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Yorita K, Kuroda N, Naroda T, Tamura M, Ohe C, Divatia M, Amin MB, Cubilla AL, Kazakov DV, Hes O, Michal M, Michal M. Penile warty mucoepidermoid carcinoma with features of stratified mucin-producing intra-epithelial lesion and invasive stratified mucin-producing carcinoma. Histopathology 2018; 72:867-873. [DOI: 10.1111/his.13438] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 10/10/2017] [Accepted: 11/10/2017] [Indexed: 11/27/2022]
Affiliation(s)
- Kenji Yorita
- Department of Diagnostic Pathology; Japanese Red Cross Kochi Hospital; Kochi-city Kochi Japan
| | - Naoto Kuroda
- Department of Diagnostic Pathology; Japanese Red Cross Kochi Hospital; Kochi-city Kochi Japan
| | - Takushi Naroda
- Department of Urology; Japanese Red Cross Kochi Hospital; Kochi-city Kochi Japan
| | - Masato Tamura
- Department of Urology; Japanese Red Cross Kochi Hospital; Kochi-city Kochi Japan
| | - Chisato Ohe
- Department of Pathology and Laboratory Medicine; Cedars-Sinai Medical Center; Los Angeles CA USA
| | - Mukul Divatia
- Department of Pathology and Laboratory Medicine; Cedars-Sinai Medical Center; Los Angeles CA USA
| | - Mahul B Amin
- Department of Pathology and Laboratory Medicine; University of Tennessee Health Sciences Center; Memphis TN USA
| | - Antonio L Cubilla
- Instituto de Patologia e Investigacion; Universidad Nacional de Asuncion; Asuncion Paraguay
| | - Dimitry V Kazakov
- Department of Pathology; Charles University; Medical Faculty and Charles University Hospital Plzen; Pilsen Czech Republic
| | - Ondrej Hes
- Department of Pathology; Charles University; Medical Faculty and Charles University Hospital Plzen; Pilsen Czech Republic
| | - Michael Michal
- Department of Pathology; Charles University; Medical Faculty and Charles University Hospital Plzen; Pilsen Czech Republic
| | - Michal Michal
- Department of Pathology; Charles University; Medical Faculty and Charles University Hospital Plzen; Pilsen Czech Republic
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Llamas-Velasco M, Mentzel T, Rütten A. Primary cutaneous secretory carcinoma: A previously overlooked low-grade sweat gland carcinoma. J Cutan Pathol 2018; 45:240-245. [PMID: 29205457 DOI: 10.1111/cup.13092] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 11/22/2017] [Accepted: 11/28/2017] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Twelve cases of primary cutaneous secretory carcinoma (PCSC) have been published, 9 showing ETV6-NTRK3 translocation, a characteristic finding shared with secretory breast carcinoma and mammary analogue secretory carcinoma. CASE REPORT A 34-year-old female presented a solitary nodule on the right groin. Biopsy revealed a secretory carcinoma staining positive with CK7, CAM5.2, mammaglobulin and S100 and negative with GATA3, CK20, podoplanin, calponin and CDX2. ETV6-NTRK3 was demonstrated by Fluorescence in situ hybridization (FISH). DISCUSSION PCSC is a rare neoplasm, described in the skin in 2009, that affects more frequently females with a mean age of 42.3 years and it is most commonly located in axilla. Histopathologically, these tumor cells are characterized by bubbly eosinophilic secretions diastase-resistant and bland nuclei and they are arranged in various growth patterns, including microcystic, tubular, solid and papillary. S100, mammoglobin and CK7 are usually positive. We review the main histopathological features to rule out histopathologic mimics such as breast metastasis, salivary tumors, cribriform carcinoma and primary cutaneous adenoid cystic carcinoma. GATA3 negative staining, as in our case, can help to rule out breast metastasis. Moreover, long-term benign follow up (144 months) in this case as well as follow-up data on outcomes from literature review support that PCSC is a low-grade sweat gland carcinoma.
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Affiliation(s)
- Mar Llamas-Velasco
- Department of Dermatology, Hospital Universitario de la Princesa, Madrid, Spain
| | - Thomas Mentzel
- Friedrichshafen Dermatopathologie, Friedrichshafen, Germany
| | - Arno Rütten
- Friedrichshafen Dermatopathologie, Friedrichshafen, Germany
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Affiliation(s)
- Robert F Moore
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jonathan D Cuda
- Department of Dermatology, The Johns Hopkins University School of Medicine, Baltimore, Maryland
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Andreasen S, Skálová A, Agaimy A, Bishop JA, Laco J, Leivo I, Franchi A, Larsen SR, Erentaite D, Ulhøi BP, von Buchwald C, Melchior LC, Michal M, Kiss K. ETV6 Gene Rearrangements Characterize a Morphologically Distinct Subset of Sinonasal Low-grade Non-intestinal-type Adenocarcinoma: A Novel Translocation-associated Carcinoma Restricted to the Sinonasal Tract. Am J Surg Pathol 2017; 41:1552-1560. [PMID: 28719468 DOI: 10.1097/pas.0000000000000912] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Low-grade sinonasal adenocarcinomas (low-grade SNACs) of the sinonasal tract comprise a poorly characterized and histologically heterogeneous group of tumors. We describe three cases of a histologically distinct variant of low-grade SNAC characterized by ETV6 gene rearrangements. The patients included 2 women (aged 32 and 88 y) and a man (aged 75 y); all were initially treated with surgery alone. Follow-up ranged from 9 to 170 months with one patient having 2 local recurrences and none experiencing distant or regional metastases. Tumors were composed of cytologically bland columnar and cuboidal eosinophilic tumor cells with basally located nuclei arranged in tubular and tubulotrabecular patterns. Immunohistochemically, CK7, DOG1, GCDFP-15, and SOX10 were positive in all cases, and vimentin was positive in 2 cases. Scattered single cells or small groups of tumor cells were S-100 positive. Only one case had weak, focal expression of GATA3, and mammaglobin was consistently negative. Two cases had ETV6-NTRK3 gene fusions, whereas ETV6 had an unknown fusion partner gene in one case. The highly similar morphology, immunohistochemical profile, and genetics of the presented cases are suggestive of a specific disease. Although translocation-associated adenocarcinomas in the sinonasal tract have previously been described exclusively as salivary-type carcinomas, we present the first type of carcinoma characterized by recurrent genetic rearrangements and distinct phenotype occurring exclusively in the sinonasal tract with no known major salivary gland counterpart. We provisionally designate this tumor ETV6-rearranged low-grade SNAC. Identification of additional cases is necessary to fully appreciate the morphologic and biological spectrum of this disease.
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Affiliation(s)
- Simon Andreasen
- Departments of *Otorhinolaryngology Head & Neck Surgery and Audiology ∥∥Pathology, Rigshospitalet, Copenhagen University Hospital, Copenhagen †Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge ††Department of Pathology, Odense University Hospital, Odense ‡‡Department of Pathology, Aalborg University Hospital, Aalborg §§Department of Pathology, Aarhus University Hospital, Aarhus, Denmark ‡Department of Pathology, Faculty of Medicine, Charles University, Pilsen ¶The Fingerland Department of Pathology, Charles University Faculty of Medicine and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic §Institute of Pathology, University Hospital of Erlangen, Erlangen, Germany ∥Departments of Pathology, Otolaryngology, and Oncology, The Johns Hopkins Medical Institutions, Baltimore, MD #Department of Pathology and Forensic Medicine, University of Turku, Turku, Finland **Department of Surgery and Translational Medicine, Division of Anatomic Pathology, University of Florence, Florence, Italy
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Genomic profiling of breast secretory carcinomas reveals distinct genetics from other breast cancers and similarity to mammary analog secretory carcinomas. Mod Pathol 2017; 30:1086-1099. [PMID: 28548128 DOI: 10.1038/modpathol.2017.32] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2017] [Revised: 02/28/2017] [Accepted: 02/28/2017] [Indexed: 12/23/2022]
Abstract
Secretory carcinomas of the breast are rare tumors with distinct histologic features, recurrent t(12;15)(p13;q25) translocation resulting in ETV6-NTRK3 gene fusion and indolent clinical behavior. Mammary analog secretory carcinomas arising in other sites are histopathologically similar to the breast tumors and also harbor ETV6-NTRK3 fusions. Breast secretory carcinomas are often triple (estrogen and progesterone receptor, HER2) negative with a basal-like immunophenotype. However, genomic studies are lacking, and whether these tumors share genetic features with other basal and/or triple negative breast cancers is unknown. Aside from shared ETV6-NTRK3 fusions, the genetic relatedness of secretory carcinomas arising in different sites is also uncertain. We immunoprofiled and sequenced 510 cancer-related genes in nine breast secretory carcinomas and six salivary gland mammary analog secretory carcinomas. Immunoprofiles of breast and salivary gland secretory carcinomas were similar. All the tumors showed strong diffuse MUC4 expression (n=15), and SOX10 was positive in all nine breast and in five out of six salivary gland tumors. All breast secretory carcinomas were triple negative or weakly ER-positive, and all tumors at both the sites expressed CK5/6 and/or EGFR, consistent with a basal-like phenotype. Sequencing revealed classic ETV6-NTRK3 fusion genes in all cases, including in carcinoma in situ of one breast tumor. Translocations were reciprocal and balanced in six out of nine breast and three out of six salivary gland tumors and were complex in three others. In contrast to most breast basal carcinomas, the mutational burden of secretory carcinomas was very low, and no additional pathogenic aberrations were identified in genes typically mutated in breast cancer. Five (56%) breast and two (33%) salivary gland tumors had simple genomes without copy number changes; the remainder had very few changes, averaging 1.3 per tumor. The ETV6-NTRK3 derivative chromosome was duplicated in one breast and one salivary gland tumor, and was the only copy number change in the latter. The findings highlight breast secretory carcinoma as a subtype more closely related to mammary analog secretory carcinoma than to basal/triple negative breast cancers of no special type. Lack of pathogenic mutations in common cancer-related genes suggests that ETV6-NTRK3 alone may suffice to drive these tumors and likely helps explain their indolent behavior.
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57
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Geyer FC, Pareja F, Weigelt B, Rakha E, Ellis IO, Schnitt SJ, Reis-Filho JS. The Spectrum of Triple-Negative Breast Disease: High- and Low-Grade Lesions. THE AMERICAN JOURNAL OF PATHOLOGY 2017; 187:2139-2151. [PMID: 28736315 DOI: 10.1016/j.ajpath.2017.03.016] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 03/27/2017] [Indexed: 02/06/2023]
Abstract
Triple-negative breast cancer is viewed clinically as an aggressive subgroup of breast cancer. In fact, most triple-negative breast cancers are poor-prognosis tumors with a complex genomic landscape. However, triple-negative disease is vastly heterogeneous, encompassing multiple entities with marked genetic, transcriptional, histologic, and clinical differences, with neoplasms in this group ranging from low to high grade. Among the less common low-grade triple-negative lesions, two large subgroups, both with a rather indolent behavior, can be distinguished: a low-grade triple-negative breast neoplasia family, which includes nonobligate precursors of triple-negative breast cancer, and, despite being low-grade, harbors the complex genomic landscape of usual triple-negative breast cancer, and the salivary gland-like tumors of the breast, lacking all the cardinal molecular features of conventional triple-negative breast cancer and underpinned by specific fusion genes or hotspot mutations, which may be of diagnostic and possibly therapeutic utility. Progression to high-grade triple-negative breast cancer likely occurs in both subgroups but at different rates. In this review, we describe the heterogeneity of triple-negative disease, focusing on the histologic and molecular features of the low-grade lesions. Recognition that triple-negative breast cancer is an operational term and that triple-negative disease is heterogeneous and includes low-grade forms driven by distinct sets of genetic alterations is germane to the successful implementation of precision medicine.
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Affiliation(s)
- Felipe C Geyer
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Fresia Pareja
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Britta Weigelt
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Emad Rakha
- Department of Pathology, Nottingham University, Nottingham, United Kingdom
| | - Ian O Ellis
- Department of Pathology, Nottingham University, Nottingham, United Kingdom
| | - Stuart J Schnitt
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts.
| | - Jorge S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
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Viswanathan K, McMillen B, Cheng E, D’Alfonso T, Patel A, Hoda SA. Juvenile Papillomatosis (Swiss-Cheese Disease) of Breast in an Adult Male With Sequential Diagnoses of Ipsilateral Intraductal, Invasive, and Widely Metastatic Carcinoma: A Case Report and Review of the Disease in Males. Int J Surg Pathol 2017; 25:536-542. [DOI: 10.1177/1066896917705198] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Juvenile papillomatosis of the breast (JPB, also known as Swiss cheese disease) is a rare ailment that typically afflicts young females, and presents as a mass-forming lesion. The lesional mass usually comprises multiple cysts and duct stasis, amid a variety of proliferative and nonproliferative epithelial changes. The proliferative changes include papillary hyperplasia, florid hyperplasia, and papillary apocrine hyperplasia. Concurrent carcinoma (either in situ or invasive) is present in approximately 10% of cases at presentation, and subsequent carcinoma (either in situ or invasive) is diagnosed in about 10% of patients. About 20% of patients have a strong family history of breast carcinoma. A total of 10 cases of JPB have been previously reported in males, both children and adults, only one of which, in a 33-year-old, was associated with invasive carcinoma. Here, another case of JPB in a 45-year-old male—one with subsequent sequential diagnoses of ipsilateral intraductal carcinoma, invasive carcinoma, and widely metastatic carcinoma over the course of 15 years—is reported.
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Affiliation(s)
| | | | - Esther Cheng
- Weill Cornell Medical College, New York, NY, USA
| | | | - Ami Patel
- Weill Cornell Medical College, New York, NY, USA
| | - Syed A. Hoda
- Weill Cornell Medical College, New York, NY, USA
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