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Moodley J, Chebib I. Emerging fusion-associated mesenchymal tumours: a tabular guide and appraisal of five 'novel' entities. J Clin Pathol 2024:jcp-2024-209460. [PMID: 39304199 DOI: 10.1136/jcp-2024-209460] [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: 02/03/2024] [Accepted: 08/08/2024] [Indexed: 09/22/2024]
Abstract
AIMS The field of molecular pathology has undergone significant advancements in the clinical impact of sarcoma diagnosis, resulting in challenges to nosology of bone and soft tissue tumours. The surge in molecular data has led to the identification of novel fusions and description of new 'entities'. To illustrate this, we have selected five emerging entities with novel fusions: clear cell stromal tumour of the lung with YAP1::TFE3 fusion, GAB1::ABL1 fusion spindle cell neoplasm, NUTM1-rearranged sarcomas, NR1D1-rearranged sarcomas and calcified chondroid mesenchymal neoplasms. METHODS Literature for the relevant case reports and case series of these five entities were reviewed and clinicopathological data was collected. Additionally, this review includes a table format of recently described fusion-associated mesenchymal neoplasms. RESULTS The morphological and immunohistochemical features, along with diagnostic challenges, are discussed for each entity. CONCLUSIONS Here, we have provided a review of selected emerging mesenchymal neoplasms, which of these neoplasms will meet the threshold to be 'new entities' remains to be determined.
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Affiliation(s)
- Jinesa Moodley
- Anatomical Pathology, BC Cancer Agency, Vancouver, British Columbia, Canada
| | - Ivan Chebib
- Department of Pathology, Harvard Medical School, Boston, Massachusetts, USA
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Agaimy A, Perret R, Demicco EG, Gross J, Liu YJ, Azmani R, Engelmann C, Schubart C, Seppet J, Stoehr R, Le Loarer F, Dickson BC. GAB1::ABL1 fusions define a distinctive soft tissue neoplasm, with variable perineurial differentiation, and a predilection for children and young adults. Genes Chromosomes Cancer 2023; 62:449-459. [PMID: 36744864 DOI: 10.1002/gcc.23131] [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: 12/10/2022] [Revised: 01/14/2023] [Accepted: 02/01/2023] [Indexed: 02/07/2023] Open
Abstract
Although well known as a fusion partner in hematological malignancies, fusion genes involving the ABL proto-oncogene 1 (ABL1), mapping to chromosomal region 9q34.12, have only been anecdotally reported in five soft tissue tumors. These neoplasms have been variously reported as perineurioma, angiofibroma, and solitary fibrous tumor, and all have harbored a GAB1::ABL1 gene fusion; however, the nosology and clinicopathological characteristics of soft tissue tumors carrying this rare fusion have not been delineated. We herein describe eight tumors containing the GAB1::ABL1 fusion and review previously reported cases in a series to define their morphological spectrum, address immunohistochemical evidence for a line of differentiation, with special reference to the presence or absence of a perineurial immunophenotype, and gather insight into their behavior. The patients included four females and four males, aged 13-37 years (median, 24 years). Two cases each originated in the shoulder area, trunk, hands, and lower extremities, with a size range of 1.5-8 cm (median, 3.4 cm). Four tumors were deep and four superficial. All tumors were morphologically similar, being composed of bland fibroblast-like spindle to ovoid cells diffusely arranged in a paucivascular fibrous to fibromyxoid stroma with variable resemblance to soft tissue perineurioma. Mitotic activity was generally low (0-8 mitoses in 10 high-power fields [HPFs]; median, 1). All lesions had at least focally infiltrative margins, but they otherwise lacked pleomorphism and necrosis. Immunohistochemistry showed focal reactivity for CD34 (5/7), epithelial membrane antigen (EMA) (3/8), claudin1 (2/3), GLUT1 (4/6), and S100 (2/7); other markers, including MUC4 (0/7), desmin (0/9), and smooth muscle actin (SMA) (0/4), were negative. RNA sequencing revealed a GAB1::ABL1 fusion in all cases with exon 6 of GAB1 fused to exon 2 of ABL1. Treatments included various forms of surgical intervention in seven cases; one tumor was biopsied only. Limited follow-up was available for five patients. One tumor regrew rapidly within 1 month to 1.5 cm after an initial marginal excision and was re-excised with close margins. Four patients were disease-free at 1, 3, 14, and 25 months of follow-up. Metastases have not, to date, been observed. This series characterizes "GAB1::ABL1 fusion-positive spindle cell neoplasm" as a distinct entity, with overlapping features with soft tissue perineurioma and predilection for children and young adults.
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Affiliation(s)
- Abbas Agaimy
- Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center, European Metropolitan Area Erlangen-Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Raul Perret
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Elizabeth G Demicco
- Department of Pathology & Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - John Gross
- Department of Pathology, The Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Yajuan J Liu
- Department of Laboratory Medicine and Pathology, Clinical Genomics Laboratory, University of Washington School of Medicine, Seattle, Washington, USA
| | - Rihab Azmani
- Bioinformatics, Data and Digital Health Department, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Carsten Engelmann
- Department of Pediatric Surgery, Brandenburg Clinic Center, Berlin, Germany
| | - Christoph Schubart
- Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center, European Metropolitan Area Erlangen-Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - Joosep Seppet
- Pathology Department, Tartu University Hospital, Tartu, Estonia
| | - Robert Stoehr
- Institute of Pathology, Erlangen University Hospital, Comprehensive Cancer Center, European Metropolitan Area Erlangen-Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Erlangen, Germany
| | - François Le Loarer
- Department of Biopathology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
- Bordeaux Institute of Oncology, BRIC U1312, INSERM, Université de Bordeaux, Institut Bergonié, Bordeaux, France
| | - Brendan C Dickson
- Department of Pathology & Laboratory Medicine, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
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Choo F, Rakheja D, Davis LE, Davare M, Park JY, Timmons CF, Neff T, Beadling C, Corless CL, Davis JL. GAB1-ABL1 fusions in tumors that have histologic overlap with NTRK-rearranged spindle cell tumors. Genes Chromosomes Cancer 2021; 60:623-630. [PMID: 34036664 DOI: 10.1002/gcc.22972] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 05/09/2021] [Accepted: 05/13/2021] [Indexed: 12/16/2022] Open
Abstract
Fibroblastic spindle cell tumors are a heterogeneous group of rare soft tissue tumors that are increasingly recognized as associated with a variety of kinase gene fusions. We report two cases of GAB1-ABL1 fusions in spindle cell tumors that histologically overlap with neurotrophic tyrosine receptor kinase (NTRK)-rearranged spindle cell tumors. The first case occurred in a 76-year-old female who had a large deep-seated spindle cell tumor composed of monotonous ovoid to spindle cells in a background of thick stromal collagen bands with prominent hyalinized vessels and inconspicuous mitoses (<1/10 HPF). Immunohistochemical stains showed co-expression of S100 and CD34. A GAB1-ABL1 fusion was detected by whole transcriptome RNA sequencing. The patient had a partial response to imatinib. The second case was previously described as a solitary fibrous tumor, occurring in a 9-year-old female with a cellular spindle cell tumor with patchy CD34 immunoexpression but no expression of S100. Upon clinicopathologic re-review, including anchored multiplex next-generation sequencing, a GAB1-ABL1 fusion was identified. In summary, we report the first two cases of spindle cell tumors with variable expression of CD34 and/or S100, driven by GAB1-ABL1 gene fusions with histologic overlap with NTRK-rearranged spindle cell tumors, suggesting that ABL-fusions may also be oncogenic drivers within this spectrum of tumors. These cases highlight the evolving understanding of fibroblastic spindle cell tumor biology and the utility of sequencing in identifying a targetable alteration.
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Affiliation(s)
- Florence Choo
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA
| | - Dinesh Rakheja
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Children's Health, Dallas, Texas, USA
| | - Lara E Davis
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.,Division of Hematology and Medical Oncology, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA.,Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Monika Davare
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, USA.,Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Jason Y Park
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Children's Health, Dallas, Texas, USA
| | - Charles F Timmons
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Children's Health, Dallas, Texas, USA
| | - Tanaya Neff
- Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Carol Beadling
- Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA
| | - Christopher L Corless
- Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA.,Department of Pathology, Oregon Health & Science University, Portland, Oregon, USA
| | - Jessica L Davis
- Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon, USA.,Department of Pathology, Oregon Health & Science University, Portland, Oregon, USA
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Panagopoulos I, Gorunova L, Andersen K, Tafjord S, Lund-Iversen M, Lobmaier I, Micci F, Heim S. Recurrent Fusion of the GRB2 Associated Binding Protein 1 ( GAB1) Gene With ABL Proto-oncogene 1 ( ABL1) in Benign Pediatric Soft Tissue Tumors. Cancer Genomics Proteomics 2021; 17:499-508. [PMID: 32859628 DOI: 10.21873/cgp.20206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/22/2020] [Accepted: 06/01/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND/AIM Fusions of the ABL proto-oncogene 1 gene (ABL1 in 9q34) are common in leukemias but rare in solid tumors. The most notable is the t(9;22)(q34;q11)/BCR-ABL1 coding for a chimeric tyrosine kinase. We herein report an ABL1-fusion in a pediatric tumor. MATERIALS AND METHODS G-banding, fluorescence in situ hybridization, reverse transcription polymerase chain reaction and Sanger sequencing were performed on a soft tissue perineurioma found in the left musculus erector spinae of a child. RESULTS A der(4)t(4;9)(q31;q34) and a fusion of the GRB2 associated binding protein 1 (GAB1 in 4q31) gene with ABL1 were found. A literature search revealed 3 more cases with similar genetic and clinicopathological characteristics: a soft tissue perineurioma with t(2;9;4)(p23;q34;q31) and ABL1 rearrangement, a soft tissue angiofibroma with a GAB1-ABL1 chimeric gene, and a solitary fibrous tumor carrying a der(4)t(4;9)(q31.1;q34). CONCLUSION GAB1-ABL1 is a recurrent fusion gene in benign pediatric tumors.
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Affiliation(s)
- Ioannis Panagopoulos
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Ludmila Gorunova
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Kristin Andersen
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Svetlana Tafjord
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Marius Lund-Iversen
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Ingvild Lobmaier
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Francesca Micci
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Sverre Heim
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Rumayor Piña A, Flores Rodríguez O, Barbosa Rodríguez E, Vértiz Félix K, Flores Flores D. A 48-year-old female with an exophytic nodule in the buccal mucosa. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:95-99. [DOI: 10.1016/j.oooo.2018.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 07/24/2018] [Accepted: 08/14/2018] [Indexed: 10/28/2022]
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Ryder EN, Turnbull N, Emanuel PO. Multiple perineuriomatous melanocytic nevi. J Cutan Pathol 2018; 45:439-442. [DOI: 10.1111/cup.13134] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 02/13/2018] [Accepted: 02/16/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Emily N.C. Ryder
- Department of Biological Sciences; University of Auckland; Auckland New Zealand
| | - Nicholas Turnbull
- Department of Dermatology; Waitemata District Health Board; Auckland New Zealand
| | - Patrick O. Emanuel
- Department of Pathology and Laboratory Medicine; University of Auckland; Auckland New Zealand
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Tancredi A, Graziano P, Dimitri L, Impagnatiello E, Taurchini M. Left Supraclavicular Swelling: Sclerosing Perineurioma. Eurasian J Med 2018. [PMID: 29531493 DOI: 10.5152/eurasianjmed.2018.17214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A sclerosing perineurioma presents as a single asymptomatic papule or nodule located on the hands of adult patients; approximately 60 cases have been reported in medical literature since 1997. Histologically, it originates from the perineural cells of the peripheral nerves and presents epithelial membrane antigen (EMA) positivity and S100 protein negativity. Here, we present the case of a 58-year-old male admitted to our surgery unit complaining of left supraclavicular swelling of 1-cm in size, having no significant past medical history. A lymph node neck tumor was suspected, and the patient underwent surgery under local anesthesia in outpatient care. The intraoperative finding was a whitish mass, wooden-fibrous in consistency, strictly adhering to the skin and apparently fixed to the deep planes. Upon histological examination, a sclerosing perineurioma was diagnosed: neoplastic cells were immunoreactive for CD34, CD99, and EMA, and negative for S100 protein, smooth-muscle actin, pancytokeratin (AE1-AE3), CD31, neurofilaments, and beta-catenin. According to the benign biological tumor behavior, radical resection was considered an adequate treatment. Our case presents as peculiarity the unusual non-acral location (first reported as supraclavicular swelling) and the rare immunopositivity for CD34 and CD99.
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Affiliation(s)
- Antonio Tancredi
- IRCCS "Casa Sollievo della Sofferenza" Hospital, Unit of General and Thoracic Surgery, Foggia, Italy.,IRCCS "Casa Sollievo della Sofferenza" Hospital, Department of Emergency, Foggia, Italy
| | - Paolo Graziano
- IRCCS "Casa Sollievo della Sofferenza" Hospital, Unit of Pathology, Foggia, Italy
| | - Lucia Dimitri
- IRCCS "Casa Sollievo della Sofferenza" Hospital, Unit of Pathology, Foggia, Italy
| | - Elvira Impagnatiello
- Azienda Sanitaria Locale di Foggia, "San Camillo De Lellis" Hospital, Unit of General Surgery, Foggia, Italy
| | - Marco Taurchini
- IRCCS "Casa Sollievo della Sofferenza" Hospital, Unit of General and Thoracic Surgery, Foggia, Italy
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