Bone and soft tissue sarcomas, tumors of the skinBone and soft tissue sarcomas, tumors of the skinСаркомы костей, мягких тканей и опухоли кожи2219-46142782-3687Publishing House ABV Press422ORTHOPAEDIC PATHOMORPHOLOGYОРТОПЕДИЧЕСКАЯ ПАТОМОРФОЛОГИЯNotochordal tumors (chordoma). Differential diagnosis. Immunohistochemical markersОпухоли нотохорды (хордома/доброкачественная опухоль нотохорды). Дифференциальный диагноз. Иммуногистохимические маркеры в помощь диагностикеBoulytchevaI. V.БулычеваИ. В.
Russian Federation

Moscow

г. Москва

irena@boulytcheva.comBertoniFranco
Italy

MD

BacchiniPatriziaБаччиниПатриция
Italy
MusaevE. R.МусаевЭ. Р.
Russian Federation

Moscow

г. Москва

N.N. Blokhin Russian Cancer Research CenterФГБНУ «Российский онкологический научный центр им. Н.Н. Блохина»Casa di Cura Villa Erbosa University of Bologna230420157231352301202223012022Copyright ©; 2015, Boulytcheva I.V., Bertoni F., Bacchini P., Musaev E.R.Copyright ©; 2015, Булычева И.В., Bertoni F., Баччини П., Мусаев Э.Р.2015Boulytcheva I.V., Bertoni F., Bacchini P., Musaev E.R.Булычева И.В., Bertoni F., Баччини П., Мусаев Э.Р.https://creativecommons.org/licenses/by/4.0https://sarbon.abvpress.ru/jour/article/view/422

Chordomas, low-grade chondrosarcomas, metastatic carcinomas share many histological features, generating at times, considerable diagnostic difficulty and, not infrequently, requiring immunohistochemical analysis for appropriate classification. In an effort to clarify the diagnosis and differentiation with other cartilaginous tumors, samples from 58 patients with sacrum chordoma were examined by immunohistochemistry with a panel of antibodies. The panel included antibodies to cytokeratin (CK), epithelial membrane antigen (EMA), D2-40, GFAP (glial fibrillary acidic protein), NSE (neuron-specific enolase), chromogranin, TTF-1 (thyroid transcription factor), PSA, CDX-2, mammaglobin. The conventional chordoma stained for CK (16/16) EMA (13/16), NSE (12/16) and was negative for chromogranin, GFAP. Specific markers were helpful in differential with metastatic carcinomas. Chordomas are difficult to excise because of their location and intimate relation to critical structures. Two cases of dedifferentiated chordoma were described.

Хордома представляет собой специфическую мезенхимальную опухоль со своеобразными клиническими и морфологическими проявлениями. По гистологическому строению хордома напоминает нотохорду. Изучено 58 случаев хордомы крестца у 28 мужчин и 30 женщин в возрасте от 32 до 72 лет. В двух наблюдениях диагностирована дедифференцированная форма заболевания. Важным в диагностике хордомы оказался иммуногистохимический метод, выявляющий экспрессию цитокератинов, EMA, GFAP, NSE, brachyury. Отрицательные реакции с хромогранином, D2-40, а также органоспецифическими белками TTF-1, mammaglobin, PSA, CDX-2 позволяли исключить хордому и выявить метастазы рака различной локализации. Приведен пример дифференциальной диагностики с доброкачественной опухолью нотохорды / рудиментарными островками ткани нотохорды.

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