title: Cytokeratin immunoreactivity in Ewing's sarcoma: prevalence in 50 cases confirmed by molecular diagnostic studies.
abstract: Ewing's sarcoma (ES) and primitive neuroectodermal tumor (PNET) are characterized by the presence of the specific t(11;22)(q24;q12) or variants thereof, producing diagnostic EWS fusion transcripts. Cytokeratin has been reported sporadically to be expressed in some cases of ES/PNET. However, its prevalence has not been assessed systematically in a series of cases with confirmatory molecular or cytogenetic evidence of a diagnostic translocation. We present in detail three index patients in whom strong cytokeratin immunoreactivity was a confounding factor in the diagnosis. To establish further the prevalence of cytokeratin immunoreactivity in a series of well-characterized ES/PNET, we then performed immunohistochemical studies with antibodies CAM5.2 and AE1/AE3 on 50 cases of ES/PNET diagnosed at Memorial Sloan-Kettering Cancer Center in which molecular evidence of a specific ES/PNET-associated translocation were available. Immunoreactivity to cytokeratin was present in 10 cases (20%), in five diffusely and five focally. There was no significant association between cytokeratin expression and the following parameters: patient age, sex, skeletal and extraskeletal primary site, and the type of EWS fusion transcript. Cytokeratin expression, a manifestation of epithelial differentiation, is present in as many as 20% of ES/PNET in either a diffuse or focal pattern.
authors.affiliation: Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
authors.forename: M
authors.initials: M
authors.lastname: Gu
authors.forename: C R
authors.initials: CR
authors.lastname: Antonescu
authors.forename: G
authors.initials: G
authors.lastname: Guiter
authors.forename: A G
authors.initials: AG
authors.lastname: Huvos
authors.forename: M
authors.initials: M
authors.lastname: Ladanyi
authors.forename: M F
authors.initials: MF
authors.lastname: Zakowski
mesh_terms: D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000096:biosynthesis / Q000276:immunology*; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000276:immunology* / Q000473:pathology; D018242:Neuroectodermal Tumors, Primitive / Q000276:immunology* / Q000473:pathology; D012512:Sarcoma, Ewing / Q000276:immunology* / Q000473:pathology
chemical_list: D007633:Keratins