Clear cell sarcoma of the mediastinum.
A 59-year-old woman presented with a large mediastinal mass. At thoracotomy, the mass was found tightly adherent to the esophageal wall and right lower lobe of the lung. Histological examination showed a solid tumor composed of closely packed nests of cells with clear and eosinophilic cytoplasm, which were strongly and diffusely positive for S100 protein but negative for HMB45 and Melan-A. The diagnosis of clear cell sarcoma was supported by demonstrating the presence of an EWS gene rearrangement by fluorescence in situ hybridization. There was no evidence that this lesion represented metastatic disease. To the best of our knowledge, primary mediastinal clear cell sarcoma has not been previously reported in the literature. We present the case and discuss the differential diagnosis.
Department of Histopathology, The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK. roberto.tirabosco@rnoh.nhs.uk
Roberto
R
Tirabosco
Loic
L
Lang-Lazdunski
Timothy C
TC
Diss
Maria Fernanda C
MF
Amary
Manuel
M
Rodriguez-Justo
David
D
Landau
Will
W
Lorenzi
Adrienne M
AM
Flanagan
D000230:Adenocarcinoma / Q000473:pathology; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000032:analysis; D001859:Bone Neoplasms / Q000188:drug therapy / Q000556:secondary; D003937:Diagnosis, Differential; D005260:Female; D046152:Gastrointestinal Stromal Tumors / Q000473:pathology; D015321:Gene Rearrangement; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008207:Lymphatic Metastasis / Q000473:pathology; D008479:Mediastinal Neoplasms / Q000235:genetics* / Q000473:pathology* / Q000628:therapy; D008875:Middle Aged; D034802:RNA-Binding Protein EWS / Q000235:genetics*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018227:Sarcoma, Clear Cell / Q000235:genetics* / Q000556:secondary* / Q000628:therapy
D014408:Biomarkers, Tumor; D034802:RNA-Binding Protein EWS