Primary pulmonary osteosarcoma - Case report and molecular analysis

BACKGROUND. Primary pulmonary osteosarcoma is an extremely rare malignancy. To date, only 12 cases have been reported, with a high mortality rate. The authors report on a newly diagnosed patient and describe investigations th at were performed using immunohistochemistry and comparative genomic hybrid ization (CGH). METHODS. The clinical course of a woman age 37 years is presented. Along wi th routine histologic examination, immunohistochemistry was used to demonst rate differentiation-associated proteins, oncoproteins, and other markers; CGH analysis for genomic alterations; and histochemistry to demonstrate alk aline phosphatase activity. RESULTS, Immunohistochemical analysis showed Varying expression patterns us ing antibodies against a panel of tumor markers. Most notable was high over expression of BCL-2 and cyclin D. CGH analysis showed that this neoplasm co ntained a much higher level of genetic aberrations compared with skeletal o steosarcoma. CONCLUSIONS. This tumor exhibited features common to skeletal osteosarcomas but also had some unique features. Genome analysis suggests that this tumo r has several genetic aberrations in common with extraskeletal osteosarcoma . The novel regions of instability identified within the tumor genome may c ontribute toward the unique tumor phenotype and relative chemoresistance. ( C) 2001 American Cancer Society.