51
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Aramin H, Zaleski M, Prieto VG, Aung PP. Skin and superficial soft tissue neoplasms with multinucleated giant cells: Clinical, histologic, phenotypic, and molecular differentiating features. Ann Diagn Pathol 2019; 42:18-32. [DOI: 10.1016/j.anndiagpath.2019.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 06/28/2019] [Indexed: 11/16/2022]
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52
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Liu S, Zhou X, Song A, Huo Z, Yao S, Wang Y, Liu Y. Management of giant benign fibrous histiocytoma in the spinal region with pleural involvement: A case report. Medicine (Baltimore) 2019; 98:e17144. [PMID: 31574815 PMCID: PMC6775359 DOI: 10.1097/md.0000000000017144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE Benign fibrous histiocytoma with pleural involvement in spinal region is a highly unusual disease with no standard curative managements yet. The objective of this study is to report an extremely rare case of a giant benign fibrous histiocytoma with pleural involvement in spinal region successfully operated by posterior spinal surgery. The management of these unique cases has yet to be well-documented. PATIENT CONCERNS A 23-year-old man presented with a 2-month history of continuous and progressive back pain. A giant, expanding lesion of the T7 vertebral and paraspinal region with pleural involvement was identified. DIAGNOSES Computed tomography scan and magnetic resonance imaging of spine showed expanding lesion of the T7 vertebral and paraspinal region involving the right thoracic cavity, which presented as a solid tumor. Postoperative pathology confirmed the diagnosis of thoracic benign fibrous histiocytoma. INTERVENTIONS The patient underwent thoracic spinal canal decompression, complete tumor resection, pleural defect repair, and T4 to T10 internal fixation procedure via a posterior approach. OUTCOMES The patient's symptom improved significantly after the surgery, and the postoperative period was uneventful at the 2-year follow-up visit. There were no complications associated with the operation during the follow-up period. LESSONS In summary, the tumor's clinical features, imaging results, and pathological characteristics are unique. Combined efforts of specialists from orthopedics, thoracic surgery, neurosurgery, pathology, and medical oncology led to the successful diagnosis and management of this patient. Giant benign fibrous histiocytoma with pleural involvement in spinal region, although rare, should be part of the differential diagnosis when the patient presents with back pain and radiculopathy. We recommend the posterior or 1-stage anterior-posterior combined approach for complete resection of the giant thoracic benign fibrous histiocytoma when the tumor has caused severe symptoms or neurological deficits.
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Affiliation(s)
| | - Xi Zhou
- Department of Orthopaedic Surgery
| | - An Song
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission
| | - Zhen Huo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Science & Peking Union Medical College, Beijing, China
| | | | | | - Yong Liu
- Department of Orthopaedic Surgery
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53
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Cohen JN, Yeh I, Jordan RC, Wolsky RJ, Horvai AE, McCalmont TH, LeBoit PE. Cutaneous Non-Neural Granular Cell Tumors Harbor Recurrent ALK Gene Fusions. Am J Surg Pathol 2019; 42:1133-1142. [PMID: 30001233 DOI: 10.1097/pas.0000000000001122] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Non-neural granular cell tumor (NNGCT; also known as primitive polypoid granular cell tumor) is a rare neoplasm composed of large ovoid cells with abundant granular cytoplasm, variable nuclear pleomorphism, and the potential for regional lymph node spread. In contrast to conventional granular cell tumor (GCT), NNGCT lacks S100 expression and can exhibit greater nuclear atypia and mitotic activity. Therefore, we investigated clinicopathologic features of 12 NNGCT, and also used next-generation sequencing to identify potential driver events in a subset of NNGCT and 6 GCT. NNGCT demonstrated mild-to-moderate nuclear pleomorphism, variable mitotic activity (0 to 10/10 high-power fields), and were S100. Genetic analysis of 5 cutaneous NNGCT revealed gene fusions involving the anaplastic lymphoma kinase gene (ALK) in 3 cases (60%). Specifically, an interstitial deletion of chromosome 2 resulting in an in-frame fusion of dyanactin 1 (DCTN1) to ALK was identified in 2 cases, and a translocation resulting in a fusion between sequestosome 1 (SQSTM1) on chromosome 5 and ALK was identified in one case. Two of 6 GCT (33%) showed gains of chromosome 7. No other molecular or chromosomal alterations were detected in NNGCT and GCT. ALK immunohistochemistry revealed weak-to-moderate positivity in 4/9 cutaneous NNCGT (44%) including all 3 tumors with ALK fusions. Three oral NNGCT lacked ALK expression. NNGCT with ALK immunostaining did not have morphologic features distinguishing them from those without ALK staining. Our results demonstrate that a subset of NNGCT harbor ALK fusions, suggest that NNGCT are molecularly diverse, and further substantiate NNGCT as distinct from GCT.
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Affiliation(s)
| | - Iwei Yeh
- Dermatopathology.,Clinical Cancer Genomics Laboratory.,Helen Diller Cancer Center, University of California, San Francisco
| | - Richard C Jordan
- Dermatopathology.,Helen Diller Cancer Center, University of California, San Francisco.,Orofacial Sciences, Pathology & Radiation Oncology
| | - Rebecca J Wolsky
- Departments of Pathology.,Department of Pathology, Zuckerberg San Francisco General Hospital, San Francisco, CA
| | | | - Timothy H McCalmont
- Departments of Pathology.,Dermatopathology.,Helen Diller Cancer Center, University of California, San Francisco
| | - Philip E LeBoit
- Departments of Pathology.,Dermatopathology.,Helen Diller Cancer Center, University of California, San Francisco
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54
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Chang KTE, Tay AZE, Kuick CH, Chen H, Algar E, Taubenheim N, Campbell J, Mechinaud F, Campbell M, Super L, Chantranuwat C, Yuen ST, Chan JKC, Chow CW. ALK-positive histiocytosis: an expanded clinicopathologic spectrum and frequent presence of KIF5B-ALK fusion. Mod Pathol 2019; 32:598-608. [PMID: 30573850 DOI: 10.1038/s41379-018-0168-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/01/2018] [Accepted: 10/01/2018] [Indexed: 12/17/2022]
Abstract
In 2008, we presented three cases of ALK-positive histiocytosis as a novel systemic histiocytic proliferation of early infancy with hepatosplenomegaly and dramatic hematological disturbances. This series of 10 cases (including the original three cases) describes an expanded clinicopathological spectrum and the molecular findings of this histiocytic proliferation. Six patients had disseminated disease: five presented in early infancy with eventual disease resolution, and the sixth presented at 2 years of age and died of intestinal, bone marrow, and brain involvement. The other four patients had localized disease involving nasal skin, foot, breast, and intracranial cavernous sinus - the first three had no recurrence after surgical resection, while the cavernous sinus lesion showed complete resolution with crizotinib therapy. The lesional histiocytes were very large, with irregularly folded nuclei, fine chromatin, and abundant eosinophilic cytoplasm, sometimes with emperipolesis. There could be an increase in foamy histiocytes and Touton giant cells with time, resembling juvenile xanthogranuloma. Immunostaining showed that the histiocytes were positive for ALK, histiocytic markers (CD68, CD163) and variably S100, while being negative for CD1a, CD207, and BRAF-V600E. Next-generation sequencing-based anchored multiplex PCR (Archer® FusionPlex®) performed in six cases identified KIF5B-ALK gene fusion in five and COL1A2-ALK fusion in one. There was no correlation of gene fusion type with disease localization or dissemination. The clinicopathological spectrum of ALK-positive histiocytosis is broader than originally described, and this entity is characterized by frequent presence of KIF5B-ALK gene fusion. We recommend that every unusual histiocytic proliferative disorder, especially disseminated lesions, be tested for ALK expression because of the potential efficacy of ALK inhibitor therapy in unresectable or disseminated disease.
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Affiliation(s)
- Kenneth Tou En Chang
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore. .,Duke-NUS Medical School, Singapore, Singapore.
| | - Amos Zhi En Tay
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Chik Hong Kuick
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Huiyi Chen
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | - Elizabeth Algar
- Center for Cancer Research, Hudson Institute of Medical Research, Clayton, VIC, Australia.,Department of Molecular and Translational Science, Monash University, Clayton, VIC, Australia
| | - Nadine Taubenheim
- Center for Cancer Research, Hudson Institute of Medical Research, Clayton, VIC, Australia
| | - Janine Campbell
- Department of Hematology, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Francoise Mechinaud
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Martin Campbell
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Leanne Super
- Children's Cancer Centre, Royal Children's Hospital, Melbourne, VIC, Australia
| | - Chavit Chantranuwat
- Department of Pathology, Faculty of Medicine, Chulalongkorn University Hospital, Bangkok, Thailand
| | - S T Yuen
- Department of Pathology, St. Paul's Hospital, Hong Kong, SAR, China
| | - John K C Chan
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong, SAR, China
| | - Chung W Chow
- Department of Anatomical Pathology, Royal Children's Hospital, Melbourne, VIC, Australia.,Department of Pediatrics, University of Melbourne, Melbourne, VIC, Australia
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55
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ALK Gene Fusions in Epithelioid Fibrous Histiocytoma: A Study of 14 Cases, With New Histopathological Findings. Am J Dermatopathol 2019; 40:805-814. [PMID: 29329131 DOI: 10.1097/dad.0000000000001085] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Previous studies showed that ALK is often positive in epithelioid fibrous histiocytoma (EFH). Two cases of EFH with ALK gene fusions have been recorded. Our objective was to study a series of EFH to present histopathological variations of EFH, identify novel ALK gene fusions, and determine whether there is a correlation between histopathological features and particular gene. We investigated 14 cases of EFH, all ALK immunopositive. The cases were assessed histopathologically as well as for ALK and TFE-3 rearrangements using FISH and ALK gene fusions using next-generation sequencing. The analysis of the sequencing results was performed using the Archer Analysis software (v5; ArcherDX Inc). The study group consisted of 8 female and 6 male patients, ranging in age from 18 to 79 years (mean 42 years; median 37.5 years). All presented with a solitary lesion. Microscopically, most lesions were polypoid and composed of epithelioid cells with ample cytoplasm. In addition, a variable number of bi-, tri-, or multinucleated, spindled, multilobated, cells with eccentric nuclei, cells with nuclear pseudoinclusions, mucinous, and grooved cells were admixed. In 5 cases, the predominant epithelioid cell component consisted of rather small cells, whereas spindled cells dominated in 3 cases. Of these, 2 lesions were composed rather of pale eosinophilic to clear cells, occasioning a resemblance to PEComa or leiomyoma. Immunohistochemically, all cases expressed ALK and 11 were positive for TFE-3. The break apart test for ALK was positive in 11 cases, whereas specimens from the remaining 3 cases were not analyzable. ALK genes fusions were found in all but 3 cases and included SQSTM1-ALK (3), VCL-ALK (3), TMP3-ALK (2), PRKAR2A-ALK (1), MLPH-ALK (1), and EML4-ALK (1). No correlation between histological features and type of ALK fusion was found. TFE-3 break apart test was negative. It is concluded that ALK-immunopositive EFH shows ALK gene fusions that involve various protein-coding genes, implicated in a variety of biological processes. Rare variants of EFH rather consist of spindled "non-epithelioid" cells.
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56
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ALK-rearranged Tumors Are Highly Enriched in the STUMP Subcategory of Uterine Tumors. Am J Surg Pathol 2019; 43:64-74. [DOI: 10.1097/pas.0000000000001083] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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57
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58
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Anderson WJ, Hornick JL. Immunohistochemical correlates of recurrent genetic alterations in sarcomas. Genes Chromosomes Cancer 2018; 58:111-123. [DOI: 10.1002/gcc.22700] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 09/25/2018] [Accepted: 10/19/2018] [Indexed: 12/16/2022] Open
Affiliation(s)
- William J. Anderson
- Department of Pathology; Brigham and Women's Hospital and Harvard Medical School; Boston Massachusetts
| | - Jason L. Hornick
- Department of Pathology; Brigham and Women's Hospital and Harvard Medical School; Boston Massachusetts
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59
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Asahina M, Saito T, Hayashi T, Fukumura Y, Mitani K, Yao T. Clinicopathological effect of PLAG1 fusion genes in pleomorphic adenoma and carcinoma ex pleomorphic adenoma with special emphasis on histological features. Histopathology 2018; 74:514-525. [PMID: 30307055 DOI: 10.1111/his.13759] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Accepted: 09/24/2018] [Indexed: 01/05/2023]
Abstract
AIMS Pleomorphic adenoma gene 1 (PLAG1) rearrangement is well known in pleomorphic adenoma (PA), which is histologically characterised by admixed epithelial and mesenchymal components. Multiple fusion variants of PLAG1 and HMGA2 have been reported; currently, however, little is known regarding the clinicopathological impacts of these fusion types METHODS AND RESULTS: We examined the PLAG1- and HMGA2-related fusion status in 105 PAs and 11 cases of carcinoma ex PAs (CXPA) arising from salivary glands and lacrimal glands to elucidate their correlation to the clinicopathological factors. Forty cases harboured PLAG1 fusion genes: CTNNB1-PLAG1 in 22 cases, CHCHD7-PLAG1 in 14 cases and LIFR-PLAG1 in four cases. Only two cases possessed HMGA2 fusion genes. The mean age of LIFR-PLAG1-positive cases was significantly higher than that of CTNNB1-PLAG1- and CHCHD7-PLAG1-positive cases (P = 0.0358). PAs located in the submandibular gland demonstrated CTNNB1-PLAG1 fusion at a significantly higher rate than other fusions (P = 0.0109). Histologically, PLAG1 fusion-positive cases exhibited chondroid formation and plasmacytoid features more commonly (P = 0.043, P = 0.015, respectively) and myxoid abundant feature less frequently (P = 0.031) than PLAG1 fusion-negative cases. For CXPAs, four CTNNB1-PLAG1 fusions were detected in two salivary duct carcinomas and two myoepithelial carcinomas. Ductal formation was observed frequently (90.9%) in residual PA. CONCLUSIONS The presence of PLAG1 fusion was associated with specific histological features in PA. Detecting the PLAG1 fusion gene and searching residual ductal formation in salivary gland malignant tumours with extensive hyalinisation could be useful for diagnosis.
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Affiliation(s)
- Miki Asahina
- Department of Human Pathology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Tsuyoshi Saito
- Department of Human Pathology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Takuo Hayashi
- Department of Human Pathology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Yuki Fukumura
- Department of Human Pathology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Keiko Mitani
- Department of Human Pathology, School of Medicine, Juntendo University, Tokyo, Japan
| | - Takashi Yao
- Department of Human Pathology, School of Medicine, Juntendo University, Tokyo, Japan
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60
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Bayart CB, Pacheco MC, Gupta D. A rapidly-growing, exophytic papule on the nose of a 9-year-old Native American boy. Pediatr Dermatol 2018; 35:678-680. [PMID: 30211471 DOI: 10.1111/pde.13518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Cheryl B Bayart
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Maria Cristina Pacheco
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA, USA.,Department of Pathology, University of Washington, Seattle, WA, USA
| | - Deepti Gupta
- Department of Pathology, University of Washington, Seattle, WA, USA.,Division of Dermatology, Department of Pediatrics, Seattle Children's Hospital, Seattle, WA, USA
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61
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Choi JH, Ro JY. Cutaneous Spindle Cell Neoplasms: Pattern-Based Diagnostic Approach. Arch Pathol Lab Med 2018; 142:958-972. [DOI: 10.5858/arpa.2018-0112-ra] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—
Spindle cell neoplasms arising in the skin comprise a heterogeneous group of tumors with divergent lineages. Cutaneous spindle cell neoplasms are relatively common and present surgical pathologists with diagnostic challenges. Recognition of their histopathologies is important for correct diagnosis and management. The current review presents a pattern-based diagnostic approach to common cutaneous spindle cell neoplasms that often cause diagnostic difficulties.
Objective.—
To provide a useful guide for diagnosis of cutaneous spindle cell neoplasms.
Data Sources.—
PubMed (US National Library of Medicine) reports and the authors' personal experiences are reviewed.
Conclusions.—
The authors briefly summarize the histologic features and differential diagnoses of common cutaneous spindle cell neoplasms.
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Affiliation(s)
| | - Jae Y. Ro
- From the Department of Pathology, Yeungnam University College of Medicine, Daegu City, Korea (Dr Choi); and the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University, Houston, Texas (Dr Ro)
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62
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Perret RE, Jullie ML, Vergier B, Coindre JM, Le Loarer F. A subset of so-called dermal non-neural granular cell tumours are underlined by ALK
fusions, further supporting the idea that they represent a variant of epithelioid fibrous histiocytoma. Histopathology 2018; 73:532-534. [DOI: 10.1111/his.13645] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Raul E Perret
- Department of Biopathology; Bergonié Institut; Bordeaux France
| | - Marie-Laure Jullie
- Department of Pathology; CHU Bordeaux; Hôpital Haut Lévêque; Pessac France
| | - Beatrice Vergier
- Department of Pathology; CHU Bordeaux; Hôpital Haut Lévêque; Pessac France
- University of Bordeaux; Talence France
| | - Jean-Michel Coindre
- Department of Biopathology; Bergonié Institut; Bordeaux France
- University of Bordeaux; Talence France
| | - François Le Loarer
- Department of Biopathology; Bergonié Institut; Bordeaux France
- University of Bordeaux; Talence France
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63
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Wiggins J, Shipman A, Mentzel T, Carr RA. An enlarging pedunculated nodule on the shoulder of a 21-year-old man. Clin Exp Dermatol 2018; 43:738-741. [PMID: 29761530 DOI: 10.1111/ced.13550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2017] [Indexed: 11/26/2022]
Affiliation(s)
- J Wiggins
- Department of Histopathology, Warwick Hospital, Warwick, Warwickshire, UK
| | - A Shipman
- Queen Alexandra Hospital, Portsmouth, Hampshire, UK
| | - T Mentzel
- Dermatopathology, Bodensee, Friedrichshafen, Germany
| | - R A Carr
- Department of Histopathology, Warwick Hospital, Warwick, Warwickshire, UK
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64
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Nakayama R, Togashi Y, Baba S, Kaku Y, Teramoto Y, Sakurai T, Haga H, Takeuchi K. Epithelioid cell histiocytoma with SQSTM1-ALK fusion: a case report. Diagn Pathol 2018; 13:28. [PMID: 29747676 PMCID: PMC5946425 DOI: 10.1186/s13000-018-0704-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 04/27/2018] [Indexed: 12/15/2022] Open
Abstract
Background Epithelioid cell histiocytoma (ECH), which is also known as epithelioid benign fibrous histiocytoma, has been classified as a rare variant of fibrous histiocytoma (FH). However, the recent detection of ALK protein expression and/or ALK gene rearrangement in ECH suggests that it might be biologically different from conventional FH. Case presentation A 27-year-old male presented with nodule on his left foot, which had been present for 5 years. A macroscopic examination revealed an exophytic, hyperkeratotic nodule on the dorsum of the left foot. Tumorectomy was performed, and a microscopic examination showed a subepidermal lesion composed of sheets of tumor cells with oval to round nuclei and ill-defined eosinophilic cytoplasm. The tumor cells were diffusely positive for factor XIIIa and ALK, but were negative for AE1/AE3 keratin, alpha-smooth muscle actin, CD30, CD34, CD68, PU.1, melan A, MITF, and S-100 protein. ALK immunostaining showed a diffuse cytoplasmic staining pattern. ALK fluorescence in situ hybridization demonstrated break-apart signals, which was suggestive of ALK rearrangement. A 5′-rapid amplification of cDNA ends assay detected SQSTM1-ALK fusion, in which exon 5 of the SQSTM1 gene was fused to exon 20 of the ALK gene. The patient was free from recurrence and distant metastasis at the 1-year of follow-up. Conclusion We were able to demonstrate the SQSTM1-ALK fusion gene in ECH. Practically, detecting immunopositivity for ALK and appropriate cell-lineage markers are the key to diagnosing ECH.
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Affiliation(s)
- Ryuko Nakayama
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Yuki Togashi
- Pathology Project for Molecular Targets, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Satoko Baba
- Pathology Project for Molecular Targets, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Yo Kaku
- Department of Dermatology, Kyoto University Hospital, Kyoto, Japan
| | - Yuki Teramoto
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Takaki Sakurai
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan
| | - Hironori Haga
- Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan.
| | - Kengo Takeuchi
- Pathology Project for Molecular Targets, the Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
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65
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Perron E, Pissaloux D, Charon Barra C, Karanian M, Lamant L, Parfait S, Alberti L, de la Fouchardière A. Melanocytic Myxoid Spindle Cell Tumor With ALK Rearrangement (MMySTAR). Am J Surg Pathol 2018; 42:595-603. [DOI: 10.1097/pas.0000000000000973] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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66
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Dickson BC, Swanson D, Charames GS, Fletcher CD, Hornick JL. Epithelioid fibrous histiocytoma: molecular characterization of ALK fusion partners in 23 cases. Mod Pathol 2018; 31:753-762. [PMID: 29327718 DOI: 10.1038/modpathol.2017.191] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 10/23/2017] [Accepted: 10/26/2017] [Indexed: 02/08/2023]
Abstract
Epithelioid fibrous histiocytoma is a rare and distinctive cutaneous neoplasm. Most cases harbor ALK rearrangement and show ALK overexpression, which distinguish this neoplasm from conventional cutaneous fibrous histiocytoma and variants. SQSTM1 and VCL have previously been shown to partner with ALK in one case each of epithelioid fibrous histiocytoma. The purpose of this study was to examine a large cohort of epithelioid fibrous histiocytomas by next-generation sequencing to characterize the nature and prevalence of ALK fusion partners. A retrospective archival review was performed to identify cases of epithelioid fibrous histiocytoma (2012-2016). Immunohistochemistry was performed to confirm ALK expression. Targeted next-generation sequencing was applied on RNA extracted from formalin-fixed paraffin-embedded tissue to identify the fusion partners. Twenty-three cases fulfilled inclusion criteria. The mean patient age was 39 years (range, 8-74), there was no sex predilection, and >75% of cases involved the lower extremities. The most common gene fusions were SQSTM1-ALK (N=12; 52%) and VCL-ALK (N=7; 30%); the other four cases harbored novel fusion partners (DCTN1, ETV6, PPFIBP1, and SPECC1L). The pattern of ALK immunoreactivity was usually granular cytoplasmic (N=12; 52%) or granular cytoplasmic and nuclear (N=10; 43%); the case containing an ETV6 fusion partner showed nuclear staining alone. There was no apparent relationship between tumor morphology and the ALK fusion partner. In summary, SQSTM1 and VCL are the most common ALK fusion partners in epithelioid fibrous histiocytoma; DCTN1, ETV6, PPFIBP1, and SPECC1L represent rare fusion partners. The proteins encoded by these genes play diverse roles in scaffolding, cell adhesion, signaling, and transcription (among others) without clear commonalities. These findings expand the oncogenic promiscuity of many of these ALK fusion genes, which drive neoplasia in tumors of diverse lineages with widely varied clinical behavior. This is the first documented account of ETV6-ALK and SPECC1L-ALK translocations in neoplasms.
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Affiliation(s)
- Brendan C Dickson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Pathobiology and Laboratory Medicine, University of Toronto, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - David Swanson
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - George S Charames
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON, Canada.,Department of Pathobiology and Laboratory Medicine, University of Toronto, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
| | - Christopher Dm Fletcher
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
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67
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Murigu T, Bhatt N, Miller K, Palmer A, Melegh Z. Spindle cell-predominant epithelioid fibrous histiocytoma. Histopathology 2018; 72:1233-1236. [DOI: 10.1111/his.13484] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 02/05/2018] [Accepted: 02/06/2018] [Indexed: 01/03/2023]
Affiliation(s)
- Timothy Murigu
- Department of Pathology; Pathology Sciences; Southmead Hospital; Bristol UK
| | - Nidhi Bhatt
- Department of Pathology; Pathology Sciences; Southmead Hospital; Bristol UK
| | - Keith Miller
- Department of Pathology; Pathology Sciences; Southmead Hospital; Bristol UK
| | - Abigail Palmer
- Bristol Genetics Laboratory; Pathology Sciences; Southmead Hospital; Bristol UK
| | - Zsombor Melegh
- Department of Pathology; Pathology Sciences; Southmead Hospital; Bristol UK
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Abstract
This overview of mesenchymal tumors presenting in the skin and/or subcutis in children brings together the range of neoplasms and hamartomas which are seen in this age-group. It is not surprising from the perspective of the pediatric or general surgical pathologist that vascular anomalies, including true neoplasms and vascular malformations, are the common phenotypic category. Since there is considerable morphologic overlap among these lesions, clinicopathologic correlation may be more important than for many of the other mesenchymal tumors. The skin and subcutis are the most common sites of clinical presentation for the infantile myofibroma which is the most common of fibrous mesenchymal tumors in children. Several of the other mesenchymal tumors are more common adults-like dermatofibrosarcoma protuberans, but nonetheless have an important presence in children, even as a congenital neoplasm. A lipomatous tumor in a young child should be considered as a possible manifestation of an overgrowth syndrome.
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Affiliation(s)
- Louis P Dehner
- 1 Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children's Hospital, Washington University Medical Center, St. Louis, Missouri.,2 Dermatopathology Center and Division of Dermatology, Washington University Medical Center, St. Louis, Missouri
| | - Alejandro A Gru
- 3 Department of Pathology, University of Virginia, Charlottesville, Virginia.,4 Department of Dermatology, University of Virginia, Charlottesville, Virginia
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69
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Martinez AP, Zou Y, Billings SD, Folpe AL. “Chondroblastoma-like” epithelioid fibrous histiocytoma: A previously undescribed and potentially confusing variant. J Cutan Pathol 2017; 45:99-103. [DOI: 10.1111/cup.13068] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 09/27/2017] [Accepted: 10/19/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Anthony P. Martinez
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester Minnesota
| | - Youran Zou
- Department of Pathology; Cleveland Clinic Foundation; Cleveland Ohio
| | | | - Andrew L. Folpe
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester Minnesota
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70
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Intradermal Proliferative Fasciitis Occurring With Chondrodermatitis Nodularis Helicis. Am J Dermatopathol 2017; 40:139-141. [PMID: 29210713 DOI: 10.1097/dad.0000000000001027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Nodular fasciitis is a benign myofibroblastic tumor. Its uncommon variant, proliferative fasciitis (PF), can present in an even less common intradermal form. We report a case of intradermal PF of the ear in a 45-year-old man who presented with recurrent episodes of pain and swelling of the lesion. Histologic examination showed a dermal, nodular proliferation of ganglion-like basophilic fibroblasts with prominent nuclei and nucleoli, admixed with foamy histiocytes and areas of spindle cells arranged in intersecting fascicles in a fibromyxoid background. Lesional cells stained positive for smooth muscle actin and were negative for AE1/AE3, p63, and Melan-A. CD68 highlighted intervening histiocytes. We postulate that the underlying chondrodermatitis nodularis helicis was a triggering etiology, consistent with the current speculation that intradermal PF results from trauma.
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71
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Anaplastic Lymphoma Kinase in Cutaneous Malignancies. Cancers (Basel) 2017; 9:cancers9090123. [PMID: 28895885 PMCID: PMC5615338 DOI: 10.3390/cancers9090123] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/05/2017] [Accepted: 09/10/2017] [Indexed: 12/22/2022] Open
Abstract
Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase that has been implicated in the pathogenesis of a variety of neoplasms. As suggested by its name, ALK was first described as part of a translocation product in cases of anaplastic large-cell lymphoma, with other genetic and cytogenetic ALK mutations subsequently coming to attention in the development of many other hematologic and solid organ malignancies. ALK has now been shown to play a role in the pathogenesis of several cutaneous malignancies, including secondary cutaneous systemic anaplastic large-cell lymphoma (ALCL) and primary cutaneous ALCL, melanoma, spitzoid tumors, epithelioid fibrous histiocytoma, Merkel cell carcinoma, and basal cell carcinoma. The characterization of ALK-positivity in these cutaneous malignancies presents exciting opportunities for utilizing ALK-targeted inhibitors in the treatment of these diseases.
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72
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73
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Alomari AK, Brown N, Andea AA, Betz BL, Patel RM. Cutaneous syncytial myoepithelioma: A recently described neoplasm which may mimic nevoid melanoma and epithelioid sarcoma. J Cutan Pathol 2017; 44:892-897. [PMID: 28708250 DOI: 10.1111/cup.13005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 06/22/2017] [Accepted: 07/10/2017] [Indexed: 12/19/2022]
Abstract
Cutaneous syncytial myoepithelioma is a recently described rare tumor of the dermis. It is derived and composed purely of myoepithelial cells and shows a characteristic syncytial growth pattern of neoplastic cells with little intervening stroma and no recognizable ductal structures. It represents a diagnostic challenge to dermatopathologists given its rarity and unusual immunophenotype. Molecular testing for rearrangement of the EWSR1 gene plays a significant role in confirming the diagnosis in most cases. Herein, we present 2 cases with mundane clinical presentations and challenging histopathological findings. In both cases, the lesion was composed of relatively well-circumscribed proliferation of epithelioid and spindle cells in the superficial dermis growing in a syncytial fashion and showing focal adipocytic metaplasia. The 2 cases had slightly different immunohistochemical profiles, but shared focal positivity for S100, EMA and pan-keratin or p63. Break-apart FISH demonstrated the presence of an EWSR1 gene rearrangement confirming the diagnosis in both cases. We discuss the most important differential diagnoses, particularly melanocytic lesions and epithelioid sarcoma and the original diagnostic considerations that the cases were referred to us with. We also review the molecular features and spectrum of immunohistochemical findings in these lesions and their role in excluding entities in the differential diagnosis.
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Affiliation(s)
- Ahmed K Alomari
- Department of Pathology, Indiana University School of Medicine, Indianapolis, Indiana.,Department of Dermatology, Indiana University School of Medicine, Indianapolis, Indiana
| | - Noah Brown
- Department of Pathology, University of Michigan, School of Medicine, Ann Arbor, Michigan
| | - Aleodor A Andea
- Department of Pathology, University of Michigan, School of Medicine, Ann Arbor, Michigan.,Department of Dermatology, University of Michigan, School of Medicine, Ann Arbor, Michigan
| | - Bryan L Betz
- Department of Pathology, University of Michigan, School of Medicine, Ann Arbor, Michigan
| | - Rajiv M Patel
- Department of Pathology, University of Michigan, School of Medicine, Ann Arbor, Michigan.,Department of Dermatology, University of Michigan, School of Medicine, Ann Arbor, Michigan
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74
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ALK-positive Large B-cell Lymphoma: A Clinicopathologic Study of 26 Cases With Review of Additional 108 Cases in the Literature. Am J Surg Pathol 2017; 41:25-38. [PMID: 27740969 DOI: 10.1097/pas.0000000000000753] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Anaplastic lymphoma kinase-positive large B-cell lymphoma (ALK LBCL) is a rare, aggressive subtype of diffuse large B-cell lymphoma with characteristic ALK rearrangements. Diagnosis of ALK LBCL can be challenging because of its rarity, unique morphologic characteristics, and unusual immunophenotypic features, which significantly overlap with other hematologic and nonhematologic neoplasms. The purpose of this study is to further explore the clinicopathologic features of ALK LBCL to ensure the awareness and accurate diagnosis of this entity. We retrospectively reviewed the data from 26 cases in our institutions and additional 108 cases from the literature. ALK LBCL typically occurred in the lymph nodes of young and middle-aged, immunocompetent patients. The medium age was 35 years with a male to female ratio of 3.5:1. Vast majority of cases showed immunoblastic and/or plasmablastic morphology. All cases expressed ALK protein with a cytoplasmic granular pattern in most of them. Common B-cell markers (CD20, CD79a, and PAX5) were typically negative, but the tumor cells mostly expressed 2 B-cell transcriptional factors, BOB1 and OCT2. The 5-year overall survival (OS) was 34%, and the median survival was 1.83 years. In patients with stage III/IV disease, the 5-year OS was only 8%. Moreover, patients below 35 years of age had a significantly better OS than those aged 35 years or above.
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75
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ALK Rearrangement and Overexpression in an Unusual Cutaneous Epithelioid Tumor With a Peculiar Whorled “Perineurioma-like” Growth Pattern: Epithelioid Fibrous Histiocytoma. Appl Immunohistochem Mol Morphol 2017; 25:e46-e48. [DOI: 10.1097/pai.0000000000000418] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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76
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Compton LA, Doyle LA. Advances in the Genetic Characterization of Cutaneous Mesenchymal Neoplasms: Implications for Tumor Classification and Novel Diagnostic Markers. Surg Pathol Clin 2017; 10:299-317. [PMID: 28477882 DOI: 10.1016/j.path.2017.01.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Cutaneous mesenchymal neoplasms often pose significant diagnostic challenges; many such entities are rare or show clinical and histologic overlap with both other mesenchymal and non-mesenchymal lesions. Recent advances in the genetic classification of many cutaneous mesenchymal neoplasms have not only helped define unique pathologic entities and increase our understanding of their biology, but have also provided new diagnostic markers. This review details these recent discoveries, with a focus on their implications for tumor classification and diagnosis.
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Affiliation(s)
- Leigh A Compton
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA
| | - Leona A Doyle
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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77
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Jin Y, Shen X, Shen L, Sun Y, Chen H, Li Y. Ciliated muconodular papillary tumor of the lung harboringALKgene rearrangement: Case report and review of the literature. Pathol Int 2017; 67:171-175. [DOI: 10.1111/pin.12512] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2016] [Accepted: 01/09/2017] [Indexed: 01/04/2023]
Affiliation(s)
- Yan Jin
- Department of Pathology; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Xuxia Shen
- Department of Pathology; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Lei Shen
- Department of Pathology; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Yihua Sun
- Department of Thoracic Surgery; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Haiquan Chen
- Department of Thoracic Surgery; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
| | - Yuan Li
- Department of Pathology; Fudan University Shanghai Cancer Center; Shanghai China
- Department of Oncology; Shanghai Medical College; Fudan University; Shanghai China
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78
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A review of kinase fusions in melanocytic tumors. J Transl Med 2017; 97:158-165. [PMID: 27892929 DOI: 10.1038/labinvest.2016.122] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 10/03/2016] [Accepted: 10/23/2016] [Indexed: 01/03/2023] Open
Abstract
Translocations resulting in a kinase fusion are well reported in many tumor types and indeed can be defining, particularly in the case of hematopoietic malignancies. The recent reports of multiple protein kinase fusions within melanocytic neoplasms, particularly in those with spitzoid morphology, have heralded a new era of classification of these melanocytic tumors. Seen within approximately half of all spitzoid neoplasms and present within the full spectrum of benign, atypical, and malignant lesions, kinase fusions likely represent an early oncogenic event contributing to cell proliferation and growth. Although the presence of a kinase fusion does not seem to correlate with the biologic potential of a given lesion, documentation of a kinase fusion will likely be important, particularly in the case of spitzoid melanoma, as numerous specific kinase receptor inhibitors have shown promise as therapeutic agents in a subset of cases with kinase fusions. Interrogation of non-spitzoid melanomas for similar kinase fusions as a potential driving oncogenic mechanism has revealed some similarities and some differences. This review will focus on the kinase fusions described to date in spitzoid neoplasms and how subsequent studies have informed current melanoma research.
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79
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Costigan DC, Doyle LA. Advances in the clinicopathological and molecular classification of cutaneous mesenchymal neoplasms. Histopathology 2016; 68:776-95. [PMID: 26763770 DOI: 10.1111/his.12930] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In recent years, there have been several important refinements in the classification of cutaneous mesenchymal neoplasms, including the description of new tumour types, along with the identification of novel and recurrent molecular genetic findings. In addition to providing new insights into tumour biology, many of these advances have had significant clinical consequences with regard to diagnostics, management, and prognostication. Newly described entities include pseudomyogenic haemangioendothelioma, haemosiderotic fibrolipomatous tumour, and fibroblastic connective tissue naevus, which are reviewed in the context of the principal differential diagnoses and significant clinical implications. Genetic characterization of several soft tissue tumour types that occur in the skin has resulted in the identification of diagnostically useful markers: ALK gene rearrangement with corresponding ALK protein expression by immunohistochemistry in epithelioid fibrous histiocytoma; the WWTR1-CAMTA1 fusion gene with CAMTA1 protein expression in epithelioid haemangioendothelioma; MYC amplification and overexpression in radiation-associated angiosarcoma; and EWSR1 gene rearrangement in cutaneous myoepithelial tumours. Finally, the classification of intradermal smooth muscle tumours and unclassified/pleomorphic dermal sarcoma has been refined, resulting in both improved classification and improved prognostication. Many of the tumour types listed above are encountered not only by specialist dermatopathologists, but also by practising general surgical pathologists, and this review should therefore provide a widely applicable update on the histological and molecular classification of cutaneous mesenchymal neoplasms, along with the appropriate use of ancillary diagnostic tests, in particular immunohistochemistry, in the evaluation of such lesions and their histological mimics.
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Affiliation(s)
- Danielle C Costigan
- Department of Histopathology, St James's Hospital and Trinity College Dublin, Dublin, Ireland
| | - Leona A Doyle
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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80
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Mertens F, Antonescu CR, Mitelman F. Gene fusions in soft tissue tumors: Recurrent and overlapping pathogenetic themes. Genes Chromosomes Cancer 2015; 55:291-310. [PMID: 26684580 DOI: 10.1002/gcc.22335] [Citation(s) in RCA: 95] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 11/01/2015] [Accepted: 11/01/2015] [Indexed: 12/21/2022] Open
Abstract
Gene fusions have been described in approximately one-third of soft tissue tumors (STT); of the 142 different fusions that have been reported, more than half are recurrent in the same histologic subtype. These gene fusions constitute pivotal driver mutations, and detailed studies of their cellular effects have provided important knowledge about pathogenetic mechanisms in STT. Furthermore, most fusions are strongly associated with a particular histotype, serving as ideal molecular diagnostic markers. In recent years, it has also become apparent that some chimeric proteins, directly or indirectly, constitute excellent treatment targets, making the detection of gene fusions in STT ever more important. Indeed, pharmacological treatment of STT displaying fusions that activate protein kinases, such as ALK and ROS1, or growth factors, such as PDGFB, is already in clinical use. However, the vast majority (52/78) of recurrent gene fusions create structurally altered and/or deregulated transcription factors, and a small but growing subset develops through rearranged chromatin regulators. The present review provides an overview of the spectrum of currently recognized gene fusions in STT, and, on the basis of the protein class involved, the mechanisms by which they exert their oncogenic effect are discussed.
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Affiliation(s)
- Fredrik Mertens
- Department of Clinical Genetics, University and Regional Laboratories, Lund University, Lund, Sweden
| | | | - Felix Mitelman
- Department of Clinical Genetics, University and Regional Laboratories, Lund University, Lund, Sweden
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81
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Abstract
Primary myoepithelial neoplasms of soft tissue are uncommon, and have been increasingly characterized by clinicopathologic and genetic means. Tumors are classified as mixed tumor/chondroid syringoma, myoepithelioma, and myoepithelial carcinoma, and they share morphologic, immunophenotypic, and genetic features with their salivary gland counterparts. However, soft tissue myoepithelial tumors are classified as malignant based on the presence of cytologic atypia, in contrast to the criterion of invasive growth in salivary gland sites. This review discusses the clinicopathologic and morphologic characteristics, distinct variants, and currently known genetic alterations of myoepithelial neoplasms of soft tissue, skin, and bone.
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Affiliation(s)
- Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115, USA.
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82
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Leguellec S, Tournier E, Karanian M, Brousset P, Mazereeuw J, Coindre JM, Lamant L. Cutaneous inflammatory myofibroblastic tumours can be anaplastic lymphoma kinase-positive: report of the first four cases. Histopathology 2015; 68:297-302. [DOI: 10.1111/his.12759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Sophie Leguellec
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
| | - Emilie Tournier
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
| | - Marie Karanian
- Department of Dermatology; Larrey Hospital; CHU de Toulouse; Toulouse France
| | - Pierre Brousset
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
| | - Juliette Mazereeuw
- Department of Dermatology; Larrey Hospital; CHU de Toulouse; Toulouse France
| | | | - Laurence Lamant
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
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83
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LAMTOR1-PRKCD and NUMA1-SFMBT1 fusion genes identified by RNA sequencing in aneurysmal benign fibrous histiocytoma with t(3;11)(p21;q13). Cancer Genet 2015; 208:545-51. [PMID: 26432191 DOI: 10.1016/j.cancergen.2015.07.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2015] [Revised: 07/24/2015] [Accepted: 07/29/2015] [Indexed: 12/30/2022]
Abstract
RNA sequencing of an aneurysmal benign fibrous histiocytoma with the karyotype 46,XY,t(3;11)(p21;q13),del(6)(p23)[17]/46,XY[2] showed that the t(3;11) generated two fusion genes: LAMTOR1-PRKCD and NUMA1-SFMBT1. RT-PCR together with Sanger sequencing verified the presence of fusion transcripts from both fusion genes. In the LAMTOR1-PRKCD fusion, the part of the PRKCD gene coding for the catalytic domain of the serine/threonine kinase is under control of the LAMTOR1 promoter. In the NUMA1-SFMBT1 fusion, the part of the SFMBT1 gene coding for two of four malignant brain tumor domains and the sterile alpha motif domain is controlled by the NUMA1 promoter. The data support a neoplastic genesis of aneurysmal benign fibrous histiocytoma and indicate a pathogenetic role for LAMTOR1-PRKCD and NUMA1-SFMBT1.
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