Histology Course S IX 11 Department of Pathology, University of Zurich Histology Course

S IX 11 Ewing's sarcoma HE further information (German) on HiPaKu
  ICD-10: C40.2; ICD-O:9260/3

12-year-old boy suffering from pain and swelling in the area of the thigh. The X-ray shows permeative, patchy osteolysis in the area of the femur diaphysis and a reaction of the periost: onion bulb formation, Codman`s triangle. Biopsy.

- Neoplastic infiltrate in the bone marrow space, canalicular system and paraosteal soft tissue: small to medium sized round cells with little cytoplasm, round nuclei and medium sized nucleoli. Few mitoses. Glycogen granula can be seen.
- Note the destruction of the bone structure.

The occasional clinical presentation with warmth and reddening of the affected area, pyrexia and leucocytosis can mimic osteomyelitis.

Diagnosis: Other neoplasms of the “round cell sarcoma” type must  be excluded, such as malignant lymphoma, neuroblastoma and embryonal rhabdomyosarcoma.

Immunohistochemical analysis includes the following:
-LU-5 Antibody: cytokeratin
-lymphoma markers
-neuroendocrine markers