 and over; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Carcinoma, Renal Cell; Child; Diagnosis, Differential; Female; Follow-Up Studies; Histiocytic Sarcoma; Humans; Lymphoma, Large B-Cell, Diffuse; Lymphoma, Large-Cell, Anaplastic; Male; Melanoma; Muramidase; Prognosis; Receptors, Cell Surface; Skin Neoplasms; Soft Tissue Neoplasms; Young Adult

Topics: Aged; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Biomarkers, Tumor; Bone Neoplasms; Carboxylic Ester Hydrolases; Humans; Leukemia, Myeloid, Acute; Magnetic Resonance Imaging; Male; Muramidase; Neoplasms, Multiple Primary; Peroxidase; Sarcoma, Myeloid; Skin Neoplasms; Soft Tissue Neoplasms; Subcutaneous Tissue

Elastofibroma is a slow-growing soft tissue lesion characteristically found between the inferior scapula and chest wall. Because it behaves clinically in a benign manner, fine-needle aspiration (FNA) represents the simplest and quickest method of obtaining a definitive diagnosis, thus obviating more invasive means of obtaining a tissue diagnosis. However, due to the nature of this lesion a correct diagnosis can inadvertently be missed. Herein we describe the findings of a recent FNA that obtained abundant diagnostic material and elaborate upon the spectrum of cytologic features of the elastic fibers that can be identified. These features should be recognized, since aspiration biopsy in elastofibromas can lead to hypocellular smears. In addition, we discuss recent developments in the pathophysiology of elastic fibers and their application toward understanding the generation of an elastofibroma.

Topics: Aged; Biopsy, Needle; Elastic Tissue; Fibroma; Humans; Immunohistochemistry; Male; Muramidase; Scapula; Soft Tissue Neoplasms

We report two cases of hyalinizing spindle cell tumors with giant rosettes arising in the pararectal space and soft tissues of the wrist in a 46-year-old man and 22-year-old-woman, respectively. Microscopically, the tumors exhibited a varied morphology, including hyalinizing hypocellular and cellular fibromatosis-like areas. The most striking morphologic feature was the formation of giant rosette like structures with collagen cores scattered throughout the tumors. Most of the tumor spindle cells were diffusely immunoreactive for lysozyme, CD-68, factor XIII and vimentin. Reactivity for smooth muscle actin, desmin and S-100 protein was not found. Ultrastructural examination of the rosettes in one case only showed normal native collagen.

Topics: Adult; Factor XIII; Female; Fibrosarcoma; Humans; Immunohistochemistry; Male; Microscopy, Electron; Middle Aged; Muramidase; Soft Tissue Neoplasms; Vimentin

By clinical, pathologic and immunohistochemical study on aniomatoid malignant fibrous histiocytoma, which is a relatively uncommon soft tissue tumor described by Enzinger in 1979, and often misdiagnosed, we are reporting 32 cases of this lesion. The distinctive histopathology were: (1) Cystic change filled with hemorrhagic fluid or blood, (2) surrounded by nests of fibroblastlike and histocyte-like cells and (3) intermingled with chronic inflammatory cells, (4) often surrounded by a fibrous pseudocapsule. Immunohistochemical staining done in 4 cases showed all to be positive in lysozyme, three positive in Mac 387 and CD 68. These results support their histiocytic origin. Follow-up information was available in 25 of 32 cases. All the 25 patients were alive, 4 with recurrence (16%), 1 with metastasis (4%). These results concur with the opinion that intrinsically, this is a low grade tumor.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Extremities; Female; Follow-Up Studies; Histiocytoma, Benign Fibrous; Humans; Immunohistochemistry; Male; Middle Aged; Muramidase; Neoplasm Recurrence, Local; Soft Tissue Neoplasms; Vimentin

This is a report on the clinical, anatomical and immunohistochemical study of thirty patients presenting dermatofibrosarcoma protuberans. Its incidence (4.8 percent), covering a 15-year period in a specialized oncological unit, wider age range and high rate of relapses (66.6 percent) are established as the result of clinical and anatomical revision. The latter findings necessitate radical removal of the neoplasm as early at its primary resection. The practical implications of the so-called "spoke-like" structures, pathognomonic for histological identification of the tumor, are discussed. The immunohistochemical study for S100 [correction of C100] protein and lysozyme is negative, while alpha 1-antitrypsin reaction is positive in single rounded histiocyte-like cells which is by no means a conclusive evidence of the phenotype characteristics of the cell population in dermatofibrosarcoma protuberans.

Topics: Adolescent; Adult; Aged; alpha 1-Antitrypsin; Carcinoma, Squamous Cell; Dermatofibrosarcoma; Histiocytoma, Benign Fibrous; Humans; Immunohistochemistry; Middle Aged; Muramidase; Neoplasm Recurrence, Local; S100 Proteins; Skin Neoplasms; Soft Tissue Neoplasms

In 52 cases of fibrohistiocytic sarcoma activity of alfa-1-antichymotripsin (ACT) in tumour cells was found in 47 cases and lysozyme in 16 cases. ACT was found in all types of tumour except angiomatous. Lysozyme was positive only in pleomorphic type, all these cases have also activity of ACT. Investigated enzymes are useful in diagnosis with correlation to others markers used in diagnostic procedure of soft tissue tumours.

Topics: Adult; Aged; alpha 1-Antichymotrypsin; Child; Female; Histiocytoma, Benign Fibrous; Humans; Immunohistochemistry; Male; Middle Aged; Muramidase; Soft Tissue Neoplasms

The staining pattern by Ricinus communis agglutinin (RCA), a lectin used as a good marker for histiocytes, in 24 cases with malignant fibrous histiocytoma (MFH) was studied and compared with that of 12 cases of fibrosarcoma (FS). In 20 (83%) of 24 cases of MFH, varying degrees of RCA binding were observed, whereas only four (33%) of 12 cases of FS were positive. RCA-positive FS included three cases with infantile FS and one adult case with post-radiation FS. Eight adult patients with FS were entirely negative. This positivity rate of RCA binding in MFH was much higher than those of antisera against lysozyme, alpha-1-antitrypsin, and alpha-1-antichymotrypsin previously reported. Seven MFH patients with focal aggregation of RCA-positive benign-appearing (reactive) histiocytes died earlier than the other patients with only scattered RCA-positive histiocytes; 5-year survival rates were 32% and 69%, respectively (p less than 0.05). These findings suggest that RCA reactivity can be used as a potential diagnostic and prognostic marker for MFH.

Topics: Adult; Aged; alpha 1-Antichymotrypsin; alpha 1-Antitrypsin; Female; Fibrosarcoma; Histiocytoma, Benign Fibrous; Histocytochemistry; Humans; Lectins; Male; Middle Aged; Muramidase; Plant Lectins; Plants, Toxic; Ricinus communis; Soft Tissue Neoplasms; Staining and Labeling

Malignant fibrous histiocytomas (MFH) belong to the most frequent soft tissue tumours in adults and have to be discriminated from other tumours with similar morphology. Various tumour markers aid the differential diagnosis. Twenty cases of MFH were studied immunohistochemically using antibodies to vimentin, TPA, desmin, lysozyme, alpha 1-antitrypsin, alpha 1-antichymotrypsin, S-100 protein, neurone-specific enolase (NSE), laminin, fibronectin and ferritin. Vimentin and lysozyme were found in the tumour cells of all, alpha 1-antitrypsin of 18, alpha 1-antichymotrypsin of 19, fibronectin of 16 and ferritin of 12 cases. Antibodies of TPA, desmin, S-100 protein, NSE and laminin did not reveal positive immunoreactivity. Exclusion of spindle-cell carcinoma can be made by positive vimentin and negative TPA reactivity, of melanoma by negative S-100 reactivity, and of leio- and rhabdomyosarcoma by lack of desmin immunoreactivity. Schwannomas contain S-100 protein, but lack lysozyme, alpha 1-antitrypsin, alpha 1-antichymotrypsin and fibronectin. Pleomorphic liposarcomas cannot be distinguished from MFH on the basis of immunohistochemical staining. Vimentin, alpha 1-antitrypsin, alpha 1-antichymotrypsin and fibronectin can, therefore, be regarded as useful markers in the differential diagnosis of MFH.

Topics: Adult; Aged; Aged, 80 and over; alpha 1-Antichymotrypsin; alpha 1-Antitrypsin; Desmin; Female; Ferritins; Fibronectins; Histiocytoma, Benign Fibrous; Humans; Immunoenzyme Techniques; Laminin; Male; Middle Aged; Muramidase; Nerve Tissue Proteins; Peptides; Phosphopyruvate Hydratase; S100 Proteins; Soft Tissue Neoplasms; Tissue Polypeptide Antigen; Vimentin

183 cases of soft tissue tumors were studied utilizing the immunoperoxidase technique to demonstrate alpha-1-antitrypsin, ferritin and lysozyme. The series comprises 50 malignant lesions, 34 intermediate malignancy lesions, 99 benign lesions of fibrohistiocytic origin, and 23 malignant tumors of non fibrohistiocytic origin. The actual results of the study are as follows: alpha-1-antitrypsin, ferritin and lysozyme were always absent in 10 fibrosarcomas, 2 liposarcomas, 2 Ewing sarcomas, 3 synovial sarcomas, 4 neurofibrosarcomas, and 2 rhabdomyosarcomas, but in 24 malignant fibrous histiocytomas, 34 cases of dermatofibrosarcoma protuberans and 102 benign fibrohistiocytic lesions, these activities were present in a percentage that ranged between 12% and 38% (average 25%). Differences in the frequency of positive reactions did not occur between benign and malignant fibrohistiocytic lesions. The immunohistological examinations carried out have, therefore, only a very limited value for the practical diagnostic evaluation, but, when positive, are important to clarify the histogenesis of the tumor.

Topics: alpha 1-Antitrypsin; Ferritins; Fibroma; Fibrosarcoma; Histiocytoma, Benign Fibrous; Histocytochemistry; Humans; Immunochemistry; Muramidase; Sarcoma; Soft Tissue Neoplasms

Serum lysozyme activity (SLA) was measured in a turbidimetric assay with a microcentrifugal analyzer. In a control group of 53 healthy dogs of both sexes and ranging in age from 4 to 10 years, SLA had a mean value of 1.2 mg/l with a range (+/- 2 SD) of 0.6 - 1.8 mg/l. In 80 dogs with a variety of neoplastic diseases the histopathological diagnosis was compared with the SLA value. SLA value was increased in 83% of the cases with malignant tumors and in 29% of the cases with benign tumors. Proper clinical examination is essential in differentiating between neoplastic disease and some interfering diseases, e.g. chronic dermatitis, pyometra and chronic nephritis. Measuring of SLA in dogs may be helpful in screening those animals with suspected malignancies.

Topics: Adenoma; Animals; Carcinoma; Dog Diseases; Dogs; Female; Immunodiffusion; Male; Mammary Glands, Animal; Melanoma; Muramidase; Neoplasms; Nephelometry and Turbidimetry; Reference Values; Sarcoma; Skin Neoplasms; Soft Tissue Neoplasms

We have studied the possible origin of histiocytic cells, present in fibrous histiocytomas (MFH) by using immunohistochemistry to demonstrate lysozyme, alpha 1-antitrypsin, alpha 1-antichymotrypsin and receptors for peanut and soy bean agglutinin in tumour cells of MFH compared with their presence in tumour cells of malignant histiocytosis (MH) ('true' histiocytic lymphoma, 'true' histiocytic sarcoma). We included in this study a number of other soft tissue tumours (STT). Lysozyme was detected in half of the cases of malignant histiocytosis (n = 16) but in only two out of 77 MFH. alpha 1-Antitrypsin and alpha 1-antichymotrypsin usually occurred together although the latter was seen in more cases. Both markers were present in majority of cases of MH whereas they were detected in a minority of cases of MFH. MFH cases of the storiform subtype were less frequently stained than the pleomorphic or giant cell subtypes. Receptors for peanut or soy bean agglutinin were detected in nearly all MH cases, whereas their presence was only detected in a small number of MFH. Lysozyme was not detectable in other STT. alpha 1-Antitrypsin and alpha 1-antichymotrypsin were uncommonly present in other STT, except in osteosarcoma and rhabdomyosarcoma. These markers therefore have a limited value as indicators of a possible histiocytic origin of MFH. Lectins showed weak affinity for other STT. In accordance with others, we therefore conclude that the progenitor cell of MFH has to be sought within the undifferentiated mesenchymal cells and that histiocytes themselves probably do not give rise to MFH.

Topics: alpha 1-Antichymotrypsin; alpha 1-Antitrypsin; Chymotrypsin; Histiocytoma, Benign Fibrous; Humans; Immunoenzyme Techniques; Lectins; Lymphatic Diseases; Muramidase; Plant Lectins; Receptors, Mitogen; Soft Tissue Neoplasms; Soybean Proteins

The aim of this study was to localize alpha 1-antitrypsin, ferritin, and lysozyme by means of the indirect immunoperoxidase technique and to evaluate the significance of these antigens as markers of histiocytic differentiation in tumors of a supposed dual fibroblastic-histiocytic origin. The series comprised 31 malignant fibrous histiocytomas (MFH) of the pleomorphic, spindle cell, and myxoid types, four cutaneous fibrous histiocytomas, and four atypical fibroxanthomas, four dermatofibrosarcoma protuberans, and two osteoclastomas of bone. For comparison, 15 soft tissue sarcomas of various other types were examined. Of the MFHs of the pleomorphic type, 18 of 22 (82 per cent) were positively stained for alpha 1-antitrypsin and 12 of 22 (54 per cent) were positively stained for ferritin. Of the five MFHs of the spindle cell type, none was positively stained for alpha 1-antitrypsin, three were positive for ferritin, and one was positive for lysozyme. None of the myxoid variants (corresponding to grade I-II myxofibrosarcoma) was positively stained for either of the antigens. These results and the observations made on the cutaneous fibrous histiocytomas, atypical fibroxanthomas, dermatofibrosarcoma protuberans, and the various soft tissue sarcomas indicated that 1) alpha 1-antitrypsin is a valuable marker of histiocytic differentiation in both benign and malignant fibrous histiocytomas, 2) ferritin can be visualized in more than half of these fibroblastic-histiocytic tumors, and the presence of ferritin distinguishes the spindle cells of these tumors from fibroblasts of connective tissue and most fibrosarcomas, and 3) lysozyme, although a good marker of histiocytic differentiation in ordinary histiocytes and benign fibrous histiocytomas, is a poor marker of neoplastic histiocytes of malignant tumors. The results further support the concept that MFH is a tumor of a dual fibroblastic-histiocytic origin.

Topics: alpha 1-Antitrypsin; Ferritins; Fibroma; Histiocytoma, Benign Fibrous; Humans; Immunochemistry; Muramidase; Sarcoma; Soft Tissue Neoplasms

Until recently, the diagnosis and classification of malignant fibrous histiocytomas (MFH) has been based on light- and electron-microscopic appearances. Tissue culture studies have led to the suggestion that these tumors have a common histiocytic origin. Using the immunoperoxidase PAP technique, a variety of soft-tissue tumors have been stained for the histiocyte markers alpha-1-antitrypsin (A1AT), alpha-1-antichymotrypsin (A1ACT) and lysozyme. A1AT and A1ACT are found to be useful specific markers for tumors of the MFH group whereas lysozyme is not a reliable marker for such tumors. The presence of these substances within the tumors supports the theory that they share a common origin from tissue histiocytes. Only a proportion of superficial skin histiocytomas stain for A1AT and A1ACT, raising the possibility that these are a heterogeneous group and do not share a common histogenesis with MFH.

Topics: alpha 1-Antichymotrypsin; alpha 1-Antitrypsin; Chymotrypsin; Histiocytoma, Benign Fibrous; Humans; Immunoenzyme Techniques; Muramidase; Soft Tissue Neoplasms