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Dhaliwal D, Sayyadioskoie S, Siatecka H, Hunt C, Diwan AH. A Tale of Two Tumors: A Collision Tumor of Atypical Fibroxanthoma and Basal Cell Carcinoma. Am J Dermatopathol 2024; 46:309-311. [PMID: 38574065 DOI: 10.1097/dad.0000000000002694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
ABSTRACT A collision tumor is an infrequent phenomenon characterized by the presence of 2 histologically distinct tumor types (either benign or malignant) occurring within the same specific anatomical site. We describe a rare case of co-occurrence of basal cell carcinoma and atypical fibroxanthoma presenting as a single lesion on the scalp in a 76-year-old man. The lesion was clinically suspicious for basal cell carcinoma and biopsied. Histologic examination showed 2 distinct tumors, one with basaloid cells and the other one with pleomorphic spindle cells colliding and growing together. Immunohistochemical stains were crucial in establishing the diagnosis. This presentation is exceedingly rare and requires additional evaluation for diagnosis.
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Affiliation(s)
- Dilshad Dhaliwal
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
| | | | - Hanna Siatecka
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
| | | | - A Hafeez Diwan
- Department of Pathology & Immunology, Baylor College of Medicine, Houston, TX
- Department of Dermatology, Baylor College of Medicine, Houston, TX; and
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2
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Barbieux S, Tallet A, Collin C, Tallegas M, Delalande F, Bens G, Levy A, Kalampokas A, Schrama D, Houben R, Touzé A, Garcia J, Macagno N, Appay R, Samimi M, Guyétant S, Kervarrec T. Genetic evidence of a sarcomatoid transformation in Merkel cell carcinoma. J Eur Acad Dermatol Venereol 2023; 37:e45-e48. [PMID: 35972820 DOI: 10.1111/jdv.18529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 08/05/2022] [Indexed: 12/15/2022]
Affiliation(s)
- Simon Barbieux
- Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France.,Platform of Somatic Tumour Molecular Genetics, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Anne Tallet
- Platform of Somatic Tumour Molecular Genetics, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Christine Collin
- Platform of Somatic Tumour Molecular Genetics, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Matthias Tallegas
- Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France.,Platform of Somatic Tumour Molecular Genetics, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Flore Delalande
- Department of Pathology, Centre Hospitalier régional d'Orléans, Orléans, France
| | - Guido Bens
- Department of Dermatology, Centre Hospitalier régional d'Orléans, Orléans, France
| | - Annie Levy
- Centre de Dermatopathologie de la Roquette, Paris, France
| | | | - David Schrama
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Roland Houben
- Department of Dermatology, Venereology and Allergology, University Hospital Würzburg, Würzburg, Germany
| | - Antoine Touzé
- "Biologie des infections à polyomavirus" Team, UMR INRAE ISP 1282, Université de Tours, Tours, France
| | - Jeremy Garcia
- Department of Pathology, Aix Marseille Univ, Timone University Hospital, Marseille, France
| | - Nicolas Macagno
- Department of Pathology, Aix Marseille Univ, Timone University Hospital, Marseille, France
| | - Romain Appay
- Department of Pathology, Aix Marseille Univ, Timone University Hospital, Marseille, France
| | - Mahtab Samimi
- "Biologie des infections à polyomavirus" Team, UMR INRAE ISP 1282, Université de Tours, Tours, France.,Department of Dermatology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France
| | - Serge Guyétant
- Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France.,Platform of Somatic Tumour Molecular Genetics, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France.,"Biologie des infections à polyomavirus" Team, UMR INRAE ISP 1282, Université de Tours, Tours, France
| | - Thibault Kervarrec
- Department of Pathology, Université de Tours, Centre Hospitalier Universitaire de Tours, Tours, France.,"Biologie des infections à polyomavirus" Team, UMR INRAE ISP 1282, Université de Tours, Tours, France
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3
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Interaction of Arsenic Exposure and Transcriptomic Profile in Basal Cell Carcinoma. Cancers (Basel) 2022; 14:cancers14225598. [PMID: 36428691 PMCID: PMC9688807 DOI: 10.3390/cancers14225598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/08/2022] [Accepted: 11/12/2022] [Indexed: 11/16/2022] Open
Abstract
Exposure to inorganic arsenic (As) is recognized as risk factor for basal cell carcinoma (BCC). We have followed-up 7000 adults for 6 years who were exposed to As and had manifest As skin toxicity. Of them, 1.7% developed BCC (males = 2.2%, females = 1.3%). In this study, we compared transcriptome-wide RNA sequencing data from the very first 26 BCC cases and healthy skin tissue from independent 16 individuals. Genes in “ cell carcinoma pathway”, “Hedgehog signaling pathway”, and “Notch signaling pathway” were overexpressed in BCC, confirming the findings from earlier studies in BCC in other populations known to be exposed to As. However, we found that the overexpression of these known pathways was less pronounced in patients with high As exposure (urinary As creatinine ratio (UACR) > 192 µg/gm creatinine) than patients with low UACR. We also found that high UACR was associated with impaired DNA replication pathway, cellular response to different DNA damage repair mechanisms, and immune response. Transcriptomic data were not strongly suggestive of great potential for immune checkpoint inhibitors; however, it suggested lower chance of platinum drug resistance in BCC patients with high UACR compared high platinum drug resistance potential in patients with lower UACR.
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4
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Genomic evidence suggests that cutaneous neuroendocrine carcinomas can arise from squamous dysplastic precursors. Mod Pathol 2022; 35:506-514. [PMID: 34593967 PMCID: PMC8964828 DOI: 10.1038/s41379-021-00928-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 08/24/2021] [Accepted: 09/07/2021] [Indexed: 02/06/2023]
Abstract
Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine carcinoma without a known dysplastic precursor. In some cases, MCC is associated with SCCIS in the overlying epidermis; however, the MCC and SCCIS populations display strikingly different morphologies, and thus far a relationship between these components has not been demonstrated. To better understand the relationship between these distinct tumor cell populations, we evaluated 7 pairs of MCC-SCCIS for overlapping genomic alterations by cancer profiling panel. A subset was further characterized by transcriptional profiling and immunohistochemistry. In 6 of 7 MCC-SCCIS pairs there was highly significant mutational overlap including shared TP53 and/or RB1 mutations. In some cases, oncogenic events previously implicated in MCC (MYCL gain, MDM4 gain, HRAS mutation) were detected in both components. Although FBXW7 mutations were enriched in MCC, no gene mutation was unique to the MCC component across all cases. Transcriptome analysis identified 2736 differentially expressed genes between MCC and SCCIS. Genes upregulated in the MCC component included Polycomb repressive complex targets; downregulated transcripts included epidermal markers, and immune genes such as HLA-A. Immunohistochemical studies revealed increased expression of SOX2 in the MCC component, with diminished H3K27Me3, Rb, and HLA-A expression. In summary, MCC-SCCIS pairs demonstrate clonal relatedness. The shift to neuroendocrine phenotype is associated with loss of Rb protein expression, decrease in global H3K27Me3, and increased expression of Merkel cell genes such as SOX2. Our findings suggest an epidermal origin of MCC in this setting, and to our knowledge provide the first molecular evidence that intraepithelial squamous dysplasia may represent a direct precursor for small cell carcinoma.
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Fernández‐Figueras M, Malvehi J, Tschandl P, Rutten A, Rongioletti F, Requena L, Kittler H, Kerl K, Kazakov D, Cribier B, Calonje E, André J, Kempf W, Cardoso J, Filosa A, Hetzer S, Kervarrec T, Llamas‐Velasco M, Valeska Matter A, Rickaby W, Saggini A, Vandersleyen V. Position paper on a simplified histopathological classification of basal cell carcinoma: results of the European Consensus Project. J Eur Acad Dermatol Venereol 2021; 36:351-359. [DOI: 10.1111/jdv.17849] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/11/2021] [Indexed: 12/26/2022]
Affiliation(s)
- M.T. Fernández‐Figueras
- Department of Pathology Hospital Universitari General de Catalunya Grupo Quironsalud & Universitat Internacional de Catalunya Sant Cugat del Vallés Spain
| | - J. Malvehi
- Department of Dermatology Hospital Clínic de Barcelona (Melanoma Unit) University of Barcelona IDIBAPS Barcelona & CIBERER Barcelona Spain
| | - P. Tschandl
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - A. Rutten
- Dermatopathology Practice Friedrichshafen/Lake Constance Friedrichshafen Germany
| | - F. Rongioletti
- Dermatology Clinic IRCCS San Raffaele Hospital Vita Salute University Milan Italy
| | - L. Requena
- Department of Dermatology Fundación Jiménez Díaz Universidad Autónoma Madrid Spain
| | - H. Kittler
- Department of Dermatology Medical University of Vienna Vienna Austria
| | - K. Kerl
- Department of Dermatology University Hospital Zürich Zürich Switzerland
| | - D. Kazakov
- Sikl's Department of Pathology Medical Faculty in Pilsen Charles University in Prague Pilsen Czech Republic
| | - B. Cribier
- Dermatology Department University Hospital Strasbourg France
| | - E. Calonje
- St John's Institute of Dermatology St Thomas Hospital London UK
| | - J. André
- Department of Dermatology Centre Hospitalier Universitaire Saint‐Pierre Université Libre de Bruxelles Brussels Belgium
| | - W. Kempf
- Kempf Pfaltz Histologische Diagnostik Zurich Switzerland
- Department of Dermatology University Hospital Zurich Zürich Switzerland
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Kim C, Brown A, Osipov V. Trichoblastic carcinosarcoma in a 34-year-old woman with histopathologic and molecular analysis, including re-demonstration of a CDKN2A p.(R58*) mutation. J Cutan Pathol 2020; 48:334-339. [PMID: 33089535 DOI: 10.1111/cup.13892] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/26/2020] [Accepted: 10/05/2020] [Indexed: 11/27/2022]
Abstract
Trichoblastic carcinosarcomas are rare, adnexal-type cutaneous carcinosarcomas that are thought to be related histogenetically to trichoblastomas, yet in which both the epithelial and stromal components show features of malignancy. Ten cases have been described in the literature thus far, with a predilection for the head and neck of older males. We present a case of cutaneous carcinosarcoma in sun-damaged skin of a 34-year-old woman showing features of a trichoblastic carcinosarcoma, with histopathologic analysis along with targeted next-generation sequencing of 50 cancer-associated genes. Two pathogenic variants in TP53 were identified, p.(R158C), p.(R273P), along with a likely pathogenic variant CDKN2A, p.(R58*). In particular, it is noted that the CDKN2A p.(R58*) missense mutation has been described in two previous cases of cutaneous carcinosarcomas, including a case of trichoblastic carcinosarcoma.
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Affiliation(s)
- Chris Kim
- Anatomical Pathology, Wellington SCL, Wellington, New Zealand
| | - Angela Brown
- Wellington Regional Genetics Laboratory, Wellington, New Zealand
| | - Vladimir Osipov
- Anatomical Pathology, Wellington SCL, Wellington, New Zealand
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7
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Kwon D, Ronen S, Giubellino A, Keiser E, Aung PP, Nagarajan P, Tetzlaff MT, Ivan D, Curry JL, Prieto VG, Torres-Cabala CA. Cutaneous adnexal carcinosarcoma: Immunohistochemical and molecular evidence of epithelial mesenchymal transition. J Cutan Pathol 2020; 48:526-534. [PMID: 32564423 DOI: 10.1111/cup.13782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/11/2020] [Accepted: 06/17/2020] [Indexed: 11/30/2022]
Abstract
Cutaneous carcinosarcomas are rare biphenotypic tumors that simultaneously show epithelial and mesenchymal differentiation. The most common carcinomatous components in skin carcinosarcomas are basal cell carcinoma and squamous cell carcinoma; adnexal carcinomas are rarely encountered. We report a case of an adnexal carcinoma with ductal and squamous differentiation and spindle cell component, which is interpreted as carcinosarcoma. Loss of immunohistochemical expression of E-cadherin and β-catenin detected in the sarcomatous component suggested epithelial mesenchymal transition (EMT). RNA sequencing analysis identified several gene mutations and alterations such as translocations and upregulations/downregulations, either shared by the two components of the tumor or differentially present in the carcinoma or the sarcoma parts. Thus, mutations in genes, such as TP53, were found in both components of the tumor while mutations in PDGFRA and RB1 (a pathogenic missense mutation) were exclusively present in the sarcomatous areas, further supporting EMT. EMT is a dynamic process by which tumors acquire mesenchymal phenotype while simultaneously losing epithelial properties. Although the pathways involved in EMT have been extensively studied, this phenomenon still needs to be investigated in cutaneous tumors of adnexal origin for a better understanding of their pathogenesis. These molecular changes may represent promising targets for personalized therapies.
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Affiliation(s)
- DongHyang Kwon
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shira Ronen
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Alessio Giubellino
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minnesota, USA
| | - Elizabeth Keiser
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Phyu P Aung
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Priyadharsini Nagarajan
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Michael T Tetzlaff
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Doina Ivan
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Jonathan L Curry
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Victor G Prieto
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Carlos A Torres-Cabala
- Department of Pathology, Dermatopathology Section, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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8
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Mestre-Alagarda C, Monteagudo C. Reply to "Primary cutaneous biphasic sarcomatoid basal cell carcinoma with myoepithelial carcinoma differentiation. Is it a new variant of sarcomatoid basal cell carcinoma or a collision tumor composed of a myoepithelial carcinoma and an incidental basal cell carcinoma?". J Cutan Pathol 2020; 47:578-580. [PMID: 32181509 DOI: 10.1111/cup.13685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/13/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Claudia Mestre-Alagarda
- Department of Anatomic Pathology, Hospital Clínico Universitario de Valencia, Valencia, Spain
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9
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Luong TMH, Akazawa Y, Mussazhanova Z, Matsuda K, Ueki N, Miura S, Hara T, Yokoyama H, Nakashima M. Cutaneous pilomatrical carcinosarcoma: a case report with molecular analysis and literature review. Diagn Pathol 2020; 15:7. [PMID: 32005258 PMCID: PMC6993389 DOI: 10.1186/s13000-020-0925-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Accepted: 01/15/2020] [Indexed: 01/09/2023] Open
Abstract
Background Cutaneous pilomatrical carcinosarcoma (CS) is a very rare biphasic tumor composed of admixed epithelial and mesenchymal malignant cells, with limited information on its pathogenesis. We report a case of pilomatrical CS of the scalp with comparative immunohistochemical and molecular analysis together with a review of the literature. Case presentation A 74-year-old woman presented with a rapidly growing long-standing tumor of the scalp. The tumor was surgically resected. Histologically, the tumor was 25 mm in diameter, and was composed of carcinoma showing a clear pilomatrical differentiation and sarcoma with pleomorphic spindle cells and giant cells. Both epithelial and mesenchymal components shared focal cytoplasmic and/or nuclear accumulation of β-catenin based on immunohistochemical analysis, although a mutation of exon 3 of the CTNNB1 gene was not detected. Fluorescence in situ hybridization analysis revealed gains of chromosomes 9p21, 3, and 7 in both the epithelial and sarcomatous components. Conclusions The current case demonstrated characteristic findings of pilomatricoma and further evidence of partial clonality between the carcinomatous and sarcomatous component, suggesting the possibility of malignant transformation of pilomatricoma. Rapid growth of a pilomatrical tumor should warrant the development of a malignant tumor, including CS.
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Affiliation(s)
- Thi My Hanh Luong
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
| | - Yuko Akazawa
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan.
| | - Zhanna Mussazhanova
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
| | - Katsuya Matsuda
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
| | - Nozomi Ueki
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
| | - Shiro Miura
- Department of Pathology, National Hospital Organization Nagasaki Medical Center, Omura, 856-8562, Nagasaki, Japan
| | - Toshihide Hara
- Department of Dermatology, Isahaya General Hospital, Isahaya, Japan
| | - Hiroko Yokoyama
- Department of Dermatology, Isahaya General Hospital, Isahaya, Japan
| | - Masahiro Nakashima
- Department of Tumor and Diagnostic Pathology, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki City, Nagasaki, 852-8523, Japan
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10
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Alegría-Landa V, Kutzner H, Requena L. Syringocystadenocarcinoma papilliferum associated with atypical stroma: A hitherto undocumented variant of sarcomatoid carcinoma. J Cutan Pathol 2019; 46:867-871. [PMID: 31237708 DOI: 10.1111/cup.13534] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/23/2019] [Accepted: 06/11/2019] [Indexed: 11/30/2022]
Abstract
Carcinosarcomas are biphasic tumors composed of admixed malignant epithelial and mesenchymal components. Numerous terms have been used to name such neoplasms; therefore, terminological confusion is frequent. Most examples of carcinosarcomas are encountered in non-cutaneous sites, with approximately 100 cases of cutaneous carcinosarcomas reported so far in the English literature. Although different theories have been suggested to explain the occurrence of these peculiar neoplasms, histogenetic mechanisms should be better hypothesized depending on each individual case. Even though prognosis tends to be related to the specific components of the lesion, especially the epithelial one, it seems that cases of cutaneous localization usually have a better outcome. We report an exceedingly rare case of syringocystadenocarcinoma papilliferum which showed an atypical stroma with sarcomatoid appearance, and highlight that the terminology used for this spectrum of lesions is disorganized and confusing.
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Affiliation(s)
| | - Heinz Kutzner
- Dermatopathologie Laboratory, Friedrichshafen, Germany
| | - Luis Requena
- Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain
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11
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Abstract
Mesenchymal Stem Cells (MSCs) are a heterogeneous population of fibroblast-like cells which maintain self-renewability and pluripotency to differentiate into mesodermal cell lineages. The use of MSCs in clinical settings began with high enthusiasm and the number of MSC-based clinical trials has been rising ever since. However; the very unique characteristics of MSCs that made them suitable to for therapeutic use, might give rise to unwanted outcomes, including tumor formation and progression. In this paper, we present a model of carcinogenesis initiated by MSCs, which chains together the tissue organization field theory, the stem cell theory, and the inflammation-cancer chain. We believe that some tissue resident stem cells could be leaked cells from bone marrow MSC pool to various injured tissue, which consequently transform and integrate in the host tissue. If the injury persists or chronic inflammation develops, as a consequence of recurring exposure to growth factors, cytokines, etc. the newly formed tissue from MSCs, which still has conserved their mesenchymal and stemness features, go through rapid population expansion, and nullify their tumor suppressor genes, and hence give rise to neoplastic cell (carcinomas, sarcomas, and carcino-sarcomas). Considering the probability of this hypothesis being true, the clinical and therapeutic use of MSCs should be with caution, and the recipients' long term follow-up seems to be insightful.
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12
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Suzuki H, Hashimoto A, Saito R, Izumi M, Aiba S. A Case of Primary Cutaneous Basal Cell Carcinosarcoma. Case Rep Dermatol 2018; 10:208-215. [PMID: 30283313 PMCID: PMC6167722 DOI: 10.1159/000492525] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/29/2018] [Indexed: 01/21/2023] Open
Abstract
A 94-year-old man consulted our hospital due to a rapidly growing tumor on the left cheek. The histological diagnosis of the tumor was basal cell carcinosarcoma, which was composed of intermingled epithelial and mesenchymal components. The former was basal cell carcinoma, while the latter was spindle cell sarcoma. The tumor was completely resected with a 3-mm margin and the patient remained free of local recurrence or distinct metastasis for 2 years. We report here a case of cutaneous basal cell carcinosarcoma and a review of the literature.
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Affiliation(s)
- Hiromi Suzuki
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akira Hashimoto
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryoko Saito
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Miki Izumi
- Department of Medical Education, Showa University School of Medicine, Sendai, Japan
| | - Setsuya Aiba
- Department of Dermatology, Tohoku University Graduate School of Medicine, Sendai, Japan
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13
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Leecy T, Ardakani NM, Harvey NT, Wood BA. Pilomatrical carcinosarcoma: report of a case with comparative genomic hybridisation analysis. Pathology 2018; 50:571-573. [PMID: 29954591 DOI: 10.1016/j.pathol.2018.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 02/16/2018] [Accepted: 02/22/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Tamazin Leecy
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia.
| | | | - Nathan T Harvey
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia
| | - Benjamin A Wood
- PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia
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14
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Wollina U, Riedel I, Abushika MR, Lotti T, Tchernev G. Giant Pendulous Carcinosarcoma - Squamous Cell Carcinoma-Type - of the Leg - A Case Report and Review of the Literature. Open Access Maced J Med Sci 2018; 6:112-114. [PMID: 29484002 PMCID: PMC5816276 DOI: 10.3889/oamjms.2018.036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Revised: 10/30/2017] [Accepted: 10/31/2017] [Indexed: 11/05/2022] Open
Abstract
Cutaneous carcinosarcoma (CCS) is a rare non-melanoma skin cancer with a biphasic growth pattern. A tumour is composed of epithelial and mesenchymal cells that show clonality. In most cases, CCS develops in the head-and-neck region on the chronic sun-exposed skin of males. Here, we describe an 80-year-old female patient who developed a giant, pendulous CCS on the leg. A tumour was surgically removed. We found no evidence of metastatic spread.
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Affiliation(s)
- Uwe Wollina
- Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany
| | - Ina Riedel
- Städtisches Klinikum Dresden - Institute of Pathology "Georg Schmorl" Dresden, Sachsen, Germany
| | - Mohammad R Abushika
- Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany
| | - Torello Lotti
- University G. Marconi of Rome - Dermatology and Venereology, Rome, Italy
| | - Georgi Tchernev
- Department of Dermatology, Venereology and Dermatologic Surgery, Medical Institute of Ministry of Interior, Sofia, Bulgaria.,Onkoderma, Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria
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15
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Cutaneous Metaplastic Carcinoma: Report of a Case With Sebaceous Differentiation. Am J Dermatopathol 2018; 40:e100-e103. [PMID: 29293124 DOI: 10.1097/dad.0000000000001070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In this study, a case of a 56-year-old woman with cutaneous metaplastic carcinoma in the neck is reported. It harbored basal cell carcinoma, squamous cell carcinoma, and sebaceous carcinoma, as well as osteosarcoma (with fibroblastic, osteoblastic, aneurysmal bone cyst-like, and chondroblastic patterns). To our knowledge, the literature does not mention sebaceous carcinoma in cutaneous metaplastic carcinoma. Epidemiology and intact mismatch repair proteins of this case support sporadic pathogenesis for this neoplasm. The patient has been followed up for 3 years after surgery with free margins, and no local recurrence or distant metastases have been observed.
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16
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Ng SB, Chung TH, Kato S, Nakamura S, Takahashi E, Ko YH, Khoury JD, Yin CC, Soong R, Jeyasekharan AD, Hoppe MM, Selvarajan V, Tan SY, Lim ST, Ong CK, Nairismägi ML, Maheshwari P, Choo SN, Fan S, Lee CK, Chuang SS, Chng WJ. Epstein-Barr virus-associated primary nodal T/NK-cell lymphoma shows a distinct molecular signature and copy number changes. Haematologica 2017; 103:278-287. [PMID: 29097495 PMCID: PMC5792272 DOI: 10.3324/haematol.2017.180430] [Citation(s) in RCA: 80] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 10/27/2017] [Indexed: 12/30/2022] Open
Abstract
The molecular biology of primary nodal T- and NK-cell lymphoma and its relationship with extranodal NK/T-cell lymphoma, nasal type is poorly understood. In this study, we assessed the relationship between nodal and extranodal Epstein-Barr virus-positive T/NK-cell lymphomas using gene expression profiling and copy number aberration analyses. We performed gene expression profiling and copy number aberration analysis on 66 cases of Epstein-Barr virus-associated T/NK-cell lymphoma from nodal and extranodal sites, and correlated the molecular signatures with clinicopathological features. Three distinct molecular clusters were identified with one enriched for nodal presentation and loss of 14q11.2 (TCRA loci). T/NK-cell lymphomas with a nodal presentation (nodal-group) were significantly associated with older age, lack of nasal involvement, and T-cell lineage compared to those with an extranodal presentation (extranodal-group). On multivariate analysis, nodal presentation was an independent factor associated with short survival. Comparing the molecular signatures of the nodal and extranodal groups it was seen that the former was characterized by upregulation of PD-L1 and T-cell-related genes, including CD2 and CD8, and downregulation of CD56, consistent with the CD8+/CD56-immunophenotype. PD-L1 and CD2 protein expression levels were validated using multiplexed immunofluorescence. Interestingly, nodal group lymphomas were associated with 14q11.2 loss which correlated with loss of TCR loci and T-cell origin. Overall, our results suggest that T/NK-cell lymphoma with nodal presentation is distinct and deserves to be classified separately from T/NK-cell lymphoma with extranodal presentation. Upregulation of PD-L1 indicates that it may be possible to use anti-PD1 immunotherapy in this distinctive entity. In addition, loss of 14q11.2 may be a potentially useful diagnostic marker of T-cell lineage.
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Affiliation(s)
- Siok-Bian Ng
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore .,Department of Pathology, National University Hospital, National University Health System, Singapore.,Cancer Science Institute of Singapore, National University of Singapore
| | - Tae-Hoon Chung
- Cancer Science Institute of Singapore, National University of Singapore
| | - Seiichi Kato
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Emiko Takahashi
- Department of Pathology, Aichi Medical University Hospital, Nagakute, Japan
| | - Young-Hyeh Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Joseph D Khoury
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - C Cameron Yin
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Richie Soong
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore.,Cancer Science Institute of Singapore, National University of Singapore
| | | | | | - Viknesvaran Selvarajan
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Soo-Yong Tan
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore.,Department of Pathology, National University Hospital, National University Health System, Singapore
| | - Soon-Thye Lim
- Lymphoma Genomic Translational Research Laboratory, National Cancer Centre Singapore, Division of Medical Oncology, National Cancer Center Singapore
| | - Choon-Kiat Ong
- Lymphoma Genomic Translational Research Laboratory, Division of Medical Oncology, National Cancer Centre Singapore
| | - Maarja-Liisa Nairismägi
- Lymphoma Genomic Translational Research Laboratory, Division of Medical Oncology, National Cancer Centre Singapore
| | - Priyanka Maheshwari
- Department of Pathology, National University Hospital, National University Health System, Singapore
| | - Shoa-Nian Choo
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Shuangyi Fan
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Chi-Kuen Lee
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore
| | | | - Wee-Joo Chng
- Cancer Science Institute of Singapore, National University of Singapore .,Department of Haematology-Oncology, National University Cancer Institute of Singapore, National University Health System
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17
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Basal Cell Carcinoma With Matrical Differentiation: Clinicopathologic, Immunohistochemical, and Molecular Biological Study of 22 Cases. Am J Surg Pathol 2017; 41:738-749. [PMID: 28368926 DOI: 10.1097/pas.0000000000000841] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Basal cell carcinoma (BCC) with matrical differentiation is a fairly rare neoplasm, with about 30 cases documented mainly as isolated case reports. We studied a series of this neoplasm, including cases with an atypical matrical component, a hitherto unreported feature. Lesions coded as BCC with matrical differentiation were reviewed; 22 cases were included. Immunohistochemical studies were performed using antibodies against BerEp4, β-catenin, and epithelial membrane antigen (EMA). Molecular genetic studies using Ion AmpliSeq Cancer Hotspot Panel v2 by massively parallel sequencing on Ion Torrent PGM were performed in 2 cases with an atypical matrical component (1 was previously subjected to microdissection to sample the matrical and BCC areas separately). There were 13 male and 9 female patients, ranging in age from 41 to 89 years. Microscopically, all lesions manifested at least 2 components, a BCC area (follicular germinative differentiation) and areas with matrical differentiation. A BCC component dominated in 14 cases, whereas a matrical component dominated in 4 cases. Matrical differentiation was recognized as matrical/supramatrical cells (n=21), shadow cells (n=21), bright red trichohyaline granules (n=18), and blue-gray corneocytes (n=18). In 2 cases, matrical areas manifested cytologic atypia, and a third case exhibited an infiltrative growth pattern, with the tumor metastasizing to a lymph node. BerEP4 labeled the follicular germinative cells, whereas it was markedly reduced or negative in matrical areas. The reverse pattern was seen with β-catenin. EMA was negative in BCC areas but stained a proportion of matrical/supramatrical cells. Genetic studies revealed mutations of the following genes: CTNNB1, KIT, CDKN2A, TP53, SMAD4, ERBB4, and PTCH1, with some differences between the matrical and BCC components. It is concluded that matrical differentiation in BCC in most cases occurs as multiple foci. Rare neoplasms manifest atypia in the matrical areas. Immunohistochemical analysis for BerEP4, EMA, and β-catenin can be helpful in limited biopsy specimens. From a molecular biological prospective, BCC and matrical components appear to share some of the gene mutations but have differences in others, but this observation must be validated in a large series.
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18
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Harms KL, Lazo de la Vega L, Hovelson DH, Rahrig S, Cani AK, Liu CJ, Fullen DR, Wang M, Andea AA, Bichakjian CK, Johnson TM, Tomlins SA, Harms PW. Molecular Profiling of Multiple Primary Merkel Cell Carcinoma to Distinguish Genetically Distinct Tumors From Clonally Related Metastases. JAMA Dermatol 2017; 153:505-512. [PMID: 28403382 DOI: 10.1001/jamadermatol.2017.0507] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine carcinoma. In rare cases, the development of an additional cutaneous MCC tumor is clinically consistent with a second primary MCC tumor rather than a cutaneous metastasis, which has important treatment and prognostic implications. Objective To evaluate genetic relatedness in 4 cases with the clinical diagnosis of multiple primary MCCs. Design, Setting, and Participants In this case series, 7 cases of clinically designated multiple primary MCC were identified; 4 cases met inclusion criteria for next-generation sequencing (NGS) analysis. Mutations, copy number alterations, and Merkel cell polyomavirus (MCPyV) sequence were analyzed and compared between clinically designated multiple primary tumors to characterize genetic relatedness and hence assess clonality. Patients with clinically designated multiple primary MCC were identified from the multidisciplinary MCC Program at the University of Michigan, a tertiary care center. Main Outcomes and Measures Four cases of clinically designated multiple primary MCC were characterized by tumor sequencing and targeted MCPyV sequencing to distinguish independent primary tumors from related metastases. Results Overall, 4 patients in their 70s or 80s were included and analyzed. Cases 1 and 4 were verified as genetically distinct primary tumors and did not harbor similar copy number alterations or demonstrate significant mutational overlap. Cases 2 and 3 were designated as clonally related based on overlapping copy number alterations. In clonally related tumors, chromosomal copy number changes were more reliable than mutations for demonstrating clonality. Regardless of clonality, we found that MCPyV status was concordant for all tumor pairs and MCPyV positive tumors harbored predominatly subclonal mutations. Conclusions and Relevance Our findings suggest that patients with MCC may develop a second genetically distinct primary tumor; in this case, the subsequent tumor is likely to develop through similar mechanisms of pathogenesis, either MCPyV-mediated or ultraviolet light-mediated. Next-generation sequencing analysis of chromosomal copy number changes and mutations is useful in distinguishing multiple primary MCCs from progression of MCC clinically resembling multiple primaries, allowing appropriate staging of the patient.
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Affiliation(s)
- Kelly L Harms
- Department of Dermatology, University of Michigan Medical School, Ann Arbor2Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor
| | - Lorena Lazo de la Vega
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor4Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Daniel H Hovelson
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor4Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Samantha Rahrig
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor4Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Andi K Cani
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor4Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Chia-Jen Liu
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor4Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Douglas R Fullen
- Department of Dermatology, University of Michigan Medical School, Ann Arbor4Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Min Wang
- Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Aleodor A Andea
- Department of Dermatology, University of Michigan Medical School, Ann Arbor4Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Christopher K Bichakjian
- Department of Dermatology, University of Michigan Medical School, Ann Arbor2Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor
| | - Timothy M Johnson
- Department of Dermatology, University of Michigan Medical School, Ann Arbor2Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor
| | - Scott A Tomlins
- Comprehensive Cancer Center, University of Michigan Medical School, Ann Arbor3Michigan Center for Translational Pathology, University of Michigan, Ann Arbor4Department of Pathology, University of Michigan Medical School, Ann Arbor5Department of Urology, University of Michigan Medical School, Ann Arbor
| | - Paul W Harms
- Department of Dermatology, University of Michigan Medical School, Ann Arbor3Michigan Center for Translational Pathology, University of Michigan, Ann Arbor4Department of Pathology, University of Michigan Medical School, Ann Arbor
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19
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Clark JJ, Bowen AR, Bowen GM, Hyngstrom JR, Hadley ML, Duffy K, Florell SR, Wada DA. Cutaneous carcinosarcoma: a series of six cases and a review of the literature. J Cutan Pathol 2016; 44:34-44. [DOI: 10.1111/cup.12843] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 10/05/2016] [Accepted: 10/06/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Joshua J. Clark
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Anneli R. Bowen
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Glen M. Bowen
- Department of Dermatology; University of Utah; Salt Lake City UT USA
- Department of Dermatology; Huntsman Cancer Institute; Salt Lake City UT USA
| | - John R. Hyngstrom
- Department of Surgery; University of Utah and Huntsman Cancer Institute; Salt Lake City UT USA
| | - Michael L. Hadley
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Keith Duffy
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - Scott R. Florell
- Department of Dermatology; University of Utah; Salt Lake City UT USA
| | - David A. Wada
- Department of Dermatology; University of Utah; Salt Lake City UT USA
- Department of Dermatology; Huntsman Cancer Institute; Salt Lake City UT USA
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20
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Vilas-Sueiro A, Fernández-Jorge B, Pérez-Valcárcel J, Monteagudo B. Primary metaplastic carcinoma with osteogenic sarcoma and squamous cell carcinoma differentiation. J Cutan Pathol 2016; 43:1081-1082. [PMID: 27584912 DOI: 10.1111/cup.12781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 05/18/2016] [Accepted: 08/03/2016] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | - Benigno Monteagudo
- Department of Dermatology, University Hospital Complex Ferrol, Ferrol, Spain
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21
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Ghannem L, Debbi K, Kerdraon R, Michenet P, Lecointre C. [Bone in skin]. Ann Pathol 2016; 36:155-8. [PMID: 26996973 DOI: 10.1016/j.annpat.2016.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 12/10/2015] [Accepted: 01/15/2016] [Indexed: 11/15/2022]
Affiliation(s)
- Lila Ghannem
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France.
| | - Kamel Debbi
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
| | - Rémy Kerdraon
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
| | - Patrick Michenet
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
| | - Claire Lecointre
- Service de pathologie, hôpital La Source, 14, avenue de l'Hôpital, 45067 Orléans cedex 2, France
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22
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Genomic copy number analysis of a spectrum of blue nevi identifies recurrent aberrations of entire chromosomal arms in melanoma ex blue nevus. Mod Pathol 2016; 29:227-39. [PMID: 26743478 DOI: 10.1038/modpathol.2015.153] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 11/22/2015] [Accepted: 11/23/2015] [Indexed: 12/14/2022]
Abstract
Blue nevi may display significant atypia or undergo malignant transformation. Morphologic diagnosis of this spectrum of lesions is notoriously difficult, and molecular tools are increasingly used to improve diagnostic accuracy. We studied copy number aberrations in a cohort of cellular blue nevi, atypical cellular blue nevi, and melanomas ex blue nevi using Affymetrix's OncoScan platform. Cases with sufficient DNA were analyzed for GNAQ, GNA11, and HRAS mutations. Copy number aberrations were detected in 0 of 5 (0%) cellular blue nevi, 3 of 12 (25%) atypical cellular blue nevi, and 6 of 9 (67%) melanomas ex blue nevi. None of the atypical cellular blue nevi displayed more than one aberration, whereas complex aberrations involving four or more regions were seen exclusively in melanomas ex blue nevi. Gains and losses of entire chromosomal arms were identified in four of five melanomas ex blue nevi with copy number aberrations. In particular, gains of 1q, 4p, 6p, and 8q, and losses of 1p and 4q were each found in at least two melanomas. Whole chromosome aberrations were also common, and represented the sole finding in one atypical cellular blue nevus. When seen in melanomas, however, whole chromosome aberrations were invariably accompanied by partial aberrations of other chromosomes. Three melanomas ex blue nevi harbored aberrations, which were absent or negligible in their precursor components, suggesting progression in tumor biology. Gene mutations involving GNAQ and GNA11 were each detected in two of eight melanomas ex blue nevi. In conclusion, copy number aberrations are more common and often complex in melanomas ex blue nevi compared with cellular and atypical cellular blue nevi. Identification of recurrent gains and losses of entire chromosomal arms in melanomas ex blue nevi suggests that development of new probes targeting these regions may improve detection and risk stratification of these lesions.
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23
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Harms PW, Collie AMB, Hovelson DH, Cani AK, Verhaegen ME, Patel RM, Fullen DR, Omata K, Dlugosz AA, Tomlins SA, Billings SD. Next generation sequencing of Cytokeratin 20-negative Merkel cell carcinoma reveals ultraviolet-signature mutations and recurrent TP53 and RB1 inactivation. Mod Pathol 2016; 29:240-8. [PMID: 26743471 PMCID: PMC4769666 DOI: 10.1038/modpathol.2015.154] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 11/13/2015] [Accepted: 11/14/2015] [Indexed: 12/18/2022]
Abstract
Merkel cell carcinoma is a rare but highly aggressive cutaneous neuroendocrine carcinoma. Cytokeratin 20 (CK20) is expressed in ~95% of Merkel cell carcinomas and is useful for distinction from morphologically similar entities including metastatic small-cell lung carcinoma. Lack of CK20 expression may make diagnosis of Merkel cell carcinoma more challenging, and has unknown biological significance. Approximately 80% of CK20-positive Merkel cell carcinomas are associated with the oncogenic Merkel cell polyomavirus. Merkel cell carcinomas lacking Merkel cell polyomavirus display distinct genetic changes from Merkel cell polyomavirus-positive Merkel cell carcinoma, including RB1 inactivating mutations. Unlike CK20-positive Merkel cell carcinoma, the majority of CK20-negative Merkel cell carcinomas are Merkel cell polyomavirus-negative, suggesting CK20-negative Merkel cell carcinomas predominantly arise through virus-independent pathway(s) and may harbor additional genetic differences from conventional Merkel cell carcinoma. Hence, we analyzed 15 CK20-negative Merkel cell carcinoma tumors (10 Merkel cell polyomavirus-negative, four Merkel cell polyomavirus-positive, and one undetermined) using the Ion Ampliseq Comprehensive Cancer Panel, which assesses copy number alterations and mutations in 409 cancer-relevant genes. Twelve tumors displayed prioritized high-level chromosomal gains or losses (average 1.9 per tumor). Non-synonymous high-confidence somatic mutations were detected in 14 tumors (average 11.9 per tumor). Assessing all somatic coding mutations, an ultraviolet-signature mutational profile was present, and more prevalent in Merkel cell polyomavirus-negative tumors. Recurrent deleterious tumor suppressor mutations affected TP53 (9/15, 60%), RB1 (3/15, 20%), and BAP1 (2/15, 13%). Oncogenic activating mutations included PIK3CA (3/15, 20%), AKT1 (1/15, 7%) and EZH2 (1/15, 7%). In conclusion, CK20-negative Merkel cell carcinoma display overlapping genetic changes with CK20-positive Merkel cell carcinoma, including RB1 mutations restricted to Merkel cell polyomavirus-negative tumors. However, some CK20-negative Merkel cell carcinomas harbor mutations not previously described in Merkel cell carcinoma. Hence, CK20-negative Merkel cell carcinomas harbor diverse oncogenic drivers which may represent therapeutic targets in individual tumors.
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Affiliation(s)
- Paul W. Harms
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA,Department of Dermatology, University of Michigan Health System, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Angela M. B. Collie
- Department of Pathology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, USA
| | - Daniel H. Hovelson
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Andi K. Cani
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Monique E. Verhaegen
- Department of Dermatology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Rajiv M. Patel
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA,Department of Dermatology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Douglas R. Fullen
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA,Department of Dermatology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Kei Omata
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Andrzej A. Dlugosz
- Department of Dermatology, University of Michigan Health System, Ann Arbor, MI, USA,Department of Cell & Developmental Biology, University of Michigan, Ann Arbor, MI USA
| | - Scott A. Tomlins
- Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USA,Michigan Center for Translational Pathology, University of Michigan Health System, Ann Arbor, MI, USA,Department of Urology, University of Michigan Health System, Ann Arbor, MI, USA
| | - Steven D. Billings
- Department of Pathology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH, USA
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24
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Chung HJ, Wolpowitz D, Scott G, Gilmore E, Bhawan J. Squamous cell carcinoma with osteoclast-like giant cells: a morphologically heterologous group including carcinosarcoma and squamous cell carcinoma with stromal changes. J Cutan Pathol 2015; 43:148-57. [DOI: 10.1111/cup.12607] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Revised: 08/04/2015] [Accepted: 08/09/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Hye Jin Chung
- Department of Dermatology, Dermatopathology Section; Boston University School of Medicine; Boston MA USA
| | - Deon Wolpowitz
- Department of Dermatology, Dermatopathology Section; Boston University School of Medicine; Boston MA USA
| | - Glynis Scott
- Department of Dermatology; University of Rochester Medical Center; Rochester NY USA
| | - Elaine Gilmore
- Department of Dermatology; University of Rochester Medical Center; Rochester NY USA
| | - Jag Bhawan
- Department of Dermatology; University of Rochester Medical Center; Rochester NY USA
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25
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Abstract
BACKGROUND The histogenesis and clinical behavior of combined cutaneous tumors (CCTs) in which the mesenchymal component consists of melanoma remain unclear. OBJECTIVE We sought to characterize the clinical, histologic, and molecular findings in CCTs with an epithelial and a melanoma component. METHODS We retrospectively reviewed the records from 2 institutions for CCTs. Fluorescence in situ hybridization was performed to assess chromosomal copy number alterations in both components. RESULTS Sixteen CCTs were included. The most common subtype was the squamomelanocytic tumor (11), followed by the basomelanocytic tumor (3) and the trichoblastomelanoma (2). CCTs were more common in men (87%), on the head and neck (57%), and had extensive solar elastosis (81%). The median follow-up was 25 months (range, 8-167 months). One case had an adverse outcome. Fluorescence in situ hybridization revealed chromosomal alterations in approximately 55% of the cases. Five cases showed chromosomal gains only in the melanocytic component. One case showed 11q13 gains in both the epithelial and melanocytic components. LIMITATIONS Our study is retrospective and the sample is small. CONCLUSIONS The low incidence of adverse outcomes suggests that CCT may be more indolent than noncombined tumors. 11q13 amplification in both components supports the theory of dual differentiation from a common progenitor cell.
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