Soft tissue sarcomas in Mosul: a pathologic evaluation


Objective: Histochemical and immunohistochemical examination of soft tissue sarcomas(STS) in Mosul to assess the value of these techniques in verifying the primary diagnosis.Methods: Paraffin embedded tissue blocks of 35 cases of soft tissue sarcomas collected over a period of 20 months in Mosul, were utilized. H&E, reticulin ,and Van Gieson's staining techniques and immunohistochemical marker for S-100 protein were applied to all the cases.Results: Soft tissue sarcoma accounts for 16.4%of the total of 213 cases of benign and malignant soft tissue neoplasms,with a mean age of 30.5 years ,and a male preponderance( Male: Female ratio of1.7:1). The most common histologic subtypes are extraskeletal Ewing’s sarcoma(ES), dermatofibrosarcoma protuberans(DFSP) ,and spindle cell sarcoma, not other wise specified (NOS). The extremities are affected in 51.4% of all cases, particularly the lower limbs. The majority of soft tissue sarcomas belong to the high grade category by applying French Federation of Cancers Centers Sarcoma Group ( FFCCSG) and American Joint Cancer Committee (AJCC) grading schemes .Both reticulin and Van Gieson's stains have been successfully depicting the growth patterns of different subtypes. Immunoreactivity for S-100 protein was positive in two cases.Conclusions: High quality H&E stained sections remain the best method for establishing the diagnosis of sarcomas .Reticulin stain proved extremely helpful in subclassifying sarcomas and S-100 protein was instrumental in changing the diagnosis of sarcoma in one case.