title: The small round blue cell tumors of the sinonasal area: histological and immunohistochemical findings.
abstract: BACKGROUND
  Primary Small round blue cell tumors (SRBCT) in sinonasal comprise histogenetically diverse entities with overlapping morphologic features. Because of the limited initial biopsy tissue materials, differential diagnostic difficulties may arise, and as they have different management, exact diagnosis and classification are very important.
  
  
  OBJECTIVE
  In this study, we analyzed the immunohistochemical expression of a panel of markers in the classification and diagnosis of sinonasal SRBCTs.
  
  
  METHODS
  This cross sectional study was performed on 36 paraffin embedded tissue samples. Histologic and immunohistochemical slides from 36 patients with SRBCT were analyzed retrospectively. The patients were admitted in Khalili hospital, Shiraz from 1383 to 1388.
  
  
  RESULTS
  There were 13 women and 23 men with the mean age of 53 ±12.1. There were 9 malignant melanoma, seven poorly differentiated SCC; six lymphoma (DLBL); 4 SCNEC; three SNUC; two ON; two Ewing/PNET; two embryonal rhabdomyosarcoma, and one plasmacytoma. Pan-cytokeratin was strongly expressed poorly differentiated SCC and all cases of SNUC. Coexpression of desmin and nuclear myoD1 was only detected in rhabdomyosarcoma. HMB45 was only expressed in sinonasal melanoma. CD99 expression was identified only in Ewing/PNET. FLI-1 was detected in 50% of PNET. P63 was expressed in poorly differentiated SCC (2/7) and SNUC (1/3).
  
  
  CONCLUSIONS
  The results of our study indicate that the integration of histopathologic findings with application of limited but highly specific markers led to the separation of carcinomas, lymphoma and melanomas from other small cell tumors. Using a panel of keratin, LCA, desmin, and HMB45 is the most practical and economic approach to accurately classify these tumors.
authors.affiliation: Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: J Ashraf
authors.affiliation: Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Leila
authors.initials: L
authors.lastname: Beigomi
authors.affiliation: Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Negar
authors.initials: N
authors.lastname: Azarpira
authors.affiliation: Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Bita
authors.initials: B
authors.lastname: Geramizadeh
authors.affiliation: Department of Otolaryngology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Bijan
authors.initials: B
authors.lastname: Khademi
authors.affiliation: Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Afsoon
authors.initials: A
authors.lastname: Hakimzadeh
authors.affiliation: Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Shiraz, IR Iran.
authors.forename: Elham
authors.initials: E
authors.lastname: Abedi
keywords: Carcinoid Tumor; Histological Techniques; IHC64