Myxoinflammatory fibroblastic sarcoma: an immunohistochemical and molecular genetic study of 73 cases

Mod Pathol. 2020 Dec;33(12):2520-2533. doi: 10.1038/s41379-020-0580-6. Epub 2020 Jun 8.

Abstract

Myxoinflammatory fibroblastic sarcoma (MIFS) is a rare, low-grade soft tissue neoplasm preferentially arising in the extremities of young to middle-aged adults characterized histologically by a variegated appearance and absence of a distinctive immunophenotype. Herein we have evaluated a series of 73 cases of MIFS to define potential features and markers that may facilitate diagnosis. An immunohistochemical study with a large panel of antibodies showed strong positivity of the tumor cells for bcl-1 (94.5%), FXIIIa (89%), CD10 (80%), and D2-40 (56%). FISH and array comparative genomic hybridization (aCGH) were performed in a large subset of cases to investigate the utility for detecting the TGFBR3 and OGA t(1;10) rearrangement and BRAF abnormalities. Using a combination of FISH and/or aCGH, t(1;10) was detected in only 3 of 54 cases (5.5%). The aCGH study also demonstrated amplification of VGLL3 on chromosome 3 that was detected in 8 of 20 cases (40%). BRAF alterations were observed by FISH in 4 of 70 cases (5.7%) and correlated with gain of chromosome 3p12 (VGLL3). A novel fusion transcript involving exon 6 of ZNF335 and exon 10 of BRAF was identified in one case. Demonstration of amplification of VGLL3 on chromosome 3 in combination with expression of bcl-1 and FXIIIa may help support the diagnosis, however, due to their low specificity these markers are not sufficient for a definitive diagnosis in the absence of the appropriate clinical-pathological context. Until a more robust genetic or immunohistochemical signature is identified, the diagnosis of MIFS rests on its characteristic clinicopathological features.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor* / analysis
  • Biomarkers, Tumor* / genetics
  • Comparative Genomic Hybridization
  • Europe
  • Female
  • Fibroblasts / chemistry*
  • Fibroblasts / pathology
  • Fibrosarcoma / chemistry*
  • Fibrosarcoma / genetics*
  • Fibrosarcoma / pathology
  • Gene Amplification
  • Gene Fusion
  • Gene Rearrangement
  • Genetic Predisposition to Disease
  • High-Throughput Nucleotide Sequencing
  • Humans
  • Immunohistochemistry*
  • In Situ Hybridization, Fluorescence
  • Male
  • Middle Aged
  • Molecular Diagnostic Techniques*
  • Phenotype
  • Soft Tissue Neoplasms / chemistry*
  • Soft Tissue Neoplasms / genetics*
  • Soft Tissue Neoplasms / pathology
  • Translocation, Genetic
  • United States
  • Young Adult

Substances

  • Biomarkers, Tumor