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. 2023 Jul 1;45(5):e635-e638.
doi: 10.1097/MPH.0000000000002673. Epub 2023 Apr 6.

CD43-positive, EWSR1::FLI1 -rearranged Soft Tissue Sarcoma in a Pediatric Patient With History of B-Cell Acute Lymphoblastic Leukemia

Timothy J D Ohlsen  1   2 , Erin R Rudzinski  3   4 , Sandra D Bohling  3   4 , Yajuan J Liu  4 , Ezekiel J Maloney  5 , Antoinette W Lindberg  6 , Catherine M Albert  1   2 , Adam J Lamble  1   2 , Mallory R Taylor  1   2
Affiliations

CD43-positive, EWSR1::FLI1 -rearranged Soft Tissue Sarcoma in a Pediatric Patient With History of B-Cell Acute Lymphoblastic Leukemia

Timothy J D Ohlsen et al. J Pediatr Hematol Oncol. .

Abstract

Ewing sarcoma is a small round blue cell tumor typically characterized by an EWSR1 rearrangement and expression of CD99 and NKX2.2, without expression of hematopoietic markers such as CD45. CD43 is an alternative hematopoietic immunohistochemical marker often utilized in the workup of these tumors and its expression typically argues against Ewing sarcoma. We report a 10-year-old with history of B-cell acute lymphoblastic leukemia presenting with an unusual malignant shoulder mass with variable CD43 positivity, but with an EWSR1::FLI1 fusion detected by RNA sequencing. Her challenging workup highlights the utility of next-generation DNA-based and RNA-based sequencing methods in cases with unclear or conflicting immunohistochemical results.

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Conflict of interest statement

The authors declare no conflict of interest.

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