When presenting in the pleura, there is a differential between synovial sarcoma and mesothelioma. One paper has specifically compared synovial sarcoma (mainly of the extremity) with mesothelioma.
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|
Synovial sarcoma |
Mesothelioma |
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biphasic |
monophasic |
poorly differentiated |
epithelioid |
sarcomatoid |
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29/41 (epithelial component positive in 14 cases, of which 5 showed staining of >10% of cells. spindle cell component positive in 24 cases, extensive in some, both cytoplasmic and nuclear.) |
23/44 (more than 10% of cells positive in 17 cases. |
10/18 (more than 10% of cells positive in 6 cases. |
23/23 (extensive positivity) |
7/7 (focal to extensive positivity) |
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28/28 (cytoplasmic and membrane, extensive in most cases) |
8/20 (mainly focal |
2/14 |
20/23 (membrane positivity) |
0/7 |
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27/30 (extensive staining of epithelial component) |
2/28 (focal reactivity) |
1/16 (focal reactivity) |
3/23 (focal reactivity) |
0/7 |
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3/32 (focal reactivity) |
1/33 (focal reactivity) |
1/17 (focal reactivity) |
5/17 (focal reactivity) |
4/7 |
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7/20 (focal reactivity only of spindle cells) |
11/33 (focal reactivity) |
1/11 |
20/21 |
5/7 |
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22/29 |
12/40 (focal reactivity) |
3/17 (focal reactivity) |
21/23 |
1/7 |
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41/41 (epithelial component) |
32/41 (focal reactivity) |
9/18 (focal reactivity) |
23/23 |
7/7 |
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29/44 (epithelial component) |
11/40 (focal reactivity) |
1/12 (focal reactivity) |
12/23 (focal reactivity) |
4/7 (focal reactivity) |
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41/41 (epithelial component) |
25/41 (focal reactivity) |
11/18 (focal reactivity) |
23/23 |
7/7 |
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0/18 |
0/31 |
0/11 |
12/17 |
0/7 |
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BerEP4 and WT1 appear to be useful in the differentiation of synovial sarcoma from mesothelioma. Cytokeratins 7 and 19 are more extensively expressed in mesothelioma than in synovial sarcoma. Bcl-2, positive in synovial sarcoma, may also be useful.
This page last revised 28.3.2005.