PMC9262382_01
Microscopic appearance of sarcomas with YWHAE-NUTM2B. Microscopically, these tumor cells are made of small round cells, with scanty eosinophilic cytoplasm and a hyperchromatic nucleus (A, x200 magnification; D, x400 magnification). Immunostaining of Ki67 shows a high proliferative index (B, x200 magnification; E, x400 magnification). CD10 was only positive in a small focus of tumor cells (C, x200 magnification; F, x400 magnification).
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H&E shows these tumor cells are made of small round cells, with scanty eosinophilic cytoplasm and a hyperchromatic nucleus ( Figures 1A, D ). IHC examination shows positive Ki67 in approximately 60% of tumor cells ( Figures 1B, E ). CD10 was only positive in a small focus of tumor cells, which is a sensitive marker for endometrial stromal sarcoma ( Figures 1C, F ).
CT findings of pelvic sarcomas and lung metastasis over the course of patient's treatment. (A) Abdominal CT scan (November 12, 2021) showed abdominal and pelvic lesions, blurred surrounding intestinal fat space, and multiple enlarged lymph nodes behind the peritoneum, which were similar to the previous findings (October 20, 2021). Abdominal and pelvic effusions were more advanced than before. (B) Abdominal CT scan (December 29, 2021) showed abdominopelvic space occupation, blurred surrounding intestinal fat space, multiple enlarged lymph nodes in the retroperitoneum, and lesions smaller than previously observed (November 12, 2021). (C) Abdominal CT scan (February 19, 2022) showed abdominopelvic multiple occupancy, blurring of surrounding intestinal fat spaces, multiple enlarged lymph nodes in the retroperitoneum, and partial reduction of previous (December 29, 2021) lesions. (D) Chest CT scan (November 12, 2021) showed right pleural effusion with atelectasis, right pulmonary nodule, and possible metastasis. (E) Chest CT scan (December 29, 2021) showed the right pulmonary nodules disappeared compared to the previous ones, and new nodules were observed (possible metastasis). (F) Chest CT scan (February 19, 2022) showed the right pulmonary nodule disappeared compared with the anterior part.
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Abdominal and pelvic effusions were more advanced than before, and the chest CT scan showed right pleural effusion with atelectasis, right pulmonary nodule, and possible metastasis ( Figures 2A, D ). After 4 courses of antitumor therapy, a CT scan (February 19, 2022) showed abdominopelvic space occupation, blurred surrounding intestinal fat space, multiple enlarged lymph nodes in the retroperitoneum, and lesions smaller than previously observed (December 29, 2021) ( Figures 2B, C ). The right pulmonary nodules disappeared as compared with the previous ones, and new nodules were observed (possible metastasis) ( Figures 2E, F ).
Line graph shows s significant decrease in serum CA125 over the course of patient's treatment.
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The latest value of CA125 was already decreased to normal (16.0 U/ml) ( Figure 3 ).