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Ahn B, Moon D, Kim HS, Lee C, Cho NH, Choi HK, Kim D, Lee JY, Nam EJ, Won D, An HJ, Kwon SY, Shin SJ, Jung HR, Kwon D, Park H, Kim M, Cha YJ, Park H, Lee Y, Noh S, Lee YM, Choi SE, Kim JM, Sung SH, Park E. Histopathologic image-based deep learning classifier for predicting platinum-based treatment responses in high-grade serous ovarian cancer. Nat Commun 2024; 15:4253. [PMID: 38762636 PMCID: PMC11102549 DOI: 10.1038/s41467-024-48667-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 05/09/2024] [Indexed: 05/20/2024] Open
Abstract
Platinum-based chemotherapy is the cornerstone treatment for female high-grade serous ovarian carcinoma (HGSOC), but choosing an appropriate treatment for patients hinges on their responsiveness to it. Currently, no available biomarkers can promptly predict responses to platinum-based treatment. Therefore, we developed the Pathologic Risk Classifier for HGSOC (PathoRiCH), a histopathologic image-based classifier. PathoRiCH was trained on an in-house cohort (n = 394) and validated on two independent external cohorts (n = 284 and n = 136). The PathoRiCH-predicted favorable and poor response groups show significantly different platinum-free intervals in all three cohorts. Combining PathoRiCH with molecular biomarkers provides an even more powerful tool for the risk stratification of patients. The decisions of PathoRiCH are explained through visualization and a transcriptomic analysis, which bolster the reliability of our model's decisions. PathoRiCH exhibits better predictive performance than current molecular biomarkers. PathoRiCH will provide a solid foundation for developing an innovative tool to transform the current diagnostic pipeline for HGSOC.
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Affiliation(s)
- Byungsoo Ahn
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Damin Moon
- Artificial Intelligence Research Center, JLK Inc., Seoul, South Korea
| | - Hyun-Soo Kim
- Department of Pathology and Translational Genomics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Chung Lee
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Nam Hoon Cho
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Heung-Kook Choi
- Artificial Intelligence Research Center, JLK Inc., Seoul, South Korea
| | - Dongmin Kim
- Artificial Intelligence Research Center, JLK Inc., Seoul, South Korea
| | - Jung-Yun Lee
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun Ji Nam
- Department of Obstetrics and Gynecology, Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, South Korea
| | - Dongju Won
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hee Jung An
- Department of Pathology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Sun Young Kwon
- Department of Pathology, Keimyung University School of Medicine, Daegu, South Korea
| | - Su-Jin Shin
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Ra Jung
- Department of Pathology, Keimyung University School of Medicine, Daegu, South Korea
| | - Dohee Kwon
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Heejung Park
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Milim Kim
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoon Jin Cha
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
- Institute of Breast Cancer Precision Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyunjin Park
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yangkyu Lee
- Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Songmi Noh
- Department of Diagnostic Pathology, Gangnam CHA Medical Center, CHA University College of Medicine, Seoul, South Korea
| | - Yong-Moon Lee
- Department of Pathology, Dankook University School of Medicine, Cheonan, South Korea
| | - Sung-Eun Choi
- Department of Pathology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, South Korea
| | - Ji Min Kim
- Department of Pathology, Ewha Womans University, Seoul, South Korea
| | - Sun Hee Sung
- Department of Pathology, Ewha Womans University, Seoul, South Korea
| | - Eunhyang Park
- Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
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Fujii H, Noguchi T, Miura T, Fujii N, Isozaki T, Fujita A, Niki T, Matsuki M, Mori H. Magnetic resonance imaging findings of sclerosing microcystic adenocarcinoma: A case report and review of the literature. Radiol Case Rep 2023; 18:3626-3631. [PMID: 37593335 PMCID: PMC10427983 DOI: 10.1016/j.radcr.2023.07.050] [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] [Received: 05/25/2023] [Revised: 07/13/2023] [Accepted: 07/21/2023] [Indexed: 08/19/2023] Open
Abstract
Sclerosing microcystic adenocarcinoma (SMA) is a rare malignant tumor of the salivary glands that closely resembles cutaneous microcystic adnexal carcinoma (MAC). It was newly listed in the 5th edition of the WHO classification of head and neck tumors. This report describes the case of a 61-year-old woman who presented with masses on the floor of the mouth. The masses showed low signal intensity on T2-weighted images (T2WI) and with low apparent diffusion coefficient (ADC) values. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) revealed a plateau or persistence after rapid initial enhancement. Histopathologically, the tumors comprised small infiltrating strands of cells that formed small ducts and cysts embedded in thick fibrous stroma, consistent with SMA. Low signal intensity on T2WI with a low ADC value and a plateau or persistence after rapid initial enhancement on DCE-MRI reflect the fibrous and cellular components of the tumor and can be considered characteristic MRI findings of SMA.
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Affiliation(s)
- Hiroyuki Fujii
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Tadahide Noguchi
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan
| | - Tamaki Miura
- Department of Integrative Pathology, Jichi Medical University, Tochigi, Japan
| | - Nana Fujii
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Takenori Isozaki
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Akifumi Fujita
- Department of Radiology, Haga Red Cross Hospital, Tochigi, Japan
| | - Toshiro Niki
- Department of Integrative Pathology, Jichi Medical University, Tochigi, Japan
| | - Mitsuru Matsuki
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Harushi Mori
- Department of Radiology, Jichi Medical University, Tochigi, Japan
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Lee YY, Hwang TZ, Jin YT, Chen CC. Sclerosing Microcystic Adenocarcinoma Arising from the Tongue: A Case Report and Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12051288. [PMID: 35626443 PMCID: PMC9140568 DOI: 10.3390/diagnostics12051288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/28/2022] Open
Abstract
Sclerosing microcystic adenocarcinoma is a rare and recently characterized cancer that affects the mucosal surfaces of the head and neck without adnexal involvement. Histologically, microcystic adnexal carcinoma of the skin resembles it. It does, however, contain unique characteristics that merit our attention for potential diagnostic errors. Therefore, we present a 48-year-old male with sclerosing microcystic adenocarcinoma of the tongue, along with a full discussion and a brief review of pertinent literature.
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Affiliation(s)
- Yi-Ying Lee
- Department of Pathology, E-DA Hospital, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Tzer-Zen Hwang
- Department of Otolaryngology-Head and Neck Surgery, E-DA Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Correspondence: (T.-Z.H.); (C.-C.C.); Tel.: +886-76-150-011 (T.-Z.H.); +886-52-765-041 (ext. 7521) (C.-C.C.)
| | - Ying-Tai Jin
- Department of Pathology, Taiwan Adventist Hospital, Taipei 10556, Taiwan;
- Department of Pathology, National Cheng Kung University Hospital, Tainan 704, Taiwan
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600, Taiwan
- Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan
- Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan 701, Taiwan
- Correspondence: (T.-Z.H.); (C.-C.C.); Tel.: +886-76-150-011 (T.-Z.H.); +886-52-765-041 (ext. 7521) (C.-C.C.)
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Bishop JA. Proceedings of the North American Society of Head and Neck Pathology, Los Angeles, CA, March 20, 2022: Emerging Entities in Salivary Gland Tumor Pathology. Head Neck Pathol 2022; 16:179-189. [PMID: 35307772 PMCID: PMC9018962 DOI: 10.1007/s12105-022-01422-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 01/20/2022] [Indexed: 12/01/2022]
Abstract
Salivary gland tumor pathology is one of the most challenging areas in all head and neck surgical pathology. Compounding its inherent difficulty are numerous novel entities, variants and concepts, most of which have been based on recent molecular discoveries. This review will serve to update the practicing pathologist on a selected group of emerging entities in salivary gland tumor pathology.
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Affiliation(s)
- Justin A Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, 6201 Harry Hines Blvd, Dallas, TX, 75390, USA.
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Tan GZL, Goh GH, Loh KS, Petersson F. Sclerosing microcystic adenocarcinoma of the parotid gland - The first recorded case with histo-cytopathologic correlation and a brief review of the literature. Ann Diagn Pathol 2021; 54:151806. [PMID: 34418769 DOI: 10.1016/j.anndiagpath.2021.151806] [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: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
We present a case of a 1.0 cm primary tumor of the left parotid gland that meets the histological criteria for the recently described entity sclerosing microcystic adenocarcinoma. The patient was a 73-year-old man with a concurrent tonsillar squamous cell carcinoma, and a history of nasopharyngeal carcinoma treated with radiotherapy 23 years prior. Fine needle aspiration cytology demonstrated low-grade biphasic basaloid neoplastic cells arranged in branching sheets and clusters with minimal nuclear pleomorphism. A biphasic appearance was apparent and some of the cell clusters were bordered by a layer of flattened cells with ovoid bland nuclei. On histology, the tumor comprised small bilayered infiltrative tubules, nests, cords, and microcysts. On immunohistochemistry, EMA, SOX-10, P63, and S-100 protein highlighted a dual cell population of luminal and abluminal cells. The cells were negative for CD117, and the Ki-67 proliferation index was low (<5%).
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Affiliation(s)
- Gideon Ze Lin Tan
- Department of Pathology, National University Hospital, National University Health System, Singapore 119074, 5 Lower Kent Ridge Road, Singapore.
| | - Giap Hean Goh
- Department of Pathology, National University Hospital, National University Health System, Singapore 119074, 5 Lower Kent Ridge Road, Singapore.
| | - Kwok Seng Loh
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, National University Health System, Singapore 119074, 5 Lower Kent Ridge Road, Singapore.
| | - Fredrik Petersson
- Department of Pathology, National University Hospital, National University Health System, Singapore 119074, 5 Lower Kent Ridge Road, Singapore.
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6
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The Decline of Salivary Adenocarcinoma Not Otherwise Specified as a Tumor Entity: Reclassification Using Contemporary Immunohistochemical Profiling and Diagnostic Criteria. Am J Surg Pathol 2021; 45:753-764. [PMID: 33284193 DOI: 10.1097/pas.0000000000001636] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The classification of salivary gland carcinomas has become increasingly specific over the last decade with the definition of new tumor types, documentation of novel molecular and immunohistochemical findings, and development of more refined diagnostic criteria. In this setting, it is unclear how many salivary tumors still cannot be easily categorized-and whether such tumors represent undifferentiated malignancies or include additional definable entities. Relying largely on current classification schemes and contemporary immunohistochemical panels, we reassessed salivary tumors previously diagnosed as adenocarcinoma, not otherwise specified (ACA NOS) from 2 large academic medical centers. Fifty-seven ACA NOS (72%) could be reclassified as more specific entities including 31 salivary duct carcinomas (39%), 7 polymorphous adenocarcinomas (9%), 5 epithelial-myoepithelial carcinomas (6%), 4 myoepithelial carcinomas (5%), 4 secretory carcinomas (5%), 1 acinic cell carcinoma (1%), 1 basal cell adenocarcinoma (1%), 1 intraductal carcinoma (1%), and 1 clear cell carcinoma (1%) as well as 2 metastatic squamous cell carcinomas (3%). Of reclassified cases, 21 (37%) represented variant histologies within these categories. ACA NOS comprised 11% of salivary malignancies before reclassification, but only 4% after reclassification. The remaining 22 ACA NOS demonstrated heterogeneous features, with an association between histologic grade and clinical outcome. In effect, ACA NOS is becoming a bygone entity as modern classification schemes and ancillary techniques now permit more specific typing of a majority of these tumors, potentially facilitating more specific prognostication and treatment. Additional distinctive entities such as mucinous adenocarcinoma may still be definable within the ACA NOS category.
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Emerging Entities in Salivary Pathology: A Practical Review of Sclerosing Microcystic Adenocarcinoma, Microsecretory Adenocarcinoma, and Secretory Myoepithelial Carcinoma. Surg Pathol Clin 2021; 14:137-150. [PMID: 33526218 DOI: 10.1016/j.path.2020.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In recent years, increased molecular testing and improved immunohistochemical panels have facilitated more specific classification of salivary gland carcinomas, leading to recognition of several novel tumor types and unique histologic variants. Sclerosing microcystic adenocarcinoma, microsecretory adenocarcinoma, and secretory myoepithelial carcinoma are three such recently described entities that demonstrate low-grade cytology, production of prominent secretory material, and variable amounts of sclerotic stroma. This review provides a practical overview of these important and overlapping emerging entities in salivary gland pathology with a focus on distinctive histologic features and helpful ancillary studies that differentiate them from a wide range of familiar morphologic mimics.
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Ide F, Matsumoto N, Kikuchi K, Kusama K. Microcystic Adenocarcinoma: An Initially Overlooked First Proposal of the Term. Head Neck Pathol 2018; 13:487-488. [PMID: 30242735 PMCID: PMC6684705 DOI: 10.1007/s12105-018-0967-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 09/15/2018] [Indexed: 11/25/2022]
Affiliation(s)
- Fumio Ide
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan.
- Department of Diagnostic Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan.
| | - Naoyuki Matsumoto
- Department of Diagnostic Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan
| | - Kentaro Kikuchi
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan
| | - Kaoru Kusama
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, 1-1 Keyakidai, Sakado, Saitama, 350-0283, Japan
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Zhang R, Cagaanan A, Hafez GR, Hu R. Sclerosing Microcystic Adenocarcinoma: Report of a Rare Case and Review of Literature. Head Neck Pathol 2018; 13:215-219. [PMID: 29987694 PMCID: PMC6513910 DOI: 10.1007/s12105-018-0945-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 07/03/2018] [Indexed: 11/24/2022]
Abstract
Sclerosing microcystic adenocarcinoma is an exceedingly rare entity occurring in the mucosal surfaces of the head and neck that closely resembles cutaneous microcystic adnexal carcinoma. Here, we report a case of sclerosing microcystic adenocarcinoma that presented as a vague mass at the floor of the mouth in a 55-year-old woman. The pathology features and the diagnostic challenges, especially in the biopsy and margin evaluation are discussed here. Similar cases published in the English literatures are reviewed.
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Affiliation(s)
- Ranran Zhang
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
| | - Alain Cagaanan
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
| | - Gholam-Reza Hafez
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
| | - Rong Hu
- Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792 USA
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