Publication: A subset of solitary fibrous tumors express nuclear PAX8 and PAX2: a potential diagnostic pitfall
Authors
McDaniel, Andrew S. ; Palanisamy, Nallasivam ; Smith, Steven C. ; Robinson, Dan R. ; Wu, Yi-Mi ; Chinnaiyan, Arul M. ; McHugh, Jonathan B. ; Greenson, Joel K. ; Kunju, Lakshmi P.
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Publisher
Universidad de Murcia. Departamento de BiologĂa Celular e HistologĂa
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Description
Abstract
Solitary fibrous tumor (SFT), a mesenchymal
neoplasm with widespread anatomic distribution, can be
diagnostically challenging in limited samples. We
recently encountered an aspirate of a pancreatic mass,
incorrectly interpreted as metastatic renal cell carcinoma
based on strong PAX8 expression by immunohistochemistry (IHC). After resection, morphologic features
with additional IHC (CD34 positivity) correctly
identified this lesion as a SFT. PAX8 and PAX2 are
commonly used as renal tumor markers; however, no
series has investigated PAX8 or PAX2 expression in
SFT. IHC for PAX8 and PAX2 was performed on 41
SFTs (biopsy and resections) from varying sites. Eight
were histologically malignant and eight were recurrences
of previous resections. PAX8 staining was observed at
least focally in 26.8% (11 of 41) SFT cases; additionally,
PAX2 was positive in 12.2% (5 of 41 cases) of SFTs. For
PAX8 and PAX2 positive cases 45.6% and 40%,
respectively, showed diffuse expression. No correlation
was found between PAX8/PAX2 positivity and age,
tumor size, site, malignancy, or recurrence. In
conclusion, a substantial minority of SFTs express PAX8
and PAX2 via IHC. This presents a diagnostic pitfall
when evaluating possible metastases from the kidney,
particularly when primary tumors show sarcomatoid or
spindle cell morphologies.
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