Differential Expression of TLE1 in Small Round Cell Tumors: A Proposed Solution for Challenging Differentials Impacting Treatment Strategies.

IF 0.9 4区 医学 Q4 PATHOLOGY
Nisha Modi, Amit Varma, Rajesh Patidar, Vrushali Gadre, Srushti Karmarkar
{"title":"Differential Expression of TLE1 in Small Round Cell Tumors: A Proposed Solution for Challenging Differentials Impacting Treatment Strategies.","authors":"Nisha Modi, Amit Varma, Rajesh Patidar, Vrushali Gadre, Srushti Karmarkar","doi":"10.1177/10668969251339810","DOIUrl":null,"url":null,"abstract":"<p><p><i>Introduction.</i> Small round cell tumors (SRCTs) represent a heterogeneous group of neoplasms with overlapping histological features but varying origins, prognoses, and treatments. TLE1 is a well-established marker for synovial sarcoma (SS). However, TLE1's diagnostic utility is limited by its expression in a broad range of tumor types, reducing its specificity for SS. This study explores TLE1 expression across SRCTs and proposes an immunohistochemical algorithm to enhance diagnostic accuracy. <i>Methods.</i> This retrospective, single-center observational study, conducted from 2019 to 2024, reviewed pathology records for SRCTs. TLE1 staining was evaluated using the immunoreactive score system, categorized as follows: 0 (negative), 1+ (weak), 2+ (moderate), and 3+ (strong). <i>Results.</i> A total of 301 SRCTs were evaluated with diverse distribution: neuroendocrine neoplasms (21%, n = 63), extraskeletal Ewing sarcoma (15%, n = 45), lymphoblastic lymphoma (11%, n = 34), and poorly differentiated synovial sarcoma (PDSS) (8%, n = 24). TLE1 expression of 3 + was most frequently observed in PDSS (75%, 18/24). Other tumors with TLE1 3 + included extraskeletal Ewing sarcoma, extracutaneous malignant melanoma, neuroendocrine neoplasms, rhabdomyosarcoma, and endometrial stromal sarcoma. TLE1 2 + was noted in lymphoblastic lymphoma and desmoplastic SRCT, while TLE1 1 + was seen in some gastrointestinal stromal tumors. The remaining specimens were negative for TLE1. These findings led to a diagnostic framework for SRCTs based on TLE1 expression patterns. <i>Conclusions.</i> Although TLE1 is a key marker for SS, its expression in other tumors can present diagnostic challenges. Integrating clinical features, histological assessment, and a panel of immunohistochemistry markers is essential for accurate diagnosis and effective management of SRCTs.</p>","PeriodicalId":14416,"journal":{"name":"International Journal of Surgical Pathology","volume":" ","pages":"10668969251339810"},"PeriodicalIF":0.9000,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Surgical Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1177/10668969251339810","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PATHOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction. Small round cell tumors (SRCTs) represent a heterogeneous group of neoplasms with overlapping histological features but varying origins, prognoses, and treatments. TLE1 is a well-established marker for synovial sarcoma (SS). However, TLE1's diagnostic utility is limited by its expression in a broad range of tumor types, reducing its specificity for SS. This study explores TLE1 expression across SRCTs and proposes an immunohistochemical algorithm to enhance diagnostic accuracy. Methods. This retrospective, single-center observational study, conducted from 2019 to 2024, reviewed pathology records for SRCTs. TLE1 staining was evaluated using the immunoreactive score system, categorized as follows: 0 (negative), 1+ (weak), 2+ (moderate), and 3+ (strong). Results. A total of 301 SRCTs were evaluated with diverse distribution: neuroendocrine neoplasms (21%, n = 63), extraskeletal Ewing sarcoma (15%, n = 45), lymphoblastic lymphoma (11%, n = 34), and poorly differentiated synovial sarcoma (PDSS) (8%, n = 24). TLE1 expression of 3 + was most frequently observed in PDSS (75%, 18/24). Other tumors with TLE1 3 + included extraskeletal Ewing sarcoma, extracutaneous malignant melanoma, neuroendocrine neoplasms, rhabdomyosarcoma, and endometrial stromal sarcoma. TLE1 2 + was noted in lymphoblastic lymphoma and desmoplastic SRCT, while TLE1 1 + was seen in some gastrointestinal stromal tumors. The remaining specimens were negative for TLE1. These findings led to a diagnostic framework for SRCTs based on TLE1 expression patterns. Conclusions. Although TLE1 is a key marker for SS, its expression in other tumors can present diagnostic challenges. Integrating clinical features, histological assessment, and a panel of immunohistochemistry markers is essential for accurate diagnosis and effective management of SRCTs.

小圆细胞肿瘤中TLE1的差异表达:一种挑战影响治疗策略的差异的解决方案。
介绍。小圆细胞瘤(srct)是一种异质性的肿瘤,具有重叠的组织学特征,但起源、预后和治疗方法各不相同。TLE1是一种公认的滑膜肉瘤(SS)标志物。然而,TLE1的诊断效用受到其在广泛肿瘤类型中的表达的限制,降低了其对SS的特异性。本研究探讨了TLE1在srct中的表达,并提出了一种免疫组织化学算法来提高诊断准确性。方法。这项回顾性的单中心观察性研究于2019年至2024年进行,回顾了srct的病理记录。采用免疫反应评分系统对TLE1染色进行评价,分为0(阴性)、1+(弱)、2+(中等)和3+(强)。结果。共评估301例srct,其分布不同:神经内分泌肿瘤(21%,n = 63),骨骼外尤文氏肉瘤(15%,n = 45),淋巴母细胞淋巴瘤(11%,n = 34)和低分化滑膜肉瘤(PDSS) (8%, n = 24)。3 +的TLE1表达在PDSS中最为常见(75%,18/24)。其他具有tle13 +的肿瘤包括骨骼外尤文氏肉瘤、皮外恶性黑色素瘤、神经内分泌肿瘤、横纹肌肉瘤和子宫内膜间质肉瘤。在淋巴母细胞淋巴瘤和结缔组织增生性SRCT中可见tle12 +,在部分胃肠道间质瘤中可见tle11 +。其余标本均为TLE1阴性。这些发现导致了基于TLE1表达模式的srct诊断框架。结论。虽然TLE1是SS的关键标志物,但其在其他肿瘤中的表达可能会带来诊断挑战。综合临床特征、组织学评估和一组免疫组织化学标志物是准确诊断和有效管理srct的必要条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
CiteScore
2.10
自引率
0.00%
发文量
198
审稿时长
1 months
期刊介绍: International Journal of Surgical Pathology (IJSP) is a peer-reviewed journal published eight times a year, which offers original research and observations covering all major organ systems, timely reviews of new techniques and procedures, discussions of controversies in surgical pathology, case reports, and images in pathology. This journal is a member of the Committee on Publication Ethics (COPE).
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信