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Alsugair Z, Lépine C, Descotes F, Lanic MD, Pissaloux D, Tirode F, Lopez J, Céruse P, Philouze P, Fieux M, Wassef M, Baglin AC, Mihaela O, Castain C, Sudaka A, Uro-Coste E, Champagnac A, Costes-Martineau V, Laé M, Benzerdjeb N. Beneath HMGA2 alterations in pleomorphic adenomas: Pathological, immunohistochemical, and molecular insights. Hum Pathol 2024; 152:105633. [PMID: 39089476 DOI: 10.1016/j.humpath.2024.105633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 07/26/2024] [Accepted: 07/28/2024] [Indexed: 08/04/2024]
Abstract
AIMS Most salivary gland neoplasms are distinguished by specific recurrent gene fusions. Recently, a subset of pleomorphic adenomas (PAs) originated from the parotid gland harboring the HMGA2:WIF1 fusion was described with a canalicular adenoma-like morphology and a greater propensity for recurrence and carcinomatous transformation. METHODS AND RESULTS This study delineates the clinicopathological attributes of 54 cases of PAs exhibiting HMGA2 alterations, predominantly characterized by the HMGA2:WIF1 fusion, alongside a comparative analysis of their morphological and immunohistochemical profiles. The cohort consisted of 23 females and 31 males (n = 54), mean age was 56.7 (25-84), tumors predominantly originated from the parotid gland (94.4%, 51/54), with 3 cases from seromucous glands (5.6%). Mean tumor size was 2.6 cm (0.8-7.5). No clinical difference (demographic, follow-up) was observed among histological subsets (conventional, hybrid, and pure). Complete excision was performed in all cases, with follow-up data available for 41% (22/54) of patients, showing 13.6% of recurrence (3/22) between 5 and 8 months. Various histological growth patterns were identified, with the pure hypercellular monomorphic subset being the most prevalent. The HMGA2:WIF1 gene was identified in all subsets without any particular predominance. Novel gene partners of HMGA2 were identified, comprising NRXN1, INPP4B, MSRB3, PHLDA1, and FLJ41278. CONCLUSIONS The present study reports that the HMGA2:WIF1 gene fusion was present in all subsets of PAs without significant predominance. However, further investigations are warranted to explore the relationship between histological subsets of PAs and the molecular alterations underlying them.
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Affiliation(s)
- Ziyad Alsugair
- Department of Pathology, Institut de Pathologie Multisite, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France
| | | | - Françoise Descotes
- Biochemistry and Molecular Biology Department, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France
| | - Marie-Delphine Lanic
- Pathology Department, Centre Henri Becquerel, INSERM U1245, Université Rouen Normandie, Rouen, France
| | - Daniel Pissaloux
- The Unit of Molecular Pathology, INSERM 1052, CNRS 5286 of Cancer Research Center of Lyon, and Team Genetics, Epigenetics and Biology of Sarcomas, Université Claude Bernard Lyon 1, Lyon, France; Biopathology department, Centre Leon Berard, Lyon, France
| | - Franck Tirode
- The Unit of Molecular Pathology, INSERM 1052, CNRS 5286 of Cancer Research Center of Lyon, and Team Genetics, Epigenetics and Biology of Sarcomas, Université Claude Bernard Lyon 1, Lyon, France
| | - Jonathan Lopez
- Biochemistry and Molecular Biology Department, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France; University of Lyon, Université Lyon 1, Lyon, France
| | - Philippe Céruse
- University of Lyon, Université Lyon 1, Lyon, France; Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Hospices Civils de Lyon, Hôpital de La Croix Rousse, Lyon, France
| | - Pierre Philouze
- University of Lyon, Université Lyon 1, Lyon, France; Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Hospices Civils de Lyon, Hôpital de La Croix Rousse, Lyon, France
| | - Maxime Fieux
- University of Lyon, Université Lyon 1, Lyon, France; Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France
| | - Michel Wassef
- Department of Pathology, Hôpital Lariboisière, AP-HP, Paris Diderot University, Paris, France
| | - Anne-Catherine Baglin
- Department of Pathology, Hôpital Lariboisière, AP-HP, Paris Diderot University, Paris, France
| | - Onea Mihaela
- Pathology Department, CHU de Strasbourg, Strasbourg, France
| | | | - Anne Sudaka
- Histopathology Department, Centre Antoine Lacassagne, Nice, France
| | - Emmanuelle Uro-Coste
- Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse, France
| | | | | | - Marick Laé
- Pathology Department, Centre Henri Becquerel, INSERM U1245, Université Rouen Normandie, Rouen, France
| | - Nazim Benzerdjeb
- Department of Pathology, Institut de Pathologie Multisite, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Bénite, France; University of Lyon, Université Lyon 1, Lyon, France; EMR3738, CICLY, Pierre-Bénite, France.
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de Lima-Souza RA, Vieira GDS, Kimura TDC, Scarini JF, Lavareze L, Maciel TF, Gonçalves MWA, Egal ESA, Altemani A, Mariano FV. Insights into the molecular alterations of PLAG1 and HMGA2 associated with malignant phenotype acquisition in pleomorphic adenoma. Crit Rev Oncol Hematol 2024; 204:104494. [PMID: 39278426 DOI: 10.1016/j.critrevonc.2024.104494] [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: 07/05/2024] [Revised: 08/14/2024] [Accepted: 08/21/2024] [Indexed: 09/18/2024] Open
Abstract
Pleomorphic adenoma (PA) is the most common neoplasm of the salivary gland, presenting with a variety of histological features. In some cases, PA can undergo malignant transformation to carcinoma ex pleomorphic adenoma (CXPA). The transition from PA to CXPA is associated with complex molecular alterations, particularly involving the pleomorphic adenoma gene 1 (PLAG1) and high mobility group protein gene (HMGA2). This review investigates the molecular alterations of PLAG1 and HMGA2 in all domains in the malignant transformation of PA. Our analysis highlights that these markers are key alterations in the etiopathogenesis of PA and CXPA, with gene fusion and amplification being frequently reported mechanisms. Although the exact role of PLAG1 and HMGA2 in the oncogenic process remains unclear, further studies on the HMGA2 and PLAG1, are needed particularly in HMGA2-PLAG1-IGF2 which is proving to be a potential pathway for the development of clinically applicable therapies, especially for CXPA management.
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Affiliation(s)
- Reydson Alcides de Lima-Souza
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
| | - Gustavo de Souza Vieira
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Talita de Carvalho Kimura
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - João Figueira Scarini
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Luccas Lavareze
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Tayná Figueiredo Maciel
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Moisés Willian Aparecido Gonçalves
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Erika Said Abu Egal
- Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Biorepository and Molecular Pathology, Huntsman Cancer Institute, University of Utah (UU), Salt Lake City, UT, United States
| | - Albina Altemani
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil
| | - Fernanda Viviane Mariano
- Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
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Alsugair Z, Pissaloux D, Descotes F, Tirode F, Lopez J, Perrot J, Lapierre A, Fieux M, Philouze P, Champagnac A, Onea M, Benzerdjeb N. Uncovering the WWTR1::NCOA2 Gene fusion in low-grade myoepithelial-rich neoplasm with HMGA2 expression: A case report. Genes Chromosomes Cancer 2024; 63:e23244. [PMID: 38747338 DOI: 10.1002/gcc.23244] [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: 09/27/2023] [Revised: 04/12/2024] [Accepted: 04/20/2024] [Indexed: 06/14/2024] Open
Abstract
We describe a case of a pleomorphic adenoma (PA) arising from the para-tracheal accessory salivary gland in a 44-year-old male harboring a novel WWTR1::NCOA2 gene fusion. To our knowledge, this novel gene fusion has not been described previously in salivary gland tumors. The patient presented with hoarseness of voice. The radiological exam revealed a mass in the upper third of the trachea involving the larynx. Histologically, the tumor consisted of bland-looking monocellular eosinophilic epithelial cells arranged in cords and sheets separated by thin fibrous stroma, focally forming a pseudo-tubular pattern. In immunohistochemistry, the tumor cells demonstrated positivity for CK7, PS100, SOX10, and HMGA2; and negativity for CK5/6, p40 p63, and PLAG1. In addition, the clustering analysis clearly demonstrates a clustering of tumors within the PA group. In addition to reporting this novel fusion in the PA spectrum, we discuss the relevant differential diagnoses and briefly review of NCOA2 and WWTR1 gene functions in normal and neoplastic contexts.
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Affiliation(s)
- Ziyad Alsugair
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Daniel Pissaloux
- Biopathology Department, Centre Leon Berard, Lyon, France
- The Unit of Molecular Pathology, INSERM 1052, CNRS 5286 of Cancer Research Center of Lyon, and Team Genetics, Epigenetics and Biology of Sarcomas, Université Claude Bernard Lyon 1, Lyon, France
| | - Françoise Descotes
- Biochemistry and Molecular Biology Department, Groupement Hospitalier Sud, Lyon, France
| | - Franck Tirode
- Biopathology Department, Centre Leon Berard, Lyon, France
- The Unit of Molecular Pathology, INSERM 1052, CNRS 5286 of Cancer Research Center of Lyon, and Team Genetics, Epigenetics and Biology of Sarcomas, Université Claude Bernard Lyon 1, Lyon, France
| | - Jonathan Lopez
- Biochemistry and Molecular Biology Department, Groupement Hospitalier Sud, Lyon, France
| | - Jimmy Perrot
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Ariane Lapierre
- Department of Oncological radiothERapy, Centre Hospitalier Universitaire Lyon Sud, France
| | - Maxime Fieux
- Department of Oto-Rhino-Laryngology, otoneurosurgery and Cervico-Faciale surgury, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
| | - Pierre Philouze
- Department of Oto-Rhino-Laryngology and Cervico-Faciale surgury, Hôpital La Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | | | - Mihaela Onea
- Department of Pathology, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Nazim Benzerdjeb
- Department of Pathology, Institut de Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon, Pierre-Bénite, France
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Alsugair Z, Perrot J, Descotes F, Lopez J, Champagnac A, Pissaloux D, Castain C, Onea M, Céruse P, Philouze P, Lépine C, Lanic MD, Laé M, Costes-Martineau V, Benzerdjeb N. Characterization of a Molecularly Distinct Subset of Oncocytic Pleomorphic Adenomas/Myoepitheliomas Harboring Recurrent ZBTB47-AS1::PLAG1 Gene Fusion. Am J Surg Pathol 2024; 48:551-561. [PMID: 38497430 DOI: 10.1097/pas.0000000000002206] [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: 03/19/2024]
Abstract
Recurrent gene fusions are common in salivary gland tumors including benign tumors, such as pleomorphic adenoma (PA) and myoepithelioma (ME). In cases where chromosomal rearrangement is identified in the pleomorphic adenoma gene 1 (PLAG1) gene, different gene partners are found. Oncocytic metaplasia, characterized by oncocytes with abundant eosinophilic granular cytoplasm and hyperchromatic nuclei, is a well-known phenomenon in salivary gland neoplasms. However, the pure oncocytic variant of PA/ME showed PLAG1 gene rearrangements involving various gene partners at the molecular level, without any recurrent fusion being found. Our study includes 20 cases of PA/ME, with 11 females and 9 males. The age of patients ranged from 37 to 96 years, with a median age of 62.8 years. Most tumors originate from the parotid gland. The median size of the tumor was 26.5 mm (range: 13 to 60 mm). Among the 20 cases, 14 were a pure oncocytic variant of PA/ME, whereas 6 cases showed focal oncocytic or oncocytic-like aspects. Molecular studies on 20 cases of PA/ME were conducted. A novel recurrent ZBTB47-AS1::PLAG1 fusion was identified in 6 of 12 cases with pure oncocytic metaplasia, whereas the other cases had PLAG1 gene fusion with different gene partners. The transcriptomic analysis of the cases harboring ZBTB47-AS1::PLAG1 fusion demonstrated that these tumors have a distinct molecular profile from conventional PA/ME. This study reveals a unique subset in the oncocytic PA/ME spectrum characterized by pure oncocytic morphology with larger oncocytic cells and recurrent ZBTB47-AS1::PLAG1 fusion. It also highlights the transcriptomic distinctness of salivary gland adenomas with pure oncocytic metaplasia in the spectrum of salivary gland neoplasms. Further studies are needed to better understand the oncocytic variant of PA/ME and to determine the true nature of oncocytic cells in PA/ME.
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Affiliation(s)
- Ziyad Alsugair
- Department of Pathology, Institut of Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon
| | - Jimmy Perrot
- Department of Pathology, Institut of Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon
| | - Françoise Descotes
- Department of Biochemistry and Molecular Biology, Groupement Hospitalier Sud, Lyon, Pierre-Bénite
| | - Jonathan Lopez
- Department of Biochemistry and Molecular Biology, Groupement Hospitalier Sud, Lyon, Pierre-Bénite
| | | | - Daniel Pissaloux
- Department of Biopathology, Centre Léon Bérard
- The Unit of Molecular Pathology, INSERM, Cancer Research Center of Lyon, and Team Genetics, Epigenetics and Biology of Sarcomas, Université Claude Bernard Lyon 1
| | - Claire Castain
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, La Croix Rousse Hospital, Hospices Civils de Lyon
| | - Mihaela Onea
- EMR3738, CICLY, University Claude Bernard Lyon 1, Lyon
| | - Philippe Céruse
- Department of Pathology, University Hospital of Bordeaux, Bordeaux
| | - Pierre Philouze
- Department of Pathology, University Hospital of Bordeaux, Bordeaux
| | - Charles Lépine
- Department of Pathology, University Hospital of Strasbourg, Strasbourg
- Department of Pathology, CHU Nantes
| | - Marie-Delphine Lanic
- Nantes University, Univ Angers, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, Nantes
- INSERM U1245, Cancer Center Henri Becquerel, Institute of Research and Innovation in Biomedicine (IRIB), University of Normandy, UNIROUEN
| | - Marick Laé
- Nantes University, Univ Angers, INSERM, CNRS, Immunology and New Concepts in ImmunoTherapy, INCIT, Nantes
- INSERM U1245, Cancer Center Henri Becquerel, Institute of Research and Innovation in Biomedicine (IRIB), University of Normandy, UNIROUEN
| | | | - Nazim Benzerdjeb
- Department of Pathology, Institut of Pathologie Multisite, Groupement Hospitalier Sud, Hospices Civils de Lyon
- Department of Pathology, University Hospital of Montpellier, Montpellier, France
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Vidyalakshmi S, Shanmugasamy K. Preoperative cytopathological investigatory aids in the diagnosis of salivary gland lesions. J Oral Maxillofac Pathol 2024; 28:172-177. [PMID: 39157837 PMCID: PMC11329079 DOI: 10.4103/jomfp.jomfp_132_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2024] [Revised: 05/25/2024] [Accepted: 06/01/2024] [Indexed: 08/20/2024] Open
Abstract
Salivary gland lesions are a group of heterogeneous lesions inclusive of non-neoplastic and neoplastic lesions. History, clinical examination and preoperative investigations attempt to minimise the challenges faced in diagnosing these diverse lesions. Preoperative investigations include imaging and cytopathology. The advent of onsite evaluation methods to ensure sample adequacy and newer reporting systems that assign risk of malignancy has improved the sensitivity and specificity of cytopathology. The scope of this review is limited to the preoperative cytopathological investigations and the diagnostic challenges met in reporting salivary gland tumours.
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Affiliation(s)
- S Vidyalakshmi
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth University, Pillayarkuppam, Puducherry, India
| | - K Shanmugasamy
- Department of Pathology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth University, Pillayarkuppam, Puducherry, India
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Molecular Targets in Salivary Gland Cancers: A Comprehensive Genomic Analysis of 118 Mucoepidermoid Carcinoma Tumors. Biomedicines 2023; 11:biomedicines11020519. [PMID: 36831055 PMCID: PMC9953533 DOI: 10.3390/biomedicines11020519] [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: 12/26/2022] [Revised: 01/24/2023] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
INTRODUCTION Salivary gland carcinomas (SGC) are histologically diverse cancers and next-generation sequencing (NGS) to identify key molecular targets is an important aspect in the management of advanced cases. METHODS DNA was extracted from paraffin embedded tissues of advanced SGC and comprehensive genomic profiling (CGP) was carried out to evaluate for base substitutions, short insertions, deletions, copy number changes, gene fusions and rearrangements. Tumor mutation burden (TMB) was calculated on approximately 1.25 Mb. Some 324 genes in the FoundationOne CDX panel were analyzed. RESULTS Mucoepidermoid carcinoma (MECa) mutations were assessed. CDKN2A and CDKN2B GA were common in mucoepidermoid carcinoma (MECa) (52.5 and 30.5%). PIK3CA was also common in MECa (16.9%). ERBB2 amplification/short variants (amp/SV) were found in MECa (5.9/0%). HRAS GA was common in MECa (14.4%) as well. Other targets, including BAP1, PTEN, and KRAS, were noted but had a low incidence. In terms of immunotherapy (IO)-predictive markers, TMB > 10 was more common in MECa (16.9%). PDL1 high was also seen in MECa (4.20%). CONCLUSION SGC are rare tumors with no FDA-approved treatment options. This large dataset reveals many opportunities for IO and targeted therapy contributing to the continuously increased precision in the selection of treatment for these patients.
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Zhang W, Zhang S, Yang Z, Zhang Y, Wang Z. Lipoblastoma in one adult and 35 pediatric patients: Retrospective analysis of 36 cases. Exp Ther Med 2022; 25:11. [PMID: 36561624 PMCID: PMC9748941 DOI: 10.3892/etm.2022.11710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/17/2022] [Indexed: 11/17/2022] Open
Abstract
Lipoblastoma is a rare benign mesenchymal neoplasm that typically occurs at various sites in infants and children but may also occur in adults. Thus, differential diagnoses are often performed. To understand this tumor type, the present study described clinicopathological features, diagnosis and differential diagnosis of different morphological lipoblastomas. A single-institution retrospective review of 36 lipoblastoma cases diagnosed between 2015 and 2021 was performed. Formalin-fixed paraffin-embedded tissue was used for S-100, CD34, P16 and desmin immunohistochemistry analysis, along with rapid fluorescence in situ hybridization (FISH) detection with pleiomorphic adenoma gene 1 (PLAG1). The 36 cases included 14 females and 22 males [age range, 7 days to 33 years (median, 16.5 years); 28 patients were aged ≤3 years] and the tumors were located in the trunk (n=16), limbs (n=12), head and neck (n=6), and perineum (n=2). Histologically, lipoblastomas were divided into classic (n=15), lipoma-like (n=13) and myxoid (n=8) subtypes. They comprised lobules of mature adipose tissue of varying size and a fine capillary network surrounded by mucinous stroma. Single- or multivesicular lipoblasts positive for S-100 (29/36, 81%) were observed, with occasional mature adipocytes. Peripheral vessels and cytoplasm of primitive mesenchymal cells were diffusely positive for CD34 (36/36, 100%), whereas primitive mesenchymal cells and striated muscle tissue were positive for desmin (26/36, 72%). Most tumor cells were negative while only few were positive for P16 (8/36, 22%). FISH revealed PLAG1 breakage and rearrangement in 24/32 (75%) patients. In total, 28 patients were followed up post-operatively (range, 2-84 months; median, 41 months; 3 patients relapsed and 8 were lost to follow-up). In conclusion, diagnosis of a typical lipoblastoma is not difficult and PLAG1 breakage detection is key for the diagnosis.
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Affiliation(s)
- Wenchuan Zhang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Shuwan Zhang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Zixin Yang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Ying Zhang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China
| | - Zhe Wang
- Department of Pathology, Shengjing Hospital of China Medical University, Shenyang, Liaoning 110004, P.R. China,Correspondence to: Professor Zhe Wang, Department of Pathology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Shenyang, Liaoning 110004, P.R. China
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Chromosome Translocations, Gene Fusions, and Their Molecular Consequences in Pleomorphic Salivary Gland Adenomas. Biomedicines 2022; 10:biomedicines10081970. [PMID: 36009517 PMCID: PMC9405559 DOI: 10.3390/biomedicines10081970] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 11/23/2022] Open
Abstract
Salivary gland tumors are a heterogeneous group of tumors originating from the major and minor salivary glands. The pleomorphic adenoma (PA), which is the most common subtype, is a benign lesion showing a remarkable morphologic diversity and that, upon recurrence or malignant transformation, can cause significant clinical problems. Cytogenetic studies of >500 PAs have revealed a complex and recurrent pattern of chromosome rearrangements. In this review, we discuss the specificity and frequency of these rearrangements and their molecular/clinical consequences. The genomic hallmark of PA is translocations with breakpoints in 8q12 and 12q13-15 resulting in gene fusions involving the transcription factor genes PLAG1 and HMGA2. Until recently, the association between these two oncogenic drivers was obscure. Studies of the Silver−Russel syndrome, a growth retardation condition infrequently caused by mutations in IGF2/HMGA2/PLAG1, have provided new clues to the understanding of the molecular pathogenesis of PA. These studies have demonstrated that HMGA2 is an upstream regulator of PLAG1 and that HMGA2 regulates the expression of IGF2 via PLAG1. This provides a novel explanation for the 8q12/12q13-15 aberrations in PA and identifies IGF2 as a major oncogenic driver and therapeutic target in PA. These studies have important diagnostic and therapeutic implications for patients with PA.
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Agaimy A. Fusion‐positive Skin/Adnexal Carcinomas. Genes Chromosomes Cancer 2022; 61:274-284. [DOI: 10.1002/gcc.23031] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 11/06/2022] Open
Affiliation(s)
- Abbas Agaimy
- Pathologisches Institut Universitätsklinikum Erlangen, Krankenhausstrasse 8‐10, 91054 Erlangen Germany
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Agaimy A, Ihrler S, Baněčková M, Costés Martineau V, Mantsopoulos K, Hartmann A, Iro H, Stoehr R, Skálová A. HMGA2-WIF1 Rearrangements Characterize a Distinctive Subset of Salivary Pleomorphic Adenomas With Prominent Trabecular (Canalicular Adenoma-like) Morphology. Am J Surg Pathol 2022; 46:190-199. [PMID: 34324456 DOI: 10.1097/pas.0000000000001783] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Most of salivary gland neoplasms (benign and malignant) are characterized by recurrent gene fusions. Pleomorphic adenoma (PA), the most frequent salivary gland tumor, is driven by chromosomal rearrangements involving PLAG1 mapped to 8q12 and HMGA2 mapped to 12q13-15 in most cases. Multiple fusion partners have been identified including CTNNB1, FGFR1, LIFR, CHCHD7 and TCEA for PLAG1 fusions and NFIB, WIF1 and FHIT for HMGA2 fusions. To date, no data exist on the morphology of the few reported HMGA2-WIF1-rearranged PAs. We present 28 major salivary gland adenomas displaying distinctive trabecular and canalicular morphology associated with recurrent genotype. Patients were 15 females and 13 males aged 43 to 87 (median: 65). All tumors originated from the parotid. Their size range was 1 to 4 cm (mean: 2.3). Histologically, all tumors showed elongated or columnar cells arranged into bilayered to multilayered communicating and branching strands and trabeculae in a manner similar to canalicular adenoma of minor salivary glands or trabecular myoepithelioma with variable solid confluent intercalated duct-like areas. Fifteen tumors were exclusively canalicular/trabecular while 13 had intermingled or well-demarcated conventional (chondromyxoid) PA component comprising 5 to >50% of the tumor. The monomorphic areas expressed uniformly CK7 (28/28), vimentin (21/21), S100 (24/24), SOX10 (16/17) and variably p63 (8/21) and mammaglobin (6/16) but were negative with p40 (0/24), smooth muscle actin (0/24) and MUC4 (0/16). Targeted RNA sequencing revealed HMGA2 fusions in 14/16 (87%) assessable cases. Fusion partner was WIF1 (12), RPSAP52 (1) and HELB (1). Separate testing of the 2 components in 1 hybrid tumor showed same HMGA2/WIF1 fusion. HMGA2 immunohistochemistry was homogeneously positive in all cases including the 2 fusion-negative cases. A control cohort of 12 genuine canalicular adenomas revealed no HMGA2 fusions (0/4) and lacked HMGA2 immunoreactivity (0/12). This study highlights a distinctive variant in the spectrum of PA characterized by prominent trabecular and canalicular adenoma-like morphology. Our data confirm that canalicular adenomas in major salivary glands (either monomorphic or part of hybrid tumors) are distinct from canalicular adenoma of minor salivary glands. Their uniform genotype irrespective of presence or absence of a conventional PA component argues for classifying those tumors lacking a conventional PA component as "monomorphic variants of PA" rather than canalicular/basal cell adenomas, intercalated duct adenoma, trabecular myoepithelioma or true hybrid tumors.
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Affiliation(s)
- Abbas Agaimy
- Institute of Pathology, Comprehensive Cancer Center (CCC) Erlangen-EMN
| | - Stephan Ihrler
- DERMPATH Muenchen
- Institute of Pathology, Ludwig Maximilians University, Munich, Germany
| | - Martina Baněčková
- Department of Pathology, Charles University, Faculty of Medicine in Plzen
- Bioptic Laboratory Ltd, Plzen, Czech Republic
| | | | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen
| | - Arndt Hartmann
- Institute of Pathology, Comprehensive Cancer Center (CCC) Erlangen-EMN
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital Erlangen
| | - Robert Stoehr
- Institute of Pathology, Comprehensive Cancer Center (CCC) Erlangen-EMN
| | - Alena Skálová
- Department of Pathology, Charles University, Faculty of Medicine in Plzen
- Bioptic Laboratory Ltd, Plzen, Czech Republic
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11
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Recent Advances on Immunohistochemistry and Molecular Biology for the Diagnosis of Adnexal Sweat Gland Tumors. Cancers (Basel) 2022; 14:cancers14030476. [PMID: 35158743 PMCID: PMC8833812 DOI: 10.3390/cancers14030476] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Cutaneous sweat gland tumors form an extremely diverse and heterogeneous group of neoplasms that show histological differentiation to the sweat apparatus. Due to their rarity, wide diagnostic range, and significant morphological overlap between entities, their accurate diagnosis remains challenging for pathologists. Until recently, little was known about the molecular pathogenesis of adnexal tumors. Recent findings have revealed a wide range of gene fusions and other oncogenic factors that can be used for diagnostic purposes and, for some, can be detected by immunohistochemistry. Among other organs containing exocrine glands, such as salivary glands, breasts, and bronchi, most of these biomarkers have been reported in homologous neoplasms that share morphological features with their cutaneous counterparts. This review aims to describe these recent molecular and immunohistochemical biomarkers in the field of sweat gland tumors. Abstract Cutaneous sweat gland tumors are a subset of adnexal neoplasms that derive or differentiate into the sweat apparatus. Their great diversity, rarity, and complex terminology make their pathological diagnosis challenging. Recent findings have revealed a wide spectrum of oncogenic drivers, several of which are of diagnostic interest for pathologists. Most of these molecular alterations are represented by gene fusions, which are shared with other homologous neoplasms occurring in organs containing exocrine glands, such as salivary and breast glands, which show similarities to the sweat apparatus. This review aims to provide a synthesis of the most recent immunohistochemical and molecular markers used for the diagnosis of sweat gland tumors and to highlight their relationship with similar tumors in other organs. It will cover adenoid cystic carcinoma (NFIB, MYB, and MYBL1 fusion), cutaneous mixed tumor (PLAG1 fusion), cylindroma and spiradenoma and their carcinomas thereof (NF-κB activation through CYLD inactivation or ALKP1 hotspot mutation), hidradenoma and hidradenocarcinoma (MAML2 fusion), myoepithelioma (EWSR1 and FUS fusion), poroma and porocarcinoma (YAP1, MAML2, and NUTM1 fusion), secretory carcinoma (ETV6, NTRK3 fusion), tubular adenoma and syringo-cystadenoma papilliferum (HRAS and BRAF activating mutations). Sweat gland tumors for which there are no known molecular abnormalities will also be briefly discussed, as well as potential future developments.
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12
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Molecular Pathology of Salivary Gland Neoplasms: Diagnostic, Prognostic, and Predictive Perspective. Adv Anat Pathol 2021; 28:81-93. [PMID: 33405400 DOI: 10.1097/pap.0000000000000291] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Salivary gland neoplasms are an uncommon and widely heterogeneous group of tumors. In recent years, there has been considerable progress in efforts to reveal the molecular landscape of these tumors, although it is still limited and appears to be only the tip of the iceberg. Genomic aberrations, especially specific chromosomal rearrangements including CRTC1-MAML2 and CRTC3-MAML2 in mucoepidermoid carcinoma, MYB-NFIB and MYBL1-NFIB fusions in adenoid cystic carcinoma, PLAG1 and HMGA2 alterations in pleomorphic adenoma and carcinoma ex pleomorphic adenoma, ETV6-NTRK3 and ETV6-RET in secretory carcinoma, EWSR1-ATF1 and EWSR1-CREM in clear cell carcinoma, provide new insights into the molecular pathogenesis of various salivary gland neoplasms and help to better classify them. These genetic aberrations primarily serve as diagnostic tools in salivary gland tumor diagnosis; however, some also have promise as prognostic or predictive biomarkers. This review summarizes the latest developments in molecular pathology of salivary gland tumors with a focus on distinctive molecular characteristics.
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13
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Zia S, Shaw B, Chapman S, Friedman BJ. An atypical chondroid syringoma with malignant degeneration: Utility of comparative genomic hybridization in confirming the diagnosis. J Cutan Pathol 2021; 48:775-780. [PMID: 33470448 DOI: 10.1111/cup.13965] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 12/13/2022]
Abstract
Chondroid syringoma (CS) represents the cutaneous counterpart of mixed tumor (pleomorphic adenoma) of salivary glands. Definitive diagnosis is made on histopathology and is based on the presence of characteristic epithelial and stromal components. We report a case of an atypical CS arising on the extremity of an elderly male patient. Histomorphologic features of necrosis and cellular atypia raised suspicion for malignant degeneration, an exceptionally rare circumstance in this context. To further support the diagnosis of malignancy, array comparative genomic hybridization was performed from both low and higher grade areas of the tumor. Both regions demonstrated multiple copy number gains and losses, with additional loss of q7p (TP53), loss of 19p, and loss of heterozygosity on16q demonstrated in the more atypical foci. To our knowledge, this is the first case description of malignant degeneration of a CS with correlative microarray analysis. The findings in this case may prove useful in confirming the diagnosis in future ambiguous cases.
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Affiliation(s)
- Shereen Zia
- Department of Pathology and Laboratory Medicine, Henry Ford Hospital, Detroit, Michigan, USA
| | - Brandon Shaw
- Department of Pathology and Laboratory Medicine, Henry Ford Hospital, Detroit, Michigan, USA
| | - Stephanie Chapman
- Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA
| | - Ben J Friedman
- Department of Pathology and Laboratory Medicine, Henry Ford Hospital, Detroit, Michigan, USA.,Department of Dermatology, Henry Ford Hospital, Detroit, Michigan, USA
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14
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Baněčková M, Uro-Coste E, Ptáková N, Šteiner P, Stanowska O, Benincasa G, Colella G, Vondrák J, Michal M, Leivo I, Skálová A. What is hiding behind S100 protein and SOX10 positive oncocytomas? Oncocytic pleomorphic adenoma and myoepithelioma with novel gene fusions in a subset of cases. Hum Pathol 2020; 103:52-62. [PMID: 32673681 DOI: 10.1016/j.humpath.2020.07.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 11/29/2022]
Abstract
Oncocytomas (OCs) in salivary glands are rare benign tumors composed of mitochondria-rich epithelial cells (oncocytes), mostly localized in the parotid gland. The treatment of choice is simple excision. Extensive oncocytic metaplasia of pleomorphic adenoma (PA) and myoepithelioma (ME) can be diagnostically challenging and may camouflage the correct diagnosis. These tumors should be treated more carefully compared with OC, given the risk of frequent recurrences and the possibility of malignant transformation. We have investigated 89 oncocytic lesions from our files, including OC (n = 74) and metaplastic oncocytic variant of PA/ME (n = 15). All OCs were stained for S100 protein and SOX10. The tumors with immunohistochemical expression of one or both markers were tested by next-generation sequencing (NGS). The NGS results were confirmed by reverse transcription-polymerase chain reaction (RT-PCR) and/or fluorescence in situ hybridization (FISH). Ten cases originally diagnosed as OC, and 1 low-grade uncertain oncocytic tumor (11/74) revealed nuclear-cytoplasmic and/or nuclear positivity for S100 protein and/or SOX10, respectively. Fusion transcripts CHCHD7-PLAG1 and GEM-PLAG1 were found in 2 cases (1 fusion in each), and these were confirmed by RT-PCR and PLAG1 break-apart FISH probe, respectively. Another 5 cases were positive for PLAG1 rearrangement by FISH. In the control group of 15 oncocytic PA/ME, 4/15 tested tumors harbored gene fusions including NFT3-PLAG1, CHCHD7-PLAG1, FBXO32-PLAG1, and C1orf116-PLAG1 (1 fusion in each case) as detected by NGS. Two fusions were confirmed by RT-PCR, 1 case by FISH, and 1 case was not analyzable by FISH. We additionally tested 24 OCs negative for S100 protein and SOX10 by immunohistochemistry (IHC) and by FISH for rearrangement of PLAG1 gene, but none of them were positive. SOX10 and/or S100 protein immunopositivity in conjunction with rearrangement of the PLAG1 gene assisted in reclassification of a subset of oncocytomas as oncocytic variants of PA and ME. Therefore, we recommend to include S100 protein and SOX10 IHC when diagnosing tumors with predominantly oncocytoma-like differentiation. In addition, by NGS, 3 new gene fusions were detected in oncocytic ME, including NTF3-PLAG1, FBXO32-PLAG1, and GEM-PLAG1, and a new fusion C1orf116-PLAG1 was detected in oncocytic PA.
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Affiliation(s)
- Martina Baněčková
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, 30605, Czech Republic; Bioptic Laboratory Ltd, Plzen, 32600, Czech Republic.
| | - Emmanuelle Uro-Coste
- Department of Pathology, Toulouse University Hospital, IUC-Oncopole, Toulouse, 31100, France; INSERM U1037, Cancer Research Center of Toulouse (CRCT), Toulouse, 31100, France
| | - Nikola Ptáková
- Molecular and Genetic Laboratory, Bioptic Laboratory Ltd, Plzen, 32600, Czech Republic
| | - Petr Šteiner
- Molecular and Genetic Laboratory, Bioptic Laboratory Ltd, Plzen, 32600, Czech Republic
| | - Olga Stanowska
- Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, 00 001, Poland
| | - Giulio Benincasa
- Department of Pathology, Clinic Pineta Grande, Castel Volturno (CE), 81030, Italy
| | - Giuseppe Colella
- Department of Maxillo-facial Surgery, University Della Campania "Luigi Vanvitelli", Policlinico Piazza Miraglia, Naples, 81100, Italy
| | - Jan Vondrák
- South Bohemian University, Ceske Budejovice, 37005, Czech Republic
| | - Michal Michal
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, 30605, Czech Republic; Bioptic Laboratory Ltd, Plzen, 32600, Czech Republic
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, And Turku University Hospital, Turku, 20500, Finland
| | - Alena Skálová
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, 30605, Czech Republic; Bioptic Laboratory Ltd, Plzen, 32600, Czech Republic
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15
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Metastasizing Pleomorphic Adenoma: Recurrent PLAG1/HMGA2 Rearrangements and Identification of a Novel HMGA2-TMTC2 Fusion. Am J Surg Pathol 2020; 43:1145-1151. [PMID: 31094927 DOI: 10.1097/pas.0000000000001280] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Pleomorphic adenoma (PA) is the most common salivary gland neoplasm. On a molecular level PA is characterized by a translocation involving PLAG1 or HMGA2. PA is considered to be a benign tumor although it can undergo malignant transformation. Alternatively, cases of histologically benign PA "metastasizing" to lymph nodes or distant body sites are well documented. Several theories have been proposed to explain this behavior. However, there is a lack of molecular data available to assess the relationship of metastasizing PA (MPA) and their benign counterparts. In this study we describe 4 cases of MPAs and perform the first molecular study linking them to conventional PA. The index case was identified in the course of routine clinical practice, while the other cases were retrieved from the archives of the authors. Slides were reviewed to confirm the diagnosis of both the primary/recurrent tumor and the metastasis. Fluorescence in situ hybridization (FISH) was performed in all cases and RNA sequencing was performed on the index case. In all cases there was a history of recurrent PA involving the parotid. Lymph node metastases were identified in 2 cases; non-lymph node metastases were identified in 3 cases. All the metastases were histologically benign. RNA sequencing performed on the index case demonstrated a novel HMGA2-TMTC2 translocation, which was confirmed by separate FISH break-apart assays for both genes. FISH performed on the remaining cases demonstrated rearrangement of PLAG1 in all 3 cases. This study demonstrates that MPA harbors the same disease-defining molecular hallmark as their benign counterparts.
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16
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The Role of Molecular Testing in the Differential Diagnosis of Salivary Gland Carcinomas. Am J Surg Pathol 2019; 42:e11-e27. [PMID: 29076877 DOI: 10.1097/pas.0000000000000980] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Salivary gland neoplasms are a morphologically heterogenous group of lesions that are often diagnostically challenging. In recent years, considerable progress in salivary gland taxonomy has been reached by the discovery of tumor type-specific fusion oncogenes generated by chromosome translocations. This review describes the clinicopathologic features of a selected group of salivary gland carcinomas with a focus on their distinctive genomic characteristics. Mammary analog secretory carcinoma is a recently described entity characterized by a t(12;15)(p13;q25) translocation resulting in an ETV6-NTRK3 fusion. Hyalinizing clear cell carcinoma is a low-grade tumor with infrequent nodal and distant metastasis, recently shown to harbor an EWSR1-ATF1 gene fusion. The CRTC1-MAML2 fusion gene resulting from a t(11;19)(q21;p13) translocation, is now known to be a feature of both low-grade and high-grade mucoepidermoid carcinomas associated with improved survival. A t(6;9)(q22-23;p23-34) translocation resulting in a MYB-NFIB gene fusion has been identified in the majority of adenoid cystic carcinomas. Polymorphous (low-grade) adenocarcinoma and cribriform adenocarcinoma of (minor) salivary gland origin are related entities with partly differing clinicopathologic and genomic profiles; they are the subject of an ongoing taxonomic debate. Polymorphous (low-grade) adenocarcinomas are characterized by hot spot point E710D mutations in the PRKD1 gene, whereas cribriform adenocarcinoma of (minor) salivary glands origin are characterized by translocations involving the PRKD1-3 genes. Salivary duct carcinoma (SDC) is a high-grade adenocarcinoma with morphologic and molecular features akin to invasive ductal carcinoma of the breast, including HER2 gene amplification, mutations of TP53, PIK3CA, and HRAS and loss or mutation of PTEN. Notably, a recurrent NCOA4-RET fusion has also been found in SDC. A subset of SDC with apocrine morphology is associated with overexpression of androgen receptors. As these genetic aberrations are recurrent they serve as powerful diagnostic tools in salivary gland tumor diagnosis, and therefore also in refinement of salivary gland cancer classification. Moreover, they are promising as prognostic biomarkers and targets of therapy.
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17
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Andreasen S, von Holstein SL, Homøe P, Heegaard S. Recurrent rearrangements of the PLAG1 and HMGA2 genes in lacrimal gland pleomorphic adenoma and carcinoma ex pleomorphic adenoma. Acta Ophthalmol 2018; 96:e768-e771. [PMID: 29437290 DOI: 10.1111/aos.13667] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 11/11/2017] [Indexed: 12/29/2022]
Abstract
PURPOSE Lacrimal gland tumours constitute a wide spectrum of neoplastic lesions that are histologically similar to tumours of the salivary gland. In the salivary gland, pleomorphic adenoma (PA) is frequently characterized by recurrent chromosomal rearrangements of the PLAG1 and HMGA2 genes, a genetic feature retained in carcinoma ex pleomorphic adenoma (ca-ex-PA) that makes it possible to distinguish ca-ex-PA from de novo carcinomas. However, whether PLAG1 and HMGA2 gene rearrangements are found in lacrimal gland PA and ca-ex-PA is not known. METHODS Twenty-one lacrimal gland PAs and four ca-ex-PAs were retrospectively reviewed and subjected to break-apart fluorescence in situ hybridization (FISH) for rearrangements of the PLAG1 gene. Cases without PLAG1 abnormalities were subjected to HMGA2 break-apart FISH. Immunohistochemical staining for PLAG1 and HMGA2 protein was performed and correlated with gene status. RESULTS Sixteen of 21 PAs showed rearrangement of PLAG1 and were all positive for PLAG1 protein. Two of the remaining five PAs showed rearrangement of HMGA2 and were the only cases positive for HMGA2 with immunohistochemistry. The three FISH-negative PAs expressed PLAG1 protein. All four ca-ex-PAs showed rearrangement of PLAG1 and expressed PLAG1 protein. None of the de novo carcinomas showed rearrangement of either of the two genes or expression of the two proteins. CONCLUSION Rearrangement of PLAG1 and HMGA2 and expression of the corresponding proteins are frequent and specific findings in lacrimal gland PA and ca-ex-PA. The mechanism for PLAG1 overexpression in FISH-negative PAs is yet to be clarified.
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Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology and Maxillofacial Surgery; Zealand University Hospital; Køge Denmark
- Department of Otorhinolaryngology Head and Neck Surgery and Audiology; Rigshospitalet; Copenhagen Denmark
| | - Sarah L. von Holstein
- Department of Ophthalmology; Rigshospitalet-Glostrup; Glostrup Denmark
- Department of Ophthalmology; Zealand University Hospital; Roskilde Denmark
| | - Preben Homøe
- Department of Otorhinolaryngology and Maxillofacial Surgery; Zealand University Hospital; Køge Denmark
| | - Steffen Heegaard
- Department of Ophthalmology; Rigshospitalet-Glostrup; Glostrup Denmark
- Department of Pathology; Rigshospitalet; Copenhagen Denmark
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18
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Kabarriti R, Quinn TJ, Ewart MR, Mehta KJ, Lomita C, Geller DS, Kalnicki S, Fox JL. Neoadjuvant radiation therapy for the management of myoepithelial carcinoma of the upper extremity. Int J Cancer 2017; 142:854-862. [PMID: 29023697 DOI: 10.1002/ijc.31101] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 08/14/2017] [Accepted: 08/29/2017] [Indexed: 11/08/2022]
Abstract
Myoepithelial tumors of the soft tissue are a rare tumor displaying myoepithelial elements and lacking obvious ductal differentiation. The rarity of these precludes any evidence-based consensus regarding optimal management. Nevertheless, the current approach to these lesions begins with amputation or complete excision. The efficacy of neoadjuvant or adjuvant radiation therapy or chemotherapy has not been established. Here, we present the first report to the authors' knowledge of neoadjuvant radiation therapy for the treatment of this rare soft tissue neoplasm and review the management and outcomes of published cases of myoepithelial carcinoma. A patient with a soft tissue myoepithelial carcinoma that declined both amputation and chemotherapy was treated with neoadjuvant radiation therapy and wide surgical excision followed by a brachytherapy boost to the resected tumor bed. Neoadjuvant radiation therapy resulted in an excellent response with extensive treatment-related changes consisting predominantly of fibrosis, hyalinization and hemorrhage and only 10% residual viable myoepithelial carcinoma present in the surgical specimen.
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Affiliation(s)
- Rafi Kabarriti
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Thomas J Quinn
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Michelle R Ewart
- Department of Pathology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Keyur J Mehta
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Craig Lomita
- Department of Orthopaedic Surgery, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - David S Geller
- Department of Orthopaedic Surgery, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Shalom Kalnicki
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
| | - Jana L Fox
- Department of Radiation Oncology, Albert-Einstein College of Medicine-Montefiore Medical Center, Bronx, NY
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19
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Mito JK, Jo VY, Chiosea SI, Dal Cin P, Krane JF. HMGA2 is a specific immunohistochemical marker for pleomorphic adenoma and carcinoma ex-pleomorphic adenoma. Histopathology 2017; 71:511-521. [PMID: 28463429 DOI: 10.1111/his.13246] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 04/26/2017] [Indexed: 11/28/2022]
Abstract
AIMS Accurate classification of salivary gland neoplasms may be challenging, owing to morphological overlap, particularly in small biopsies. Recurrent translocations involving the high-mobility group AT-hook 2 (HMGA2) gene are present in a subset of pleomorphic adenomas (PAs) and carcinoma ex-pleomorphic adenomas (CA ex-PAs). The aim of this study was to evaluate immunohistochemical HMGA2 expression in 225 salivary gland tumours, including 56 PAs, 37 CA ex-PAs, and 132 potential histological mimics, to determine its diagnostic utility. METHODS AND RESULTS HMGA2 expression was identified in 19 PAs (33.9%) and nine CA ex-PAs (24.3%). Expression was strong and diffuse throughout all PAs, and in four of nine positive CA ex-PAs. In five CA ex-PAs, HMGA2 showed weak-to-strong multifocal staining within the carcinomatous component, and strong diffuse HMGA2 expression in the residual PA. Among histological mimics, six de-novo salivary duct carcinomas (28.5%), three epithelial-myoepithelial carcinomas (33.3%) and one case each of myoepithelioma and basal cell adenoma expressed HMGA2. Fluorescence in-situ hybridization for HMGA2 rearrangement performed on a subset of tumours that showed diffuse HMGA2 expression in PAs and CA ex-PAs was frequently associated with rearrangement of the HMGA2 locus, whereas cases of de-novo salivary duct carcinoma, or CA ex-PA with limited or no HMGA2 expression, had an intact HMGA2 locus. CONCLUSIONS HMGA2 expression is a highly specific (96.2%), but low-sensitivity (29.8%), marker for PA and CA ex-PA when compared with histological mimics, and is frequently associated with rearrangement of the HMGA2 locus.
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Affiliation(s)
- Jeffrey K Mito
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Simion I Chiosea
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Paola Dal Cin
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jeffrey F Krane
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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20
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Evrard SM, Meilleroux J, Daniel G, Basset C, Lacoste-Collin L, Vergez S, Uro-Coste E, Courtade-Saidi M. Use of fluorescent in-situ hybridisation in salivary gland cytology: A powerful diagnostic tool. Cytopathology 2017; 28:312-320. [PMID: 28503786 DOI: 10.1111/cyt.12427] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2017] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Salivary gland cytology is challenging because it includes a diversity of lesions and a wide spectra of tumours. Recently, it has been reported that many types of salivary gland tumours have specific molecular diagnostic signatures that could be identified by fluorescent in-situ hybridisation (FISH). The aim of the present study was to demonstrate the feasibility and efficiency of FISH on routine cytological salivary gland smears. METHODS FISH was conducted on 37 cytological salivary gland smears from 34 patients. According to the cytological diagnosis suspected, MECT1/MAML2 gene fusion and rearrangements of PLAG1, MYB, or ETV6 were analysed. The presence and percentages of cells that had gene rearrangements were evaluated. Results were compared with the histological surgical samples, available from 26 patients. RESULTS The PLAG1 rearrangement was observed in 12/20 (60%) cases of pleomorphic adenoma. MECT1/MAML2 gene fusion was observed in 1:2 mucoepidermoid carcinomas but was not observed in five other tumours (two pleomorphic adenomas, one Warthin's tumour, one mammary analogue secretory carcinoma [MASC] and one cystic tumour). MYB rearrangement was observed in 4/4 adenoid cystic carcinomas. ETV6-gene splitting identified one MASC. CONCLUSION Overall, FISH had a specificity of 100% and a sensitivity of 66.7%. When FISH and cytological analyses were combined, the overall sensitivity was increased to 93.3%. It can thus be concluded that when the FISH analysis is positive, the extent of surgery could be determined with confidence pre-operatively without needing a diagnosis from a frozen section.
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Affiliation(s)
- S M Evrard
- Rangueil Medical School, Histology and Embryology, Toulouse III Paul Sabatier University, Toulouse Cedex, France.,Pathology and Cytology Department, CHU Toulouse, IUCT Oncopole, Toulouse Cedex 9, France
| | - J Meilleroux
- Pathology and Cytology Department, CHU Toulouse, IUCT Oncopole, Toulouse Cedex 9, France
| | - G Daniel
- Pathology and Cytology Department, CHU Toulouse, IUCT Oncopole, Toulouse Cedex 9, France
| | - C Basset
- Rangueil Medical School, Histology and Embryology, Toulouse III Paul Sabatier University, Toulouse Cedex, France.,Pathology and Cytology Department, CHU Toulouse, IUCT Oncopole, Toulouse Cedex 9, France
| | - L Lacoste-Collin
- Rangueil Medical School, Histology and Embryology, Toulouse III Paul Sabatier University, Toulouse Cedex, France.,Pathology and Cytology Department, CHU Toulouse, IUCT Oncopole, Toulouse Cedex 9, France
| | - S Vergez
- Otolaryngology Department, Head and Neck Surgery, CHU Toulouse, Larrey Hospital, Toulouse Cedex 9, France.,Otolaryngology Department, Head and Neck Surgery, CHU Toulouse, IUCT Oncopole, Toulouse Cedex 9, France.,Rangueil Medical School, Toulouse III Paul Sabatier University, Toulouse Cedex, France
| | - E Uro-Coste
- Rangueil Medical School, Histology and Embryology, Toulouse III Paul Sabatier University, Toulouse Cedex, France.,Rangueil Medical School, Toulouse III Paul Sabatier University, Toulouse Cedex, France
| | - M Courtade-Saidi
- Rangueil Medical School, Histology and Embryology, Toulouse III Paul Sabatier University, Toulouse Cedex, France.,Pathology and Cytology Department, CHU Toulouse, IUCT Oncopole, Toulouse Cedex 9, France
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21
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Andreasen S, Esmaeli B, Holstein SLV, Mikkelsen LH, Rasmussen PK, Heegaard S. An Update on Tumors of the Lacrimal Gland. Asia Pac J Ophthalmol (Phila) 2017; 6:159-172. [PMID: 28399336 DOI: 10.22608/apo.201707] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 02/06/2017] [Indexed: 02/06/2023] Open
Abstract
Lacrimal gland tumors are rare and constitute a wide spectrum of different entities ranging from benign epithelial and lymphoid lesions to high-grade carcinomas, lymphomas, and sarcomas with large differences in prognosis and clinical management. The symptoms and findings of a lacrimal gland lesion are a growing mass at the site of the lacrimal gland, including displacement of the eyeball, decreased motility, diplopia, and ptosis. Pain is the cardinal symptom of an adenoid cystic carcinoma. Radiological findings characteristically include an oval, well-demarcated mass for benign lesions whereas malignant lesions typically display calcifications, destruction of bone, and invasion of adjacent structures. The diagnosis ultimately relies on histology, as does the choice of treatment and the prognosis. In recent years, the understanding of the biology of numerous types of lacrimal gland neoplasia has improved and the choice of treatment has changed accordingly and holds further promise for future targeted therapies. Treatment of benign epithelial lesions is surgical excision whereas carcinomas often require adjuvant radiotherapy and/or chemotherapy. In contrast, the cornerstone in management of lymphoid lesions is chemotherapy, often including a monoclonal antibody. This article presents an update on the clinical, radiological, histological, and molecular features, along with treatment strategies for tumors of the lacrimal gland.
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Affiliation(s)
- Simon Andreasen
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Otorhinolaryngology and Maxillofacial Surgery, Zealand University Hospital, Køge, Denmark
| | - Bita Esmaeli
- Orbital Oncology and Ophthalmic Plastic Surgery, Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Sarah Linéa von Holstein
- Department of Ophthalmology, Zealand University Hospital, Roskilde, Denmark
- Department of Pathology, Rigshospitalet, University of Copenhagen, Cophenhagen, Denmark
| | - Lauge Hjorth Mikkelsen
- Department of Pathology, Rigshospitalet, University of Copenhagen, Cophenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Peter Kristian Rasmussen
- Department of Pathology, Rigshospitalet, University of Copenhagen, Cophenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
| | - Steffen Heegaard
- Department of Pathology, Rigshospitalet, University of Copenhagen, Cophenhagen, Denmark
- Department of Ophthalmology, Rigshospitalet-Glostrup, University of Copenhagen, Copenhagen, Denmark
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22
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Andersson MK, Stenman G. The landscape of gene fusions and somatic mutations in salivary gland neoplasms - Implications for diagnosis and therapy. Oral Oncol 2016; 57:63-9. [PMID: 27101980 DOI: 10.1016/j.oraloncology.2016.04.002] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 04/01/2016] [Indexed: 12/15/2022]
Abstract
Recent studies of the genomic landscape of salivary gland tumors have provided important insights into the molecular pathogenesis of these tumors. The most consistent alterations identified include a translocation-generated gene fusion network involving transcription factors, transcriptional coactivators, tyrosine kinase receptors, and other kinases. In addition, next-generation sequencing studies of a few subtypes of salivary neoplasms have revealed hotspot mutations in individual genes and mutations clustering to specific pathways frequently altered in cancer. Although limited, these studies have opened up new avenues for improved classification and targeted therapies of salivary gland cancers. In this review, we summarize the latest developments in this field, focusing on tumor types for which clinically important molecular data are available.
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Affiliation(s)
- Mattias K Andersson
- Sahlgrenska Cancer Center, Department of Pathology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Göran Stenman
- Sahlgrenska Cancer Center, Department of Pathology, Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
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23
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Tian Z, Li L, Zhang CY, Gu T, Li J. Differences in MYB expression and gene abnormalities further confirm that salivary cribriform basal cell tumors and adenoid cystic carcinoma are two distinct tumor entities. J Oral Pathol Med 2015; 45:698-703. [PMID: 26711587 DOI: 10.1111/jop.12414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2015] [Indexed: 12/19/2022]
Abstract
BACKGROUND In practices, some cases of salivary basal cell tumors that consist mainly of cribriform growth pattern are difficult to differentiate from adenoid cystic carcinoma (AdCC). Identification of reliable molecular biomarkers for the differential diagnosis between them is required. METHODS Twenty-two cases of cribriform salivary basal cell tumors (at least 10% cribriform pattern present in each tumor) comprising 18 cases of basal cell adenoma (BCA) and four cases of basal cell adenocarcinoma (BcAC) were collected between 1985 and 2008. Twenty cases of cribriform AdCC were retrieved from our archives. MYB protein expression and gene abnormalities were detected in all cases by immunohistochemistry (IHC) and fluorescent in situ hybridization (FISH) analyses, respectively. RESULTS Neither MYB protein nor split genes were detected in any of the cases of cribriform basal cell tumors, while 55% (11/20) of cases of cribriform AdCC had MYB protein expression. High MYB expression was detected in 81.8% (9/11) cases, while low expression was found in the remaining cases. FISH analysis indicated that nine AdCC tumors with high MYB protein expression were split gene-positive, while MYB gene splitting was not detected in the 11 cases with low or absent MYB protein expression. CONCLUSION The molecular changes in AdCC differ from those associated with cribriform basal cell tumors, which further confirms that cribriform basal cell tumors and AdCC are two distinct tumor entities. Simultaneous detection of MYB protein expression and the associated molecular changes could be beneficial in differentiating salivary cribriform basal cell tumors from AdCC.
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Affiliation(s)
- Zhen Tian
- Department of Oral Pathology, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Li
- Department of Oral Pathology, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chun-Ye Zhang
- Department of Oral Pathology, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ting Gu
- Department of Oral Pathology, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Li
- Department of Oral Pathology, Ninth People's Hospital, School of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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24
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Vander Poorten V, Triantafyllou A, Thompson LDR, Bishop J, Hauben E, Hunt J, Skalova A, Stenman G, Takes RP, Gnepp DR, Hellquist H, Wenig B, Bell D, Rinaldo A, Ferlito A. Salivary acinic cell carcinoma: reappraisal and update. Eur Arch Otorhinolaryngol 2015; 273:3511-3531. [PMID: 26685679 DOI: 10.1007/s00405-015-3855-7] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Accepted: 12/07/2015] [Indexed: 01/10/2023]
Abstract
Epidemiologic and clinicopathologic features, therapeutic strategies, and prognosis for acinic cell carcinoma of the major and minor salivary glands are critically reviewed. We explore histopathologic, histochemical, electron microscopic and immunohistochemical aspects and discuss histologic grading, histogenesis, animal models, and genetic events. In the context of possible diagnostic difficulties, the relationship to mammary analog secretory carcinoma is probed and a classification is suggested. Areas of controversy or uncertainty, which may benefit from further investigations, are also highlighted.
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Affiliation(s)
- V Vander Poorten
- Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, Department of Oncology-Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium. .,European Salivary Gland Society, Geneva, Switzerland.
| | - A Triantafyllou
- School of Dentistry, University of Liverpool, Liverpool, UK.,Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK
| | - L D R Thompson
- Southern California Permanente Medical Group, Woodland Hills, CA, USA
| | - J Bishop
- Department of Pathology and Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - E Hauben
- Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - J Hunt
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - A Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles, University Prague, Prague, Czech Republic
| | - G Stenman
- European Salivary Gland Society, Geneva, Switzerland.,Department of Pathology, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
| | - R P Takes
- Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - D R Gnepp
- University Pathologists, Fall River, MA, USA
| | - H Hellquist
- Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal
| | - B Wenig
- Department of Pathology, Beth Israel Medical Center, New York, NY, USA
| | - D Bell
- Department of Pathology, MD Anderson Cancer Center, Houston, TX, USA
| | - A Rinaldo
- University of Udine School of Medicine, Udine, Italy
| | - A Ferlito
- Coordinator of the International Head and Neck Scientific Group, Padua, Italy
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25
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Abstract
Tumors of the lacrimal gland comprise a wide spectrum, of which the most common demonstrate epithelial and lymphoid differentiation. The diagnosis of lacrimal gland tumors depends primarily on histological evaluation, as do the choice of treatment and prognosis. For some lacrimal gland neoplasms, such as adenoid cystic carcinoma, the outlook is grave. Optimal treatment for several lacrimal gland tumors is also a matter of controversy. However, recent progress has been made in the molecular and genetic understanding of tumorigenesis for such lesions. This article presents an overview of the histopathology of lacrimal gland tumors, together with their epidemiological features, clinical characteristics, and treatment strategies.
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Affiliation(s)
- Sarah Linea von Holstein
- Eye Pathology Section, Department of Neuroscience and Pharmacology, University of Copenhagen, Frederik V׳s Vej 11, 1, DK-2100 Copenhagen, Denmark; Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Peter Kristian Rasmussen
- Eye Pathology Section, Department of Neuroscience and Pharmacology, University of Copenhagen, Frederik V׳s Vej 11, 1, DK-2100 Copenhagen, Denmark; Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Steffen Heegaard
- Eye Pathology Section, Department of Neuroscience and Pharmacology, University of Copenhagen, Frederik V׳s Vej 11, 1, DK-2100 Copenhagen, Denmark; Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark; Department of Pathology, Rigshospitalet, University of Copenhagen, Frederiks V's Vej, DK-2100 Copenhagen, Denmark.
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26
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27
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Salivary gland lesions: recent advances and evolving concepts. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 119:661-74. [DOI: 10.1016/j.oooo.2015.02.481] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Revised: 02/07/2015] [Accepted: 02/20/2015] [Indexed: 12/18/2022]
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28
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Fusion Transcripts That Characterize Malignancies of Salivary Gland Origin. AJSP-REVIEWS AND REPORTS 2015. [DOI: 10.1097/pcr.0000000000000075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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29
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Mas A, Cervelló I, Fernández-Álvarez A, Faus A, Díaz A, Burgués O, Casado M, Simón C. Overexpression of the truncated form of High Mobility Group A proteins (HMGA2) in human myometrial cells induces leiomyoma-like tissue formation. Mol Hum Reprod 2014; 21:330-8. [PMID: 25542836 DOI: 10.1093/molehr/gau114] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 12/17/2014] [Indexed: 12/24/2022] Open
Abstract
The pathogenesis of uterine leiomyomas, the most common benign tumor in women, is still unknown. This lack of basic knowledge limits the development of novel non-invasive therapies. Our group has previously demonstrated that leiomyoma side population (SP) cells are present in tumor lesions and act like putative tumor-initiating stem cells in human leiomyoma. Moreover, accumulated evidence demonstrates that these benign tumors of mesenchymal origin are characterized by rearrangements of the High Mobility Group A proteins (HMGA). In this work, we tested the hypothesis that leiomyoma development may be due to overexpression of HMGA2 (encoding high mobility group AT-hook2) in myometrial stem cells using in vitro and in vivo approaches. Our work demonstrates that the truncated/short form of HMGA2 induces myometrial cell transformation toward putative tumor-initiating leiomyoma cells and opens up new possibilities to understand the origin of leiomyomas and the development of new therapeutic approaches.
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Affiliation(s)
- Aymara Mas
- Fundación IVI, Instituto Universitario IVI, Department of Obstetrics & Gynecology, School of Medicine, University of Valencia, INCLIVA, Valencia, Spain
| | - Irene Cervelló
- Fundación IVI, Instituto Universitario IVI, Department of Obstetrics & Gynecology, School of Medicine, University of Valencia, INCLIVA, Valencia, Spain
| | | | - Amparo Faus
- Fundación IVI, Instituto Universitario IVI, Department of Obstetrics & Gynecology, School of Medicine, University of Valencia, INCLIVA, Valencia, Spain
| | - Ana Díaz
- Central Service for Experimental Research, University of Valencia, INCLIVA, Valencia, Spain
| | - Octavio Burgués
- Department of Pathology, Hospital Clínico Universitario of Valencia, Valencia, Spain
| | - Marta Casado
- Biomedical Institute of Valencia (IBV-CSIC), Valencia, Spain
| | - Carlos Simón
- Fundación IVI, Instituto Universitario IVI, Department of Obstetrics & Gynecology, School of Medicine, University of Valencia, INCLIVA, Valencia, Spain Department of Obstetrics and Gynecology, School of Medicine, Stanford University, Stanford, CA, USA
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30
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Abstract
Soft tissue tumours represent a heterogeneous group of mesenchymal lesions and their classification continues to evolve as a result of incorporating advances in cytogenetic and molecular techniques. In the last decade, traditional diagnostic approaches were supplemented with a significant number of reliable molecular diagnostic tools, detecting tumour type specific genetic alterations. Additionally, the successful application of some of these techniques to formalin fixed, paraffin embedded tissue enabled a broader range of clinical material to be subjected to molecular analysis. However, despite all these remarkable advances, the realisation that some of the genetic abnormalities are not fully histotype specific and that certain gene aberrations can be shared among different sarcoma types, otherwise completely unrelated clinically or immunophenotypically, has introduced some drawbacks in surgical pathology practice. One such common example is the presence of EWSR1 gene rearrangements by fluorescence in situ hybridisation (FISH), a test now preferred over the elaborate RT-PCR testing, in a variety of benign and highly malignant soft tissue tumours, in addition to a subset of carcinomas. Furthermore, the presence of identical gene fusions in completely different sarcoma types (i.e., EWSR1-ATF1, EWSR1-CREB1) or in non-mesenchymal malignancies (epithelial or haematological) has raised skepticism as to their diagnostic utility, and their lack of specificity has been compared to the limitations of other ancillary techniques, in particular immunohistochemistry. This review catalogues the main groups of genes that behave in a promiscuous manner within recurrent fusion events in soft tissue tumours. Although we acknowledge that the present molecular classification of soft tissue tumours is much more complex than two decades ago, when EWSR1 gene rearrangements had been described as the hallmark of Ewing sarcoma, we make the strong argument that with very few exceptions, the prevalence of fusion transcripts in most sarcomas is such that they come to define these entities and can be used as highly specific molecular diagnostic markers in the right clinical and pathological context.
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31
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Stenman G, Persson F, Andersson MK. Diagnostic and therapeutic implications of new molecular biomarkers in salivary gland cancers. Oral Oncol 2014; 50:683-90. [DOI: 10.1016/j.oraloncology.2014.04.008] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 04/22/2014] [Accepted: 04/26/2014] [Indexed: 12/19/2022]
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32
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Lacrimal Gland Pleomorphic Adenoma and Carcinoma ex Pleomorphic Adenoma. Ophthalmology 2014; 121:1125-33. [DOI: 10.1016/j.ophtha.2013.11.037] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 11/20/2013] [Accepted: 11/21/2013] [Indexed: 12/28/2022] Open
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33
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CRTC1-MAML2 and CRTC3-MAML2 fusions were not detected in metaplastic Warthin tumor and metaplastic pleomorphic adenoma of salivary glands. Am J Surg Pathol 2013; 37:1743-50. [PMID: 24121173 DOI: 10.1097/pas.0000000000000065] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The recurrent translocations t(11;19) and t(11;15) resulting in CRTC1-MAML2 or CRTC3-MAML2 fusion oncogenes, respectively, are identified in a large proportion of mucoepidermoid carcinomas (MECs) of the salivary gland and have impact on prognosis. However, there are conflicting data on the specificity of this translocation, in particular, on its putative occurrence in Warthin tumor (WT) of the parotid gland as reported in few previous cases. It was speculated that extensive squamous metaplasia could explain the presence of t(11;19) translocation in a subset of WTs. We evaluated 76 salivary gland tumors, including 16 cases of metaplastic WT and 8 cases of pleomorphic adenoma (PA) with squamous and/or mucinous metaplasia, extensive enough morphologically to mimic MEC. Detection of CRTC1-MAML2 and CRTC3-MAML2 fusion transcripts and MAML2 gene break was performed using nested reverse transcription-polymerase chain reaction and fluorescence in situ hybridization (FISH), respectively. None of 16 analyzed metaplastic WTs showed positivity for fusion transcripts CRTC1-MAML2 or CRTC3-MAML2, and none showed rearrangement of the MAML2 gene by FISH. Similarly, we did not detect these transcripts or break of MAML2 gene in any case of PA with extensive squamous/mucinous metaplasia. For comparison, 40 cases of low-grade MEC were also evaluated. CRTC1-MAML2 and CRTC3-MAML2 fusion transcripts were detected in 17 and 5 cases, respectively. The FISH method using break-apart probe demonstrated the MAML2 gene rearrangement in 25 cases of low-grade MEC. In contrast to low-grade MEC, neither metaplastic WTs nor metaplastic PAs harbored translocations t(11;19) and anticipated t(11;15) resulting in CRTC1-MAML2 and CRTC3-MAML2 fusion transcripts, respectively, and/or MAML2 gene rearrangement.
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34
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von Holstein SL. Tumours of the lacrimal gland. Epidemiological, clinical and genetic characteristics. Acta Ophthalmol 2013; 91 Thesis 6:1-28. [PMID: 24893972 DOI: 10.1111/aos.12271] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Tumours of the lacrimal gland are rare, but the prognosis may be grave. To date, no population-based incidence and distribution data on lacrimal gland tumours exist. In addition, almost nothing is known about the genetic profile of epithelial tumours of the lacrimal gland. We collected specimens and clinical files on all biopsied lacrimal gland lesions in Denmark over a 34-year period and re-evaluated the diagnosis to provide updated population-based incidence rates and epidemiological characteristics. Clinical data regarding symptoms, clinical examinations, treatment and follow-up were collected for patients with adenoid cystic carcinoma (ACC), pleomorphic adenoma (PA), carcinoma ex pleomorphic adenoma (Ca-ex-PA) and mucoepidermoid carcinoma (MEC). Using RT-PCR, FISH, immunohistochemistry, Q-PCR and high-resolution array-based comparative genomic hybridization (arrayCGH) we explored the genetic characteristics including copy number alterations (CNA) in ACC, PA, Ca-ex-PA and MEC. The incidence of biopsied lacrimal gland lesions was 1.3/1,000,000/year, and ~50% were neoplastic lesions. Of these, 55% were malignant tumours with epithelial tumours as the most frequent. The overall incidence was increasing, and this was caused by an increase in biopsied non-neoplastic lesions. We found that 10/14 ACCs either expressed the MYB-NFIB fusion gene and/or had rearrangements of MYB. All ACCs expressed the MYB protein. ACC was characterized by recurrent copy number losses involving 6q, 12q and 17q and gains involving 19q, 8q and 11q. ArrayCGH revealed an apparently normal genomic profile in 11/19 PAs. The remaining 8 PAs had recurrent copy number losses involving 1p, 6q, 8q and 13q and gain involving 9p. PA expressed PLAG1 in all tumours whereas only 2/29 tumours expressed HMGA2. Ca-ex-PA was characterized by recurrent copy number gain involving 22q. PLAG1 was expressed in 3/5 Ca-ex-PA whereas none of these tumours expressed HMGA2. MEC expressed the CRTC1-MAML2, and this fusion was found to be tumour-specific for lacrimal gland MEC. In conclusion, lacrimal gland lesions that require pathological evaluation are rare in the Danish population, and the incidence rate of biopsied benign lesions is increasing. Epithelial tumours of the lacrimal gland are molecularly very similar to their salivary gland counterparts in the expression of the tumour-specific fusion genes and in their genomic imbalances as demonstrated by arrayCGH. MYB-NFIB is a useful biomarker for ACC and MYB, and its downstream target genes may be potential therapeutic targets for these tumours.
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35
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Abstract
In recent years the discovery of translocations and the fusion oncogenes that they result in has changed the way diagnoses are made in the salivary gland. These genetic aberrations are recurrent and reproducible and at the very least serve as powerful diagnostic tools in salivary gland diagnosis and salivary gland classification. They also show promise as prognostic markers and hopefully as targets of therapy. Many of these fusions have been found in other tumor types that show little to no overlap with their salivary gland counterparts, but effectively they are specific within the salivary gland. In this review the 5 tumors currently known to harbor translocations will be discussed, namely pleomorphic adenoma, mucoepidermoid carcinoma, adenoid cystic carcinoma, mammary analog secretory carcinoma, and hyalinizing clear cell carcinoma. The discovery and implications of each fusion will be highlighted and how they have helped reshape the current classification of salivary gland tumors.
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MESH Headings
- Activating Transcription Factor 1/genetics
- Adenocarcinoma, Clear Cell/genetics
- Adenocarcinoma, Clear Cell/pathology
- Adenoma, Pleomorphic/genetics
- Adenoma, Pleomorphic/pathology
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Calmodulin-Binding Proteins/genetics
- Carcinoma/genetics
- Carcinoma/pathology
- Carcinoma, Adenoid Cystic/genetics
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/pathology
- DNA-Binding Proteins/genetics
- Humans
- NFI Transcription Factors/genetics
- Nuclear Proteins/genetics
- Oncogene Proteins v-myb/genetics
- Oncogene Proteins, Fusion/genetics
- Proto-Oncogene Proteins c-ets/genetics
- RNA-Binding Protein EWS
- RNA-Binding Proteins/genetics
- Receptor, trkC/genetics
- Repressor Proteins/genetics
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/pathology
- Trans-Activators
- Transcription Factors/genetics
- Translocation, Genetic
- ETS Translocation Variant 6 Protein
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Affiliation(s)
- Ilan Weinreb
- *Department of Pathology, University Health Network †Department of Pathobiology and Laboratory medicine, University of Toronto, ON, Canada
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36
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Aberrantly activated AREG-EGFR signaling is required for the growth and survival of CRTC1-MAML2 fusion-positive mucoepidermoid carcinoma cells. Oncogene 2013; 33:3869-77. [PMID: 23975434 DOI: 10.1038/onc.2013.348] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 07/08/2013] [Accepted: 07/23/2013] [Indexed: 12/15/2022]
Abstract
Salivary gland tumors (SGT) are a group of highly heterogeneous head and neck malignancies with widely varied clinical outcomes and no standard effective treatments. The CRTC1-MAML2 fusion oncogene, encoded by a recurring chromosomal translocation t(11;19)(q14-21;p12-13), is a frequent genetic alteration found in >50% of mucoepidermoid carcinomas (MEC), the most common malignant SGT. In this study, we aimed to define the role of the CRTC1-MAML2 oncogene in the maintenance of MEC tumor growth and to investigate critical downstream target genes and pathways for therapeutic targeting of MEC. By performing gene expression analyses and functional studies via RNA interference and pharmacological modulation, we determined the importance of the CRTC1-MAML2 fusion gene and its downstream AREG-EGFR signaling in human MEC cancer cell growth and survival in vitro and in vivo using human MEC xenograft models. We found that CRTC1-MAML2 fusion oncogene was required for the growth and survival of fusion-positive human MEC cancer cells in vitro and in vivo. The CRTC1-MAML2 oncoprotein induced the upregulation of the epidermal growth factor receptor (EGFR) ligand Amphiregulin (AREG) by co-activating the transcription factor CREB, and AREG subsequently activated EGFR signaling in an autocrine manner that promoted MEC cell growth and survival. Importantly, CRTC1-MAML2-positive MEC cells were highly sensitive to EGFR signaling inhibition. Therefore, our study revealed that aberrantly activated AREG-EGFR signaling is required for CRTC1-MAML2-positive MEC cell growth and survival, suggesting that EGFR-targeted therapies will benefit patients with advanced, unresectable CRTC1-MAML2-positive MEC.
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37
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Deen M, Ebrahim S, Schloff D, Mohamed AN. A novel PLAG1-RAD51L1 gene fusion resulting from a t(8;14)(q12;q24) in a case of lipoblastoma. Cancer Genet 2013; 206:233-7. [PMID: 23890983 DOI: 10.1016/j.cancergen.2013.05.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2013] [Revised: 05/23/2013] [Accepted: 05/27/2013] [Indexed: 11/29/2022]
Abstract
Lipoblastomas are rare benign tumors that arise from embryonic adipose tissue and occur predominantly in the pediatric population. Here, we report a case of lipoblastoma in an 8-month-old boy. Surgical excision and subsequent histopathologic examination were consistent with features of lipoblastoma. Chromosome analysis of the tumor revealed a clonal unbalanced t(8;14) translocation. Genomic microarray analysis of the tumor delineated the exact breakpoints at 8q12.1 and 14q24.1, which involved the PLAG1 and RADA51L1 genes, respectively. Furthermore, fluorescence in situ hybridization demonstrated that the translocation fused the PLAG1-RAD51L1 genes. These results suggest that RAD51L1 is an alternative fusion partner gene for the PLAG1 gene in a lipoblastoma with an 8q12 rearrangement.
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Affiliation(s)
- Mazin Deen
- Cytogenetic Laboratory, Department of Pathology, Wayne State University School of Medicine, Detroit Medical Center, Detroit, MI, USA
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Stenman G. Fusion oncogenes in salivary gland tumors: molecular and clinical consequences. Head Neck Pathol 2013; 7 Suppl 1:S12-9. [PMID: 23821214 PMCID: PMC3712096 DOI: 10.1007/s12105-013-0462-z] [Citation(s) in RCA: 122] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 06/10/2013] [Indexed: 01/03/2023]
Abstract
Salivary gland tumors constitute a heterogeneous group of uncommon diseases that pose significant diagnostic and therapeutic challenges. However, the recent discovery of a translocation-generated gene fusion network in salivary gland carcinomas as well in benign salivary gland tumors opens up new avenues for improved diagnosis, prognostication, and development of specific targeted therapies. The gene fusions encode novel fusion oncoproteins or ectopically expressed normal or truncated oncoproteins. The major targets of the translocations are transcriptional coactivators, tyrosine kinase receptors, and transcription factors involved in growth factor signaling and cell cycle regulation. Notably, several of these targets or pathways activated by these targets are druggable. Examples of clinically significant gene fusions in salivary gland cancers are the MYB-NFIB fusion specific for adenoid cystic carcinoma, the CRTC1-MAML2 fusion typical of low/intermediate-grade mucoepidermoid carcinoma, and the recently identified ETV6-NTRK3 fusion in mammary analogue secretory carcinoma. Similarly, gene fusions involving the PLAG1 and HMGA2 oncogenes are specific for benign pleomorphic adenomas. Continued studies of the molecular consequences of these fusion oncoproteins and their down-stream targets will ultimately lead to the identification of novel driver genes in salivary gland neoplasms and will also form the basis for the development of new therapeutic strategies for salivary gland cancers and, perhaps, other neoplasms.
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Affiliation(s)
- Göran Stenman
- Department of Pathology, Sahlgrenska Cancer Center, University of Gothenburg, Box 425, 405 30 Göteborg, Sweden
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von Holstein SL, Coupland SE, Briscoe D, Le Tourneau C, Heegaard S. Epithelial tumours of the lacrimal gland: a clinical, histopathological, surgical and oncological survey. Acta Ophthalmol 2013; 91:195-206. [PMID: 22471335 DOI: 10.1111/j.1755-3768.2012.02402.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Epithelial tumours of the lacrimal gland represent a large spectrum of lesions with similarities in clinical signs and symptoms but with different biological behaviour and prognosis. They are rare, but with aggressive malignant potential. Tumours of the lacrimal gland may present with swelling of the lacrimal gland, displacement of the eyeball, reduced eye motility and diplopia. Pain and symptoms of short duration before the first ophthalmic consultation are characteristic of malignant tumours. The histological diagnosis determines the subsequent treatment regimen and provides important clues regarding the prognosis. The purpose of this paper is to describe the various primary epithelial tumours of the lacrimal gland. In the first part of the review, the frequency, demographics, clinical presentation and diagnostic features are described. In the second part, primarily tumour-specific histological characteristics are given. Finally, treatment modalities including surgical procedures and medical oncology as well as prognosis are discussed.
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MESH Headings
- Adenocarcinoma/epidemiology
- Adenocarcinoma/pathology
- Adenocarcinoma/surgery
- Adenoma, Pleomorphic/epidemiology
- Adenoma, Pleomorphic/pathology
- Adenoma, Pleomorphic/surgery
- Adult
- Carcinoma/epidemiology
- Carcinoma/pathology
- Carcinoma/surgery
- Carcinoma, Adenoid Cystic/epidemiology
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Adenoid Cystic/surgery
- Carcinoma, Mucoepidermoid/epidemiology
- Carcinoma, Mucoepidermoid/pathology
- Carcinoma, Mucoepidermoid/surgery
- Eye Neoplasms/epidemiology
- Eye Neoplasms/pathology
- Eye Neoplasms/surgery
- Humans
- Lacrimal Apparatus Diseases/epidemiology
- Lacrimal Apparatus Diseases/pathology
- Lacrimal Apparatus Diseases/surgery
- Male
- Middle Aged
- Neoplasms, Glandular and Epithelial/epidemiology
- Neoplasms, Glandular and Epithelial/pathology
- Neoplasms, Glandular and Epithelial/surgery
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Affiliation(s)
- Sarah Linéa von Holstein
- Eye Pathology Institute, Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
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Zhang L, Mitani Y, Caulin C, Rao PH, Kies MS, Saintigny P, Zhang N, Weber RS, Lippman SM, El-Naggar AK. Detailed genome-wide SNP analysis of major salivary carcinomas localizes subtype-specific chromosome sites and oncogenes of potential clinical significance. THE AMERICAN JOURNAL OF PATHOLOGY 2013; 182:2048-57. [PMID: 23583282 DOI: 10.1016/j.ajpath.2013.02.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 02/04/2013] [Accepted: 02/11/2013] [Indexed: 01/31/2023]
Abstract
The molecular genetic alterations underlying the development and diversity of salivary gland carcinomas are largely unknown. To characterize these events, comparative genomic hybridization analysis was performed, using a single-nucleotide polymorphism microarray platform, of 60 fresh-frozen specimens that represent the main salivary carcinoma types: mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ACC), and salivary duct carcinoma (SDC). The results were correlated with the clinicopathologic features and translocation statuses to characterize the genetic alterations. The most commonly shared copy number abnormalities (CNAs) in all types were losses at chromosomes 6q23-26 and the 9p21 region. Subtype-specific CNAs included a loss at 12q11-12 in ACC and a gain at 17q11-12 in SDC. Focal copy number losses included 1p36.33-p36-22 in ACC, 9p13.2 in MEC, and 3p12.3-q11-2, 6q21-22.1, 12q14.1, and 12q15 in SDC. Tumor-specific amplicons were identified at 11q23.3 (PVRL1) in ACC, 11q13.3 (NUMA1) in MEC, and 6p21.1 (CCND3), 9p13.2 (PAX5), 12q15 (CNOT2/RAB3IP), 12q21.1 (GLIPR1L1), and 17q12 (ERBB2/CCL4) in SDC. A comparative CNA analysis of fusion-positive and fusion-negative ACCs and MECs revealed relatively lower CNAs in fusion-positive tumors than in fusion-negative tumors in both tumor types. An association between CNAs and high grade and advanced stage was observed in MECs only. These findings support the pathogenetic segregation of these entities and define novel chromosomal sites for future identification of biomarkers and therapeutic targets.
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Affiliation(s)
- Li Zhang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
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Sirivanichsuntorn P, Keelawat S, Danuthai K, Mutirangura A, Subbalekha K, Kitkumthorn N. LINE-1 and Alu hypomethylation in mucoepidermoid carcinoma. BMC Clin Pathol 2013; 13:10. [PMID: 23510117 PMCID: PMC3610265 DOI: 10.1186/1472-6890-13-10] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2012] [Accepted: 02/26/2013] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Mucoepidermoid carcinoma (MEC) can be classified into low-, intermediate-, and high-grade tumors based on its histological features. MEC is mainly composed of three cell types (squamous or epidermoid, mucous and intermediate cells), which correlates with the histological grade and reflects its clinical behavior. Most cancers exhibit reduced methylation of repetitive sequences such as Long INterspersed Element-1 (LINE-1) and Alu elements. However, to date very little information is available on the LINE-1 and Alu methylation status in MEC. The aim of this study was to investigate LINE-1 and Alu element methylation in MEC and compare if key differences in the methylation status exist between the three different cell types, and adjacent normal salivary gland cells, to see if this may reflect the histological grade. METHODS LINE-1 and Alu element methylation of 24 MEC, and 14 normal salivary gland tissues were compared using Combine Bisulfite Restriction Analysis (COBRA). Furthermore, the three different cell types from MEC samples were isolated for enrichment by laser capture microdissection (LCM), essentially to see if COBRA was likely to increase the predictive value of LINE-1 and Alu element methylation. RESULTS LINE-1 and Alu element methylation levels were significantly different (p<0.001) between the cell types, and showed a stepwise decrease from the adjacent normal salivary gland to the intermediate, mucous and squamous cells. The reduced methylation levels of LINE-1 were correlated with a poorer histological grade. In addition, MEC tissue showed a significantly lower level of LINE-1 and Alu element methylation overall compared to normal salivary gland tissue (p<0.001). CONCLUSIONS Our findings suggest that LINE-1 methylation differed among histological grade mucoepidermoid carcinoma. Hence, this epigenetic event may hold value for MEC diagnosis and prognostic prediction.
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Affiliation(s)
- Porntipa Sirivanichsuntorn
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, Bangkok 10330, Thailand.
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Bell D, El-Naggar AK. Molecular heterogeneity in mucoepidermoid carcinoma: conceptual and practical implications. Head Neck Pathol 2013; 7:23-7. [PMID: 23459841 PMCID: PMC3597160 DOI: 10.1007/s12105-013-0432-5] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 02/27/2013] [Indexed: 01/19/2023]
Abstract
Mucoepidermoid carcinoma (MEC), the most common salivary gland malignancy of the upper aerodigestive tract and tracheobronchial tree, is also known for its considerable cellular heterogeneity including epidermoid, intermediate and mucin producing cells. Despite this structural and cellular heterogeneity, MEC is uniquely characterized by a specific translocation t(11; 19) (q12; p13), resulting in a fusion between the MECT1 and the MAML2 genes. Although the incidence of this fusion in MEC varies, it is generally accepted that more than 50 % of this entity manifest the MECT1-MAML2. Fusion-positive cases showed significantly better survival than fusion-negative cases, suggesting that MECT1-MAML2 represents a specific prognostic molecular marker in MEC. We contend that fusion in MEC represents a distinct mechanism in the development of this entity. In that context, fusion positive MEC, regardless of grade, manifest a more stable genome and better clinical behaviour, while fusion negative MEC represent a distinctly different pathway characterized by marked genomic instability and relatively aggressive tumors.
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Affiliation(s)
- Diana Bell
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030 USA
| | - Adel K. El-Naggar
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030 USA
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Mori D, Akashi M, Shibaki M, Koike E, Miyazaki J. Nonsebaceous lymphadenoma in the parotid gland: true neoplastic or reactive? A report of two cases. Int J Surg Pathol 2013; 21:509-13. [PMID: 23426964 DOI: 10.1177/1066896913476739] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report 2 rare cases of nonsebaceous lymphadenoma (NSL) in the parotid gland. In both cases, microscopic examination revealed central dilated duct-like structure and its surrounding many cysts in the background of the lymphoid stroma. The cysts were lined with luminal cells and abluminal cells, with the latter being predominant. Occasionally, foci of abluminal epithelial islands were observed. Immunohistochemical findings showed that these tumors had basal cell phenotypes and could support the diagnosis of NSL. The microscopic architectural pattern indicated a cystic dilated duct-glands unit and metaplasia or hyperplasia of abluminal cells. We wondered whether these NSLs were true neoplasia or an indication of a nonneoplastic reactive process. Further investigation of molecular studies of large series in, for example, the clonal or chromosomal state, would be necessary to clarify this point.
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Affiliation(s)
- Daisuke Mori
- 1Saga Prefectural Hospital, Koseikan, Saga, Japan
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11q21 rearrangement is a frequent and highly specific genetic alteration in mucoepidermoid carcinoma. ACTA ACUST UNITED AC 2012; 21:134-7. [PMID: 22847156 DOI: 10.1097/pdm.0b013e318255552c] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor. Translocation t(11;19)(q21;p13) involving the MECT1 and MAML2 genes has been suggested as a diagnostic marker in these tumors. To determine the specificity of 11q21 locus rearrangements for MEC, fluorescence in situ hybridization analysis with specific MEC-I Dual Color Break Apart Probe was performed on a tissue microarray containing samples from almost 1200 salivary gland adenomas and carcinomas. Rearrangements of 11q21 were observed in 40% of 217 MECs. The frequency of rearrangements decreased with tumor grade and was found in 53% of G1, 43% of G2, and 31% of G3 tumors (P=0.015). There were no 11q21 rearrangements found in other salivary gland carcinomas including 142 adenoid cystic carcinomas, 104 acinic cell adenocarcinomas, 76 adenocarcinoma not otherwise specified, 38 epithelial-myoepithelial carcinomas, 15 polymorphous low-grade adenocarcinomas, 18 basal cell adenocarcinomas, 19 myoepithelial carcinomas, 12 papillary cystadenocarcinomas, 6 salivary duct carcinomas, and 10 oncocytic carcinomas. Furthermore, all analyzed salivary gland adenomas, including 39 cases of Warthin tumor and control samples, either from the salivary gland or from other organs were negative for 11q21 rearrangements. It is concluded that MECT1-MAML2 gene fusion is a highly specific genetic alteration in MEC with predominance in low-grade and intermediate-grade tumors.
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Ghahhari NM, Ghahhari HM, Kadivar M. Could a Possible Crosstalk between AMPK and TGF-β Signaling Pathways Be a Key Player in Benign and Malignant Salivary Gland Tumors? Oncol Res Treat 2012. [DOI: 10.1159/000345131] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Wemmert S, Willnecker V, Brunner C, Wenzel GI, Sauter B, Meinelt H, Bartholmé N, Saada C, Bohle RM, Urbschat S, Schick B. New genetic findings in parotid gland pleomorphic adenomas. Head Neck 2012; 35:1431-8. [PMID: 22987447 DOI: 10.1002/hed.23147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2012] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Despite numerous studies, the tumor biology of pleomorphic adenomas, the most common salivary gland tumors, is still not completely defined. In order to identify further candidate genes important for tumor biology of pleomorphic adenomas, extended cytogenetic and molecular analysis are mandatory. METHODS We performed a detailed molecular cytogenetic analysis using comparative genomic hybridization (CGH) followed by fluorescence in situ hybridization (FISH) with probes for chromosome X, 16p, 17, and 20 on a large cohort of pleomorphic adenomas (n = 29). RESULTS We could confirm previously described deletions in pleomorphic adenomas affecting 16p, 17, 20q, and 22 by FISH and/or CGH analysis. Moreover, our CGH study revealed novel candidate regions on 8p23.1pter, 9p, 10q25.1q25.3, and 11q24qter in the series of analyzed pleomorphic adenomas. CONCLUSION Our present study reveals new insights in novel candidate regions implicated in pleomorphic adenoma tumorigenesis which should be considered in further molecular studies.
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Affiliation(s)
- Silke Wemmert
- Department of Otorhinolaryngology, Saarland University Medical Center, Homburg/Saar, Germany
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Skalova A, Vanecek T, Simpson RH, Michal M. Molecular advances in salivary gland pathology and their practical application. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.mpdhp.2012.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Abstract
Salivary gland carcinomas are a heterogeneous group of tumors with different biologic behavior. Given the lack of large randomized studies, there is no standard treatment for advanced and/or metastatic salivary gland tumors, and systemic therapy is empirically based. Tumor-specific recurrent chromosomal translocations and fusion oncogenes in aggressive head and neck malignancies have diagnostic, therapeutic, and prognostic implications. Pathognomonic fusion transcripts have been identified in subsets of mucoepidermoid carcinoma and adenoid cystic carcinoma. These translocations target 1) transcription factors involved in growth factor signaling and cell cycle regulation, 2) transcriptional co-activators, and 3) tyrosine kinase receptors. Prioritizing studies with a translational component to advance the molecular understanding of these cancers and molecular-targeted therapy clinical trials is critical.
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Affiliation(s)
- Diana Bell
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
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Pedeutour F, Deville A, Steyaert H, Ranchere-Vince D, Ambrosetti D, Sirvent N. Rearrangement of HMGA2 in a case of infantile lipoblastoma without Plag1 alteration. Pediatr Blood Cancer 2012; 58:798-800. [PMID: 22223189 DOI: 10.1002/pbc.23335] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2011] [Accepted: 08/09/2011] [Indexed: 11/07/2022]
Abstract
Lipoblastoma is a rare benign adipocytic tumor that occurs usually in children. It can be difficult to distinguish a lipoblastoma from other lipogenic tumors. In such cases, the detection of a rearrangement of the PLAG1 gene by fluorescence in situ hybridization analysis is useful for characterizing a lipoblastoma. We present here a novel case of morphological infantile lipoblastoma showing a rearrangement of HMGA2 instead of the classical PLAG1 alteration. HMGA2 is the main target of clonal aberrations encountered in lipomas. This result supports the hypothesis that benign lipomatous tumors harboring PLAG1 or HMGA2 rearrangement could constitute a unique pathogenetic entity.
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