Soft tissue sarcomas: from immunohistochemistry to molecular biology. A practical approach

The cinicopathological classification of sarcomas in general, and specifically of soft tissue sarcomas, is becoming more complex, due not only to the increasing number of new entities identified in recent years, but also to the fact that most of these neoplasms have a common mesenchymal cell origin. Thus, these tumors might express a divergent phenotype with numerous histological varieties with overlapping features, producing confusion in their identification. Therefore, any histological study needs to be complemented with both immunohistochemistry and electron microscopy as well as with new ancillary techniques such as cytogenetics and especially molecular biology. Thus, nowadays it is mandatory to combine the clinical stage, histological grade histological variety and immunohistochemical characterization in order to obtain a clear pattern for a given sarcoma and its prognostic outcome. Additionally, cytogenetics and molecular biology identify two clearly different subgroups of sarcomas: those presenting mainly a small number of rearrangements with specific chromosomal and genetic translocations against a second, larger group of neoplasms harboring complex kariotype reorganizations and numerous genetic imbalances. Although few of these genetic reorganizations provide any additional value for establishing predictive or prognostic outcome for the patient, they have opened up new ways to obtain more precise classification, complementing conventional histology and simultaneously creating new possibilities for targeted therapy. This review on soft tissue sarcomas provides the most up-to-date findings in these fields, reviewing the clinical stage, histopathology, immunohistochemistry and molecular biology of the major soft-tissue tumor types based upon the WHO classification.

immunohistochemestry, soft tissue sarcoma, sarcoma subtypes, cytogenetics

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