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Mylonakis A, Driva TS, Lykoudis P, Frountzas M, Machairas N, Tsapralis D, Toutouzas KG, Schizas D. Undifferentiated carcinoma with osteoclast-like giant cells of the pancreas: An individual participant data meta-analysis. Ann Hepatobiliary Pancreat Surg 2024; 28:125-133. [PMID: 38389117 PMCID: PMC11128790 DOI: 10.14701/ahbps.23-161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Undifferentiated carcinoma with osteoclast-like giant cells (UC-OGCs) of the pancreas is a rare neoplasm that accounts for less than 1% of all pancreatic malignancies. The aim of this study was to review the literature regarding UC-OGC, and to highlight its biological behavior, clinicopathologic characteristics, prognosis, and therapeutic options. A systematic review of the literature in PubMed/Medline and Scopus databases was performed (last search October 31st, 2023) for articles concerning pancreatic UC-OGC in the adult population. Fifty-seven studies met the inclusion criteria, involving 69 patients with a male-to-female ratio of 1.1:1 and a mean age of 62.96. Main symptoms included abdominal pain (33.3%), jaundice (14.5%), weight loss (8.7%), while fourteen patients (20.3%) were asymptomatic. Surgical resection was performed in 88.4% of cases. Survival rates at one, three, and five years were 58%, 44.7%, and 37.3% respectively. Sex, age, size (cut-off of 4 cm), location, and adjuvant treatment did not significantly affect patient survival. UC-OGC of the pancreas is a rare subtype of undifferentiated pancreatic carcinoma with a better prognosis than conventional pancreatic ductal adenocarcinoma or undifferentiated carcinoma without giant cells. The establishment of a dedicated patient registry is imperative to further delineate the optimal treatment for this uncommon clinical entity.
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Affiliation(s)
- Adam Mylonakis
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | - Tatiana S. Driva
- First Department of Pathology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Panagis Lykoudis
- Third Department of Surgery, National and Kapodistrian University of Athens, Attikon University Hospital, Athens, Greece
| | - Maximos Frountzas
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Nikolaos Machairas
- Second Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
| | | | - Konstantinos G. Toutouzas
- First Propaedeutic Department of Surgery, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece
| | - Dimitrios Schizas
- First Department of Surgery, National and Kapodistrian University of Athens, Laikon General Hospital, Athens, Greece
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Rusu A, Giuşcă SE, Apostol DGC, Ionescu L, Căruntu ID. Cephalic undifferentiated carcinoma with osteoclast-like giant cells arising from the main pancreatic duct: case report and literature review. Arch Clin Cases 2021; 6:6-21. [PMID: 34754903 PMCID: PMC8565694 DOI: 10.22551/2019.22.0601.10148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Undifferentiated carcinoma with osteoclast-like giant cell (UCOGC) is a ductal carcinoma variant with a recently reported more protracted survival and pathognomonic histology comprising two cell populations: the mononuclear tumoral cells and nontumoral multinucleated giant cells. It usually presents as a large heterogenic tumor with mixed solid-cystic components. The tumor develops from the ductal epithelium but the sequence of epithelial changes is often not identified due to the rapid tumoral growth and associated necrotic changes. We report a case of a 76-year-old patient diagnosed with cephalic UCOGC originating in the epithelium of the main pancreatic duct with endoluminal growth and foci of other ductal neoplasms (high-grade pancreatic intraepithelial neoplasia (PanIN) and conventional ductal carcinoma). The particularity of our case consists in the identification of the columnar epithelium conversion, through high-grade PanIN, into UCOGC specific malignant features, in a large size tumor - aspect usually reported in small tumors. Alongside our case we also present a brief literature review of cephalic UCOGC case reports and case series.
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Affiliation(s)
- Andreea Rusu
- Department of Morphofunctional Sciences I - Histology, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Simona Eliza Giuşcă
- Department of Morphofunctional Sciences I - Pathology, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Delia Gabriela Ciobanu Apostol
- Department of Morphofunctional Sciences I - Pathology, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania.,Department of Pathology "Sf. Spiridon" County Clinical Emergency Hospital, Iaşi, Romania
| | - Lidia Ionescu
- Department of Surgery, Third Surgery Clinic, "St. Spiridon" County Clinical Emergency Hospital, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania
| | - Irina-Draga Căruntu
- Department of Morphofunctional Sciences I - Histology, "Grigore T. Popa" University of Medicine and Pharmacy, Iaşi, Romania
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Cavalcanti E, Schena N, Serino G, Lantone G, Armentano R. Assessment and management of undifferentiated carcinoma with osteoclastic like giant cells of the pancreas: a case report and revision of literature. BMC Gastroenterol 2021; 21:247. [PMID: 34078293 PMCID: PMC8170928 DOI: 10.1186/s12876-021-01779-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 04/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Undifferentiated carcinoma with osteoclast-like giant cells (UCOGCs) is a rare and aggressive non endocrine pancreatic carcinoma characterized by the presence of osteoclastic giant cells mixed with mononuclear cell. Very few cases have been reported in the literature and the histogenesis is controversial as, at the time of diagnosis, the tumor is often of advanced size and stage and it is difficult to pathologically observe its relationship with the pancreatic duct. CASE PRESENTATION We present a case of 65-year-old male patient presenting with abdominal pain, nausea, and weight loss, which was treated with surgical resection. Histological examination revealed an undifferentiated pancreatic carcinoma with osteoclast-like giant cells. The patient underwent to a routine pylorus preserving pancreatoduodenectomy. Actually, the patient was in good performance status and disease-free five months. CONCLUSIONS Based on the present case and limited previous data, further researches preferably with large cohorts are necessary to clarify the pathogenesis of the neoplasm. However, as show in this case, histopathological and immunohistochemically studies are the gold standard for the diagnosis of UCPOGC. Investigation of the genomic alterations in UPOGCs could help to explain the histologic diversity of variant tumor and could provide a genetic basis for prognosis and treatment.
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Affiliation(s)
- Elisabetta Cavalcanti
- Histopathology Unit of National Institute of Gastroenterology "S. de Bellis," Research Hospital, Via Turi 27, 70013, Castellana Grotte, Bari, Italy.
| | - Nicolo' Schena
- Histopathology Unit of National Institute of Gastroenterology "S. de Bellis," Research Hospital, Via Turi 27, 70013, Castellana Grotte, Bari, Italy
| | - Grazia Serino
- Laboratory of Experimental Immunopathology, National Institute of Gastroenterology "S. de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Giulio Lantone
- Surgery Unit of National Institute of Gastroenterology "S. de Bellis," Research Hospital, Castellana Grotte, Bari, Italy
| | - Raffaele Armentano
- Histopathology Unit of National Institute of Gastroenterology "S. de Bellis," Research Hospital, Via Turi 27, 70013, Castellana Grotte, Bari, Italy
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Bazzichetto C, Luchini C, Conciatori F, Vaccaro V, Di Cello I, Mattiolo P, Falcone I, Ferretti G, Scarpa A, Cognetti F, Milella M. Morphologic and Molecular Landscape of Pancreatic Cancer Variants as the Basis of New Therapeutic Strategies for Precision Oncology. Int J Mol Sci 2020; 21:E8841. [PMID: 33266496 PMCID: PMC7700259 DOI: 10.3390/ijms21228841] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/16/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
To date, pancreatic cancer is still one of the most lethal cancers in the world, mainly due to the lack of early diagnosis and personalized treatment strategies. In this context, the possibility and the opportunity of identifying genetic and molecular biomarkers are crucial to improve the feasibility of precision medicine. In 2019, the World Health Organization classified pancreatic ductal adenocarcinoma cancer (the most common pancreatic tumor type) into eight variants, according to specific histomorphological features. They are: colloid carcinoma, medullary carcinoma, adenosquamous carcinoma, undifferentiated carcinoma, including also rhabdoid carcinoma, undifferentiated carcinoma with osteoclast-like giant cells, hepatoid carcinoma, and signet-ring/poorly cohesive cells carcinoma. Interestingly, despite the very low incidence of these variants, innovative high throughput genomic/transcriptomic techniques allowed the investigation of both somatic and germline mutations in each specific variant, paving the way for their possible classification according also to specific alterations, along with the canonical mutations of pancreatic cancer (KRAS, TP53, CDKN2A, SMAD4). In this review, we aim to report the current evidence about genetic/molecular profiles of pancreatic cancer variants, highlighting their role in therapeutic and clinical impact.
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Affiliation(s)
- Chiara Bazzichetto
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Claudio Luchini
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, 37134 Verona, Italy; (C.L.); (I.D.C.); (P.M.)
| | - Fabiana Conciatori
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Vanja Vaccaro
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Ilaria Di Cello
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, 37134 Verona, Italy; (C.L.); (I.D.C.); (P.M.)
| | - Paola Mattiolo
- Department of Diagnostics and Public Health, Section of Pathology, University and Hospital Trust of Verona, 37134 Verona, Italy; (C.L.); (I.D.C.); (P.M.)
| | - Italia Falcone
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Gianluigi Ferretti
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Aldo Scarpa
- Department ARC-Net Research Centre, University and Hospital Trust of Verona, 37126 Verona, Italy;
| | - Francesco Cognetti
- Medical Oncology 1, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (C.B.); (V.V.); (I.F.); (G.F.); (F.C.)
| | - Michele Milella
- Division of Oncology, University of Verona, 37126 Verona, Italy;
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Sato K, Urakawa H, Sakamoto K, Ito E, Hamada Y, Yoshimitsu K. Undifferentiated carcinoma of the pancreas with osteoclast-like giant cells showing intraductal growth and intratumoral hemorrhage: MRI features. Radiol Case Rep 2019; 14:1283-1287. [PMID: 31452826 PMCID: PMC6704396 DOI: 10.1016/j.radcr.2019.07.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 07/29/2019] [Accepted: 07/30/2019] [Indexed: 01/27/2023] Open
Abstract
We report a case of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells ocalized within the main pancreatic duct (MPD). A 61-year-old woman was referred to our hospital for evaluation of dilatation of the MPD that was detected on screening sonogram. Preoperative MR imaging revealed a small hypervascular tumor within the dilated MPD, showing high signal on R2* map and signal reduction on in-phase as compared to out-of-phase. R2* hyperintensity and in-phase signal reduction may be a characteristic feature of undifferentiated carcinoma of the pancreas with osteoclast-like giant cells, which indicates intratumoral hemorrhage even if they are small.
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Affiliation(s)
- Keisuke Sato
- Department of Radiology, Fukuoka University Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan
| | - Hiroshi Urakawa
- Department of Radiology, Fukuoka University Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan
| | - Keiko Sakamoto
- Department of Radiology, Fukuoka University Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan
| | - Emi Ito
- Department of Radiology, Fukuoka University Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan
| | - Yoshihiro Hamada
- Department of Pathology, Fukuoka University Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan
| | - Kengo Yoshimitsu
- Department of Radiology, Fukuoka University Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonan-ku, Fukuoka-shi, Fukuoka 814-0180, Japan
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6
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Tanigawa M, Naito Y, Akiba J, Kawahara A, Okabe Y, Ishida Y, Ishikawa H, Hisaka T, Fujita F, Yasunaga M, Shigaki T, Sudo T, Mihara Y, Nakayama M, Kondo R, Kusano H, Shimamatsu K, Okuda K, Akagi Y, Yano H. PD-L1 expression in pancreatic adenosquamous carcinoma: PD-L1 expression is limited to the squamous component. Pathol Res Pract 2018; 214:2069-2074. [PMID: 30477643 DOI: 10.1016/j.prp.2018.10.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/14/2018] [Accepted: 10/17/2018] [Indexed: 12/12/2022]
Abstract
AIM We examined the programmed death-ligand 1 (PD-L1) expression in surgically resected pancreatic adenosquamous carcinoma (PASC) samples. Furthermore, the detection rate was also assessed using biopsy cases obtained from endoscopic ultrasound-guided fine needle aspiration (EUS-FNA). METHODS Fifteen cases of PASC (six resected and nine EUS-FNA biopsied) from the Kurume University Hospital between 2009 and 2016 were used for the evaluation of PD-L1 expression. As a control group, 34 cases of pancreatic ductal adenocarcinomas (PDACs) were selected. To compare the positivity and intensity of PD-L1, two types of clones (SP263, E1L3N) were examined for immunostaining. Only the membrane expression of PD-L1 was regarded as positive. The PD-L1 expressions in the squamous cell carcinoma component (SCc), adenocarcinoma component (ACc), and immune cells were assessed separately. The ratio of PD-L1 expression was calculated by counting the positive tumor cells, and tumor proportion score (TPS) was applied (TPS; Null < 1%, low expression; 1 ≤ TPS ≤ 49% and high expression; ≥ 50%). RESULTS PD-L1 expression was observed in five surgical PASC samples (83%). This shows that SCc presented a high expression in these cases. However, the overall TPS indicated a low expression. In contrast, only one case (3%) was positive for PD-L1 in PDACs, and the TPS indicated a low expression. No differences in PD-L1 expression were observed between the two clones, SP263 and E1L3N. High PD-L1 expression in the EUS-FNA sample was found in only one case (11%). DISCUSSION Although assessment using the tumor cells of PASC samples obtained from EUS-FNA was difficult, this study suggests the selective expression of PD-L1 in the SCc of PASC. Furthermore, it was considered that immune checkpoint inhibitors could provide therapeutic effects selectively on the SCc for the entire range of TPSs, though the PD-L1 expression was low.
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Affiliation(s)
- Masahiko Tanigawa
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yoshiki Naito
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan; Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Akihiko Kawahara
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Yoshinobu Okabe
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yusuke Ishida
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hiroto Ishikawa
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Toru Hisaka
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Fumihiko Fujita
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Masafumi Yasunaga
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Takahiro Shigaki
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Tomoya Sudo
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yutaro Mihara
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Masamichi Nakayama
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Reiichiro Kondo
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Hironori Kusano
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | | | - Koji Okuda
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Yoshito Akagi
- Department of Surgery, Kurume University School of Medicine, Kurume, Japan
| | - Hirohisa Yano
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
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Naito Y, Kawahara A, Taira T, Takase Y, Murata K, Ishida Y, Okabe Y, Tanigawa M, Mihara Y, Nakayama M, Shimamatsu K, Yano H, Akiba J. Cytopathological and immunocytochemical findings of pancreatic anaplastic carcinoma with ZEB1 expression by means of touch imprint cytology. Diagn Cytopathol 2017; 46:198-203. [DOI: 10.1002/dc.23823] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 08/21/2017] [Accepted: 09/13/2017] [Indexed: 11/11/2022]
Affiliation(s)
- Yoshiki Naito
- Department of Diagnostic Pathology; Kurume University Hospital; Kurume Japan
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Akihiko Kawahara
- Department of Diagnostic Pathology; Kurume University Hospital; Kurume Japan
| | - Tomoki Taira
- Department of Diagnostic Pathology; Kurume University Hospital; Kurume Japan
| | - Yorihiko Takase
- Department of Diagnostic Pathology; Kurume University Hospital; Kurume Japan
| | - Kazuya Murata
- Department of Diagnostic Pathology; Kurume University Hospital; Kurume Japan
| | - Yusuke Ishida
- Division of Gastroenterology, Department of Internal Medicine; Kurume University; Kurume Japan
| | - Yoshinobu Okabe
- Division of Gastroenterology, Department of Internal Medicine; Kurume University; Kurume Japan
| | - Masahiko Tanigawa
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Yutaro Mihara
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Masamichi Nakayama
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | | | - Hirohisa Yano
- Department of Pathology; Kurume University School of Medicine; Kurume Japan
| | - Jun Akiba
- Department of Diagnostic Pathology; Kurume University Hospital; Kurume Japan
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8
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Kubota N, Naito Y, Kawahara A, Taira T, Yamaguchi T, Yoshida T, Abe H, Takase Y, Fukumitsu C, Murata K, Ishida Y, Okabe Y, Kimura Y, Tanigawa M, Mihara Y, Nakayama M, Yamaguchi R, Akiba J, Yano H. Granulocyte colony-stimulating factor-producing pancreatic anaplastic carcinoma in ascitic fluid at initial diagnosis: A case report. Diagn Cytopathol 2017; 45:463-467. [PMID: 28185423 DOI: 10.1002/dc.23682] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 01/18/2017] [Accepted: 01/24/2017] [Indexed: 11/09/2022]
Abstract
Granulocyte colony-stimulating factor (G-CSF)-producing pancreatic tumors are extremely rare. These tumors have an aggressive clinical course and no established treatment. Here, we report an autopsy case of G-CSF-production in pancreatic anaplastic carcinoma (PAC). A 72-year-old woman presented with a large pancreatic head mass and multiple liver metastases. Laboratory data showed leukocytosis (leukocyte count 113.3 × 103 /µL) and high serum G-CSF levels (441 pg/mL; normal range: <39.0 pg/mL). The ascitic fluid was submitted to our pathology laboratory at initial diagnosis. Cytopathology showed that smears from the ascitic fluid were highly cellular and contained numerous malignant cells, mainly in loose groupings. Occasional pseudoglandular formations and giant cells were also present. The malignant cells were round, and no spindle-shaped cells were visible. The nuclei were round to ovoid with coarsely granular chromatin and large prominent nucleoli. Upon immunocytochemistry, tumor cells were positive for G-CSF and vimentin; there was no E-cadherin expression. Histopathological examination of the tumor showed a mixed composition of adenocarcinomatous and sarcomatous regions. Upon immunohistochemistry, both components were positive for G-CSF. Few CD34-positive myeloblasts were observed in the bone marrow. Thus, we diagnosed this as a case of G-CSF production in PAC with leukocytosis. To the best of our knowledge, this is the first report on G-CSF expression immunocytochemically confirmed in PAC. Diagn. Cytopathol. 2017;45:463-467. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Nao Kubota
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Yoshiki Naito
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Akihiko Kawahara
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Tomoki Taira
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Tomohiko Yamaguchi
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Tomoko Yoshida
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Hideyuki Abe
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Yorihiko Takase
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Chihiro Fukumitsu
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Kazuya Murata
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Yusuke Ishida
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshinobu Okabe
- Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshizo Kimura
- Department of Diagnostic Pathology, St. Mary's Hospital, Kurume, Japan
| | - Masahiko Tanigawa
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Yutaro Mihara
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Masamichi Nakayama
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Rin Yamaguchi
- Department of Pathology and Laboratory Medicine, Kurume University Medical Center, Kurume, kurume, Japan
| | - Jun Akiba
- Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan
| | - Hirohisa Yano
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
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9
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Miura K, Kimura K, Amano R, Yamazoe S, Ohira G, Nishio K, Kametani N, Hirakawa K, Ohira M. Analysis of the origin of anaplastic pancreatic cancer and the mechanism of its dedifferentiation. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2017; 24:176-184. [PMID: 28064441 DOI: 10.1002/jhbp.429] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND We researched the origin and progression of anaplastic pancreatic cancer (APC) from the viewpoints of cell lineage, epithelial-mesenchymal transition (EMT) and cancer stem-like cells (CSC). METHODS Using specimens from patients with APC and differentiated pancreatic ductal adenocarcinoma (PDAC), expression of sex-determining region Y-box 9 (SOX9), E-cadherin, vimentin, ZEB1, Snail, N-cadherin, CD24 and CD44 was estimated using immunohistochemistry. RESULTS Almost all cases were positive for SOX9 expression. APC cases were negative, but many PDAC cases were positive for the expression of E-cadherin. A much higher number of APC cases than PDAC cases were positive for the expression of other EMT related proteins and for the expression of CSC related proteins. The ductal cancerous component of APC accounted for an average of 12% of the cancerous lesion and the expression of each marker in this component was similar to that of PDAC cases. CONCLUSIONS Anaplastic pancreatic cancer had pancreatic duct cell like features and might gain dedifferentiate components through EMT and the acquisition of CSC properties.
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Affiliation(s)
- Kotaro Miura
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kenjiro Kimura
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Ryosuke Amano
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Sadaaki Yamazoe
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Go Ohira
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kohei Nishio
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Naoki Kametani
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Kosei Hirakawa
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Masaichi Ohira
- Department of Surgical Oncology, Osaka City University Graduate School of Medicine, Osaka, Japan
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Muraki T, Reid MD, Basturk O, Jang KT, Bedolla G, Bagci P, Mittal P, Memis B, Katabi N, Bandyopadhyay S, Sarmiento JM, Krasinskas A, Klimstra DS, Adsay V. Undifferentiated Carcinoma With Osteoclastic Giant Cells of the Pancreas: Clinicopathologic Analysis of 38 Cases Highlights a More Protracted Clinical Course Than Currently Appreciated. Am J Surg Pathol 2016; 40:1203-16. [PMID: 27508975 PMCID: PMC4987218 DOI: 10.1097/pas.0000000000000689] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Undifferentiated carcinomas with osteoclastic giant cells of the pancreas (OGC) are rare tumors. The current impression in the literature is that they are highly aggressive tumors similar in prognosis to ductal adenocarcinomas. In this study, the clinicopathologic characteristics of 38 resected OGCs were investigated and contrasted with 725 resected pancreatic ductal adenocarcinomas without osteoclastic cells (PDCs). The frequency among systematically reviewed pancreatic cancers was 1.4%. OGCs showed a slight female predominance (62.9%, vs. 51.4% in PDCs). The mean age was 57.9 years (vs. 65.0). The mean size of invasive cancer was 5.3 cm (vs. 3.2). They were characterized by nodular, pushing-border growth, and 8 arose in tumoral intraepithelial neoplasms (4 in mucinous cystic neoplasms, 4 in intraductal papillary mucinous neoplasms type lesions), and 23 (61%) also showed prominent intraductal/intracystic growth. Twenty-nine (76%) had an invasive ductal/tubular adenocarcinoma component. Osteoid was seen in 12. Despite their larger size, perineural invasion and nodal metastasis were uncommon (31.6% and 22.6%, vs. 85.5% and 64.0%, respectively). Immunohistochemistry performed on 24 cases revealed that osteoclastic cells expressed the histiocytic marker CD68, and background spindle cells and pleomorphic/giant carcinoma cells often showed p53 and often lacked cytokeratin. Survival of OGCs was significantly better than that of PDCs (5 yr, 59.1% vs. 15.7%, respectively, P=0.0009). In conclusion, pancreatic OGCs present with larger tumor size and in slightly younger patients than PDC, 21% arise in mucinous cystic neoplasms/intraductal papillary mucinous neoplasms, and 61% show intraductal/intracystic polypoid growth. OGCs have a significantly better prognosis than is currently believed in the literature.
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Affiliation(s)
- Takashi Muraki
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - Michelle D. Reid
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - Olca Basturk
- Department of Pathology, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Kee-Taek Jang
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Gabriela Bedolla
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - Pelin Bagci
- Department of Pathology, Marmara University, Istanbul, Turkey
| | - Pardeep Mittal
- Department of Radiology, Emory University School of Medicine, GA, USA
| | - Bahar Memis
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - Nora Katabi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, NY, USA
| | | | | | - Alyssa Krasinskas
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
| | - David S. Klimstra
- Department of Pathology, Memorial Sloan Kettering Cancer Center, NY, USA
| | - Volkan Adsay
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, GA, USA
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Anaplastic adenocarcinoma of the pancreas. J Gastrointest Cancer 2014; 46:68-73. [PMID: 25417074 DOI: 10.1007/s12029-014-9669-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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12
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Togawa Y, Tonouchi A, Chiku T, Sano W, Doki T, Yano K, Uno H, Muronoi T, Kaneoya K, Shinagawa T, Harigaya K, Toyoda A. A case report of undifferentiated carcinoma with osteoclast-like giant cells of the pancreas and literature review. Clin J Gastroenterol 2010; 3:195-203. [PMID: 26190247 DOI: 10.1007/s12328-010-0160-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Accepted: 06/06/2010] [Indexed: 02/07/2023]
Abstract
Osteoclast-like giant cell tumors rarely arise in the pancreas. Here we report the case of a 78-year-old woman who was diagnosed with a well-defined 3 cm multilocular mass in the pancreatic body by the use of ultrasonography, computed tomography and magnetic resonance imaging. The rim and the septa of the tumor were well enhanced. The distal pancreas was removed with the spleen and the peripancreatic lymph nodes. Macroscopically, the mass was composed predominantly of a multilocular cystic tumor filled with hemorrhagic necrosis, and partly composed of solid components. A histopathological study showed a proliferation of multinucleated osteoclast-like giant cells and spindle cells. Although the predominant tumor cells were strongly positive for vimentin and CD68 and negative for epithelial markers, there were some sparsely scattered cytokeratin-positive neoplastic glands. Seventeen months after surgery, the patient is still alive and has had no recurrence. Below we review 32 cases of osteoclast-like giant cell tumor of the pancreas that have been reported in English literature since 2000.
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Affiliation(s)
- Yasuhiro Togawa
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan.
| | - Akihiko Tonouchi
- Department of Surgery, Saitama Red Cross Hospital, 8-3-33 Kamiochiai, Chuou, Saitama, Saitama, 338-8553, Japan
| | - Tsuyoshi Chiku
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Wataru Sano
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Tomoko Doki
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Kentaro Yano
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Hidehiko Uno
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Tomohiro Muronoi
- Department of Surgery, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Katsuhiko Kaneoya
- Department of Radiology, Kamitsuga General Hospital, 1-1033 Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Takashi Shinagawa
- Department of Gastroenterology, Kamitsuga General Hospital, 1-1033, Shimota, Kanuma, Tochigi, 322-8550, Japan
| | - Kenichi Harigaya
- Department of Molecular and Tumor Pathology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou, Chiba, Chiba, 260-8677, Japan
| | - Akihiro Toyoda
- Department of Molecular and Tumor Pathology, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuou, Chiba, Chiba, 260-8677, Japan
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