Successfully reported this slideshow.
We use your LinkedIn profile and activity data to personalize ads and to show you more relevant ads. You can change your ad preferences anytime.
BY – Dr. KANWALPREET KAUR
MODERATOR-Dr. KARUNA GUPTA
Heterogeneous group of neoplasms are characterised
by the sheets of poorly differentiated cells:
• Small (similar to lymph...
• Ewings sarcoma/Primitive neuroectodermal tumour(ES/PNET
• Hematopoietic malignancies
• Plasma cell neoplasms
• Small cel...
• Histological grading of bone sarcomas is an attempt to
predict the biological behaviour of a malignant tumour
• Criteria...
• Round cell sarcomas that show varying degrees of
neuroectodermal differentiation
Ewing’s sarcoma - limited neural diffe...
OSTEOLYTIC
LESION
LAMELLATED
PERIOSTEAL
REACTION
SUNBURST
PERIOSTEAL
REACTION
• Generally arises in
medullary cavity of
shaft from which it
permeates cortex and
invades soft tissue
• Rarely, periostea...
1. Classic or conventional (typical) Ewing sarcoma
2. Primitive neuroectodermal tumor(PNET)
3. Atypical Ewing sarcoma
• Sa...
sheets of uniform
population of cells;
round nuclei ; finely
granular chromatin;
indistinct cell borders;
necrosis common;...
Homer- wright rosette
3. ATYPICAL-most difficult group to recognize
• Great degree of cytologic variability and/or unusual growth
patterns e.g. ...
The cells of ES/PNET usually
contain large amounts of
cytoplasmic glycogen, as
demonstrated by a PAS stain
with diastase c...
Non reactive for chromogranin, glial fibrillary protein, desmin, muscle
specific actin, myogenin and CD45. Keratin is posi...
CD 99 reactivity FLI-1 Protein expression
• CD99- strong, diffuse membranous staining pattern
• 84-100% sensitive. If a tumor is negative for
CD99, it is highly unl...
• FLI1- Only nuclear staining is considered positive
NOT SPECIFIC MARKER
But also positive in lymphoblastic lymphoma,
myel...
• Reciprocal translocation t(11;22)(q24;q12)
• Fusion of EWSR1 gene(encodes for RNA binding protein) at
22q12 with FLI1 ge...
• Rearrangements of EWSR1 with non–ETS-family
genes—including NFATC2,POU5F1, SMARCA5, ZSG,
and SP3—are also rarely identif...
• FISH for EWSR1 genomic rearrangements
is highly sensitive (>95%) but nonspecific because
other tumours may show rearrang...
• Primary Lymphoma- Originates in bone with no evidence of
extraskeletal disease or disseminated bone marrow
involvement. ...
Extensive involment with permeative
destructive process.
Shaft is usually involved
Radiographs appear as if there are
mult...
->Under low power, lesion is
visible between normal bony
trabeculae and in marrow fat
->Nodular growth pattern-
distinctly...
• B-cell lymphomas, most commonly diffuse large B-cell
lymphoma
• T-cell lymphomas of bone-Anaplastic large cell
lymphoma
...
TUMOUR MARKERS
B-cell lymphomas CD45,
pan B-cell markers (CD19, CD20,
CD79a,PAX-5)
Negative for CD3, CD5
Anaplastic large ...
• Lymphoblastic lymphoma may be positive for CD99 and
negative for CD45, an immunoprofile that overlaps with
that of Ewing...
• Specific studies on primary lymphomas of bone are
lacking.
• malignant proliferation of monoclonal plasma cells
• can present as a solitary lesions (solitary plasmacytoma)
or more c...
Multiple punched out lesions
Purely lytic
Rarely associated with sclerosis
Purely lytic lesion;
Well defined margins
• Usually has a soft red-brown appearance.
• However, some myelomas show the fish-flesh
appearance typical of malignant ly...
WELL DIFFERNTIATED MYELOMA POORLY DIFFERNTIATED MYELOMA
• HISTOLOGICAL DIFFERENTIAL DIAGNOSIS
INCLUDES:
• 1.Lymphoma
• 2.malignant carcinoma
• 3.occasionally chronic osteomyeliti...
• Myeloma cells positive- CD38
CD138
Multiple myeloma oncogene 1 (MUM-1)
• Characteristically express monotypic cytoplasmi...
• Myeloma cells negative  CD19,CD20,CD27,CD22
Normal plasma cells  CD 27+ , CD 19+
• Myeloma cells frequently express th...
• Myeloma cells weakly positive or negative for CD45,CD20
most B-cell lymphomas strong staining for both markers.
• Both...
• Aggressive cartilaginous neoplasm
• AGE-20-60 year
• BONES COMMONLY AFFECTED- jaw bones
• ribs
• vertebrae
• pelvis
• US...
Hemangiopericytomatous patternmalignant cartilaginous nodule ;
hypercellular region of small cells
• Vimentin
• S-100 protein staining- limited to chondroblastic islands.
lacking in small cell component
• CD57
• CD99- lim...
• Hematopoietic stains will rule out lymphoma
• Both mesenchymal chondrosarcoma and Ewings
sarcoma/PNET share immunoreacti...
• Osteosarcoma is the most common nonhematopoietic
primary malignant bone tumor.
• But small cell osteosarcoma ( histologi...
• Small cell osteosarcoma is a rare histological variant
• MICROSCOPY- Small size and uniformity of tumour cells
and diffu...
• IMMUNOHISTOCHEMISTRY-
• No specific immunophenotype for osteosarcoma
• Immunohistochemically heterogenous
• Positive for...
• Hematopoietic immunostains will distinguish lymphoma
from small cell osteosarcoma
• Small cell osteosarcoma can be immun...
• The stromal component of small cell osteosarcoma may
resemble mesenchymal chondrosarcoma.
both can show reactivity to CD...
• Small cell variant of poorly differentiated synovial
sarcoma is easily misdiagnosed for other small round cell
tumours
•...
• Only two categories show small round cell picture on
histology:
1.Embryonal rhabdomyosarcoma
2.Alveolar rhabdomyosarcoma
EMBRYONAL RHABDOMYOSARCOMA
• Arises from unsegmented and undifferientiated mesoderm
• SITE- head and neck region- orbit, n...
Perivascular pseudorosette
Small round cells
Spindle shaped
cells;Nuclei oval;
cytoplasm scanty &
eosinophilic
Small round cells
Connective tissue septa
IMMUNOHISTOGRAM OF RHABDOMYOSARCOMA
Embryonal rhabdomyosarcoma
Alveolar rhabdomyosarcoma
ALVEOLAR RHABDOMYOSARCOMA:
• t(2;13)(q35;q14) with PAX3/FOXO1A fusion
• t(1;13)(p36;q14) with PAX7/FOXO1A fusion
(FOXO1A w...
Thank you…
Round cell tumours
Round cell tumours
Round cell tumours
Upcoming SlideShare
Loading in …5
×

Round cell tumours

6,066 views

Published on

pathology of round cell tumours of osseo articular system like ewings sarcoma, mesenchymal chondrosarcoma,small cell osteosarcoma, plasma cell neoplasms and other hematopoietic malignancies. how immunochemistry os playing pivotal role in differential diagnosis.

Published in: Health & Medicine
  • Hello! I can recommend a site that has helped me. It's called ⇒ www.WritePaper.info ⇐ So make sure to check it out!
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • You can ask here for a help. They helped me a lot an i`m highly satisfied with quality of work done. I can promise you 100% un-plagiarized text and good experts there. Use with pleasure! ⇒ www.HelpWriting.net ⇐
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • Hi there! I just wanted to share a list of sites that helped me a lot during my studies: .................................................................................................................................... www.EssayWrite.best - Write an essay .................................................................................................................................... www.LitReview.xyz - Summary of books .................................................................................................................................... www.Coursework.best - Online coursework .................................................................................................................................... www.Dissertations.me - proquest dissertations .................................................................................................................................... www.ReMovie.club - Movies reviews .................................................................................................................................... www.WebSlides.vip - Best powerpoint presentations .................................................................................................................................... www.WritePaper.info - Write a research paper .................................................................................................................................... www.EddyHelp.com - Homework help online .................................................................................................................................... www.MyResumeHelp.net - Professional resume writing service .................................................................................................................................. www.HelpWriting.net - Help with writing any papers ......................................................................................................................................... Save so as not to lose
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • DOWNLOAD THE BOOK INTO AVAILABLE FORMAT (New Update) ......................................................................................................................... ......................................................................................................................... Download Full PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download Full EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download Full doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download PDF EBOOK here { https://soo.gd/irt2 } ......................................................................................................................... Download EPUB Ebook here { https://soo.gd/irt2 } ......................................................................................................................... Download doc Ebook here { https://soo.gd/irt2 } ......................................................................................................................... ......................................................................................................................... ................................................................................................................................... eBook is an electronic version of a traditional print book THE can be read by using a personal computer or by using an eBook reader. (An eBook reader can be a software application for use on a computer such as Microsoft's free Reader application, or a book-sized computer THE is used solely as a reading device such as Nuvomedia's Rocket eBook.) Users can purchase an eBook on diskette or CD, but the most popular method of getting an eBook is to purchase a downloadable file of the eBook (or other reading material) from a Web site (such as Barnes and Noble) to be read from the user's computer or reading device. Generally, an eBook can be downloaded in five minutes or less ......................................................................................................................... .............. Browse by Genre Available eBOOK .............................................................................................................................. Art, Biography, Business, Chick Lit, Children's, Christian, Classics, Comics, Contemporary, CookBOOK, Manga, Memoir, Music, Mystery, Non Fiction, Paranormal, Philosophy, Poetry, Psychology, Religion, Romance, Science, Science Fiction, Self Help, Suspense, Spirituality, Sports, Thriller, Travel, Young Adult, Crime, EBOOK, Fantasy, Fiction, Graphic Novels, Historical Fiction, History, Horror, Humor And Comedy, ......................................................................................................................... ......................................................................................................................... .....BEST SELLER FOR EBOOK RECOMMEND............................................................. ......................................................................................................................... Blowout: Corrupted Democracy, Rogue State Russia, and the Richest, Most Destructive Industry on Earth,-- The Ride of a Lifetime: Lessons Learned from 15 Years as CEO of the Walt Disney Company,-- Call Sign Chaos: Learning to Lead,-- StrengthsFinder 2.0,-- Stillness Is the Key,-- She Said: Breaking the Sexual Harassment Story THE Helped Ignite a Movement,-- Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones,-- Everything Is Figureoutable,-- What It Takes: Lessons in the Pursuit of Excellence,-- Rich Dad Poor Dad: What the Rich Teach Their Kids About Money THE the Poor and Middle Class Do Not!,-- The Total Money Makeover: Classic Edition: A Proven Plan for Financial Fitness,-- Shut Up and Listen!: Hard Business Truths THE Will Help You Succeed, ......................................................................................................................... .........................................................................................................................
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here
  • NO NO NO... ▲▲▲ https://bit.ly/2WL1mUf
       Reply 
    Are you sure you want to  Yes  No
    Your message goes here

Round cell tumours

  1. 1. BY – Dr. KANWALPREET KAUR MODERATOR-Dr. KARUNA GUPTA
  2. 2. Heterogeneous group of neoplasms are characterised by the sheets of poorly differentiated cells: • Small (similar to lymphocyte in size) • Round (round nuclei and scanty cytoplasm) • Blue (blue staining due to high nuclear/cytoplasmic ratios
  3. 3. • Ewings sarcoma/Primitive neuroectodermal tumour(ES/PNET • Hematopoietic malignancies • Plasma cell neoplasms • Small cell osteosarcoma • Mesenchymal chondrosarcoma • Poorly differentiated small cell synovial sarcoma • Rhabdomyosarcoma(embryonal and alveolar subtypes)
  4. 4. • Histological grading of bone sarcomas is an attempt to predict the biological behaviour of a malignant tumour • Criteria used— 1. Cellularity i.e., the relative amount of cells compared to matrix 2.Nuclear features of the tumour cells • Tumours which are monomorphic, such as small cell malignancies (Ewing sarcoma, malignant lymphoma and myeloma), do not lend themselves to histological grading. • Mesenchymal chondrosarcomas and dedifferentiated chondrosarcomas are always high grade
  5. 5. • Round cell sarcomas that show varying degrees of neuroectodermal differentiation Ewing’s sarcoma - limited neural differentiation PNET - more neural features • AGE- 5-20 years (commonly) • infancy or adulthood rarely • SEX PREDILITION- males:females=1.4:1
  6. 6. OSTEOLYTIC LESION LAMELLATED PERIOSTEAL REACTION SUNBURST PERIOSTEAL REACTION
  7. 7. • Generally arises in medullary cavity of shaft from which it permeates cortex and invades soft tissue • Rarely, periosteal • Soft, tan-white, areas of haemorrhage and necrosis
  8. 8. 1. Classic or conventional (typical) Ewing sarcoma 2. Primitive neuroectodermal tumor(PNET) 3. Atypical Ewing sarcoma • Same immunohistochemical and molecular features, differing only in the extent of neural differentiation. • Each subtype is considered a high-grade tumor.
  9. 9. sheets of uniform population of cells; round nuclei ; finely granular chromatin; indistinct cell borders; necrosis common; mitotic activity usually not prominent
  10. 10. Homer- wright rosette
  11. 11. 3. ATYPICAL-most difficult group to recognize • Great degree of cytologic variability and/or unusual growth patterns e.g. large nuclei with irregular nuclear membranes and prominent nucleoli; abundant eosinophilic cytoplasm imparting a rhabdoid appearance.
  12. 12. The cells of ES/PNET usually contain large amounts of cytoplasmic glycogen, as demonstrated by a PAS stain with diastase control
  13. 13. Non reactive for chromogranin, glial fibrillary protein, desmin, muscle specific actin, myogenin and CD45. Keratin is positive in 20% to 30% of cases, usually with a focal distribution.
  14. 14. CD 99 reactivity FLI-1 Protein expression
  15. 15. • CD99- strong, diffuse membranous staining pattern • 84-100% sensitive. If a tumor is negative for CD99, it is highly unlikely to be Ewing sarcoma • NOT A SPECIFIC MARKER • Can be seen in RMS, glial tumours, neuroendocrine tumours, lymphoblastic lymphoma, WT, clear cell sarcoma of kidney, teratoma, synovial sarcoma, osteosarcoma and mesenchymal chondrosarcoma • CD99 is important for distinction between Ewings sarcoma/PNET and metastatic neuroblastoma
  16. 16. • FLI1- Only nuclear staining is considered positive NOT SPECIFIC MARKER But also positive in lymphoblastic lymphoma, myeloid neoplasms, DSRCT, Malignant melanoma, merkel cell carcinoma,synovial sarcoma, and some vascular neoplasms.
  17. 17. • Reciprocal translocation t(11;22)(q24;q12) • Fusion of EWSR1 gene(encodes for RNA binding protein) at 22q12 with FLI1 gene(member of ETS family of transcription factors) • The t(21;22)(q12;q12) translocation involves the gene ERG, which is located on chromosome 21 • t(7;22)(p22;q12) translocation involves a gene known as ETV1 at 7p22. • Recently a translocation involving chromosomes 4 and 9 with CIC and DUX4 gene has been identified
  18. 18. • Rearrangements of EWSR1 with non–ETS-family genes—including NFATC2,POU5F1, SMARCA5, ZSG, and SP3—are also rarely identified
  19. 19. • FISH for EWSR1 genomic rearrangements is highly sensitive (>95%) but nonspecific because other tumours may show rearrangement of this locus. • RT-PCR for EWSR1 fusion genes - highly sensitive (>95%) and specific (100%).
  20. 20. • Primary Lymphoma- Originates in bone with no evidence of extraskeletal disease or disseminated bone marrow involvement. Rare • Secondary skeletal involvement by a primary extraosseous lymphoma is much more common than primary bone lymphoma • AGE-usually affects 40-60 years • Lymphoma however can involve children; though it is much less common than Ewing sarcoma in this age group • SITE- meta-diaphyses of long bones (femur, humerus, and tibia) and axial skeleton (pelvis and vertebrae)
  21. 21. Extensive involment with permeative destructive process. Shaft is usually involved Radiographs appear as if there are multiple small holes with intervening normal bone Lesion shows mixture of lysis and sclerosis Periosteal new bone formation is unusual Bone scan- positive Positive bone scan or lesion on MRI + normal radiograhs = suggest malignant lymphoma
  22. 22. ->Under low power, lesion is visible between normal bony trabeculae and in marrow fat ->Nodular growth pattern- distinctly uncommon ->Fine fibrosis may be evident ->Most lymphomas show polymorphic infiltrate ->Nuclei are not uniform in shape and size This lack of uniformity is helpful in distinguishing lymphoma from Ewings sarcoma of bone
  23. 23. • B-cell lymphomas, most commonly diffuse large B-cell lymphoma • T-cell lymphomas of bone-Anaplastic large cell lymphoma • Lymphoblastic lymphoma • Non-Hodgkin B-cell lymphomas, including follicular lymphoma, marginal zone lymphoma, mantle cell lymphoma, and small lymphocytic lymphoma • Hodgkin lymphoma- late stages • Myeloid sarcoma (granulocytic sarcoma)
  24. 24. TUMOUR MARKERS B-cell lymphomas CD45, pan B-cell markers (CD19, CD20, CD79a,PAX-5) Negative for CD3, CD5 Anaplastic large cell lymphoma CD30 ,CD3, CD4, Lymphoblastic lymphoma terminal deoxynucleotidyl transferase. CD10, CD43, CD99, FLI-1, CD45 - weakly positive or negative Hodgkin’s lymphoma CD30, PAX-5, CD15. Myeloid sarcoma (granulocytic sarcoma) Positive- myeloperoxidase, lysozyme, and CD43,CD45 Negative for CD20 and CD3 Most of lymphomas except lymphoblastic lymphoma are negative for CD99
  25. 25. • Lymphoblastic lymphoma may be positive for CD99 and negative for CD45, an immunoprofile that overlaps with that of Ewing sarcoma • TdT, CD34,CD43,CD10, CD79a and genetic rearrangement studies- distinguish lymphoblastic lymphoma from EWS/PNET
  26. 26. • Specific studies on primary lymphomas of bone are lacking.
  27. 27. • malignant proliferation of monoclonal plasma cells • can present as a solitary lesions (solitary plasmacytoma) or more commonly as part of widespread disease (multiple myeloma) • AGE-50-70years • rare below 40 years • SITE-: vertebrae, ribs, skull, pelvis, femur, clavicle and scapula
  28. 28. Multiple punched out lesions Purely lytic Rarely associated with sclerosis Purely lytic lesion; Well defined margins
  29. 29. • Usually has a soft red-brown appearance. • However, some myelomas show the fish-flesh appearance typical of malignant lymphoma.
  30. 30. WELL DIFFERNTIATED MYELOMA POORLY DIFFERNTIATED MYELOMA
  31. 31. • HISTOLOGICAL DIFFERENTIAL DIAGNOSIS INCLUDES: • 1.Lymphoma • 2.malignant carcinoma • 3.occasionally chronic osteomyelitis • Immunohistochemitry plays an important role here
  32. 32. • Myeloma cells positive- CD38 CD138 Multiple myeloma oncogene 1 (MUM-1) • Characteristically express monotypic cytoplasmic Ig and lacks surface Ig • The monotypic expression of kappa or lambda immunoglobulin by the tumour cells establishes the diagnosis of malignancy
  33. 33. • Myeloma cells negative  CD19,CD20,CD27,CD22 Normal plasma cells  CD 27+ , CD 19+ • Myeloma cells frequently express the natural killer antigen CD56/58 which is not expressed in reactive plasma cells
  34. 34. • Myeloma cells weakly positive or negative for CD45,CD20 most B-cell lymphomas strong staining for both markers. • Both myeloma and carcinoma are positive for EMA Keratin markers are more reliable in ruling out carcinoma • Myeloma cells  positive for CD138 Multiple myeloma oncogene 1 (MUM-1) Some carcinomas occasionally express CD138 MUM-1 is helpful in making distinction
  35. 35. • Aggressive cartilaginous neoplasm • AGE-20-60 year • BONES COMMONLY AFFECTED- jaw bones • ribs • vertebrae • pelvis • USUAL LOCATION WITHIN LONG BONE- diaphysis (cortex or medulla)
  36. 36. Hemangiopericytomatous patternmalignant cartilaginous nodule ; hypercellular region of small cells
  37. 37. • Vimentin • S-100 protein staining- limited to chondroblastic islands. lacking in small cell component • CD57 • CD99- limited to small cell component • Nuclear immunoreactivity – Sox9 and osteocalcin • Focal reactivity for actin,desmin,myogenin,NSE MOLECULAR GENETICS • HEY1–NCOA2 gene fusion • complex cytogenetic alterations, including identical Robertsonian translocation t(13;21)(q10;q10)
  38. 38. • Hematopoietic stains will rule out lymphoma • Both mesenchymal chondrosarcoma and Ewings sarcoma/PNET share immunoreactivity for CD99 FLI-1-positive in 75% cases of Ewings sarcoma Sox9- sensitive and specific marker for mesenchymal chondrosarcoma
  39. 39. • Osteosarcoma is the most common nonhematopoietic primary malignant bone tumor. • But small cell osteosarcoma ( histological variant) is an extremely uncommon tumor with a poor prognosis • AGE- 10-25 years ; rare in preschool children • another peak age incidence- after 40 • SEX- M:F=3:2 • SITE- metaphyseal area of long bones • lower end of femur • upper end of tibia • upper end of humerus
  40. 40. • Small cell osteosarcoma is a rare histological variant • MICROSCOPY- Small size and uniformity of tumour cells and diffuse pattern of growth is seen – simulating appearance of Ewing sarcoma/PNET and malignant lymphoma • Some cases- these cells are spindle rather than round • Focal production of osteoid – distinguishing feature • Areas of cartilage production can be seen • Difficult to distinguish small cell osteosarcoma from ewings sarcoma/PNET when osteoid is not present
  41. 41. • IMMUNOHISTOCHEMISTRY- • No specific immunophenotype for osteosarcoma • Immunohistochemically heterogenous • Positive for vimentin, • desmin, • smooth muscle actin, cytokeratin epithelial membrane antigen, S-100 type I collagen, type II collagen, type IV collagen proteins associated with bone metabolism like- osteonectin,osteocalcin, osteopontin. CD 99
  42. 42. • Hematopoietic immunostains will distinguish lymphoma from small cell osteosarcoma • Small cell osteosarcoma can be immunoreactive with CD99, so it is not a useful stain in ruling out Ewing sarcoma FLI-1 is a better marker most Ewing sarcomas are positive but small cell osteosarcomas are negative.
  43. 43. • The stromal component of small cell osteosarcoma may resemble mesenchymal chondrosarcoma. both can show reactivity to CD99 - Careful attention paid to the type of matrix production— osteoid in osteosarcoma and cartilage in mesenchymal chondrosarcoma is the best way to make the distinction
  44. 44. • Small cell variant of poorly differentiated synovial sarcoma is easily misdiagnosed for other small round cell tumours • IMMUNOCHEMISTRY- positive for keratin 7,13 and 19 EMA, vimentin , CD99 • MOLECULAR GENETICS- t(x;18)(p11.2;q11.2) fusion of SS18( chr 18) with SSX1 (chr X)
  45. 45. • Only two categories show small round cell picture on histology: 1.Embryonal rhabdomyosarcoma 2.Alveolar rhabdomyosarcoma
  46. 46. EMBRYONAL RHABDOMYOSARCOMA • Arises from unsegmented and undifferientiated mesoderm • SITE- head and neck region- orbit, nasopharynx, middle ear retroperitoneum bile ducts urogenital tract • AGE- 3-12 years • GROSS- poorly circumscribed, white, soft ALVEOLAR RHABDOMYOSARCOMA • AGE- 10- 25 years • SITE- Extremities- forearm,arms, perirectal, perineal regions Most common sites of metastatic involvement bone marrow, lungs, soft tissues, lymph nodes
  47. 47. Perivascular pseudorosette Small round cells
  48. 48. Spindle shaped cells;Nuclei oval; cytoplasm scanty & eosinophilic
  49. 49. Small round cells Connective tissue septa
  50. 50. IMMUNOHISTOGRAM OF RHABDOMYOSARCOMA
  51. 51. Embryonal rhabdomyosarcoma Alveolar rhabdomyosarcoma
  52. 52. ALVEOLAR RHABDOMYOSARCOMA: • t(2;13)(q35;q14) with PAX3/FOXO1A fusion • t(1;13)(p36;q14) with PAX7/FOXO1A fusion (FOXO1A was previously known as FKHR) Detected in paraffin embedded tissue with FISH technique EMBRYONAL RHABDOMYOSARCOMA • No distinctive genetic alterations • Loss of heterozygosity at 11p15.5 • Gain of chromosomes 2,8,13
  53. 53. Thank you…

×