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Sarcomas are a group of uncommon malignant neoplasms occurring in both bone and soft tissue with a wide range of histologic types and prognoses.
Tests generally appear in the order most useful for common clinical situations
| Test name: DDIT3 (CHOP) (12q13) Gene Rearrangement by FISH |
| ARUP #: 0049378 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Diagnosis of myxoid/round cell liposarcoma in paraffin-embedded tissue |
| Limitations: Assay will indicate if translocation has occurred but will not identify the specific translocation partner |
| Test name: FOXO1 (FKHR) (13q14) Gene Rearrangement by FISH |
| ARUP #: 2001497 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Detect FKHR gene rearrangements for the diagnosis of alveolar rhabdomyosarcoma |
| Test name: EWSR1 (22q12) Gene Rearrangement by FISH |
| ARUP #: 0049335 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Differential diagnosis of small-cell neoplasms in paraffin-embedded tissue Diagnose ESFT neoplasm |
| Test name: Ewing Sarcoma by RT-PCR |
| ARUP #: 0051220 |
| Methodology: Reverse Transcription Polymerase Chain Reaction/Fluorescence Monitoring |
| Use: Detect the most common types of EWS-FLI1 translocations that occur in ESFT Distinguish between the EWS-FLI1 type 1 and type 2 fusions |
| Test name: SYT-SSX t(X;18) Translocations by RT-PCR |
| ARUP #: 0040114 |
| Methodology: Reverse Transcription Polymerase Chain Reaction/Fluorescence Monitoring |
| Use: Diagnose synovial sarcoma |
| Test name: SS18 (SYT) (18q11) Gene Rearrangement by FISH |
| ARUP #: 0049380 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Diagnose synovial sarcoma |
| Test name: MDM2 Gene Amplification by FISH |
| ARUP #: 2003016 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Diagnose well-differentiated liposarcoma (atypical lipomatous tumor) |
| Test name: Anaplastic Lymphoma Kinase 1 (ALK-1) by Immunohistochemistry |
| ARUP #: 2003439 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of inflammatory myofibroblastic tumors Stained and returned to client pathologist; consultation available if needed |
| Test name: CD21 (Dendritic Cell) by Immunohistochemistry |
| ARUP #: 2003535 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of follicular dendritic sarcoma Stained and returned to client pathologist; consultation available if needed |
| Test name: CD34, QBEnd/10 by Immunohistochemistry |
| ARUP #: 2003556 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of solitary fibrous tumor Stained and returned to client pathologist; consultation available if needed |
| Test name: CD56 (NCAM) by Immunohistochemistry |
| ARUP #: 2003589 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of rhabdomyosarcoma, neuroblastoma Stained and returned to client pathologist; consultation available if needed |
| Test name: Ewing Sarcoma (O13) by Immunohistochemistry |
| ARUP #: 2004055 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of Ewing sarcoma Stained and returned to client pathologist; consultation available if needed |
| Test name: CD117 (c-Kit) by Immunohistochemistry |
| ARUP #: 2003806 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of GIST, blasts Stained and returned to client pathologist; consultation available if needed |
| Test name: CDK4 by Immunohistochemistry |
| ARUP #: 2005534 |
| Methodology: Immunohistochemistry |
| Use: Distinguish well-differentiated liposarcoma (+) from benign adipose tumors (-), and distinguish dedifferentiated liposarcoma (+) from poorly differentiated sarcomas (-) Stained and returned to client pathologist; consultation available if needed |
| Test name: Desmin by Immunohistochemistry |
| ARUP #: 2003863 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of leiomyosarcomas, myogenic sarcomas, rhabdomyosarcoma, neuroblastomas and intra-abdominal desmoplastic small round cell tumors Stained and returned to client pathologist; consultation available if needed |
| Test name: Epithelial Membrane Antigen (EMA) by Immunohistochemistry |
| ARUP #: 2003872 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of synovial sarcoma Stained and returned to client pathologist; consultation available if needed |
| Test name: Friend Leukemia Integration-1 (Fli-1) by Immunohistochemistry |
| ARUP #: 2003887 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of Ewing and synovial sarcomas Stained and returned to client pathologist; consultation available if needed |
| Test name: INI1 (BAF47) by Immunohistochemistry |
| ARUP #: 2003448 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of rhabdomyosarcomas Stained and returned to client pathologist; consultation available if needed |
| Test name: Muscle-Specific Actin (MSA) by Immunohistochemistry |
| ARUP #: 2004011 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of soft tissue tumors with muscle differentiation (leiomyomas, leiomyosarcomas and rhabdomyosarcomas), some pleomorphic liposarcomas, glomus tumors, and desmoid tumors Stained and returned to client pathologist; consultation available if needed |
| Test name: Myogenin (Myf4) by Immunohistochemistry |
| ARUP #: 2004017 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of alveolar rhabdomyosarcomas Stained and returned to client pathologist; consultation available if needed |
| Test name: Myoglobin by Immunohistochemistry |
| ARUP #: 2004031 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of rhabdomyosarcoma Stained and returned to client pathologist; consultation available if needed |
| Test name: Myosin by Immunohistochemistry |
| ARUP #: 2004034 |
| Methodology: Immunohistochemistry |
| Use: Aid in smooth muscle differentiation Stained and returned to client pathologist; consultation available if needed |
| Test name: Smooth Muscle Actin (SMA) by Immunohistochemistry |
| ARUP #: 2004130 |
| Methodology: Immunohistochemistry |
| Use: Aid in differentiating leiomyosarcoma from rhabdomyosarcoma Stained and returned to client pathologist; consultation available if needed |
| Test name: Ulex Europaeus Agglutinin 1 (UEA-1) by Immunohistochemistry |
| ARUP #: 2004172 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of angiosarcomas Stained and returned to client pathologist |
| Test name: Vimentin by Immunohistochemistry |
| ARUP #: 2004181 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of schwannomas Stained and returned to client pathologist; consultation available if needed |
| Test name: Wilms Tumor (WT-1), N-terminus by Immunohistochemistry |
| ARUP #: 2004184 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of desmoplastic round-cell tumors Stained and returned to client pathologist; consultation available if needed |
| Test name: MDM2 by Immunohistochemistry |
| ARUP #: 2005848 |
| Methodology: Immunohistochemistry |
| Use: Aid in histologic diagnosis of desmoplastic round-cell tumors Stained and returned to client pathologist; consultation available if needed |
| Test name: Chromosome FISH, Interphase |
| ARUP #: 2002298 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Differential diagnosis of small-cell neoplasms in fluid-based samples Order EWSR1 for determining presence of 22q12 translocation Indicate names of probes needed for testing Order SYT for determining presence of SYT (SS18) 18q11.2 translocation |
| Limitations: EWSR1 FISH does not identify the 22q12 translocation partner; therefore, this test by itself cannot distinguish between sarcomas involving EWSR1 (eg, ESFT, desmoplastic small round-cell tumor, clear cell sarcoma, and myxoid chondrosarcoma) |
| Test name: Chromosome Analysis, Solid Tumor |
| ARUP #: 2002296 |
| Methodology: Giemsa-Band Analysis |
| Use: Detect recurrent chromosome abnormalities in tumor biopsy consistent with the diagnosis of a sarcoma |
| Limitations: Tumor cells may not grow well in culture and may not be present in the cells analyzed; test should be performed in conjunction with interphase FISH when either a EWSR1 or SYT translocation is in the differential |