|
1
|
Agrawal S, Ameline B, Folpe AL, Azzato E, Astbury C, Mentzel T, Knapp C, Rütten A, Creytens D, Sukov W, Baumhoer D, Billings SD, Fritchie KJ. ALK-rearranged, CD34-positive spindle cell neoplasms resembling dermatofibrosarcoma protuberans: a study of seven cases. Histopathology 2024. [PMID: 38867577 DOI: 10.1111/his.15239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/22/2024] [Accepted: 05/25/2024] [Indexed: 06/14/2024]
Abstract
AIMS The majority of dermatofibrosarcoma protuberans (DFSP) harbour PDGFB or PDGFD rearrangements. We encountered ALK expression/rearrangement in a PDGFB/D-negative CD34-positive spindle cell neoplasm with features similar to DFSP, prompting evaluation of ALK-rearrangements in DFSP and plaque-like CD34-positive dermal fibroma (P-LDF). METHODS AND RESULTS We searched the archives of academic institutions for cases previously coded as DFSP and P-LDF. NGS-naïve or PDGFB-negative DFSP were screened for ALK (clone D5F3) expression by immunohistochemistry. NGS or ALK FISH was performed on ALK-positive cases. Methylome profiling studies were performed and compared with conventional DFSP. One case of "DFSP" and two "P-LDF" with ALK expression were identified from the archives, while four cases were detected prospectively. These seven cases (6F:1M; 8 months to 76 years) arose in the dermis of the arm (two), scalp, eyelid, thigh, abdomen, and shoulder and ranged from 0.4 to 4.2 cm. Tumours were composed of spindled cells and displayed a storiform growth pattern. Cytologic atypia was absent, and mitotic figures were scarce (0-2/10 HPFs, high power fields). The lesional cells were diffusely positive for CD34 and ALK and negative for S100 protein. By NGS (n = 5), ALK fusion partners included DCTN1 (2), PLEKHH2, and CLIP2 in DFSP-like cases and FLNA in P-LDF-like lesions. ALK FISH was positive in one (of two) cases previously labelled P-LDF. Methylome profiling of two (of three) ALK-rearranged DFSP-like tumours showed clustering with conventional DFSP in the UMAP dimension reduction plot. To date, no tumour has recurred (n = 2; 26, 27 months). CONCLUSION We describe a cohort of novel ALK-rearranged tumours with morphologic features similar to DFSP.
Collapse
Affiliation(s)
- Shruti Agrawal
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
- Department of Dermatology, Mayo Clinic, Rochester, MN, USA
| | - Baptiste Ameline
- Bone Tumor Reference Center at the Institute for Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Andrew L Folpe
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Elizabeth Azzato
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Caroline Astbury
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Thomas Mentzel
- MVZ Dermatopathologie Friedrichshafen/Bodensee Part G, Friedrichshafen, Germany
| | - Calvin Knapp
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Arno Rütten
- MVZ Dermatopathologie Friedrichshafen/Bodensee Part G, Friedrichshafen, Germany
| | - David Creytens
- Department of Pathology, Ghent University and Ghent University Hospital, Ghent, Belgium
- CRIG, Cancer Research Institute Ghent, Ghent University and Ghent University Hospital, Ghent, Belgium
| | - William Sukov
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Daniel Baumhoer
- Bone Tumor Reference Center at the Institute for Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Steven D Billings
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| | - Karen J Fritchie
- Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
|
2
|
Cordier F, Ferdinande L, Hoorens A, Van de Vijver K, Van Dorpe J, Creytens D. Soft Tissue and Bone Tumor Diagnostics: Harnessing the Power of Molecular Techniques. Genes (Basel) 2023; 14:2229. [PMID: 38137051 PMCID: PMC10742688 DOI: 10.3390/genes14122229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 12/12/2023] [Accepted: 12/15/2023] [Indexed: 12/24/2023] Open
Abstract
Since the introduction of new molecular techniques, the diagnostic landscape of soft tissue and bone tumors has expanded greatly over the past few years. The use of new molecular techniques has led to the identification of new genetic alterations and, therefore, to a better understanding of tumorigenesis, tumor detection and classification. Furthermore, methylation profiling has emerged as a classification tool for soft tissue and bone tumors. Molecular pathology also plays an important role in the determination of patient prognosis and in the identification of targets that can be used for targeted therapy. As a result, molecular pathology has gained a more prominent role in the daily practice of the surgical pathologist. This review delves into various molecular techniques applied in the surgical pathology of soft tissue and bone tumors. It highlights their applications through the analysis of five specific cases.
Collapse
Affiliation(s)
- Fleur Cordier
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
- CRIG, Cancer Research Institute Ghent, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Liesbeth Ferdinande
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
| | - Anne Hoorens
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
| | - Koen Van de Vijver
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
- CRIG, Cancer Research Institute Ghent, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - Jo Van Dorpe
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
- CRIG, Cancer Research Institute Ghent, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| | - David Creytens
- Department of Pathology, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium; (F.C.); (L.F.); (A.H.); (K.V.d.V.); (J.V.D.)
- CRIG, Cancer Research Institute Ghent, Ghent University Hospital, Ghent University, 9000 Ghent, Belgium
| |
Collapse
|
|
3
|
Li J, Zheng Z, Deng H, Men Y, Chen Y, Han Q. Extraskeletal myxoid chondrosarcoma of the gingival: a rare case report and review of the literature. Diagn Pathol 2023; 18:103. [PMID: 37705036 PMCID: PMC10498572 DOI: 10.1186/s13000-023-01390-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 09/03/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Extraskeletal myxoid chondrosarcoma (EMC) is a rare malignant tumor described in the head and neck region, especially in the gingival. We present one case arising in the gingival of right mandible, and briefly reviewed the related literature. CASE PRESENTATION A 24-year-old male patient with a lesion of 3.5*2.0 cm in buccal gingival of right posterior mandible for 2 months. The tumor was composed of cartilaginous structures and myxoid matrix. Immunohistochemical(IHC) showed that the tumor cells to be positive for vimentin, focally positive for S-100, negative for calponin, SMA, SOX10. The Ki-67 labelling index was 80%. Fluorescent in situ Hybridization (FISH) was positive for NR4A3 rearrangement. CONCLUSIONS Due to its unusual site and low incidence in the oral region, a combination of histological findings, immunohistochemistry, and molecular pathology as well as differential diagnosis with other diseases should be taken into consideration in the process of clinical diagnosis and treatment.
Collapse
Affiliation(s)
- Jiaqi Li
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
- State Key Laboratory of Oral Diseases &, Department of Oral Pathology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Zhijian Zheng
- State Key Laboratory of Oral Diseases &, Department of Oral Pathology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Hao Deng
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
- Department of Stomatology, The First People's Hospital of Ziyang, Ziyang, 641300, P.R. China
| | - Yi Men
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
- State Key Laboratory of Oral Diseases &, Department of Head and Neck Oncology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China
| | - Yu Chen
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China.
- State Key Laboratory of Oral Diseases &, Department of Oral Pathology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China.
| | - Qi Han
- State Key Laboratory of Oral Diseases &, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China.
- State Key Laboratory of Oral Diseases &, Department of Oral Pathology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, 610041, P.R. China.
| |
Collapse
|