Histopathological and immunohistochemical studies of 120 cases of osteosarcoma

Ｈｉｓｔｏｐａｔｈｏｌｏｇｉｃａｌａｎｄｉｍｍｕｎｏｈｉｓｔｏｃｈｅｍｉｃａｌｓｔｕｄｉｅｓｏｆ１２０ｃａｓｅｓｏｆｏｓｔｅｏｓａｒｃｏｍａＧａｏＦｅｎｇｘｕｎ（高奉浔）；ＬｉＺｅｎｇｐｅｎｇ（李增鹏）；ＤｏｎｇＺｈｉｑｉａｎ（董志谦）；ＳｕＨｏｎｇ...

Histopathological and immunohistochemical studies of 120 cases of osteosarcoma

One hundren and twenty cases of osteosarcoma (OS) were studied histopathologically and immunohistochemically. It is now generally accepted that the demonstration of neoplastic osteoid is not essential for the diagnosis of osteosarcoma but the microscopic features of sarcomatous stroma, the heteromorphism of osteoblasts and the sarcomatous background of anaplastic giant cells and chondrosarcomatous and fibrosarcomatous tissues are of diagnostic significance. Re-examination of all our tissue specimens revealed that typical neoplastic osteoid was ouly found in 83% of our series. The differential diagnosis between neoplastic osteoid and pseudo-osteoid or fibrillar hyalinized collagen is discussed. Forty-eight surgical specimens were stained with polyclonal actin, monoclonal BMP (bone morphogenetic protein), vimentin, collagen type IV (C-IV) and UEA-1 with immunohistochemical ABC method. It was found that when there was positive expression of monoclonal BMP, vimentin, C-IV,UEA-1 and polyclonal actin, that of monoclonal BMP, vimentin, UEA-1 and/or polyclonal actin, or that of monoclonal BMP, vimentin and/or polyclonal actin, it was of diagnostic significance for osteosarcoma. However, the 5 markers were of no value to differentiate fibrillar hyalinized collagen from osteoid stroma. It is believed that appropriate combination of the immunohistochemical markers is imperative to promote the accuracy of the pathological diagnosis of osteosarcoma and its differential diagnosis.