1
|
Sun M, Shao M, Liu J, Zhao L, Weng Lao I, Yu L, Wang J. Plexiform Cellular Schwannoma in Infancy and Childhood: A Clinicopathological Study of Seven Cases of an Underrecognized Nerve Sheath Tumor with a Tendency Toward Local Recurrence. Int J Surg Pathol 2021; 30:265-272. [PMID: 34696615 DOI: 10.1177/10668969211052236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Plexiform cellular schwannoma (PCS) is very rare, and it is not completely understood. We present our experience with 7 additional cases of PCS in infancy and childhood to further characterize its distinctive clinicopathological features. There were 5 females and 2 males with a mean age of 28 months (ranging, 2 months to 8 years). The involved sites included the left forearm (n = 2), sacrococcygeal region (n = 2), retroperitoneum (n = 1), thoracic spinal canal and thoracic cavity (n = 1), and neck (n = 1). Tumor sizes ranged from 3 to 13 cm in maximum diameter (mean, 7.1 cm). Histologically, all tumors consisted of abundant spindle cells arranged in a multinodular or plexiform growth pattern, possessing elongated, hyperchromatic nuclei and pale eosinophilic cytoplasm with indistinct cell margins. Mitotic figures were easily identified, with a mean count of 4 per 10 consecutive high power fields (HPF). Immunohistochemically, all tumors were strongly and diffusely positive for S100 protein, SOX10 and H3K27me3. The Ki-67 index ranged from 5% to 30% (mean, 15%). Follow-up (available in 6 cases) revealed that 5 patients experienced local recurrence and were treated by re-excision. There was no evidence of recurrence and metastasis in 3 patients, and the other 2 were alive with the disease. In conclusion, PCS is an uncommon nerve sheath tumor predominantly occurring in infants and children, featuring a plexiform or multinodular growth pattern and exhibiting a tendency toward local recurrence. PCS is easily mistaken as malignant peripheral nerve sheath tumor (MPNST) due to its locally aggressive behaviors and worrisome features, including hypercellularity, hyperchromatism and high proliferative activity. Increased awareness of its potential occurrence and greater familiarity with its characteristic features are helpful for both clinicians and pathologists to avoid misdiagnosis and unnecessary overtreatment.
Collapse
Affiliation(s)
- Meng Sun
- 89667Fudan University, Shanghai 200032, China.,Institute of Pathology, 89667Fudan University, Shanghai 200032, China
| | - Mengyuan Shao
- 89667Fudan University, Shanghai 200032, China.,Institute of Pathology, 89667Fudan University, Shanghai 200032, China
| | - Jiahan Liu
- 89667Fudan University, Shanghai 200032, China.,Institute of Pathology, 89667Fudan University, Shanghai 200032, China
| | - Lu Zhao
- 89667Fudan University, Shanghai 200032, China.,Institute of Pathology, 89667Fudan University, Shanghai 200032, China
| | - I Weng Lao
- 89667Fudan University, Shanghai 200032, China.,Institute of Pathology, 89667Fudan University, Shanghai 200032, China
| | - Lin Yu
- 89667Fudan University, Shanghai 200032, China.,Institute of Pathology, 89667Fudan University, Shanghai 200032, China
| | - Jian Wang
- 89667Fudan University, Shanghai 200032, China.,Institute of Pathology, 89667Fudan University, Shanghai 200032, China
| |
Collapse
|
2
|
Flucke U, van Noesel MM, Wijnen M, Zhang L, Chen CL, Sung YS, Antonescu CR. TFG-MET fusion in an infantile spindle cell sarcoma with neural features. Genes Chromosomes Cancer 2017; 56:663-667. [PMID: 28510278 DOI: 10.1002/gcc.22470] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 05/04/2017] [Accepted: 05/05/2017] [Indexed: 12/21/2022] Open
Abstract
An increasing number of congenital and infantile sarcomas displaying a primitive, monomorphic spindle cell phenotype have been characterized to harbor recurrent gene fusions, including infantile fibrosarcoma and congenital spindle cell rhabdomyosarcoma. Here, we report an unusual spindle cell sarcoma presenting as a large and infiltrative pelvic soft tissue mass in a 4-month-old girl, which revealed a novel TFG-MET gene fusion by whole transcriptome RNA sequencing. The tumor resembled the morphology of an infantile fibrosarcoma with both fascicular and patternless growth, however, it expressed strong S100 protein immunoreactivity, while lacking SOX10 staining and retaining H3K27me3 expression. Although this immunoprofile suggested partial neural/neuroectodermal differentiation, overall features were unusual and did not fit into any known tumor types (cellular schwannoma, MPNST), raising the possibility of a novel pathologic entity. The TFG-MET gene fusion expands the genetic spectrum implicated in the pathogenesis of congenital spindle cell sarcomas, with yet another example of kinase oncogenic activation through chromosomal translocation. The discovery of this new fusion is significant since the resulting MET activation can potentially be inhibited by targeted therapy, as MET inhibitors are presently available in clinical trials.
Collapse
Affiliation(s)
- Uta Flucke
- Department of Pathology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Max M van Noesel
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Marc Wijnen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Lei Zhang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Chun-Liang Chen
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Yun-Shao Sung
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Cristina R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
3
|
Giant invasive sacral schwannoma showing chromosomal numerical aberrations [-14,+18,+22]. Asian Spine J 2013; 7:227-31. [PMID: 24066220 PMCID: PMC3779776 DOI: 10.4184/asj.2013.7.3.227] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 08/01/2012] [Accepted: 08/04/2012] [Indexed: 11/08/2022] Open
Abstract
Here, we report on a rare case of a giant invasive sacral schwannoma. The patient was a 58-year-old woman who had a 6-year history of non-specific buttock pain. Histological investigation confirmed the diagnosis of cellular schwannoma. The following numerical aberration was detected using the GTG-banding method for karyotypes: 47,XX,-14,+18,+22. Cytogenetic studies of schwannomas have indicated a complete or partial loss of chromosome 22 as the most common abnormality, but this case is cytogenetically rare because of the recurrence of trisomy 22.
Collapse
|
4
|
Tassano E, Sementa AR, Tavella E, Garaventa A, Panarello C, Morerio C. Trisomy 17 in congenital plexiform (multinodular) cellular schwannoma. ACTA ACUST UNITED AC 2011; 203:313-5. [PMID: 21156251 DOI: 10.1016/j.cancergencyto.2010.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2010] [Revised: 07/23/2010] [Accepted: 08/01/2010] [Indexed: 11/19/2022]
Abstract
Plexiform (multinodular) cellular schwannomas are rare tumors, not associated with neurofibromatosis type 1, that occur more often in children and can be congenital. Their biology is benign and is characterized by the tendency to recur locally without being metastatic. Cytogenetic studies in adult cases of schwannoma indicate a complete or partial loss of chromosome 22 as the most common abnormality. Only two cytogenetic studies describe cases in children, one of which concerned a congenital cellular plexiform schwannoma. Here, we report the cytogenetic analysis of a second case in an 8-month-old boy with recurrence of trisomy 17.
Collapse
Affiliation(s)
- Elisa Tassano
- Department of Pediatric Hematology/Oncology, Giannina Gaslini Institute, Genova, Italy
| | | | | | | | | | | |
Collapse
|
5
|
Manor E, Tetro S, Noyhous M, Kachko P, Bodner L. Translocation (2;13) and other chromosome abnormalities in intraosseous schwannoma of the mandible. ACTA ACUST UNITED AC 2009; 193:116-8. [DOI: 10.1016/j.cancergencyto.2009.04.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2009] [Revised: 04/02/2009] [Accepted: 04/15/2009] [Indexed: 10/20/2022]
|
6
|
Bayani J, Pandita A, Squire JA. Molecular cytogenetic analysis in the study of brain tumors: findings and applications. Neurosurg Focus 2005; 19:E1. [PMID: 16398459 DOI: 10.3171/foc.2005.19.5.2] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Classic cytogenetics has evolved from black and white to technicolor images of chromosomes as a result of advances in fluorescence in situ hybridization (FISH) techniques, and is now called molecular cytogenetics. Improvements in the quality and diversity of probes suitable for FISH, coupled with advances in computerized image analysis, now permit the genome or tissue of interest to be analyzed in detail on a glass slide. It is evident that the growing list of options for cytogenetic analysis has improved the understanding of chromosomal changes in disease initiation, progression, and response to treatment. The contributions of classic and molecular cytogenetics to the study of brain tumors have provided scientists and clinicians alike with new avenues for investigation. In this review the authors summarize the contributions of molecular cytogenetics to the study of brain tumors, encompassing the findings of classic cytogenetics, interphase- and metaphase-based FISH studies, spectral karyotyping, and metaphase- and array-based comparative genomic hybridization. In addition, this review also details the role of molecular cytogenetic techniques in other aspects of understanding the pathogenesis of brain tumors, including xenograft, cancer stem cell, and telomere length studies.
Collapse
Affiliation(s)
- Jane Bayani
- Department of Applied Molecular Oncology, Ontario Cancer Institute, Princess Margaret Hospital, University Health Network, Ontario, Canada.
| | | | | |
Collapse
|