title: Expression of WT-1, Bcl-2, and CD34 by primary renal spindle cell tumors in children.
abstract: The confident diagnosis of renal spindle cell tumors in children is often difficult. An immunohistochemical study of WT-1, Bcl-2, and CD34 was performed to determine their expression profiles and to assess the potential utility of these immunohistochemical markers in the differential diagnosis of 36 cases of renal spindle cell tumors of childhood. The cases included 11 stromal predominant Wilms tumors, 12 cellular mesoblastic nephromas, 9 clear cell sarcomas of the kidney (CCSK), and 4 monophasic synovial sarcomas. WT-1 was uniformly positive in primitive undifferentiated stromal Wilms tumors (6 of 6) and negative in the differentiating and differentiated stromal elements of Wilms tumors (0 of 5). WT-1 was also negative in cellular mesoblastic nephromas (0 of 12), CCSKs (0 of 12), and synovial sarcomas (0 of 4). Bcl-2 was expressed in all stromal Wilms tumors (11 of 11), all synovial sarcomas (4 of 4), some CCSKs (4 of 9), and none of the cellular mesoblastic nephromas (0 of 12). Although CD34 was absent in the tumor cells of all the tumors studied (0 of 36), CD34 immunohistochemistry nicely demonstrated the evenly distributed septal capillaries characteristic of CCSK in all 9 cases of this tumor. We conclude that a combination of WT-1 and Bcl-2 immunohistochemistry may aid in the distinction of stromal Wilms tumor, monophasic synovial sarcoma, cellular mesoblastic nephroma, and CCSK.
authors.affiliation: Department of Pathology and Laboratory Medicine, Children's Mercy Hospital, 2401 Gillham Road, Suite 2567, Kansas City, MO 64108, USA.
authors.forename: Lei
authors.initials: L
authors.lastname: Shao
authors.forename: D Ashley
authors.initials: DA
authors.lastname: Hill
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Perlman
mesh_terms: D018952:Antigens, CD34 / Q000096:biosynthesis*; D014408:Biomarkers, Tumor / Q000032:analysis; D002648:Child; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007680:Kidney Neoplasms / Q000378:metabolism* / Q000473:pathology; D008297:Male; D018201:Nephroma, Mesoblastic / Q000378:metabolism / Q000473:pathology; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000096:biosynthesis*; D012509:Sarcoma / Q000378:metabolism* / Q000473:pathology; D018227:Sarcoma, Clear Cell / Q000378:metabolism / Q000473:pathology; D013584:Sarcoma, Synovial / Q000378:metabolism / Q000473:pathology; D025721:WT1 Proteins / Q000096:biosynthesis*; D009396:Wilms Tumor / Q000378:metabolism / Q000473:pathology
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D019253:Proto-Oncogene Proteins c-bcl-2; D025721:WT1 Proteins