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Virchows Archiv A

, Volume 414, Issue 3, pp 243–251 | Cite as

Ewing's sarcoma

A retrospective study of histological and immunohistochemical factors and their relation to prognosis
  • S. Daugaard
  • C. Kamby
  • L. M. Sunde
  • O. Myhre-Jensen
  • T. Schiødt
Article

Summary

Histological and immunohistochemical features of 87 patients with conventionally diagnosed Ewing's sarcoma were studied retrospectively on routinely processed material and evaluated with regard to prognostic significance. 74% were convincingly positive when stained for vimentin, 13% were doubtful, and 13% were negative. A varying degree of positivity for neuron-specific enolase (NSE) was found in 15%; these cases all co-expressed vimentin. A single tumour contained scattered cytokeratin-positive cells. Positivity for the leukocyte common antigen (LCA) could be demonstrated in three cases; these were excluded from the statistical analysis of prognostic factors.

Growth pattern, soft tissue invasion, monomorphic or dimorphic cell population, and PAS-, NSE- or vimentin-positivity did not influence survival significantly. However, prognosis was increasingly poor with increasing degree of necrosis: median survival was 28 months for grade I necrosis (<10%), 16 months for grade II (10–50%), and 11 months for grade III (>50%),p<0.0005. A mitosis count of <1 per high-powerfield (HPF) was correlated to a median survival of 26 months, ≥ 1 per HPF to 12 months,p<0.05.

The findings indicate some degree of heterogeneity in Ewing's sarcoma which may be related to primitive peripheral neuroectodermal tumours (PNETs), or be a true blastoma. In future trials, diagnostic criteria (including immunohistochemistry) should be clearly defined and materials should be large enough to allow for stratification according to prognostic factors.

Key words

Ewing's sarcoma Histology Immunohistochemistry Prognostic factors 

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Copyright information

© Springer-Verlag 1989

Authors and Affiliations

  • S. Daugaard
    • 1
  • C. Kamby
    • 2
  • L. M. Sunde
    • 3
  • O. Myhre-Jensen
    • 4
  • T. Schiødt
    • 1
  1. 1.The Bone and Soft Tissue Tumour Centres of Copenhagen and of Aarhus: Department of PathologyThe Finsen Institute/RigshospitaletCopenhagen
  2. 2.Department of Oncology ONA and OrthopaedicsThe Finsen Institute/RigshospitaletCopenhagen
  3. 3.Hospital of Orthopaedics and Department of OncologyThe Municipal HospitalAarhus
  4. 4.Department of PathologyThe County HospitalAarhusDenmark

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