Diagnostic Utility of TLE1 (Transducer-Like Enhancer of Split 1) in Distinguishing Synovial Sarcoma from Mimicking Tumors

Madiha Bilal Qureshi,1 Muhammad Usman Tariq,1 Jamshid Abdul-Ghafar,2 Qurratulain Chundriger,1 Nasir Ud Din1 1Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan; 2Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Ch...

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Autores principales:	Qureshi MB, Tariq MU, Abdul-Ghafar J, Chundriger Q, Ud Din N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	synovial sarcoma monophasic synovial sarcoma tle1 Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/65ed29099ae44cb2a57adeb30fb51e40
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spelling	oai:doaj.org-article:65ed29099ae44cb2a57adeb30fb51e402021-11-30T18:50:36ZDiagnostic Utility of TLE1 (Transducer-Like Enhancer of Split 1) in Distinguishing Synovial Sarcoma from Mimicking Tumors1178-7074https://doaj.org/article/65ed29099ae44cb2a57adeb30fb51e402021-12-01T00:00:00Zhttps://www.dovepress.com/diagnostic-utility-of-tle1-transducer-like-enhancer-of-split-1-in-dist-peer-reviewed-fulltext-article-IJGMhttps://doaj.org/toc/1178-7074Madiha Bilal Qureshi,1 Muhammad Usman Tariq,1 Jamshid Abdul-Ghafar,2 Qurratulain Chundriger,1 Nasir Ud Din1 1Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan; 2Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, AfghanistanCorrespondence: Jamshid Abdul-GhafarDepartment of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, AfghanistanTel +93 792 827 287Email jamshid.jalal@fmic.org.afBackground: Synovial sarcoma (SS) is a high-grade spindle cell tumor that accounts for 5% to 10% of soft tissue sarcomas. The majority originate from the deep intramuscular soft tissues of extremities with common sites including knee, ankle and feet. Immunohistochemical (IHC) stain TLE1 (transducer-like enhancer of split 1) is a potent diagnostic marker for distinguishing SS from mimicking tumors.Methodology: The study was performed on 177 tumor cases, including 89 SS and 88 non-synovial sarcoma (N-SS) cases which were diagnosed at Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, from July 2019 to June 2020. Hematoxylin and eosin (H&E) and IHC stained glass slides of these cases were reviewed. TLE1 expression was assessed based on the Remmele scoring system.Results: Eighty-nine cases of SS and 88 cases of N-SS were included in the study. SS cases included 42 (47.2%) monophasic subtype, 6 (6.7%) biphasic subtype and 41 (46.1%) poorly differentiated subtype. Major tumor types in N-SS cases were 27 (30.7%) Ewing sarcoma (ES), 13 (14.8%) leiomyosarcoma, 10 (11.4%) undifferentiated sarcoma (US), 8 (9.1%) fibrosarcomatous dermatofibrosarcoma protuberans and 7 (8%) malignant peripheral nerve sheath tumor cases. Mean patients’ age for SS cases was 26.14 years and for N-SS cases was 32.64 years. All 89 SS cases showed positive TLE1 expression. Out of 88 N-SS cases, 71 (80.7%) were TLE1 negative and 17 (19.3%) showed positive expression.Conclusion: This study shows that TLE1 is a very sensitive and relatively specific IHC marker for SS. TLE1 expression can be observed in other soft tissue sarcomas but diffuse strong TLE1 expression is highly specific for SS. The diagnosis should not solely rely on TLE1 expression and morphologic features but should include soft tissue specific lineage markers to avoid misdiagnosis.Keywords: synovial sarcoma, monophasic synovial sarcoma, TLE1Qureshi MBTariq MUAbdul-Ghafar JChundriger QUd Din NDove Medical Pressarticlesynovial sarcomamonophasic synovial sarcomatle1Medicine (General)R5-920ENInternational Journal of General Medicine, Vol Volume 14, Pp 9173-9179 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	synovial sarcoma monophasic synovial sarcoma tle1 Medicine (General) R5-920
spellingShingle	synovial sarcoma monophasic synovial sarcoma tle1 Medicine (General) R5-920 Qureshi MB Tariq MU Abdul-Ghafar J Chundriger Q Ud Din N Diagnostic Utility of TLE1 (Transducer-Like Enhancer of Split 1) in Distinguishing Synovial Sarcoma from Mimicking Tumors
description	Madiha Bilal Qureshi,1 Muhammad Usman Tariq,1 Jamshid Abdul-Ghafar,2 Qurratulain Chundriger,1 Nasir Ud Din1 1Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, Karachi, Pakistan; 2Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, AfghanistanCorrespondence: Jamshid Abdul-GhafarDepartment of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, AfghanistanTel +93 792 827 287Email jamshid.jalal@fmic.org.afBackground: Synovial sarcoma (SS) is a high-grade spindle cell tumor that accounts for 5% to 10% of soft tissue sarcomas. The majority originate from the deep intramuscular soft tissues of extremities with common sites including knee, ankle and feet. Immunohistochemical (IHC) stain TLE1 (transducer-like enhancer of split 1) is a potent diagnostic marker for distinguishing SS from mimicking tumors.Methodology: The study was performed on 177 tumor cases, including 89 SS and 88 non-synovial sarcoma (N-SS) cases which were diagnosed at Department of Pathology and Laboratory Medicine, Aga Khan University Hospital, from July 2019 to June 2020. Hematoxylin and eosin (H&E) and IHC stained glass slides of these cases were reviewed. TLE1 expression was assessed based on the Remmele scoring system.Results: Eighty-nine cases of SS and 88 cases of N-SS were included in the study. SS cases included 42 (47.2%) monophasic subtype, 6 (6.7%) biphasic subtype and 41 (46.1%) poorly differentiated subtype. Major tumor types in N-SS cases were 27 (30.7%) Ewing sarcoma (ES), 13 (14.8%) leiomyosarcoma, 10 (11.4%) undifferentiated sarcoma (US), 8 (9.1%) fibrosarcomatous dermatofibrosarcoma protuberans and 7 (8%) malignant peripheral nerve sheath tumor cases. Mean patients’ age for SS cases was 26.14 years and for N-SS cases was 32.64 years. All 89 SS cases showed positive TLE1 expression. Out of 88 N-SS cases, 71 (80.7%) were TLE1 negative and 17 (19.3%) showed positive expression.Conclusion: This study shows that TLE1 is a very sensitive and relatively specific IHC marker for SS. TLE1 expression can be observed in other soft tissue sarcomas but diffuse strong TLE1 expression is highly specific for SS. The diagnosis should not solely rely on TLE1 expression and morphologic features but should include soft tissue specific lineage markers to avoid misdiagnosis.Keywords: synovial sarcoma, monophasic synovial sarcoma, TLE1
format	article
author	Qureshi MB Tariq MU Abdul-Ghafar J Chundriger Q Ud Din N
author_facet	Qureshi MB Tariq MU Abdul-Ghafar J Chundriger Q Ud Din N
author_sort	Qureshi MB
title	Diagnostic Utility of TLE1 (Transducer-Like Enhancer of Split 1) in Distinguishing Synovial Sarcoma from Mimicking Tumors
title_short	Diagnostic Utility of TLE1 (Transducer-Like Enhancer of Split 1) in Distinguishing Synovial Sarcoma from Mimicking Tumors
title_full	Diagnostic Utility of TLE1 (Transducer-Like Enhancer of Split 1) in Distinguishing Synovial Sarcoma from Mimicking Tumors
title_fullStr	Diagnostic Utility of TLE1 (Transducer-Like Enhancer of Split 1) in Distinguishing Synovial Sarcoma from Mimicking Tumors
title_full_unstemmed	Diagnostic Utility of TLE1 (Transducer-Like Enhancer of Split 1) in Distinguishing Synovial Sarcoma from Mimicking Tumors
title_sort	diagnostic utility of tle1 (transducer-like enhancer of split 1) in distinguishing synovial sarcoma from mimicking tumors
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/65ed29099ae44cb2a57adeb30fb51e40
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Diagnostic Utility of TLE1 (Transducer-Like Enhancer of Split 1) in Distinguishing Synovial Sarcoma from Mimicking Tumors

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