Virchows Archiv

, Volume 459, Issue 6, pp 615–621 | Cite as

TLE1 is expressed in the majority of primary pleuropulmonary synovial sarcomas

  • Leonardo Saúl Lino-Silva
  • Juan Pablo Flores-Gutiérrez
  • Natalia Vilches-Cisneros
  • Hugo Ricardo Domínguez-Malagón
Original Article


Pleuropulmonary synovial sarcoma (PPSS) is a rare entity, similar to synovial sarcoma of soft tissue (STSS). There are 120 published cases of PPSS, but no studies have explored the expression of TLE1. In soft tissues, it has been proven a useful marker, but in tumors of other sites, its expression has not been explored. The main objective was to study the expression and diagnostic sensitivity and specificity of TLE1 in a group of PPSS, of which the diagnosis was corroborated by fluorescence in situ hybridization confirming t(X;18) in a tissue microarray. Immunohistochemistry including TLE1, vimentin, CD99, CD56, bcl-2, AE1-AE3, EMA, CD34, CK7, CK19, calponin, and S-100 was performed on all PPSS and on 25 control cases (five carcinomas, ten mesotheliomas, and ten thoracic sarcomas). TLE1 was positive in 11 cases (73.3%); bcl-2 and vimentin in 100%; calponin and CD56 in 26.6%; CD99, CK AE1-AE3, CK19, CK7, and EMA in 80%; and S100 negative in all. The only biphasic PPSS was positive for epithelial markers only in the epithelial component. TLE1 was negative in all control cases. TLE1 is expressed in 73% of PPSS, a value inferior to that reported in STSS, but is highly specific for PPSS. TLE1 may therefore be of value in the differential diagnosis of PPSS, but should be used in a panel of antibodies.


Synovial sarcoma Pleuropulmonary sarcomas TLE1 


  1. 1.
    Aubry MC, Bridge JA, Wickert R et al (2002) Primary monophasic synovial sarcoma of the pleura: five cases confirmed by the presence of SYT–SSX fusion transcript. Am J Surg Pathol 25:776–781CrossRefGoogle Scholar
  2. 2.
    Begueret H, Galateau-Salle F, Guillou L et al (2005) Primary intrathoracic synovial sarcoma: a clinicopathologic study of 40 t(X;18)-positive cases from the French Sarcoma Group and the Mesopath Group. Am J Surg Pathol 29:339–346PubMedCrossRefGoogle Scholar
  3. 3.
    Fletcher CD (2002) World Health Organization classification of tumors of soft tissue and bone. IARC, LyonGoogle Scholar
  4. 4.
    Fligman I, Lonardo F, Jhanwar SC et al (1996) Molecular diagnosis of synovial sarcoma and characterization of a variant SYT–SSX2 fusion transcript. Am J Pathol 147:1592–1599Google Scholar
  5. 5.
    Gaertner E, Zeren EH, Fleming MV et al (1996) Biphasic synovial sarcomas arising in the pleural cavity. A clinicopathologic study of five cases. Am J Surg Pathol 20:36–45PubMedCrossRefGoogle Scholar
  6. 6.
    Takenaka S, Ueda T, Naka N (2008) Prognostic implication of SYT–SSX fusion type in synovial sarcoma: a multi-institutional retrospective analysis in Japan. Oncology Reports 19:467–476PubMedGoogle Scholar
  7. 7.
    Folpe Al, Schmidt RA, Chapman D et al (1998) Poorly differentiated synovial sarcoma: immunohistochemical distinction from primitive neuroectodermal tumors and high grade malignant peripheral nerve sheath tumors. Am J Surg Pathol 22:673–682PubMedCrossRefGoogle Scholar
  8. 8.
    Fischer C, Montgomery E, Healey V (2003) Calponin and h-caldesmon expression in synovial sarcoma; the use of calponin in diagnosis. Histopathology 42:588–593CrossRefGoogle Scholar
  9. 9.
    Verbeke SLJ, Fletcher CDM, Alberghini M et al (2010) A reappraisal of hemangiopericytoma of bone; analysis of cases reclassified as synovial sarcoma and solitary fibrous tumor of bone. Am J Surg Pathol 34:777–783PubMedCrossRefGoogle Scholar
  10. 10.
    Mirzoyan M, Muslimani A, Setrakian S, Swedh M, Daw HA (2008) Primary pleuropulmonary synovial sarcoma. Clinical Lung Cancer 9:257–261PubMedCrossRefGoogle Scholar
  11. 11.
    Olsen SH, Thomas DG, Lucas DR (2006) Cluster analysis of immunohistochemical profiles in synovial sarcoma, malignant peripheral nerve sheath tumor and Ewing’s sarcoma. Mod Pathol 19:659–568PubMedCrossRefGoogle Scholar
  12. 12.
    Guillou L, Wadden C, Kraus MD (1996) S-100 protein reactivity in synovial sarcomas—a potentially frequent diagnostic pitfall: immunohistochemical analysis of 100 cases. Appl Immunohistochem 4:167–172Google Scholar
  13. 13.
    Heuvel SE, Hoekstra HJ, Bastiaannet E (2009) The classic prognostic factors tumor stage, tumor size, and tumor grade are the strongest predictors of outcome in synovial sarcoma: no role for SSX fusion type or ezrin expression. Appl Immunohistochem Mol Morphol 17:189–195PubMedCrossRefGoogle Scholar
  14. 14.
    Zeren H, Morán CA, Suster S et al (1995) Primary pleuropulmonar sarcomas with features of monophasic synovial sarcoma: a clinicopathological, immunohistochemical and ultrastructural study of 25 cases. Human Pathol 26:474–480CrossRefGoogle Scholar
  15. 15.
    Safar A, Wickert R, Nelson M et al (1998) Characterization of a variant SYT–SSX1 synovial sarcoma fusion transcript. Diag Mol Pathol 7:283–287CrossRefGoogle Scholar
  16. 16.
    Sistla R, Tameem A, Vidyasagar VS (2010) Intraarticular synovial sarcoma. Indian J of Pathol and Microbiol 53:115–116CrossRefGoogle Scholar
  17. 17.
    Terry J, Saito T, Subramanian S et al (2007) TLE1 as a diagnostic immunohistochemical marker of synovial sarcoma emerging from gene expression profiling studies. Am J Surg Pathol 31:240PubMedCrossRefGoogle Scholar
  18. 18.
    Kosemehmetoglu K, Vrana JA, Folpe AL (2007) TLE1 expression is not specific for synovial sarcoma: a whole section study of 163 soft tissue and bone neoplasms. Mod Pathol 22:872–878CrossRefGoogle Scholar
  19. 19.
    Krskova L, Sumerauer D, Stejskalova E, Kodet R (2007) A novel variant of SYT–SSX1 fusion gene in a case of spindle cell synovial sarcoma. Diagn Mol Pathol 16:179–183PubMedCrossRefGoogle Scholar
  20. 20.
    Van de Rijn M, Barr FG, Xiong QB et al (1999) Poorly differentiated synovial sarcoma: an analysis of clinical, pathologic and molecular genetic features. Am J Surg Pathol 23:106–112PubMedCrossRefGoogle Scholar
  21. 21.
    Ladanyi M, Antonescu CR, Leung DH (2002) Impact of SYT–SSX fusion type on the clinical behavior of synovial sarcoma: a multi-institutional retrospective study of 243 patients. Cancer Res 62:135–140PubMedGoogle Scholar
  22. 22.
    Matsuyama A, Hisaoka A, Iwasaki M, Iwashita M, Hishinaga S, Hashimoto H (2010) TLE1 expression in malignant mesothelioma. Virchows Arch 457:577–583PubMedCrossRefGoogle Scholar
  23. 23.
    Essary LR, Vargas SO, Fletcher CD (2002) Primary pleuropulmonary synovial sarcoma: reappraisal of a recently described anatomic subset. Cancer 94:459–469PubMedCrossRefGoogle Scholar
  24. 24.
    Hartel PH, Fanburg-Smith JC, Frazier AA et al (2007) Primary pulmonary and mediastinal synovial sarcoma: a clinicopathologic study of 60 cases and comparison with five prior series. Mod Pathol 20:760–769PubMedCrossRefGoogle Scholar
  25. 25.
    Jagdis A, Rubin BP, Tubbs RR, Pacheco M, Nielsen TO (2009) Prospective evaluation of TLE1 as a diagnostic immunohistochemical marker in synovial sarcoma. Am J Surg Pathol 33:1743–1751PubMedCrossRefGoogle Scholar
  26. 26.
    Knösel T, Heretsch S, Altendorf-Hofmann A, Richter P, Katenkamp K, Katenkamp D, Berndt A, Petersen I (2010) TLE1 is a robust diagnostic biomarker for synovial sarcomas and correlates with t(X;18): analysis of 319 cases. Eur J Cancer 46:1170–1176PubMedCrossRefGoogle Scholar
  27. 27.
    Lee W, Han K, Charles P, Harris A, Shim S, Kim S, Meisner LF (1993) Analysis of chromosome rearrangement in synovial sarcoma cells from paraffin-embedded specimens. Am J Pathol 142:15–19Google Scholar
  28. 28.
    Mandhal N, Heim S, Arheden K et al (1998) Multiple karyotypic rearrangements, including t(X;18)(p11;q11), in a fibrosarcoma. Cancer Genet Cytogenet 30:323–327CrossRefGoogle Scholar
  29. 29.
    Pelmus M, Guillou L, Holstein I et al (2002) Monophasic fibrous an poorly differentiated synovial sarcoma: immunohistochemical reassessment of 60 t(X:18)(SYT-SSX)-positive cases. Am J Surg Pathol 26:1434–1440PubMedCrossRefGoogle Scholar
  30. 30.
    Suster S, Fischer C, Moran CA (1998) Expression of bcl-2 oncoprotein in benign and malignant spindle cell tumors of soft tissue, skin, serosal superfices and gastrointestinal tract. Am J Surg Pathol 22:863–872PubMedCrossRefGoogle Scholar
  31. 31.
    Törnkvist M, Brodin B, Bartolazzi A et al (2002) A novel type of SYT/SSX fusion: methodological and biological implications. Mod Pathol 15:679–685PubMedCrossRefGoogle Scholar
  32. 32.
    Seo SW, Lee H, Lee HI, Kim HS (2011) The role of TLE1 in synovial sarcoma. J Orthop Res 29:1131–1136PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Leonardo Saúl Lino-Silva
    • 1
    • 3
  • Juan Pablo Flores-Gutiérrez
    • 2
  • Natalia Vilches-Cisneros
    • 2
  • Hugo Ricardo Domínguez-Malagón
    • 1
  1. 1.Department of Anatomic Pathology, Instituto Nacional de CancerologíaMéxico CityMexico
  2. 2.Department of Anatomic Pathology, Hospital UniversitarioUniversidad Autónoma de Nuevo LeonMonterreyMexico
  3. 3.México CityMexico

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