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Legarrea JMA, Alves HDS, Chaves RRM, Soares CD, Robinson L, van Heerden WFP, de Andrade BAB, Polti LF, de Souza SF, Gomez RS, de Cáceres CVBL, Vargas PA, Fonseca FP. Histiocytic sarcoma affecting the oral cavity: a clinical, pathologic and molecular study. Oral Surg Oral Med Oral Pathol Oral Radiol 2024; 138:543-555. [PMID: 39048487 DOI: 10.1016/j.oooo.2024.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 06/07/2024] [Accepted: 06/21/2024] [Indexed: 07/27/2024]
Abstract
OBJECTIVE To investigate the clinicopathological, immunohistochemical and molecular features of histiocytic sarcomas affecting the oral cavity. METHODS Pathology files of two institutions were searched for cases of histiocytic sarcoma, and new H&E-stained slides and immunohistochemistry reactions evaluated for diagnosis confirmation. Molecular screening for KRAS and PIK3CA mutations was performed through polymerase chain reaction (PCR) followed by Sanger sequencing. BRAFp.V600E mutation was assessed by pyrosequencing. Clinical data regarding sex, age, tumor location, systemic manifestations, clinical presentation, follow-up time, treatment applied and status at last follow-up were collected from patients' pathology and medical files. RESULTS Three cases were retrieved during the period investigated (2000-2023). Two females and one male were affected, with a wide age range, involving the tongue, palate and gingiva. Histopathologically, the neoplasms presented as highly pleomorphic atypical cells distributed diffusely with infiltration of normal structures. All cases demonstrated histiocytic differentiation expressing CD68 and CD163, and a high Ki67 expression. Genetic mutations were evaluated in two cases. One case harboured BRAF-V600E mutation, but not in KRAS and PIK3CA, while the second case did not show mutation in BRAF-V600E, KRAS and PI3KCA. One patient was lost, and two patients died after eight and four months of follow-up. CONCLUSION Histiocytic sarcomas involving the oral cavity are extremely rare, and may represent dissemination of a systemic condition. It has an aggressive biological behaviour with a poor overall prognosis.
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Affiliation(s)
- Juan Manuel Arteaga Legarrea
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Humberto de Souza Alves
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Roberta Rayra Martins Chaves
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Liam Robinson
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Willie F P van Heerden
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; PathCare Vermaak Histopathology, Centurion, Pretoria, South Africa
| | | | - Lucas Fabian Polti
- Pathology, School of Dentistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Silvia Ferreira de Souza
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Pablo Agustin Vargas
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Department of Oral and Maxillofacial Pathology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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Yang Y, Fan W, Liu X, Chen Q. NF1 mutation and TUBB3 amplification in gastric histiocytic sarcoma: a case report and literature review. Med Mol Morphol 2024; 57:244-251. [PMID: 38914690 DOI: 10.1007/s00795-024-00393-0] [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: 03/06/2024] [Accepted: 06/19/2024] [Indexed: 06/26/2024]
Abstract
Histiocytic sarcoma is a rare neoplasm of mature histiocytes with an aggressive clinical course and poor response to treatment. Primary gastric histiocytic sarcoma is rarer and just reported sporadically.Histiocytic sarcoma is a rare neoplasm of mature histiocytes with an aggressive clinical course and poor response to treatment. Primary gastric histiocytic sarcoma is rarer and just reported sporadically. A case of a 71-year-old female admitted with a one-year history of upper abdominal pain exacerbated after meals. After CT scans revealed a bulged mass at the lesser curvature of the gastric body, the patient underwent endoscopic submucosal dissection. Microscopically, non-cohesive neoplastic cells diffusely infiltrated lamina propria and submucosa, and diffusely expressed LCA, CD4, CD163, CD68 (KP1), Cyclin D1, Lysozyme, and Vimentin. PD-L1 (22CS) expression evaluated as CPS 60. The final pathological diagnosis was gastric histiocytic sarcoma. Subsequently, next-generation sequencing identified a nonsense mutation in exon 21 of NF1 gene [c.2446C > T (p.R816*)] and the TUBB3 gene amplification (copy number: 4.55). The patient refused further treatment and died of the tumor half a year later. This case broadens the spectrum of differential diagnosis of gastric cancer and emphasizes the value of immunohistochemical and molecular tests in the accurate diagnosis of histiocytic sarcoma. Furthermore, we performed literature review of 11 cases of gastric histiocytic sarcoma so as to strengthen the understanding of the clinicopathologic features, treatment, and prognosis.
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Affiliation(s)
- Yi Yang
- Department of Pathology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan City, Hubei Province, China
| | - Wei Fan
- Department of Pathology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan City, Hubei Province, China
| | - Xiaoping Liu
- Department of Pathology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan City, Hubei Province, China
| | - Qiongrong Chen
- Department of Pathology, Zhongnan Hospital of Wuhan University, No. 169, Donghu Road, Wuchang District, Wuhan City, Hubei Province, China.
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3
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Chiu LJ, Huang WT, Wang MC, Medeiros LJ, Chang KC. Low-grade histiocytic sarcoma with aggressive clinical behaviour: an unusual case with novel genetic mutations identified by whole genome sequencing. Pathology 2024:S0031-3025(24)00182-X. [PMID: 39138077 DOI: 10.1016/j.pathol.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 05/12/2024] [Accepted: 05/20/2024] [Indexed: 08/15/2024]
Affiliation(s)
- Ling-Jung Chiu
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Wan-Ting Huang
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ming-Chung Wang
- Division of Hematology-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - L Jeffrey Medeiros
- Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Kung-Chao Chang
- Department of Pathology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Center for Cancer Research, Kaohsiung Medical University, Kaohsiung, Taiwan.
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4
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Zhang M, Xiao F, Fang J, Liu Z, Shen Y, Zhu D, Zhang Y, Hou J, Huang H. Long-Term Remission with Novel Combined Immune-Targeted Treatment for Histiocytic Sarcoma Accompanied by Follicular Lymphoma: Case Report and Literature Review. Int J Mol Sci 2024; 25:7293. [PMID: 39000399 PMCID: PMC11242306 DOI: 10.3390/ijms25137293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 06/18/2024] [Accepted: 06/26/2024] [Indexed: 07/16/2024] Open
Abstract
Histiocytic sarcoma (HS) is an extremely rare but aggressive hematopoietic malignancy, and the prognosis has been reported to be rather unfavorable with a median overall survival of merely 6 months. We presented a 58-year-old female patient complaining of abdominal pain and fever, who was admitted to our institution in September 2021. Fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET/CT) scan showed enlargement of generalized multiple lymph nodes. Subsequently, laparoscopic retroperitoneal lesion biopsy and bone marrow aspiration were performed. The pathological findings indicated the diagnosis of HS concurrent with follicular lymphoma. The immunohistochemistry (IHC) staining of the tumor lesion revealed a high expression of CD38 and PD-L1 proteins. Furthermore, KRAS gene mutation was identified by means of next-generation sequencing. The patient exhibited poor treatment response to both first- and second-line cytotoxic chemotherapies. Therefore, she underwent six cycles of Daratumumab (anti-CD38 monoclonal antibody), Pazopanib (multi-target receptor tyrosine kinases inhibitor) combined with third-line chemotherapy, followed by involved-site radiotherapy and maintenance therapy with the PD-1 inhibitor Tislelizumab. Long-term partial remission was finally achieved after multi-modality treatment. Duration of remission and overall survival reached 22 and 32 months, respectively. Our case indicated that immuno-targeted treatment coupled with chemotherapy and radiotherapy might constitute a potential therapeutic option for HS.
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Affiliation(s)
- Minyue Zhang
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Fei Xiao
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Jianchen Fang
- Department of Pathology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Zebing Liu
- Department of Pathology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Yanying Shen
- Department of Pathology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Di Zhu
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Yiwei Zhang
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Jian Hou
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Honghui Huang
- Department of Hematology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
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Artymiuk CJ, Basu S, Koganti T, Tandale P, Balan J, Dina MA, Barr Fritcher EG, Wu X, Ashworth T, He R, Viswanatha DS. Clinical Validation of a Targeted Next-Generation Sequencing Panel for Lymphoid Malignancies. J Mol Diagn 2024; 26:583-598. [PMID: 38582399 DOI: 10.1016/j.jmoldx.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/16/2024] [Accepted: 03/22/2024] [Indexed: 04/08/2024] Open
Abstract
Lymphoid malignancies are a heterogeneous group of hematological disorders characterized by a diverse range of morphologic, immunophenotypic, and clinical features. Next-generation sequencing (NGS) is increasingly being applied to delineate the complex nature of these malignancies and identify high-value biomarkers with diagnostic, prognostic, or therapeutic benefit. However, there are various challenges in using NGS routinely to characterize lymphoid malignancies, including pre-analytic issues, such as sequencing DNA from formalin-fixed, paraffin-embedded tissue, and optimizing the bioinformatic workflow for accurate variant calling and filtering. This study reports the clinical validation of a custom capture-based NGS panel to test for molecular markers in a range of lymphoproliferative diseases and histiocytic neoplasms. The fully validated clinical assay represents an accurate and sensitive tool for detection of single-nucleotide variants and small insertion/deletion events to facilitate the characterization and management of patients with hematologic cancers specifically of lymphoid origin.
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Affiliation(s)
- Cody J Artymiuk
- Molecular Hematopathology Laboratory, Mayo Clinic, Rochester, Minnesota.
| | - Shubham Basu
- Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Tejaswi Koganti
- Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | | | | | - Michelle A Dina
- Molecular Hematopathology Laboratory, Mayo Clinic, Rochester, Minnesota
| | | | - Xianglin Wu
- Clinical Genome Sequencing Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Taylor Ashworth
- Clinical Genome Sequencing Laboratory, Mayo Clinic, Rochester, Minnesota
| | - Rong He
- Hematopathology Division, Mayo Clinic, Rochester, Minnesota
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Ruan GJ, Zanwar S, Ravindran A, Schram S, Abeykoon JP, Hazim A, Young JR, Shah MV, Bennani NN, Jiang L, Morlote D, Rech KL, Goyal G, Go RS. Clinical characteristics, molecular aberrations, treatments, and outcomes of malignant histiocytosis. Am J Hematol 2024; 99:871-879. [PMID: 38409747 PMCID: PMC11038892 DOI: 10.1002/ajh.27263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/12/2024] [Accepted: 02/13/2024] [Indexed: 02/28/2024]
Abstract
Malignant histiocytosis (MH) is an extremely rare neoplasm of the macrophage-dendritic cell lineage. We report the clinical characteristics, molecular aberrations, treatments, and outcomes of patients with MH seen at two referral centers from January 2000 to May 2023. We identified 43 patients with MH, of which 26 had histiocytic sarcoma (MH-H), 9 interdigitating dendritic cell sarcoma (MH-IDC), and 8 Langerhans cell sarcoma (MH-LC). The median age at diagnosis was 61 years (range, 3-83). Thirty-three patients (77%) had multifocal disease, while 10 had unifocal involvement. Tumor specimens from 22 patients (51%) underwent targeted next generation sequencing, and 19 of 22 (86%) had at least one pathogenic mutation, including mutations in MAPK pathway genes (73%). The median overall survival (OS) among the entire cohort was 16 months (95% CI: 8-50). The outcomes of those with multifocal disease were significantly shorter than their unifocal counterpart: median OS of 10 months versus 50 months (p = .07). Patients with risk organ involvement (bone marrow, spleen, or liver) had significantly inferior outcomes. Chemotherapy and surgery were the most common first-line treatments for multifocal and unifocal disease, respectively. While the outcome for patients with multifocal disease was poor, there was a subset of patients who had durable responses to treatment. Our study highlights that MH has heterogeneous clinical presentation, frequent oncogenic mutations, and prognosis, which is strongly tied to disease extent and type of organ involvement.
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Affiliation(s)
- Gordon J Ruan
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Saurabh Zanwar
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Aishwarya Ravindran
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
- Division of Laboratory Medicine-Hematopathology, Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Susan Schram
- Sawtooth Epidemiology & Infectious Diseases, Boise, Idaho, USA
| | | | - Antonious Hazim
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jason R Young
- Department of Radiology, Mayo Clinic, Jacksonville, Florida, USA
| | - Mithun V Shah
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - N Nora Bennani
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
| | - Liuyan Jiang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, Florida, USA
| | - Diana Morlote
- Division of Laboratory Medicine-Hematopathology, Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Karen L Rech
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Gaurav Goyal
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
- Division of Hematology-Oncology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, Minnesota, USA
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7
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Choi JK, Xiao W, Chen X, Loghavi S, Elenitoba-Johnson KS, Naresh KN, Medeiros LJ, Czader M. Fifth Edition of the World Health Organization Classification of Tumors of the Hematopoietic and Lymphoid Tissues: Acute Lymphoblastic Leukemias, Mixed-Phenotype Acute Leukemias, Myeloid/Lymphoid Neoplasms With Eosinophilia, Dendritic/Histiocytic Neoplasms, and Genetic Tumor Syndromes. Mod Pathol 2024; 37:100466. [PMID: 38460674 DOI: 10.1016/j.modpat.2024.100466] [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: 10/06/2023] [Revised: 02/11/2024] [Accepted: 03/01/2024] [Indexed: 03/11/2024]
Abstract
This manuscript represents a review of lymphoblastic leukemia/lymphoma (acute lymphoblastic leukemia/lymphoblastic lymphoma), acute leukemias of ambiguous lineage, mixed-phenotype acute leukemias, myeloid/lymphoid neoplasms with eosinophilia and defining gene rearrangements, histiocytic and dendritic neoplasms, and genetic tumor syndromes of the 5th edition of the World Health Organization Classification of Tumors of the Hematopoietic and Lymphoid Tissues. The diagnostic, clinicopathologic, cytogenetic, and molecular genetic features are discussed. The differences in comparison to the 4th revised edition of the World Health Organization classification of hematolymphoid neoplasms are highlighted.
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Affiliation(s)
- John K Choi
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Wenbin Xiao
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Xueyan Chen
- Section of Pathology, Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
| | - Sanam Loghavi
- Department of Hematopathology, MD Anderson Cancer Center, Houston, Texas
| | - Kojo S Elenitoba-Johnson
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kikkeri N Naresh
- Section of Pathology, Translational Science and Therapeutics Division, Fred Hutchinson Cancer Center, Seattle, Washington; Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington
| | - L Jeffrey Medeiros
- Department of Hematopathology, MD Anderson Cancer Center, Houston, Texas
| | - Magdalena Czader
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana.
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Shi C, Lytle A, Milman T, Penne R, Bagg A. Composite Histiocytic Sarcoma and Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma of the Ocular Adnexa. Ophthalmic Plast Reconstr Surg 2024:00002341-990000000-00377. [PMID: 38624159 DOI: 10.1097/iop.0000000000002670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Histiocytic sarcoma (HS) is a rare and aggressive hematologic neoplasm characterized by the proliferation of malignant histiocytes. It infrequently presents with periorbital involvement. Here we present the first documented case of ocular adnexal histiocytic sarcoma composite with chronic lymphocytic leukemia/small lymphocytic lymphoma and provide compelling evidence for the transdifferentiation of chronic lymphocytic leukemia/small lymphocytic lymphoma to histiocytic sarcoma in an 80-year-old woman. Comprehending the clinicopathological characteristics of histiocytic sarcoma and various other histiocytic proliferations and neoplasms affecting orbital and ocular structures is imperative for ophthalmic surgeons and pathologists.
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Affiliation(s)
- Chenxu Shi
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
| | - Andrew Lytle
- Centre for Lymphoid Cancer, BC Cancer and Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Tatyana Milman
- Department of Ophthalmology Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
- Department of Pathology, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
| | - Robert Penne
- Department of Ophthalmology Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
- Department of Oculoplastic and Orbital Surgery, Wills Eye Hospital, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, U.S.A
| | - Adam Bagg
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, U.S.A
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Srinivasan T, Sharma P, Sachdeva MUS, Palla S, Bal A, Peiyam S, Sreedharanunni S, Naseem S, Kumar A, Nahar U. An intriguing case of childhood primary bone marrow histiocytic sarcoma: A diagnostic challenge. Int J Lab Hematol 2024; 46:156-159. [PMID: 37596848 DOI: 10.1111/ijlh.14152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/08/2023] [Indexed: 08/20/2023]
Affiliation(s)
- Tharageswari Srinivasan
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Praveen Sharma
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Man Updesh Singh Sachdeva
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Swetha Palla
- Department of Pediatrics (Hematology and Oncology division), Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amanjit Bal
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Srinivasan Peiyam
- Department of Pediatrics (Hematology and Oncology division), Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sreejesh Sreedharanunni
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shano Naseem
- Department of Hematology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashwini Kumar
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Uma Nahar
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Zhang L, Zhang G, Zheng H, Jiang B, Ju Y, Duan Q, An L, Shi H. A rare case of primary central nervous system histiocytic sarcoma harboring a novel ARHGAP45::BRAF fusion: a case report and literature review. Brain Tumor Pathol 2024; 41:18-29. [PMID: 38100030 DOI: 10.1007/s10014-023-00471-8] [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: 09/26/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024]
Abstract
INTRODUCTION Patients with histiocytic sarcoma occurring in the central nervous system (CNS) are rare and have a very poor prognosis. The increased use of molecular diagnostic approaches in solid tumors has brought more opportunities for the diagnosis and treatment of central nervous system histiocytic sarcoma (CNSHS). CASE DESCRIPTION A 9-year-old girl was admitted to the hospital with pain in her head and neck, as well as vomiting. Imaging scans showed a prominent abnormality in the anterior falciform region, and histopathology revealed the presence of CD68 (+) and CD163 (+) cells, leading to a preliminary diagnosis of primary intracerebral CNSHS. Molecular profiling tests identified a new variant of ARHGAP45::BRAF fusion in this case, which has not been reported in any other tumor. The patient underwent surgical removal of the tumor and will require long-term monitoring. CONCLUSION The presence of the BRAF point mutation, predominantly BRAF p.V600E, has been documented in prior literature of CNSHS. This is the first case of pediatric histiocytic sarcoma in the anterior falciform region who has a unique ARHGAP45::BRAF fusion. The findings of our study indicate that a broader range of molecular assays should be employed in the diagnosis of CNSHS and opens up new possibilities for the treatment of the patient.
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Affiliation(s)
- Luyi Zhang
- Department of Neurosurgery, Xi'an Children's Hospital Affiliated to Xi'an Jiaotong University, No 69, Xiju Yuan Lane, Lianhu District, Xi'an, 710000, Shanxi, People's Republic of China
| | - Gang Zhang
- Department of Neurosurgery, Xi'an Children's Hospital Affiliated to Xi'an Jiaotong University, No 69, Xiju Yuan Lane, Lianhu District, Xi'an, 710000, Shanxi, People's Republic of China
| | - Han Zheng
- Department of Neurosurgery, Xi'an Children's Hospital Affiliated to Xi'an Jiaotong University, No 69, Xiju Yuan Lane, Lianhu District, Xi'an, 710000, Shanxi, People's Republic of China
| | - Bin Jiang
- Department of Neurosurgery, Xi'an Children's Hospital Affiliated to Xi'an Jiaotong University, No 69, Xiju Yuan Lane, Lianhu District, Xi'an, 710000, Shanxi, People's Republic of China
| | - Yongzhi Ju
- The Medical Department, State Key Laboratory of Neurology and Oncology Drug Development, Jiangsu Simcere Pharmaceutical Co., Ltd., Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, Jiangsu, People's Republic of China
| | - Qianqian Duan
- The Medical Department, State Key Laboratory of Neurology and Oncology Drug Development, Jiangsu Simcere Pharmaceutical Co., Ltd., Jiangsu Simcere Diagnostics Co., Ltd., Nanjing, Jiangsu, People's Republic of China
| | - Lu An
- Department of Pathology, Xi'an Children's Hospital Affiliated to Xi'an Jiaotong University, Xi'an, Shanxi, People's Republic of China
| | - Hangyu Shi
- Department of Neurosurgery, Xi'an Children's Hospital Affiliated to Xi'an Jiaotong University, No 69, Xiju Yuan Lane, Lianhu District, Xi'an, 710000, Shanxi, People's Republic of China.
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Jaffe ES. Evolution of Lymphoma Diagnosis in the Era of Personalized Medicine: A Marriage of Pathology and Genomics for Clinical Practice. THE AMERICAN JOURNAL OF PATHOLOGY 2023; 193:1880-1886. [PMID: 37734589 PMCID: PMC10734280 DOI: 10.1016/j.ajpath.2023.08.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 08/15/2023] [Indexed: 09/23/2023]
Abstract
The modern taxonomy of disease builds a framework for precision medicine, by which traditional pathologic criteria are integrated with clinical and genomic features to define disease entities. Two of the most common subtypes of lymphoma on a worldwide basis are follicular lymphoma (FL) and diffuse large B-cell lymphoma. Although BCL2 translocation is the signature lesion of most nodal FL, recent studies have identified significant diversity among follicle center-derived lesions. BCL2-negative FL is a genetically heterogeneous disease that occurs in both nodal and extranodal sites. Several distinct entities have been recognized in the pediatric age group, including pediatric-type FL, testicular FL, and interferon regulatory factor 4 (IRF4)-rearranged large B-cell lymphoma. Diffuse large B-cell lymphoma is a family of aggressive B-cell neoplasms with marked variation in pathogenesis and clinical features. Gene expression profiling >20 years ago identified the cell of origin as a key discriminator, but more recently high-throughput sequencing has identified highly varied mutational profiles that point the way in the future toward improvements in targeted therapy and patient outcome.
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Affiliation(s)
- Elaine S Jaffe
- Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland.
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Ravindran A, Dasari S, Ruan GJ, Artymiuk CJ, He R, Viswanatha DS, Abeykoon JP, Zanwar S, Young JR, Goyal G, Go RS, Rech KL. Malignant Histiocytosis Comprises a Phenotypic Spectrum That Parallels the Lineage Differentiation of Monocytes, Macrophages, Dendritic Cells, and Langerhans Cells. Mod Pathol 2023; 36:100268. [PMID: 37406859 DOI: 10.1016/j.modpat.2023.100268] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 06/22/2023] [Accepted: 06/27/2023] [Indexed: 07/07/2023]
Abstract
Malignant histiocytoses (MHs), or the 'M group' of the Histiocyte Society classification, are characterized by neoplastic histiocytes with large pleomorphic nuclei. MH encompasses the diagnoses of histiocytic sarcoma, interdigitating dendritic cell sarcoma, and Langerhans cell sarcoma. We aimed to define the phenotypic spectrum of MH and examine the genotypic features across this spectrum. Using immunohistochemistry, we arranged the 22 cases into 4 subtypes that correspond to the lines of differentiation from monocytic and dendritic cell precursors as follows: (1) macrophage (n = 5): CD68+, CD163+, CD14+, and Factor 13a+; (2) monocyte-macrophage (n = 5): CD68+, CD163+, CD14+, S100+, and OCT2+; (3) dendritic cell (n = 6): CD68+, CD11c+, S100+, lysozyme+, ZBTB46+, and CD1a/langerin < 5%; and (4) Langerhans cell (n = 6): CD68+, CD11c+, S100+, ZBTB46+, CD1a+, and langerin+. The phenotypic subtypes align with those seen in low-grade histiocytic neoplasms as follows: MH-macrophage type correlates with Erdheim-Chester disease phenotype; MH-monocyte-macrophage type with Rosai-Dorfman disease phenotype, and MH-Langerhans cell type with Langerhans cell histiocytosis. Activating mutations in MAPK-pathway genes were identified in 80% of MH cases; 29% had mutations in the PI3k-AKT-mTOR pathway and 59% had mutations in epigenetic modulating genes. Strong expression of cyclin D1 was present in all cases, whereas p-ERK and p-AKT were not uniformly expressed. Eight of 22 (36%) MH cases were proven to be clonally related to a prior B-cell lymphoma. Defining the phenotypic spectrum of MH provides a guide to diagnosis and allows further exploration into the potential biological and clinical significance.
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Affiliation(s)
- Aishwarya Ravindran
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota; Division of Laboratory Medicine-Hematopathology, Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Surendra Dasari
- Division of Computational Biology, Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Gordon J Ruan
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Cody J Artymiuk
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Rong He
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - David S Viswanatha
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | - Jithma P Abeykoon
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Saurabh Zanwar
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Jason R Young
- Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - Gaurav Goyal
- Division of Hematology-Medical Oncology, The University of Alabama at Birmingham, Birmingham, Alabama; Research Collaborator (limited tenure), Mayo Clinic, Rochester, Minnesota
| | - Ronald S Go
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota
| | - Karen L Rech
- Division of Hematopathology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota.
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13
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Frigola G, Bühler M, Marginet M, Enjuanes A, Nadeu F, Papaleo N, Salido M, Haralambieva E, Alamo J, Garcia-Bragado F, Álvarez R, Ramos R, Aldecoa I, Campo E, Colomo L, Balagué O. MYC and TP53 Alterations but Not MAPK Pathway Mutations Are Common Oncogenic Mechanisms in Follicular Dendritic Cell Sarcomas. Arch Pathol Lab Med 2023; 147:896-906. [PMID: 36355424 DOI: 10.5858/arpa.2021-0517-oa] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2022] [Indexed: 07/28/2023]
Abstract
CONTEXT.— Despite their stromal origin, follicular dendritic cells (FDCs) share many functions with hematopoietic system cells. FDC neoplasms are currently classified by the World Health Organization along with those of a histiocytic nature. However, the molecular alterations driving oncogenesis in FDC sarcomas (FDCSs) are beginning to be unveiled and do not seem to concur with those described in histiocytic neoplasms, namely MAPK pathway activation. OBJECTIVE.— To identify molecular alterations driving tumorigenesis in FDCS. DESIGN.— We investigated the role of MYC and TP53 in FDC-derived tumor oncogenesis and assessed comprehensively the status of the MAPK pathway in 16 FDCSs, 6 inflammatory pseudotumor (IPT)-like FDCSs, and 8 IPTs. RESULTS.— MYC structural alterations (both amplifications and rearrangements) were identified in 5 of 14 FDCSs (35.7%), all associated with MYC overexpression. TP53 mutations were identified in 4 of 14 FDCSs (28.6%), all of which displayed intense and diffuse p53 expression. None of these alterations were identified in any IPT-like FDCSs or in IPT cases. No MAPK pathway gene alterations were identified in any of the cases studied. CONCLUSIONS.— The presence of MYC and TP53 alterations and the lack of association with Epstein-Barr virus segregate classical FDCS from IPT-like FDCS, pointing at different oncogenic mechanisms in both entities. Our results suggest a possible oncogenic role of MYC and TP53 alterations in FDCS. The absence of MAPK pathway alterations confirms the lack of a significant role of this pathway in the oncogenesis of FDC-derived neoplasms.
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Affiliation(s)
- Gerard Frigola
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
| | - Marco Bühler
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
- The Department of Pathology, University Hospital Zürich, Zürich, Switzerland (Bühler, Haralambieva)
| | - Marta Marginet
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
| | - Anna Enjuanes
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
| | - Ferran Nadeu
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
- The Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain (Nadeu, Campo, Balagué)
| | - Natalia Papaleo
- The Department of Pathology, Parc Taulí Hospital Universitari, Sabadell, Spain (Papaleo)
- The Department of Pathology, Hospital del Mar, Barcelona, Spain (Papaleo, Salido, Colomo)
- The Department of Diagnostic Fundamentals, University Pompeu Fabra, Barcelona, Spain (Papaleo, Colomo)
| | - Marta Salido
- The Department of Pathology, Hospital del Mar, Barcelona, Spain (Papaleo, Salido, Colomo)
| | - Eugenia Haralambieva
- The Department of Pathology, University Hospital Zürich, Zürich, Switzerland (Bühler, Haralambieva)
| | - José Alamo
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
| | - Federico Garcia-Bragado
- The Department of Pathology, Complejo Hospitalario de Navarra, Pamplona, Spain (Garcia-Bragado)
| | - Ramiro Álvarez
- The Department of Pathology, Hospital Universitario Miguel Servet, Zaragoza, Spain (Álvarez)
| | - Rafael Ramos
- The Department of Pathology, Hospital Universitari Son Espases, Palma de Mallorca, Spain (Ramos)
| | - Iban Aldecoa
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
| | - Elías Campo
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
- The Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain (Nadeu, Campo, Balagué)
- The Department of Clinical Fundamentals, University of Barcelona, Barcelona, Spain (Campo, Balagué)
| | - Lluis Colomo
- The Department of Pathology, Hospital del Mar, Barcelona, Spain (Papaleo, Salido, Colomo)
- The Department of Diagnostic Fundamentals, University Pompeu Fabra, Barcelona, Spain (Papaleo, Colomo)
| | - Olga Balagué
- From the Department of Pathology, Hospital Clínic of Barcelona, Barcelona, Spain (Frigola, Bühler, Marginet, Alamo, Aldecoa, Campo, Balagué)
- The Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain (Frigola, Bühler, Enjuanes, Nadeu, Campo, Balagué)
- The Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Madrid, Spain (Nadeu, Campo, Balagué)
- The Department of Clinical Fundamentals, University of Barcelona, Barcelona, Spain (Campo, Balagué)
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14
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Janke LJ, Rehg JE. The many faces of mouse histiocytic sarcoma in C57BL/6J mice. Vet Pathol 2023; 60:443-460. [PMID: 37132518 DOI: 10.1177/03009858231166658] [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] [Indexed: 05/04/2023]
Abstract
Histiocytic sarcoma is a tumor of the hematopoietic system considered to be derived from macrophages. Although rare in humans, it occurs frequently in mice. Histiocytic sarcoma can be a difficult tumor to diagnose due to its diverse cellular morphologies, growth patterns, and organ distributions. The varying morphology of histiocytic sarcomas makes it easy to confuse them with other types of neoplasia, including hepatic hemangiosarcoma, uterine schwannoma, leiomyosarcoma, uterine stromal cell tumor, intramedullary osteosarcoma, and myeloid leukemia. As such, immunohistochemistry (IHC) is often needed to differentiate histiocytic sarcomas from other common tumors in mice that they can morphologically mimic. The goal of this article is to present a broader perspective of the diverse cellular morphologies, growth patterns, organ distributions, and IHC labeling of histiocytic sarcomas encountered by the authors. This article describes these features in a set of 62 mouse histiocytic sarcomas, including the IHC characterization of the tumors using a panel of markers for the macrophage antigens F4/80, IBA1, MAC2, CD163, CD68, and lysozyme, and describes differentiating features of histiocytic sarcomas from other morphologically similar tumors. The genetic changes underlying the pathogenesis of histiocytic sarcoma in humans are beginning to be elucidated, but this is difficult due to its rarity. The higher prevalence of this tumor in mice provides opportunities to investigate mechanisms of its development and to test potential treatments.
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15
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Hélias-Rodzewicz Z, Donadieu J, Terrones N, Barkaoui MA, Lambilliotte A, Moshous D, Thomas C, Azarnoush S, Pasquet M, Mansuy L, Aladjidi N, Jeziorski E, Marec-Berard P, Gilibert-Yvert M, Spiegel A, Saultier P, Pellier I, Pagnier A, Pertuisel S, Poiree M, Bodet D, Millot F, Isfan F, Stephan JL, Leruste A, Rigaud C, Filhon B, Carausu L, Reguerre Y, Kieffer I, Brichard B, Ben Jannet R, Bakari M, Idbaih A, Bodemer C, Cohen-Aubart F, Haroche J, Tazi A, Boudjemaa S, Fraitag S, Emile JF, Heritier S. Molecular and clinicopathologic characterization of pediatric histiocytoses. Am J Hematol 2023; 98:1058-1069. [PMID: 37115038 DOI: 10.1002/ajh.26938] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023]
Abstract
The spectrum of somatic mutations in pediatric histiocytoses and their clinical implications are not fully characterized, especially for non-Langerhans cell histiocytosis (-LCH) subtypes. A cohort of 415 children with histiocytosis from the French histiocytosis registry was reviewed and analyzed for BRAFV600E . Most BRAFWT samples were analyzed by next-generation sequencing (NGS) with a custom panel of genes for histiocytosis and myeloid neoplasia. Of 415 case samples, there were 366 LCH, 1 Erdheim-Chester disease, 21 Rosai-Dorfman disease (RDD), 21 juvenile xanthogranuloma (JXG, mostly with severe presentation), and 6 malignant histiocytosis (MH). BRAFV600E was the most common mutation found in LCH (50.3%, n = 184). Among 105 non-BRAFV600E -mutated LCH case samples, NGS revealed mutations as follows: MAP2K1 (n = 44), BRAF exon 12 deletions (n = 26), and duplications (n = 8), other BRAF V600 codon mutation (n = 4), and non-MAP-kinase pathway genes (n = 5). Wild-type sequences were identified in 17.1% of samples. BRAFV600E was the only variant significantly correlated with critical presentations: organ-risk involvement and neurodegeneration. MAP-kinase pathway mutations were identified in seven RDD (mostly MAP2K1) and three JXG samples, but most samples were wild-type on NGS. Finally, two MH samples had KRAS mutations, and one had a novel BRAFG469R mutation. Rarely, we identified mutations unrelated to MAP-kinase pathway genes. In conclusion, we characterized the mutational spectrum of childhood LCH and clinical correlations of variants and subtypes. Variants responsible for JXG and RDD were not elucidated in more than half of the cases, calling for other sequencing approaches.
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Affiliation(s)
- Zofia Hélias-Rodzewicz
- EA4340 BECCOH, Pathology Department, Ambroise Paré Hospital, AP-HP, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Jean Donadieu
- French Reference Center for Histiocytosis, Department of Pediatric Hematology and Oncology, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Nathalie Terrones
- EA4340 BECCOH, Pathology Department, Ambroise Paré Hospital, AP-HP, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Mohamed-Aziz Barkaoui
- French Reference Center for Histiocytosis, Department of Pediatric Hematology and Oncology, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Anne Lambilliotte
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Lille, Lille, France
| | - Despina Moshous
- Department of Pediatric Immunology, Hematology and Rheumatology, Necker Hospital, AP-HP, Centre-Université Paris Cité, Institut Imagine, Paris, France
| | - Caroline Thomas
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Nantes, Nantes, France
| | - Saba Azarnoush
- Department of Pediatric Immunology and Hematology, Robert Debré Hospital, AP-HP, Nord-Université Paris Cité, Paris, France
| | - Marlène Pasquet
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Ludovic Mansuy
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Nancy, Vandœuvre-lès-Nancy, France
| | - Nathalie Aladjidi
- Department of Pediatric Hematology and Oncology, Centre d'Investigation Clinique (CIC) 1401, INSERM, Centre Hospitalo-Universitaire de Bordeaux, Bordeaux, France
| | - Eric Jeziorski
- Department of Paediatric, Hôpital Arnaud de Villeneuve, Centre Hospitalo-Universitaire de Montpellier, Montpellier, France
| | - Perrine Marec-Berard
- Department of Paediatric Oncology, Institut d'Hémato-Oncologie Pediatrique, Lyon, France
| | - Marion Gilibert-Yvert
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Tours, Tours, France
| | - Alexandra Spiegel
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Strasbourg, Strasbourg, France
| | - Paul Saultier
- Department of Pediatric Hematology, Immunology and Oncology, Aix Marseille, APHM University, INSERM, INRAe, C2VN, La Timone Children's Hospital, Marseille, France
| | - Isabelle Pellier
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Angers, Angers, France
| | - Anne Pagnier
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Grenoble, Grenoble, France
| | - Sophie Pertuisel
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Rennes, Rennes, France
| | - Maryline Poiree
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Nice, Nice, France
| | - Damien Bodet
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Cean, Cean, France
| | - Frédéric Millot
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Poitiers, Poitiers, France
| | - Florentina Isfan
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Clermont-Ferrand, Clermont-Ferrand, France
| | - Jean-Louis Stephan
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Saint Etienne, Saint-Étienne, France
| | - Amaury Leruste
- Pediatric, Adolescent and Young Adult Oncology Department, Institut Curie Medical Center, Paris, France
| | - Charlotte Rigaud
- Department of Paediatric and Adolescent Oncology, Gustave Roussy Cancer Campus, Villejuif, France
| | - Bruno Filhon
- Department of Pediatric Hematology and Oncology, Groupe Hospitalier du Havre, Montivilliers, France
| | - Liana Carausu
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire de Brest, Brest, France
| | - Yves Reguerre
- Department of Pediatric Hematology and Oncology, Centre Hospitalo-Universitaire Saint Denis de la Réunion, Saint-Denis, Réunion, France
| | - Isabelle Kieffer
- Service National d'Onco-Hematologie Pediatrique (SNOHP), Kannerklinik, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
| | - Bénédicte Brichard
- Department of Pediatric Hematology and Oncology, Cliniques Universitaires Saint Luc, Brussels, Belgium
| | - Rim Ben Jannet
- EA4340 BECCOH, Pathology Department, Ambroise Paré Hospital, AP-HP, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Mariama Bakari
- EA4340 BECCOH, Pathology Department, Ambroise Paré Hospital, AP-HP, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Ahmed Idbaih
- Sorbonne Université, Institut du Cerveau-Paris Brain Institute-ICM, Inserm, CNRS, AP-HP, Hôpital Universitaire La Pitié Salpêtrière, DMU Neurosciences, Paris, France
| | - Christine Bodemer
- Department of Dermatology, Necker Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Fleur Cohen-Aubart
- Department of Internal Medicine, La Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Julien Haroche
- Department of Internal Medicine, La Pitié Salpêtrière Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Abdellatif Tazi
- Université Paris Cité, INSEM U976, AP-HP Pulmonary Department, Saint-Louis Hospital, Paris, France
| | - Sabah Boudjemaa
- Pathology Department, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
| | - Sylvie Fraitag
- Pathology Department, Necker Hospital, AP-HP, Centre-Université Paris Cité, Institut Imagine, Paris, France
| | - Jean-François Emile
- EA4340 BECCOH, Pathology Department, Ambroise Paré Hospital, AP-HP, Université Paris-Saclay, Boulogne-Billancourt, France
| | - Sébastien Heritier
- French Reference Center for Histiocytosis, Department of Pediatric Hematology and Oncology, Trousseau Hospital, AP-HP, Sorbonne Université, Paris, France
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16
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Asada H, Tani A, Sakuma H, Hirabayashi M, Matsumoto Y, Watanabe K, Tsuboi M, Yoshida S, Harada K, Uchikai T, Goto-Koshino Y, Chambers JK, Ishihara G, Kobayashi T, Irie M, Uchida K, Ohno K, Bonkobara M, Tsujimoto H, Tomiyasu H. Whole exome and transcriptome analysis revealed the activation of ERK and Akt signaling pathway in canine histiocytic sarcoma. Sci Rep 2023; 13:8512. [PMID: 37231193 DOI: 10.1038/s41598-023-35813-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/24/2023] [Indexed: 05/27/2023] Open
Abstract
Histiocytic sarcoma (HS) is an incurable aggressive tumor, and no consensus has been made on the treatment due to its rare occurrence. Since dogs spontaneously develop the disease and several cell lines are available, they have been advocated as translational animal models. In the present study, therefore, we explored gene mutations and aberrant molecular pathways in canine HS by next generation sequencing to identify molecular targets for treatment. Whole exome sequencing and RNA-sequencing revealed gene mutations related to receptor tyrosine kinase pathways and activation of ERK1/2, PI3K-AKT, and STAT3 pathways. Analysis by quantitative PCR and immunohistochemistry revealed that fibroblast growth factor receptor 1 (FGFR1) is over-expressed. Moreover, activation of ERK and Akt signaling were confirmed in all HS cell lines, and FGFR1 inhibitors showed dose-dependent growth inhibitory effects in two of the twelve canine HS cell lines. The findings obtained in the present study indicated that ERK and Akt signaling were activated in canine HS and drugs targeting FGFR1 might be effective in part of the cases. The present study provides translational evidence that leads to establishment of novel therapeutic strategies targeting ERK and Akt signaling in HS patients.
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Affiliation(s)
- Hajime Asada
- Department of Veterinary Internal Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, IL, 60637, USA
| | - Akiyoshi Tani
- Department of Veterinary Internal Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiroki Sakuma
- Department of Veterinary Internal Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Miyuki Hirabayashi
- Department of Veterinary Pathology, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuki Matsumoto
- Anicom Specialty Medical Institute Inc., Shinjuku-ku, Tokyo, Japan
| | - Kei Watanabe
- Anicom Specialty Medical Institute Inc., Shinjuku-ku, Tokyo, Japan
| | - Masaya Tsuboi
- Veterinary Medical Center, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Shino Yoshida
- Department of Veterinary Internal Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Kei Harada
- Japan Small Animal Cancer Center, Tokorozawa, Saitama, Japan
| | - Takao Uchikai
- Anicom Specialty Medical Institute Inc., Shinjuku-ku, Tokyo, Japan
| | - Yuko Goto-Koshino
- Department of Veterinary Internal Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - James K Chambers
- Department of Veterinary Pathology, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Genki Ishihara
- Anicom Specialty Medical Institute Inc., Shinjuku-ku, Tokyo, Japan
| | | | - Mitsuhiro Irie
- Shikoku Veterinary Medical Center, Kita-gun, Kagawa, Japan
| | - Kazuyuki Uchida
- Department of Veterinary Pathology, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Koichi Ohno
- Department of Veterinary Internal Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Makoto Bonkobara
- Department of Veterinary Clinical Pathology, Nippon Veterinary and Life Science University, Musashino, Tokyo, Japan
| | - Hajime Tsujimoto
- Department of Veterinary Internal Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hirotaka Tomiyasu
- Department of Veterinary Internal Medicine, the University of Tokyo, Bunkyo-ku, Tokyo, Japan.
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17
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Zhao Y, Deng Y, Jiang Y, Zheng W, Tan Y, Yang Z, Wang Z, Xu F, Cheng Z, Yuan L, Peng H. Case report: Targeting the PD-1 receptor and genetic mutations validated in primary histiocytic sarcoma with hemophagocytic lymphohistiocytosis. Front Immunol 2023; 14:1127599. [PMID: 36969238 PMCID: PMC10030599 DOI: 10.3389/fimmu.2023.1127599] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/22/2023] [Indexed: 03/10/2023] Open
Abstract
Histiocytic sarcoma (HS) is a rare hematological malignancy with limited treatment options, and it is also prone to complications such as hemophagocytic lymphohistiocytosis (HLH) in the later stages of the disease, leading to difficulties in treatment and poor prognosis. It highlights the importance of developing novel therapeutic agents. Herein, we present a case of a 45-year-old male patient who was diagnosed with PD-L1-positive HS with HLH. The patient was admitted to our hospital with recurrent high fever, multiple skin rashes with pruritus throughout the body and enlarged lymph nodes. Subsequently, pathological biopsy of the lymph nodes revealed high expression of CD163, CD68, S100, Lys and CD34 in the tumor cells and no expression of CD1a and CD207, confirming this rare clinical diagnosis. Concerning the low remission rate by conventional treatment in this disease, the patient was administered with sintilimab (an anti-programmed cell death 1 [anti-PD-1] monoclonal antibody) at 200 mg/d combined with a first-line chemotherapy regimen for one cycle. Further exploration of pathological biopsy by using next-generation gene sequencing led to the use of targeted therapy of chidamide. After one cycle of combination therapy (chidamide+sintilimab, abbreviated as CS), the patient achieved a favorable response. The patient showed remarkable improvement in the general symptoms and laboratory examination results (e.g., elevated indicators of inflammation); even the clinical benefits was not persistent, he survived one more month after his cessation of treatment by himself due to economic difficulty. Our case suggests that PD-1 inhibitor coupled with targeted therapy might constitute a potential therapeutic option for primary HS with HLH.
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Affiliation(s)
- Yan Zhao
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yating Deng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yi Jiang
- Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wenli Zheng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanlin Tan
- Department of Imaging, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhiwu Yang
- Department of Hematology, Yiyang Central Hospital, Yiyang, Hunan, China
| | - Zhihua Wang
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Feng Xu
- Department of Thyroid and Breast Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhao Cheng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lingli Yuan
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- *Correspondence: Lingli Yuan, ; Hongling Peng,
| | - Hongling Peng
- Department of Hematology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hunan Engineering Research Center of Cell Immunotherapy for Hematopoietic Malignancies, Changsha, Hunan, China
- *Correspondence: Lingli Yuan, ; Hongling Peng,
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18
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Xia YY, Huang YH, Huang WH, Wu KL, Lee JJ. An invasive primary nasal histiocytic sarcoma in a cat. VETERINARY RECORD CASE REPORTS 2023. [DOI: 10.1002/vrc2.578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Yuan Yuan Xia
- Department of Veterinary Medicine School of Veterinary Medicine National Taiwan University Taipei Taiwan
- National Taiwan University Veterinary Hospital College of Bioresources and Agriculture National Taiwan University Taipei Taiwan
| | - Yi Hsiang Huang
- Graduate Institute of Molecular and Comparative Pathobiology School of Veterinary Medicine National Taiwan University Taipei Taiwan
| | - Wei Hsiang Huang
- Graduate Institute of Molecular and Comparative Pathobiology School of Veterinary Medicine National Taiwan University Taipei Taiwan
| | - Kuan Lun Wu
- National Taiwan University Veterinary Hospital College of Bioresources and Agriculture National Taiwan University Taipei Taiwan
| | - Jih Jong Lee
- Department of Veterinary Medicine School of Veterinary Medicine National Taiwan University Taipei Taiwan
- National Taiwan University Veterinary Hospital College of Bioresources and Agriculture National Taiwan University Taipei Taiwan
- Graduate Institute of Veterinary Clinical Science School of Veterinary Medicine National Taiwan University Taipei Taiwan
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19
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Nishimura K, Miyazaki K, Suzuki K, Hachiya K, Tono Y, Tamaru S, Imai H, Miyoshi H, Ohshima K, Okugawa Y, Tawara I, Yamaguchi M. Combined use of pathological and genomic alteration analyses for the diagnosis of gray zone lymphoma. J Clin Exp Hematop 2022; 62:253-257. [PMID: 36575002 PMCID: PMC9898712 DOI: 10.3960/jslrt.22024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Histiocytic sarcoma (HS) is a rare malignancy showing morphologic and immunophenotypic features of histiocytes. HS has morphologic overlap with many other diseases, including various kinds of lymphomas. Gray zone lymphoma (GZL) is a rare B-cell lymphoma subtype characterized by overlapping features between diffuse large B-cell lymphoma and classic Hodgkin lymphoma. The histologic overlap with other diverse diseases of HS and the pathological diversity of GZL make it difficult to render a diagnosis. A 44-year-old woman who was initially diagnosed with HS was diagnosed with GZL after reexamination, including a genetic alteration test. After 6 cycles of brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine, she achieved a complete response. Genomic alteration assessment may be useful for the accurate diagnosis of malignant lymphomas, which are difficult to diagnose, such as GZL.
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Affiliation(s)
- Komei Nishimura
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kana Miyazaki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kazutaka Suzuki
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kensuke Hachiya
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Yasutaka Tono
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Satoshi Tamaru
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroshi Imai
- Pathology Division, Mie University Hospital, Tsu, Japan
| | - Hiroaki Miyoshi
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Koichi Ohshima
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | | | - Isao Tawara
- Department of Hematology and Oncology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Motoko Yamaguchi
- Department of Hematological Malignancies, Mie University Graduate School of Medicine, Tsu, Japan
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20
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Neurological Erdheim-Chester Disease Manifesting with Subacute or Progressive Cerebellar Ataxia: Novel Case Series and Review of the Literature. Brain Sci 2022; 13:brainsci13010026. [PMID: 36672008 PMCID: PMC9856726 DOI: 10.3390/brainsci13010026] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/16/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022] Open
Abstract
Neurological involvement is relatively common in Erdheim-Chester disease (ECD), a rare clonal disorder of histiocytic myeloid precursors characterized by multisystem involvement. In ECD patients, neurological symptoms can occur either at onset or during the disease course and may lead to various degrees of neurological disability or affect patients' life expectancy. The clinical neurological presentation of ECD often consists of cerebellar symptoms, showing either a subacute or progressive course. In this latter case, patients manifest with a slowly progressive cerebellar ataxia, variably associated with other non-specific neurological signs, infratentorial leukoencephalopathy, and cerebellar atrophy, possibly mimicking either adult-onset degenerative or immune-mediated ataxia. In such cases, diagnosis of ECD may be particularly challenging, yet some peculiar features are helpful to address it. Here, we retrospectively describe four novel ECD patients, all manifesting cerebellar symptoms at onset. In two cases, slow disease progression and associated brain MRI features simulated a degenerative cerebellar ataxia. Three patients received a definite diagnosis of histiocytosis, whereas one case lacked histology confirmation, although clinical diagnostic features were strongly suggestive. Our findings regarding existing literature data focused on neurological ECD will be also discussed to highlight those diagnostic clues helpful to address diagnosis.
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21
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Muacevic A, Adler JR, Sukaina M, Shaik Masthan S, Bint I Munir A, Iqbal Y, Qureshi MH, Husnain A, Ghafoor S, Ghafoor B, Nagarajan JS, Pervaiz F, Haseeb ul Rasool M. Histiocytic Sarcoma Secondary to Gastrointestinal Stromal Tumors: A Literature Review. Cureus 2022; 14:e33055. [PMID: 36721560 PMCID: PMC9882698 DOI: 10.7759/cureus.33055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2022] [Indexed: 12/29/2022] Open
Abstract
Histiocytic sarcoma (HS) is a rare tumor that may result from the transdifferentiation of preexisting hematolymphoid neoplasms in a subset of patients. There are instances of correlation or concurrence between HS and a number of cancers, particularly B-cell-associated hematopoietic tumors. Only three cases of HS occurring subsequent to or concurrently with gastrointestinal stromal tumors (GIST) have been recorded. Our main objective was to give an overview of demographics, clinical signs and symptoms, histopathological findings, and immunohistochemical and molecular analysis when HS develops secondary to or concurrently with GIST. A search of PubMed, Google Scholar, and ScienceDirect was undertaken using Medical Subject Headings (MeSH) keywords. According to the findings of our review, there were two males (66.6%) and one female (33.3%). The average age of patients at presentation was 59.6 years. On the immunohistochemistry, three patients were positive for cluster of differentiation (CD) 68 (100%), two patients were positive for CD 163 (67%), one patient was positive for leukocyte common antigen (LCA) (33%), and only one patient was positive for CD 4, CD 10, CD 31, CD 45, human leukocyte antigen (HLA)-DR, lysozyme, and vimentin (33%). On molecular investigation, the gastric mass of only one patient (33.33%) contained a KIT mutation on exon 11. Emperipolesis was observed in one patient (33.33%) on histological examination. Our study provides an important overview of the available literature and gives insight into important diagnostic markers of HS when it occurs secondary to or concurrently with GIST.
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22
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de Leval L, Alizadeh AA, Bergsagel PL, Campo E, Davies A, Dogan A, Fitzgibbon J, Horwitz SM, Melnick AM, Morice WG, Morin RD, Nadel B, Pileri SA, Rosenquist R, Rossi D, Salaverria I, Steidl C, Treon SP, Zelenetz AD, Advani RH, Allen CE, Ansell SM, Chan WC, Cook JR, Cook LB, d’Amore F, Dirnhofer S, Dreyling M, Dunleavy K, Feldman AL, Fend F, Gaulard P, Ghia P, Gribben JG, Hermine O, Hodson DJ, Hsi ED, Inghirami G, Jaffe ES, Karube K, Kataoka K, Klapper W, Kim WS, King RL, Ko YH, LaCasce AS, Lenz G, Martin-Subero JI, Piris MA, Pittaluga S, Pasqualucci L, Quintanilla-Martinez L, Rodig SJ, Rosenwald A, Salles GA, San-Miguel J, Savage KJ, Sehn LH, Semenzato G, Staudt LM, Swerdlow SH, Tam CS, Trotman J, Vose JM, Weigert O, Wilson WH, Winter JN, Wu CJ, Zinzani PL, Zucca E, Bagg A, Scott DW. Genomic profiling for clinical decision making in lymphoid neoplasms. Blood 2022; 140:2193-2227. [PMID: 36001803 PMCID: PMC9837456 DOI: 10.1182/blood.2022015854] [Citation(s) in RCA: 61] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/15/2022] [Indexed: 01/28/2023] Open
Abstract
With the introduction of large-scale molecular profiling methods and high-throughput sequencing technologies, the genomic features of most lymphoid neoplasms have been characterized at an unprecedented scale. Although the principles for the classification and diagnosis of these disorders, founded on a multidimensional definition of disease entities, have been consolidated over the past 25 years, novel genomic data have markedly enhanced our understanding of lymphomagenesis and enriched the description of disease entities at the molecular level. Yet, the current diagnosis of lymphoid tumors is largely based on morphological assessment and immunophenotyping, with only few entities being defined by genomic criteria. This paper, which accompanies the International Consensus Classification of mature lymphoid neoplasms, will address how established assays and newly developed technologies for molecular testing already complement clinical diagnoses and provide a novel lens on disease classification. More specifically, their contributions to diagnosis refinement, risk stratification, and therapy prediction will be considered for the main categories of lymphoid neoplasms. The potential of whole-genome sequencing, circulating tumor DNA analyses, single-cell analyses, and epigenetic profiling will be discussed because these will likely become important future tools for implementing precision medicine approaches in clinical decision making for patients with lymphoid malignancies.
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Affiliation(s)
- Laurence de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Ash A. Alizadeh
- Division of Oncology, Department of Medicine, Stanford University, Stanford, CA
- Stanford Cancer Institute, Stanford University, Stanford, CA
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University, Stanford, CA
- Division of Hematology, Department of Medicine, Stanford University, Stanford, CA
| | - P. Leif Bergsagel
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ
| | - Elias Campo
- Haematopathology Section, Hospital Clínic, Institut d'Investigaciones Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Andrew Davies
- Centre for Cancer Immunology, University of Southampton, Southampton, United Kingdom
| | - Ahmet Dogan
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jude Fitzgibbon
- Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Steven M. Horwitz
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ari M. Melnick
- Department of Medicine, Weill Cornell Medicine, New York, NY
| | - William G. Morice
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Ryan D. Morin
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
- Genome Sciences Centre, BC Cancer, Vancouver, BC, Canada
- BC Cancer Centre for Lymphoid Cancer, Vancouver, BC, Canada
| | - Bertrand Nadel
- Aix Marseille University, CNRS, INSERM, CIML, Marseille, France
| | - Stefano A. Pileri
- Haematopathology Division, IRCCS, Istituto Europeo di Oncologia, IEO, Milan, Italy
| | - Richard Rosenquist
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Clinical Genetics, Karolinska University Laboratory, Karolinska University Hospital, Solna, Sweden
| | - Davide Rossi
- Institute of Oncology Research and Oncology Institute of Southern Switzerland, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Itziar Salaverria
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Christian Steidl
- Centre for Lymphoid Cancer, BC Cancer and University of British Columbia, Vancouver, Canada
| | | | - Andrew D. Zelenetz
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
- Department of Medicine, Weill Cornell Medicine, New York, NY
| | - Ranjana H. Advani
- Division of Oncology, Department of Medicine, Stanford University, Stanford, CA
| | - Carl E. Allen
- Division of Pediatric Hematology-Oncology, Baylor College of Medicine, Houston, TX
| | | | - Wing C. Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA
| | - James R. Cook
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH
| | - Lucy B. Cook
- Centre for Haematology, Imperial College London, London, United Kingdom
| | - Francesco d’Amore
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Stefan Dirnhofer
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | | | - Kieron Dunleavy
- Division of Hematology and Oncology, Georgetown Lombardi Comprehensive Cancer Centre, Georgetown University Hospital, Washington, DC
| | - Andrew L. Feldman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Falko Fend
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Philippe Gaulard
- Department of Pathology, University Hospital Henri Mondor, AP-HP, Créteil, France
- Faculty of Medicine, IMRB, INSERM U955, University of Paris-Est Créteil, Créteil, France
| | - Paolo Ghia
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - John G. Gribben
- Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Olivier Hermine
- Service D’hématologie, Hôpital Universitaire Necker, Université René Descartes, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Daniel J. Hodson
- Wellcome MRC Cambridge Stem Cell Institute, Cambridge Biomedical Campus, Cambridge, United Kingdom
- Department of Haematology, University of Cambridge, Cambridge, United Kingdom
| | - Eric D. Hsi
- Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Giorgio Inghirami
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY
| | - Elaine S. Jaffe
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Kennosuke Karube
- Department of Pathology and Laboratory Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Keisuke Kataoka
- Division of Molecular Oncology, National Cancer Center Research Institute, Toyko, Japan
- Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Wolfram Klapper
- Hematopathology Section and Lymph Node Registry, Department of Pathology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Won Seog Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea
| | - Rebecca L. King
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Young H. Ko
- Department of Pathology, Cheju Halla General Hospital, Jeju, Korea
| | | | - Georg Lenz
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Muenster, Muenster, Germany
| | - José I. Martin-Subero
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain
| | - Miguel A. Piris
- Department of Pathology, Jiménez Díaz Foundation University Hospital, CIBERONC, Madrid, Spain
| | - Stefania Pittaluga
- Hematopathology Section, Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Laura Pasqualucci
- Institute for Cancer Genetics, Columbia University, New York, NY
- Department of Pathology & Cell Biology, Columbia University, New York, NY
- The Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Scott J. Rodig
- Department of Pathology, Brigham and Women’s Hospital, Boston, MA
| | | | - Gilles A. Salles
- Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jesus San-Miguel
- Clínica Universidad de Navarra, Navarra, Cancer Center of University of Navarra, Cima Universidad de NavarraI, Instituto de Investigacion Sanitaria de Navarra, Centro de Investigación Biomédica en Red de Céncer, Pamplona, Spain
| | - Kerry J. Savage
- Centre for Lymphoid Cancer, BC Cancer and University of British Columbia, Vancouver, Canada
| | - Laurie H. Sehn
- Centre for Lymphoid Cancer, BC Cancer and University of British Columbia, Vancouver, Canada
| | - Gianpietro Semenzato
- Department of Medicine, University of Padua and Veneto Institute of Molecular Medicine, Padova, Italy
| | - Louis M. Staudt
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Steven H. Swerdlow
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Judith Trotman
- Haematology Department, Concord Repatriation General Hospital, Sydney, Australia
| | - Julie M. Vose
- Department of Internal Medicine, Division of Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE
| | - Oliver Weigert
- Department of Medicine III, LMU Hospital, Munich, Germany
| | - Wyndham H. Wilson
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Jane N. Winter
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | - Pier L. Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Istitudo di Ematologia “Seràgnoli” and Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale Università di Bologna, Bologna, Italy
| | - Emanuele Zucca
- Institute of Oncology Research and Oncology Institute of Southern Switzerland, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Adam Bagg
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - David W. Scott
- Centre for Lymphoid Cancer, BC Cancer and University of British Columbia, Vancouver, Canada
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23
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Meek K, Yang YT, Takada M, Parys M, Richter M, Engleberg AI, Thaiwong T, Griffin RL, Schall PZ, Kramer AJ, Yuzbasiyan-Gurkan V. Identification of a Hypomorphic FANCG Variant in Bernese Mountain Dogs. Genes (Basel) 2022; 13:1693. [PMID: 36292578 PMCID: PMC9601343 DOI: 10.3390/genes13101693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 09/12/2022] [Accepted: 09/19/2022] [Indexed: 05/26/2024] Open
Abstract
Bernese mountain dogs (BMDs), have an overall cancer incidence of 50%, half of which is comprised of an otherwise rare tumor, histiocytic sarcoma (HS). While recent studies have identified driver mutations in the MAPK pathway, identification of key predisposing genes has been elusive. Studies have identified several loci to be associated with predisposition to HS in BMDs, including near the MTAP/CDKN2A region, but no causative coding variant has been identified. Here we report the presence of a coding polymorphism in the gene encoding FANCG, near the MTAP/CDKN2A locus. This variant is in a conserved region of the protein and appears to be specific to BMDs. Canine fibroblasts derived from dogs homozygous for this variant are hypersensitive to cisplatin. We show this canine FANCG variant and a previously defined hypomorphic FANCG allele in humans impart similar defects in DNA repair. However, our data also indicate that this variant is neither necessary nor sufficient for the development of HS. Furthermore, BMDs homozygous for this FANCG allele display none of the characteristic phenotypes associated with Fanconi anemia (FA) such as anemia, short stature, infertility, or an earlier age of onset for HS. This is similar to findings in FA deficient mice, which do not develop overt FA without secondary genetic mutations that exacerbate the FA deficit. In sum, our data suggest that dogs with deficits in the FA pathway are, like mice, innately resistant to the development of FA.
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Affiliation(s)
- Katheryn Meek
- Comparative Medicine and Integrative Biology Program, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
- Department of Microbiology and Molecular Genetics, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Ya-Ting Yang
- Comparative Medicine and Integrative Biology Program, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Marilia Takada
- Comparative Medicine and Integrative Biology Program, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Maciej Parys
- Comparative Medicine and Integrative Biology Program, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Marlee Richter
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Alexander I. Engleberg
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Tuddow Thaiwong
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48190, USA
| | - Rachel L. Griffin
- College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Peter Z. Schall
- Comparative Medicine and Integrative Biology Program, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Alana J. Kramer
- College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Vilma Yuzbasiyan-Gurkan
- Comparative Medicine and Integrative Biology Program, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
- Department of Microbiology and Molecular Genetics, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824, USA
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24
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Kazama S, Yokoyama K, Ueki T, Kazumoto H, Satomi H, Sumi M, Ito I, Yusa N, Kasajima R, Shimizu E, Yamaguchi R, Imoto S, Miyano S, Tanaka Y, Denda T, Ota Y, Tojo A, Kobayashi H. Case report: Common clonal origin of concurrent langerhans cell histiocytosis and acute myeloid leukemia. Front Oncol 2022; 12:974307. [PMID: 36185232 PMCID: PMC9523168 DOI: 10.3389/fonc.2022.974307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/18/2022] [Indexed: 11/13/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) and acute myeloid leukemia (AML) are distinct entities of blood neoplasms, and the exact developmental origin of both neoplasms are considered be heterogenous among patients. However, reports of concurrent LCH and AML are rare. Herein we report a novel case of concurrent LCH and AML which shared same the driver mutations, strongly suggesting a common clonal origin.An 84-year-old female presented with cervical lymphadenopathy and pruritic skin rash on the face and scalp. Laboratory tests revealed pancytopenia with 13% of blasts, elevated LDH and liver enzymes, in addition to generalised lymphadenopathy and splenomegaly by computed tomography. Bone marrow specimens showed massive infiltration of MPO-positive myeloblasts, whereas S-100 and CD1a positive atypical dendritic cell-like cells accounted for 10% of the atypical cells on bone marrow pathology, suggesting a mixture of LCH and AML. A biopsy specimen from a cervical lymph node and the skin demonstrated the accumulation of atypical cells which were positive for S-100 and CD1a. LCH was found in lymph nodes, skin and bone marrow; AML was found in peripheral blood and bone marrow (AML was predominant compared with LCH in the bone marrow).Next generation sequencing revealed four somatic driver mutations (NRAS-G13D, IDH2-R140Q, and DNMT3A-F640fs/-I715fs), equally shared by both the lymph node and bone marrow, suggesting a common clonal origin for the concurrent LCH and AML. Prednisolone and vinblastine were initially given with partial response in LCH; peripheral blood blasts also disappeared for 3 months. Salvage chemotherapy with low dose cytarabine and aclarubicin were given for relapse, with partial response in both LCH and AML. She died from pneumonia and septicemia on day 384. Our case demonstrates a common cell of origin for LCH and AML with a common genetic mutation, providing evidence to support the proposal to classify histiocytosis, including LCH, as a myeloid/myeloproliferative malignancy.
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Affiliation(s)
- Shintaro Kazama
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - Kazuaki Yokoyama
- Division of Molecular Therapy, Institute of Medical Science, Advanced Clinical Research Center, The University of Tokyo, Tokyo, Japan
- *Correspondence: Kazuaki Yokoyama, ; Arinobu Tojo,
| | - Toshimitsu Ueki
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - Hiroko Kazumoto
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - Hidetoshi Satomi
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan
| | - Masahiko Sumi
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
| | - Ichiro Ito
- Department of Pathology, Nagano Red Cross Hospital, Nagano, Japan
| | - Nozomi Yusa
- Department of Applied Genomics, Research Hospital, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Rika Kasajima
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, Yokohama, Japan
| | - Eigo Shimizu
- Division of Health Medical Data Science, Health Intelligence Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Rui Yamaguchi
- Division of Cancer Systems Biology, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Seiya Imoto
- Division of Health Medical Data Science, Health Intelligence Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Satoru Miyano
- Department of Integrated Data Science, Medical and Dental Data Science Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yukihisa Tanaka
- Department of Diagnostic Pathology, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Tamami Denda
- Department of Diagnostic Pathology, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Yasunori Ota
- Department of Diagnostic Pathology, IMSUT Hospital, Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - Arinobu Tojo
- Department of Data Science and Faculty Affairs, Tokyo Medical and Dental University, Tokyo, Japan
- *Correspondence: Kazuaki Yokoyama, ; Arinobu Tojo,
| | - Hikaru Kobayashi
- Department of Hematology, Nagano Red Cross Hospital, Nagano, Japan
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25
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Campo E, Jaffe ES, Cook JR, Quintanilla-Martinez L, Swerdlow SH, Anderson KC, Brousset P, Cerroni L, de Leval L, Dirnhofer S, Dogan A, Feldman AL, Fend F, Friedberg JW, Gaulard P, Ghia P, Horwitz SM, King RL, Salles G, San-Miguel J, Seymour JF, Treon SP, Vose JM, Zucca E, Advani R, Ansell S, Au WY, Barrionuevo C, Bergsagel L, Chan WC, Cohen JI, d'Amore F, Davies A, Falini B, Ghobrial IM, Goodlad JR, Gribben JG, Hsi ED, Kahl BS, Kim WS, Kumar S, LaCasce AS, Laurent C, Lenz G, Leonard JP, Link MP, Lopez-Guillermo A, Mateos MV, Macintyre E, Melnick AM, Morschhauser F, Nakamura S, Narbaitz M, Pavlovsky A, Pileri SA, Piris M, Pro B, Rajkumar V, Rosen ST, Sander B, Sehn L, Shipp MA, Smith SM, Staudt LM, Thieblemont C, Tousseyn T, Wilson WH, Yoshino T, Zinzani PL, Dreyling M, Scott DW, Winter JN, Zelenetz AD. The International Consensus Classification of Mature Lymphoid Neoplasms: a report from the Clinical Advisory Committee. Blood 2022; 140:1229-1253. [PMID: 35653592 PMCID: PMC9479027 DOI: 10.1182/blood.2022015851] [Citation(s) in RCA: 549] [Impact Index Per Article: 274.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 05/18/2022] [Indexed: 11/20/2022] Open
Abstract
Since the publication of the Revised European-American Classification of Lymphoid Neoplasms in 1994, subsequent updates of the classification of lymphoid neoplasms have been generated through iterative international efforts to achieve broad consensus among hematopathologists, geneticists, molecular scientists, and clinicians. Significant progress has recently been made in the characterization of malignancies of the immune system, with many new insights provided by genomic studies. They have led to this proposal. We have followed the same process that was successfully used for the third and fourth editions of the World Health Organization Classification of Hematologic Neoplasms. The definition, recommended studies, and criteria for the diagnosis of many entities have been extensively refined. Some categories considered provisional have now been upgraded to definite entities. Terminology for some diseases has been revised to adapt nomenclature to the current knowledge of their biology, but these modifications have been restricted to well-justified situations. Major findings from recent genomic studies have impacted the conceptual framework and diagnostic criteria for many disease entities. These changes will have an impact on optimal clinical management. The conclusions of this work are summarized in this report as the proposed International Consensus Classification of mature lymphoid, histiocytic, and dendritic cell tumors.
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Affiliation(s)
- Elias Campo
- Haematopathology Section, Hospital Clínic of Barcelona, Institut d'Investigaciones Biomèdiques August Pi I Sunyer (IDIBAPS), University of Barcelona, Centro de Investigación Biomédica en Red de Cancer (CIBERONC), Barcelona, Spain
| | - Elaine S Jaffe
- Hematopathology Section, Laboratory of Pathology, Center for Cancer Research, National Cancer Institute, Bethesda, MD
| | - James R Cook
- Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH
| | - Leticia Quintanilla-Martinez
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | - Steven H Swerdlow
- Department of Pathology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA
| | | | - Pierre Brousset
- Department of Pathology, Institut Universitaire du Cancer de Toulouse-Oncopole, and Laboratoire d'Excellence Toulouse Cancer, Toulouse, France
| | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Laurence de Leval
- Institute of Pathology, Department of Laboratory Medicine and Pathology, Lausanne University Hospital and Lausanne University, Lausanne, Switzerland
| | - Stefan Dirnhofer
- Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Ahmet Dogan
- Laboratory of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Andrew L Feldman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Falko Fend
- Institute of Pathology and Neuropathology, Eberhard Karls University of Tübingen and Comprehensive Cancer Center, University Hospital Tübingen, Tübingen, Germany
| | | | - Philippe Gaulard
- Department of Pathology, University Hospital Henri Mondor, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
- Mondor Institute for Biomedical Research, INSERM U955, Faculty of Medicine, University of Paris-Est Créteil, Créteil, France
| | - Paolo Ghia
- Strategic Research Program on Chronic Lymphocytic Leukemia, Division of Experimental Oncology, IRCCS Ospedale San Raffaele and Università Vita-Salute San Raffaele, Milan, Italy
| | - Steven M Horwitz
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Rebecca L King
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Gilles Salles
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Jesus San-Miguel
- Clínica Universidad de Navarra, Centro de Investigación Médica Aplicada, Instituto de Investigación Sanitaria de Navarra, CIBERONC, Pamplona, Spain
| | - John F Seymour
- Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, VIC, Australia
| | | | - Julie M Vose
- Division of Hematology-Oncology, Department of Internal Medicine, University of Nebraska Medical Center, University of Nebraska, Omaha, NE
| | - Emanuele Zucca
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, and Institute of Oncology Research, Università della Svizzera Italiana, Bellinzona, Switzerland
| | - Ranjana Advani
- Stanford Cancer Center, Blood and Marrow Transplant Program, Stanford University, Stanford, CA
| | - Stephen Ansell
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN
| | - Wing-Yan Au
- Blood-Med Clinic, Hong Kong, People's Republic of China
| | - Carlos Barrionuevo
- Department of Pathology, Instituto Nacional de Enfermedades Neoplásicas, Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
| | - Leif Bergsagel
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Phoenix, AZ
| | - Wing C Chan
- Department of Pathology, City of Hope National Medical Center, Duarte, CA
| | - Jeffrey I Cohen
- Medical Virology Section, Laboratory of Infectious Diseases, National Institutes of Health, National Institute of Allergy and Infectious Diseases, Bethesda, MD
| | - Francesco d'Amore
- Department of Hematology, Aarhus University Hospital, Aarhus, Denmark
| | - Andrew Davies
- Cancer Research UK Centre, Centre for Cancer Immunology, Faculty of Medicine, Southampton General Hospital, University of Southampton, Southampton, United Kingdom
| | - Brunangelo Falini
- Institute of Hematology and Center for Hemato-Oncology Research, Hospital of Perugia, University of Perugia , Perugia, Italy
| | - Irene M Ghobrial
- Dana-Farber Cancer Institute, Boston, MA
- Harvard Medical School, Harvard University, Boston, MA
| | - John R Goodlad
- National Health Service Greater Glasgow and Clyde, Glasgow, United Kingdom
| | - John G Gribben
- Department of Haemato-Oncology, Barts Cancer Institute, Queen Mary University of London, London, United Kingdom
| | - Eric D Hsi
- Department of Pathology, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC
| | - Brad S Kahl
- Oncology Division, Washington University School of Medicine, Washington University in St. Louis, St. Louis, MO
| | - Won-Seog Kim
- Hematology and Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Shaji Kumar
- Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN
| | | | - Camille Laurent
- Department of Pathology, Institut Universitaire du Cancer de Toulouse-Oncopole, and Laboratoire d'Excellence Toulouse Cancer, Toulouse, France
| | - Georg Lenz
- Department of Medicine A, Hematology, Oncology and Pneumology, University Hospital Muenster, Muenster, Germany
| | - John P Leonard
- Weill Department of Medicine, Weill Medical College, Cornell University, New York, NY
| | - Michael P Link
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Stanford University School of Medicine, Stanford University, Stanford, CA
| | - Armando Lopez-Guillermo
- Department of Hematology, Hospital Clínic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Maria Victoria Mateos
- Department of Hematology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca, Centro de Investigación del Cancer, Universidad de Salamanca, Salamanca, Spain
| | - Elizabeth Macintyre
- Laboratoire d'Onco-Hématologie, AP-HP, Hôpital Necker-Enfants Malades, Université de Paris Cité and Institut Necker-Enfants Malades, Paris, France
| | - Ari M Melnick
- Division of Hematology and Oncology, Weill Medical College, Cornell University, New York, NY
| | - Franck Morschhauser
- Department of Hematology, Centre Hospitalier Universitaire de Lille, University Lille, Lille, France
| | - Shigeo Nakamura
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Marina Narbaitz
- Department of Pathology, Instituto de Investigaciones Hematológicas, Academia Nacional de Medicina and Fundacion para combatir la leucemia (FUNDALEU), Buenos Aires, Argentina
| | - Astrid Pavlovsky
- Fundación para Combatir la Leucemia (FUNDALEU), Centro de Hematología Pavlovsky, Buenos Aires, Argentina
| | - Stefano A Pileri
- Haematopathology Division, IRCCS, Istituto Europeo di Oncologia, Milan, Italy
| | - Miguel Piris
- Jiménez Díaz Foundation University Hospital, Universidad Autónoma de Madrid, Madrid, Spain
| | - Barbara Pro
- Division of Hematology and Oncology, Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Vincent Rajkumar
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Steven T Rosen
- Beckman Research Institute, and Department of Hematology & Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA
| | - Birgitta Sander
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Laurie Sehn
- Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver, BC, Canada
| | | | - Sonali M Smith
- Section of Hematology/Oncology, University of Chicago, Chicago, IL
| | - Louis M Staudt
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Catherine Thieblemont
- Service Hémato-Oncologie, AP-HP, Hôpital Saint-Louis, Paris, France
- DMU-DHI, Université de Paris-Paris Diderot, Paris, France
| | - Thomas Tousseyn
- Department of Pathology, Universitair Ziekenhuis Leuven Hospitals, Leuven, Belgium
| | - Wyndham H Wilson
- Lymphoid Malignancies Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | - Tadashi Yoshino
- Department of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Pier-Luigi Zinzani
- Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seragnoli", Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italy
| | - Martin Dreyling
- Department of Medicine III, Ludwig-Maximilians-University Hospital, Munich, Germany
| | - David W Scott
- Centre for Lymphoid Cancer, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Jane N Winter
- Feinberg School of Medicine, Northwestern University, Chicago, IL; and
| | - Andrew D Zelenetz
- Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
- Weill Medical College, Cornell University, New York, NY
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Hirabayashi M, Chambers JK, Tani A, Tomiyasu H, Motegi T, Rimpo K, Nakayama H, Uchida K. mRNA sequencing analysis and growth inhibitory effects of palbociclib on cell lines from canine histiocytic proliferative disorders. Vet Comp Oncol 2022; 20:587-601. [PMID: 35278028 DOI: 10.1111/vco.12812] [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: 01/10/2022] [Revised: 03/09/2022] [Accepted: 03/09/2022] [Indexed: 11/27/2022]
Abstract
Canine histiocytic proliferative disorders include aggressive and fatal diseases, such as histiocytic sarcoma (HS) and histiocytosis (SyH). The molecular mechanisms underlying cell proliferation need to be elucidated for the development of effective treatments. In the present study, mRNA expression levels were comprehensively analysed in cell lines derived from localized HS, disseminated HS, SyH and Langerhans cell histiocytosis (LCH) in dogs. Based on the results obtained, the growth inhibitory effects of palbociclib, a CDK4/6 inhibitor, were verified with the cell lines in vitro and in xenograft mouse model. Hierarchical clustering and principal component analysis plots of mRNA expression profiles divided the cell lines into three groups: a localized HS group, disseminated HS/SyH group, and LCH. The results of an ingenuity pathway analysis suggested that the MAPK signalling pathway was activated in the localized HS and LCH cell lines, and the PI3K signalling pathway in the disseminated and localized HS cell lines. In all cell lines, the expression of the tumour suppressor genes TP53, CDKN2A and CDKN1A was down-regulated, whereas that of Rb was preserved. In vitro assessments revealed the growth inhibitory effects of palbociclib in all cell lines examined. In a xenograft mouse model using a cell line from disseminated HS, palbociclib exerted significant growth inhibitory effects. These results suggest the potential of palbociclib as a therapeutic drug candidate for the treatment of malignant histiocytic proliferative disorders of the dog.
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Affiliation(s)
- Miyuki Hirabayashi
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
- Saitama Animal Medical Center, Saitama, Japan
| | - James K Chambers
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Akiyoshi Tani
- Laboratory of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Hirotaka Tomiyasu
- Laboratory of Veterinary Internal Medicine, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Tomoki Motegi
- Veterinary Medical Center, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Kenji Rimpo
- Saitama Animal Medical Center, Saitama, Japan
| | - Hiroyuki Nakayama
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Kazuyuki Uchida
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
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27
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Rogawski DS, Nirschl JJ, McDonald J, Nie E, Schwartz NU, Vogel H, Scott BJ, Gold CA, Kipp L. A rare neuromyelitis optica mimic: Primary CNS histiocytic sarcoma. Mult Scler 2022; 28:1651-1654. [PMID: 35876468 PMCID: PMC9942914 DOI: 10.1177/13524585221097564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary central nervous system (CNS) histiocytic sarcoma is a rare hematolymphoid malignancy with features of mature histiocytes and carries a poor prognosis. We describe a unique case in which a 50-year-old woman presented with recurrent acute brainstem syndrome, area postrema syndrome, and myelitis with corresponding magnetic resonance imaging (MRI) lesions meeting diagnostic criteria for seronegative neuromyelitis optica spectrum disorder (NMOSD). Despite initial improvement with steroids and plasma exchange, she experienced recurrent symptoms over 10 months referable to new and persistently enhancing lesions. At autopsy, neuropathology revealed a diffusely infiltrative primary CNS histiocytic sarcoma. This case represents a rare clinicoradiologic mimic of NMOSD, underscoring the importance of evaluation for infiltrative diseases in cases of atypical seronegative NMOSD.
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Affiliation(s)
- David S. Rogawski
- Department of Neurology and Neurological Sciences, Stanford Medicine, Palo Alto, CA 94304
| | | | - Jamie McDonald
- Department of Neurology and Neurological Sciences, Stanford Medicine, Palo Alto, CA 94304
| | - Esther Nie
- Department of Neurology and Neurological Sciences, Stanford Medicine, Palo Alto, CA 94304
| | - Nicholas U. Schwartz
- Department of Neurology and Neurological Sciences, Stanford Medicine, Palo Alto, CA 94304
| | - Hannes Vogel
- Department of Pathology, Stanford Medicine, Palo Alto, CA 94304
| | - Brian J. Scott
- Department of Neurology and Neurological Sciences, Stanford Medicine, Palo Alto, CA 94304
| | - Carl A. Gold
- Department of Neurology and Neurological Sciences, Stanford Medicine, Palo Alto, CA 94304
| | - Lucas Kipp
- Department of Neurology and Neurological Sciences, Stanford Medicine, Palo Alto, CA 94304,Corresponding author
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28
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Campedel L, Kharroubi D, Vozy A, Spano JP, Emile JF, Haroche J. Malignant Histiocytosis With PD-L1 Expression-Dramatic Response to Nivolumab. Mayo Clin Proc 2022; 97:1401-1403. [PMID: 35787870 DOI: 10.1016/j.mayocp.2022.05.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 05/16/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Luca Campedel
- AP-HP Hôpital de la Pitié Salpêtrière Sorbonne Université Paris, France
| | - Dris Kharroubi
- AP-HP Hôpital de la Pitié Salpêtrière Sorbonne Université Paris, France
| | - Aurore Vozy
- AP-HP Hôpital de la Pitié Salpêtrière Sorbonne Université Paris, France
| | | | | | - Julien Haroche
- AP-HP Hôpital de la Pitié Salpêtrière Sorbonne Université Paris, France
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29
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Hanna JA, Langdon CG, Garcia MR, Benton A, Lanman NA, Finkelstein D, Rehg JE, Hatley ME. Genetic context of oncogenic drivers dictates vascular sarcoma development in
aP2‐Cre
mice. J Pathol 2022; 257:109-124. [PMID: 35066877 PMCID: PMC9007915 DOI: 10.1002/path.5873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 01/06/2022] [Accepted: 01/20/2022] [Indexed: 12/02/2022]
Abstract
Angiosarcomas are aggressive vascular sarcomas that arise from endothelial cells and have an extremely poor prognosis. Because of the rarity of angiosarcomas, knowledge of molecular drivers and optimized treatment strategies is lacking, highlighting the need for in vivo models to study the disease. Previously, we generated genetically engineered mouse models of angiosarcoma driven by aP2‐Cre‐mediated biallelic loss of Dicer1 or conditional activation of KrasG12D with Cdkn2a loss that histologically and genetically resemble human tumors. In the present study, we found that DICER1 functions as a potent tumor suppressor and its deletion, in combination with either KRASG12D expression or Cdkn2a loss, is associated with angiosarcoma development. Independent of the genetic driver, the mTOR pathway was activated in all murine angiosarcoma models. Direct activation of the mTOR pathway by conditional deletion of Tsc1 with aP2‐Cre resulted in tumors that resemble intermediate grade human kaposiform hemangioendotheliomas, indicating that mTOR activation was not sufficient to drive the malignant angiosarcoma phenotype. Genetic dissection of the spectrum of vascular tumors identified genes specifically regulated in the aggressive murine angiosarcomas that are also enriched in human angiosarcoma. The genetic dissection driving the transition across the malignant spectrum of endothelial sarcomas provides an opportunity to identify key determinants of the malignant phenotype, novel therapies for angiosarcoma, and novel in vivo models to further explore angiosarcoma pathogenesis. © 2022 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Jason A. Hanna
- Department of Oncology St. Jude Children's Research Hospital 262 Danny Thomas Place Memphis TN 38105 USA
- Department of Biological Sciences Purdue University 201 S. University Street West Lafayette IN 47906 USA
- Purdue University Center for Cancer Research Purdue University West Lafayette, IN, 47907 USA
| | - Casey G. Langdon
- Department of Oncology St. Jude Children's Research Hospital 262 Danny Thomas Place Memphis TN 38105 USA
| | - Matthew R. Garcia
- Department of Oncology St. Jude Children's Research Hospital 262 Danny Thomas Place Memphis TN 38105 USA
| | - Annaleigh Benton
- Department of Biological Sciences Purdue University 201 S. University Street West Lafayette IN 47906 USA
- Purdue University Center for Cancer Research Purdue University West Lafayette, IN, 47907 USA
| | - Nadia A. Lanman
- Department of Comparative Pathobiology Purdue University 201 S. University Street West Lafayette IN 47906 USA
- Purdue University Center for Cancer Research Purdue University West Lafayette, IN, 47907 USA
| | - David Finkelstein
- Department of Computational Biology St. Jude Children's Research Hospital 262 Danny Thomas Place Memphis TN 38105 USA
| | - Jerold E. Rehg
- Department of Pathology St. Jude Children's Research Hospital 262 Danny Thomas Place Memphis TN 38105 USA
| | - Mark E. Hatley
- Department of Oncology St. Jude Children's Research Hospital 262 Danny Thomas Place Memphis TN 38105 USA
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30
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Kemps PG, Picarsic J, Durham BH, Hélias-Rodzewicz Z, Hiemcke-Jiwa L, van den Bos C, van de Wetering MD, van Noesel CJM, van Laar JAM, Verdijk RM, Flucke UE, Hogendoorn PCW, Woei-A-Jin FJSH, Sciot R, Beilken A, Feuerhake F, Ebinger M, Möhle R, Fend F, Bornemann A, Wiegering V, Ernestus K, Méry T, Gryniewicz-Kwiatkowska O, Dembowska-Baginska B, Evseev DA, Potapenko V, Baykov VV, Gaspari S, Rossi S, Gessi M, Tamburrini G, Héritier S, Donadieu J, Bonneau-Lagacherie J, Lamaison C, Farnault L, Fraitag S, Jullié ML, Haroche J, Collin M, Allotey J, Madni M, Turner K, Picton S, Barbaro PM, Poulin A, Tam IS, El Demellawy D, Empringham B, Whitlock JA, Raghunathan A, Swanson AA, Suchi M, Brandt JM, Yaseen NR, Weinstein JL, Eldem I, Sisk BA, Sridhar V, Atkinson M, Massoth LR, Hornick JL, Alexandrescu S, Yeo KK, Petrova-Drus K, Peeke SZ, Muñoz-Arcos LS, Leino DG, Grier DD, Lorsbach R, Roy S, Kumar AR, Garg S, Tiwari N, Schafernak KT, Henry MM, van Halteren AGS, Abla O, Diamond EL, Emile JF. ALK-positive histiocytosis: a new clinicopathologic spectrum highlighting neurologic involvement and responses to ALK inhibition. Blood 2022; 139:256-280. [PMID: 34727172 PMCID: PMC8759533 DOI: 10.1182/blood.2021013338] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/18/2021] [Indexed: 11/20/2022] Open
Abstract
ALK-positive histiocytosis is a rare subtype of histiocytic neoplasm first described in 2008 in 3 infants with multisystemic disease involving the liver and hematopoietic system. This entity has subsequently been documented in case reports and series to occupy a wider clinicopathologic spectrum with recurrent KIF5B-ALK fusions. The full clinicopathologic and molecular spectra of ALK-positive histiocytosis remain, however, poorly characterized. Here, we describe the largest study of ALK-positive histiocytosis to date, with detailed clinicopathologic data of 39 cases, including 37 cases with confirmed ALK rearrangements. The clinical spectrum comprised distinct clinical phenotypic groups: infants with multisystemic disease with liver and hematopoietic involvement, as originally described (Group 1A: 6/39), other patients with multisystemic disease (Group 1B: 10/39), and patients with single-system disease (Group 2: 23/39). Nineteen patients of the entire cohort (49%) had neurologic involvement (7 and 12 from Groups 1B and 2, respectively). Histology included classic xanthogranuloma features in almost one-third of cases, whereas the majority displayed a more densely cellular, monomorphic appearance without lipidized histiocytes but sometimes more spindled or epithelioid morphology. Neoplastic histiocytes were positive for macrophage markers and often conferred strong expression of phosphorylated extracellular signal-regulated kinase, confirming MAPK pathway activation. KIF5B-ALK fusions were detected in 27 patients, whereas CLTC-ALK, TPM3-ALK, TFG-ALK, EML4-ALK, and DCTN1-ALK fusions were identified in single cases. Robust and durable responses were observed in 11/11 patients treated with ALK inhibition, 10 with neurologic involvement. This study presents the existing clinicopathologic and molecular landscape of ALK-positive histiocytosis and provides guidance for the clinical management of this emerging histiocytic entity.
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Affiliation(s)
- Paul G Kemps
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Jennifer Picarsic
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Benjamin H Durham
- Human Oncology and Pathogenesis Program, Department of Medicine, and
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Zofia Hélias-Rodzewicz
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
| | | | - Cor van den Bos
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Marianne D van de Wetering
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatric Oncology, Emma Children's Hospital, and
| | - Carel J M van Noesel
- Department of Pathology, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jan A M van Laar
- Department of Internal Medicine and Immunology, and
- Section of Clinical Immunology, Department of Immunology, and
| | - Robert M Verdijk
- Department of Pathology, Erasmus Medical Center University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Uta E Flucke
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - F J Sherida H Woei-A-Jin
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Katholieke Universiteit Leuven, Leuven, Belgium
| | | | | | - Martin Ebinger
- Department I - General Pediatrics, Children's Hospital, Hematology and Oncology
| | | | - Falko Fend
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Antje Bornemann
- Department of Pathology and Neuropathology and Comprehensive Cancer Center, University Hospital Tuebingen, Tuebingen, Germany
| | - Verena Wiegering
- Department of Oncology, Hematology and Stem Cell Transplantation, University Children's Hospital Würzburg, Würzburg, Germany
| | - Karen Ernestus
- Department of Pathology, University of Würzburg and Comprehensive Cancer Center Mainfranken, Würzburg, Germany
| | - Tina Méry
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Klinikum Chemnitz, Chemnitz, Germany
| | | | | | - Dmitry A Evseev
- Dmitriy Rogachev National Center for Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Vsevolod Potapenko
- Department of Hematology and Oncology, Municipal Educational Hospital N°31, Saint Petersburg, Russia
- Department of Bone Marrow Transplantation and
| | - Vadim V Baykov
- Department of Pathology, Pavlov First Saint Petersburg State Medical University, Saint Petersburg, Russia
| | - Stefania Gaspari
- Department of Hematology/Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Sabrina Rossi
- Pathology Unit, Laboratories Department, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | | | - Gianpiero Tamburrini
- Department of Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Sébastien Héritier
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Jean Donadieu
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | | | - Claire Lamaison
- Department of Pathology, Rennes University Hospital, Rennes, France
| | - Laure Farnault
- Department of Hematology, La Conception, University Hospital of Marseille, Marseille, France
| | - Sylvie Fraitag
- Department of Pathology, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marie-Laure Jullié
- Department of Pathology, University Hospital of Bordeaux, Bordeaux, France
| | - Julien Haroche
- Department of Internal Medicine, University Hospital La Pitié-Salpêtrière Paris, French National Reference Center for Histiocytoses, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Matthew Collin
- Newcastle upon Tyne Hospitals, Newcastle upon Tyne, United Kingdom
| | | | - Majid Madni
- Department of Pediatric Hematology and Oncology, Nottingham University Hospitals, Nottingham, United Kingdom
| | | | - Susan Picton
- Department of Pediatric Oncology, Leeds Children's Hospital, Leeds, United Kingdom
| | - Pasquale M Barbaro
- Department of Hematology, Queensland Children's Hospital, Brisbane, QLD, Australia
| | - Alysa Poulin
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Ingrid S Tam
- Department of Pathology and Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada
| | - Dina El Demellawy
- Department of Pathology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Brianna Empringham
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - James A Whitlock
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | | | - Amy A Swanson
- Division of Anatomic Pathology, Mayo Clinic Rochester, Rochester, MN
| | - Mariko Suchi
- Department of Pathology, Medical College of Wisconsin, Milwaukee, WI
| | - Jon M Brandt
- Department of Pediatric Oncology, Hospital Sisters Health System St Vincent Children's Hospital, Green Bay, WI
| | - Nabeel R Yaseen
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Joanna L Weinstein
- Department of Hematology, Oncology and Stem Cell Transplantation, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Irem Eldem
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Bryan A Sisk
- Department of Pediatric Hematology and Oncology, St Louis Children's Hospital, Washington University in St Louis, St Louis, MO
| | - Vaishnavi Sridhar
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Mandy Atkinson
- Department of Pediatric Hematology and Oncology, Carilion Children's Pediatric Hematology and Oncology, Roanoke, VA
| | - Lucas R Massoth
- Department of Pathology, Massachusetts General Hospital, and
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Sanda Alexandrescu
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
- Department of Pathology, Boston Children's Hospital, Boston, MA
| | - Kee Kiat Yeo
- Department of Pediatric Oncology, Dana Farber/Boston Children's Cancer and Blood Disorders Center, Boston, MA
| | | | - Stephen Z Peeke
- Department of Hematology and Medical Oncology, Maimonides Medical Center, Brooklyn, NY
| | - Laura S Muñoz-Arcos
- Department of Internal Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY
| | - Daniel G Leino
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - David D Grier
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Robert Lorsbach
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Somak Roy
- Division of Pathology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Ashish R Kumar
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
- Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | | | | | | | - Michael M Henry
- Center for Cancer and Blood Disorders, Phoenix Children's Hospital, Phoenix, AZ
| | - Astrid G S van Halteren
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Pediatrics, Leiden University Medical Center, Leiden, The Netherlands; and
| | - Oussama Abla
- Department of Hematology/Oncology, The Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
| | - Eli L Diamond
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Jean-François Emile
- Department of Pathology, Ambroise Paré Hospital, Assistance Publique-Hôpitaux de Paris, Boulogne, France
- EA4340-Biomarqueurs et Essais Cliniques en Cancérologie et Onco-Hématologie, Versailles Saint-Quentin-en-Yvelines University, Boulogne, France
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Histiocytoses converge through common pathways. Blood 2022; 139:157-159. [PMID: 35024810 DOI: 10.1182/blood.2021014529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 11/01/2021] [Indexed: 01/22/2023] Open
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Liu Z, Xiao Y, Liu X, Li Q, Liu T, Zhu F, Wu G, Zhang L. Case Report: Long-Term Response to Radiotherapy Combined With Targeted Therapy in Histiocytic Sarcoma Harboring Mutations in MAPK and PI3K/AKT Pathways. Front Oncol 2021; 11:755893. [PMID: 34938656 PMCID: PMC8685210 DOI: 10.3389/fonc.2021.755893] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/11/2021] [Indexed: 01/22/2023] Open
Abstract
Background Histiocytic sarcoma (HS) is a rare hematopoietic malignancy with an aggressive clinical presentation associated with a poor overall survival. To date, surgical resection, radiation therapy, and chemotherapy were often utilized for HS, but curative effects are rather disappointing. Case Presentation A 19-year-old female was referred to our hospital with a pathologic diagnosis of HS in December 2017. The patient had a severe airway obstruction resulting from a large mass (6.0 cm × 4.4 cm) arising from the left parapharyngeal space. She did not respond to cyclophosphamide, doxorubicin, vincristine, prednisone, and etoposide (CHOEP) chemotherapy, then she was switched to radiotherapy and crizotinib according to next-generation sequencing (NGS) results (mutations in MET and MAP2K1). The patient got a partial response after radiotherapy and crizotinib, then she switched to imatinib combined with thalidomide treatment. The patient got a long-term complete response from the treatment and is alive 44 months after initial diagnosis without disease progression. Further KEGG pathway enrichment analysis of NGS results from patient’s tissue revealed that phosphatidylinositol 3′ kinase (PI3K)/AKT and mitogen-activated protein kinase (MAPK) pathways were activated in this HS patient. We further performed experiments in vitro in a canine histiocytic sarcoma cell line DH82, in order to explore the possible mechanism of imatinib plus thalidomide in HS. Results of cell counting kit-8 (CCK8) assays showed that the proliferation activity of DH82 was significantly inhibited by imatinib but not thalidomide. Combined thalidomide and imatinib treatment did not improve the inhibitory effects of imatinib to DH82. Results of Western blot confirmed the inhibitory effects of imatinib on DH82 by targeting activation of MAPK and PI3K/AKT pathways. Conclusion Radiotherapy combined with targeted therapy guided by NGS may be promising, and further perspective clinical trial is warranted for the localized HS.
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Affiliation(s)
- Zijian Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yin Xiao
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinxiu Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qiuhui Li
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tao Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fang Zhu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gang Wu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liling Zhang
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Cassidy DP, Rosenberg AE, Poveda J, Velez-Torres J, Chapman J. Nonlymphoid Hematopoietic Diseases Presenting in Bone, Soft Tissue, and Other Extranodal Sites. Arch Pathol Lab Med 2021; 146:1144-1159. [DOI: 10.5858/arpa.2021-0229-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2021] [Indexed: 11/06/2022]
Abstract
Context.—
Although rare in everyday practice, the initial presentation of hematopoietic neoplasms other than lymphoma in the musculoskeletal system and other extranodal sites can generate challenging diagnostic problems for surgical pathologists.
Objective.—
To review the morphologic and immunophenotypic features of various nonlymphoid hematopoietic diseases presenting at extranodal sites, with emphasis on the inherent diagnostic pitfalls and differential diagnoses of these entities to aid surgical pathologists in their accurate recognition.
Data Sources.—
Cases reviewed herein represent both in-house and consult cases seen at our institution between 2010 and 2021.
Conclusions.—
Entities that present in this way include myeloid neoplasms and histiocytic/dendritic cell neoplasms. These tumors commonly cause nonspecific symptoms, and their histologic appearance can overlap with a variety of benign neoplasms and reactive processes. This can lead to delay in diagnosis and intervention with potentially lifesaving therapy; thus, accurate and expedient recognition is of paramount importance.
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Affiliation(s)
- Daniel P. Cassidy
- From the Division of Hematopathology (Cassidy, Poveda, Chapman), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Division of Bone and Soft Tissue Pathology (Cassidy, Rosenberg, Velez-Torres), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Andrew E. Rosenberg
- Division of Bone and Soft Tissue Pathology (Cassidy, Rosenberg, Velez-Torres), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Julio Poveda
- From the Division of Hematopathology (Cassidy, Poveda, Chapman), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Jaylou Velez-Torres
- Division of Bone and Soft Tissue Pathology (Cassidy, Rosenberg, Velez-Torres), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
| | - Jennifer Chapman
- From the Division of Hematopathology (Cassidy, Poveda, Chapman), University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine/Sylvester Comprehensive Cancer Center, Miami, Florida
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Venkataraman V, Massoth LR, Sullivan RJ, Friedmann AM. Secondary histiocytic sarcoma with BRAF V600E mutation responsive to MAPK-targeted therapy presenting with recurrence with mTOR mutation responsive to mTOR-targeted therapy. Pediatr Blood Cancer 2021; 68:e29166. [PMID: 34061432 DOI: 10.1002/pbc.29166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/13/2021] [Accepted: 05/19/2021] [Indexed: 12/16/2022]
Affiliation(s)
- Vinayak Venkataraman
- Departments of Medicine and Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lucas R Massoth
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Ryan J Sullivan
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Alison M Friedmann
- Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts, USA
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35
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Abstract
Histiocytic sarcoma (HS) is an extremely rare non-Langerhans cell disorder with an aggressive course and limited treatment options. HS most often presents at an advanced clinical stage, with a limited response to chemotherapy and high mortality. No standard treatment has been established for HS. We herein describe the first case of HS concomitant with laryngeal carcinoma that was promptly diagnosed and successfully treated; the condition of the patient has remained stable for 4 years with no recurrence.
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Affiliation(s)
- Satoko Oka
- Division of Hematology, Japanese Red Cross Society Wakayama Medical Center, Japan
| | - Kazuo Ono
- Division of Pathology, Japanese Red Cross Society Wakayama Medical Center, Japan
| | - Masaharu Nohgawa
- Division of Hematology, Japanese Red Cross Society Wakayama Medical Center, Japan
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36
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Sabatini PJB, Tremblay-LeMay R, Ahmadi Moghaddam P, Delabie JMA, Sakhdari A. Marginal zone lymphoma transdifferentiated to histiocytic sarcoma. Br J Haematol 2021; 194:1090-1094. [PMID: 34096049 DOI: 10.1111/bjh.17582] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Peter J B Sabatini
- Laboratory Medicine and Pathobiology, University Health Network, Toronto, Canada
| | | | | | - Jan M A Delabie
- Laboratory Medicine and Pathobiology, University Health Network, Toronto, Canada
| | - Ali Sakhdari
- Laboratory Medicine and Pathobiology, University Health Network, Toronto, Canada
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37
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Wehrmann S, Rudolph H, Ernst D, Siepmann T, Kaltofen D, Hänel M, Mirow L. Case Report: Eighteen Month Relapse- Free Survival Following Radical Multidisciplinary Oncological Treatment in a 68-Year-Old Male Patient With Histiocytic Sarcoma. Front Oncol 2021; 11:633215. [PMID: 34164336 PMCID: PMC8215356 DOI: 10.3389/fonc.2021.633215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/13/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Histiocytic Sarcoma (HS) is a rare and aggressive malignancy, and patients can present with rapid tumor growth and invasion. The optimal diagnostic and therapeutic management is unknown since only a few cases have been published. Here we report a patient with histiocytic sarcoma of the right groin. Case A 68 year-old male patient presented to our hospital with suspicion of a superinfected atheroma of the right groin. Computed tomography showed an abdominal tumor of unknown entity. Detailed assessment including immunohistochemically evaluation of biopsy material confirmed HS. The patient underwent radical tumor resection including compartment-resection of the right thigh. During five additional cycles of chemotherapy over a period of 1.5 years he remained relapse-free. Summary Diagnostic work up and treatment of HS is challenging, as there is a paucity of clinical reports and lack of standard guidelines for care. In the present case report, aggressive multidisciplinary treatment resulted in good clinical outcome, however, further studies evaluating this approach in similar patients are needed.
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Affiliation(s)
- Stefan Wehrmann
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Hagen Rudolph
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Dominikus Ernst
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Timo Siepmann
- Department of Neurology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Dorothea Kaltofen
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Mathias Hänel
- Department of Medical Oncology, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
| | - Lutz Mirow
- Department of General and Visceral Surgery, Klinikum Chemnitz gemeinnützige Gesellschaft mit beschränkter Haftung (gGmbH), Chemnitz, Germany
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38
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Massoth LR, Hung YP, Ferry JA, Hasserjian RP, Nardi V, Nielsen GP, Sadigh S, Venkataraman V, Selig M, Friedmann AM, Samore W, Killian JK, Milante R, Giessinger J, Foley-Peres K, Marcus C, Severson E, Duncan D, Sivakumar S, Ross JS, Desphande V, Ramkissoon SH, Vergilio JA, Louissaint A, Zukerberg LR, Williams EA. Histiocytic and Dendritic Cell Sarcomas of Hematopoietic Origin Share Targetable Genomic Alterations Distinct from Follicular Dendritic Cell Sarcoma. Oncologist 2021; 26:e1263-e1272. [PMID: 33904632 PMCID: PMC8265357 DOI: 10.1002/onco.13801] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 03/16/2021] [Indexed: 12/18/2022] Open
Abstract
Background Histiocytic and dendritic cell neoplasms are a diverse group of tumors arising from monocytic or dendritic cell lineage. Whereas the genomic features for Langerhans cell histiocytosis and Erdheim‐Chester disease have been well described, other less common and often aggressive tumors in this broad category remain poorly characterized, and comparison studies across the World Health Organization diagnostic categories are lacking. Methods Tumor samples from a total of 102 patient cases within four major subtypes of malignant histiocytic and dendritic cell neoplasms, including 44 follicular dendritic cell sarcomas (FDCSs), 41 histiocytic sarcomas (HSs), 7 interdigitating dendritic cell sarcomas (IDCSs), and 10 Langerhans cell sarcomas (LCSs), underwent hybridization capture with analysis of up to 406 cancer‐related genes. Results Among the entire cohort of 102 patients, CDKN2A mutations were most frequent across subtypes and made up 32% of cases, followed by TP53 mutations (22%). Mitogen‐activated protein kinase (MAPK) pathway mutations were present and enriched among the malignant histiocytosis (M) group (HS, IDCS, and LCS) but absent in FDCS (72% vs. 0%; p < .0001). In contrast, NF‐κB pathway mutations were frequent in FDCSs but rare in M group histiocytoses (61% vs. 12%; p < .0001). Tumor mutational burden was significantly higher in M group histiocytoses as compared with FDCSs (median 4.0/Mb vs. 2.4/Mb; p = .012). We also describe a pediatric patient with recurrent secondary histiocytic sarcoma treated with targeted therapy and interrogated by molecular analysis to identify mechanisms of therapeutic resistance. Conclusion A total of 42 patient tumors (41%) harbored pathogenic mutations that were potentially targetable by approved and/or investigative therapies. Our findings highlight the potential value of molecular testing to enable precise tumor classification, identify candidate oncogenic drivers, and define personalized therapeutic options for patients with these aggressive tumors. Implications for Practice This study presents comprehensive genomic profiling results on 102 patient cases within four major subtypes of malignant histiocytic and dendritic cell neoplasms, including 44 follicular dendritic cell sarcomas (FDCSs), 41 histiocytic sarcomas (HSs), 7 interdigitating dendritic cell sarcomas (IDCSs), and 10 Langerhans cell sarcomas (LCSs). MAPK pathway mutations were present and enriched among the malignant histiocytosis (M) group (HS, IDCS, and LCS) but absent in FDCSs. In contrast, NF‐κB pathway mutations were frequent in FDCSs but rare in M group histiocytosis. A total of 42 patient tumors (41%) harbored pathogenic mutations that were potentially targetable by approved and/or investigative therapies. Histiocytic and dendritic cell neoplasms are a diverse group of tumors arising from the monocytic or dendritic cell lineage. This article presents the molecular characteristics of the four major subtypes of malignant histiocytic and dendritic cell neoplasms, focusing on genomic alterations that could represent therapeutic targets.
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Affiliation(s)
- Lucas R Massoth
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Yin P Hung
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Judith A Ferry
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Robert P Hasserjian
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Valentina Nardi
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Sam Sadigh
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Vinayak Venkataraman
- Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Martin Selig
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Alison M Friedmann
- Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Wesley Samore
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | | | - Riza Milante
- Department of Dermatology, Jose R. Reyes Memorial Medical Center, Manila, Philippines
| | - Joseph Giessinger
- A.T. Still University School of Osteopathic Medicine, Mesa, Arizona, USA
| | - Kathleen Foley-Peres
- Department of Biology, Bristol Community College, Fall River, Massachusetts, USA
| | - Chelsea Marcus
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
| | - Eric Severson
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
| | - Daniel Duncan
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA
| | | | - Jeffrey S Ross
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA.,Department of Pathology, State University of New York Upstate Medical University, Syracuse, New York, USA
| | - Vikram Desphande
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Shakti H Ramkissoon
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA.,Wake Forest Comprehensive Cancer Center and Department of Pathology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Abner Louissaint
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Lawrence R Zukerberg
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Erik A Williams
- Foundation Medicine, Inc., Cambridge, Massachusetts, USA.,Department of Pathology, Department of Dermatology, UCSF Dermatopathology Service, University of California San Francisco, San Francisco, California, USA
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A Rare Case of Histiocytic Sarcoma Secondary to Gastrointestinal Stromal Tumor in the Stomach: Transdifferentiation or Synchronicity? Case Rep Hematol 2021; 2021:8856649. [PMID: 33747577 PMCID: PMC7960056 DOI: 10.1155/2021/8856649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 03/01/2021] [Indexed: 11/18/2022] Open
Abstract
Histiocytic sarcoma is a rare malignant histiocytic neoplasm composed of cells with morphologic and immunophenotypic features of mature tissue histiocytes. It occurs anywhere in the body and behaves aggressively. However, its etiology is unknown. Here, we report a 68-year-old female who developed histiocytic sarcoma following chemotherapy with imatinib (Gleevec) for gastrointestinal stromal tumor. Possible mechanisms of transdifferentiation from gastrointestinal stromal tumor to histiocytic sarcoma are discussed based on the features of our case and other two similar cases in the literature.
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40
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Dedifferentiated and Undifferentiated Melanomas: Report of 35 New Cases With Literature Review and Proposal of Diagnostic Criteria. Am J Surg Pathol 2021; 45:240-254. [PMID: 33428337 DOI: 10.1097/pas.0000000000001645] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Dedifferentiated melanoma (DM) and undifferentiated melanoma (UM) is defined as a primary or metastatic melanoma showing transition between conventional and undifferentiated components (DM) or lacking histologic and immunophenotypic features of melanoma altogether (UM). The latter is impossible to verify as melanoma by conventional diagnostic tools alone. We herein describe our experience with 35 unpublished cases to expand on their morphologic, phenotypic, and genotypic spectrum, along with a review of 50 previously reported cases (total: 85) to establish the diagnostic criteria. By definition, the dedifferentiated/undifferentiated component lacked expression of 5 routinely used melanoma markers (S100, SOX10, Melan-A, HMB45, Pan-melanoma). Initial diagnoses (known in 66 cases) were undifferentiated/unclassified pleomorphic sarcoma (n=30), unclassified epithelioid malignancy (n=7), pleomorphic rhabdomyosarcoma (n=5), other specific sarcoma types (n=6), poorly differentiated carcinoma (n=2), collision tumor (n=2), atypical fibroxanthoma (n=2), and reactive osteochondromatous lesion (n=1). In only 11 cases (16.6%) was a diagnosis of melanoma considered. Three main categories were identified: The largest group (n=56) comprised patients with a history of verified previous melanoma who presented with metastatic DM or UM. Axillary or inguinal lymph nodes, soft tissue, bone, and lung were mainly affected. A melanoma-compatible mutation was detected in 35 of 48 (73%) evaluable cases: BRAF (n=20; 40.8%), and NRAS (n=15; 30.6%). The second group (n=15) had clinicopathologic features similar to group 1, but a melanoma history was lacking. Axillary lymph nodes (n=6) was the major site in this group followed by the lung, soft tissue, and multiple site involvement. For this group, NRAS mutation was much more frequent (n=9; 60%) than BRAF (n=3; 20%) and NF1 (n=1; 6.6%). The third category (n=14) comprised primary DM (12) or UM (2). A melanoma-compatible mutation was detected in only 7 cases: BRAF (n=2), NF1 (n=2), NRAS (n=2), and KIT exon 11 (n=1). This extended follow-up study highlights the high phenotypic plasticity of DM/UM and indicates significant underrecognition of this aggressive disease among general surgical pathologists. The major clues to the diagnosis of DM and UM are: (1) presence of minimal differentiated clone in DM, (2) earlier history of melanoma, (3) undifferentiated histology that does not fit any defined entity, (4) locations at sites that are unusual for undifferentiated/unclassified pleomorphic sarcoma (axilla, inguinal, neck, digestive system, etc.), (5) unusual multifocal disease typical of melanoma spread, (6) detection of a melanoma-compatible gene mutation, and (7) absence of another genuine primary (eg, anaplastic carcinoma) in other organs.
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41
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Erdheim-Chester disease: consensus recommendations for evaluation, diagnosis, and treatment in the molecular era. Blood 2021; 135:1929-1945. [PMID: 32187362 DOI: 10.1182/blood.2019003507] [Citation(s) in RCA: 177] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 03/04/2020] [Indexed: 01/18/2023] Open
Abstract
Erdheim-Chester disease (ECD) is a rare histiocytosis that was recently recognized as a neoplastic disorder owing to the discovery of recurrent activating MAPK (RAS-RAF-MEK-ERK) pathway mutations. Typical findings of ECD include central diabetes insipidus, restrictive pericarditis, perinephric fibrosis, and sclerotic bone lesions. The histopathologic diagnosis of ECD is often challenging due to nonspecific inflammatory and fibrotic findings on histopathologic review of tissue specimens. Additionally, the association of ECD with unusual tissue tropism and an insidious onset often results in diagnostic errors and delays. Most patients with ECD require treatment, except for a minority of patients with minimally symptomatic single-organ disease. The first ECD consensus guidelines were published in 2014 on behalf of the physicians and researchers within the Erdheim-Chester Disease Global Alliance. With the recent molecular discoveries and the approval of the first targeted therapy (vemurafenib) for BRAF-V600-mutant ECD, there is a need for updated clinical practice guidelines to optimize the diagnosis and treatment of this disease. This document presents consensus recommendations that resulted from the International Medical Symposia on ECD in 2017 and 2019. Herein, we include the guidelines for the clinical, laboratory, histologic, and radiographic evaluation of ECD patients along with treatment recommendations based on our clinical experience and review of literature in the molecular era.
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d'Amore ESG, Mainardi C, Mussolin L, Carraro E, Alaggio R, Lazzari E, Fusetti S, Ghirotto C, Marzollo A, Biddeci G, Toffolutti T, Massano D, Scarzello G, Zuliani M, Putti MC, Biffi A, Pillon M. Histiocytic sarcoma arising in a child affected by Burkitt lymphoma, with t(8;14)(q24;q32) positivity in both tumors. Pediatr Hematol Oncol 2021; 38:1-7. [PMID: 33621154 DOI: 10.1080/08880018.2020.1871452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
| | - Chiara Mainardi
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Lara Mussolin
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy.,Institute of Pediatric Research, Fondazione Città della Speranza, Padova, Italy
| | - Elisa Carraro
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Rita Alaggio
- Department of Pathology, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Elena Lazzari
- Department of Pathology, San Bortolo Hospital, Vicenza, Italy
| | - Stefano Fusetti
- Maxillofacial Surgery Unit, Department of Neurosciences, University of Padova Medical School, Padova, Italy
| | - Cristina Ghirotto
- Maxillofacial Surgery Unit, ULSS 3 Serenissima Hospital, Venezia, Italy
| | - Antonio Marzollo
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Giada Biddeci
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Tiziana Toffolutti
- Department of Medicine, Pediatric Radiology Unit Radiology Institute Hospital-University of Padova, Padova, Italy
| | - Davide Massano
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Giovanni Scarzello
- Radiotherapy Department, Istituto Oncologico Veneto-IRCCS, Padova, Italy
| | - Monica Zuliani
- Department of Medicine, Pediatric Radiology Unit Radiology Institute Hospital-University of Padova, Padova, Italy
| | - Maria Caterina Putti
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
| | - Alessandra Biffi
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy.,Institute of Pediatric Research, Fondazione Città della Speranza, Padova, Italy.,Gene Therapy Program, Dana Farber/Boston Children's Cancer and Blood Disorders Centers, Boston, Massachusetts, USA
| | - Marta Pillon
- Clinic of Pediatric Haemato-Oncology, Hospital-University of Padova, Padova, Italy
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Valera ET, Brassesco MS, Reis MBFD, Maggioni G, Guerino-Cunha RL, Grecco CE, Jr JE, Kato M, Tone LG. Short-term response to alemtuzumab in CD52-positive secondary histiocytic sarcoma in a child: Is it time to consider new targets? Pediatr Hematol Oncol 2021; 38:89-96. [PMID: 32897114 DOI: 10.1080/08880018.2020.1811438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Elvis Terci Valera
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - María Sol Brassesco
- Department of Biology, Faculty of Philosophy, Sciences and Letters at Ribeirão Preto, University of São Paulo, Brazil
| | | | | | - Renato Luiz Guerino-Cunha
- Bone Marrow Transplantation and Cellular Therapy Unit, Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo Brazil
| | - Carlos Eduardo Grecco
- Bone Marrow Transplantation and Cellular Therapy Unit, Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo Brazil
| | - Jorge Elias Jr
- Department of Medical Imaging, Hematology and Clinical Oncology, Ribeirão Preto Medical School, University of São Paulo Brazil
| | - Mery Kato
- Diagnostic of Nuclear Medicine - DIMEN - Ribeirão Preto, Brazil
| | - Luiz Gonzaga Tone
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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44
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The mutational landscape of histiocytic sarcoma associated with lymphoid malignancy. Mod Pathol 2021; 34:336-347. [PMID: 32929178 PMCID: PMC9161669 DOI: 10.1038/s41379-020-00673-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022]
Abstract
Histiocytic sarcoma and tumors with dendritic cell differentiation (HDT) are uncommon neoplasms often with an aggressive clinical course that may occur in association with another hematologic malignancy or mediastinal germ cell tumor (secondary HDT, sHDT). Previous studies have shown mutations in the RAS/MAPK pathway in HDT and have demonstrated a clonal relationship between HDT and associated lymphoid malignancies through common translocations or identical immunoglobulin or T-cell receptor gene rearrangements. We performed whole exome sequencing on 16 cases of sHDT to further evaluate the spectrum of mutations that occur in sHDT in the context of an associated lymphoid malignancy, including cases associated with follicular lymphoma (FL), chronic lymphocytic leukemia/small lymphocytic lymphoma, B- and T-cell acute lymphoblastic leukemia/lymphoma and peripheral T-cell lymphoma, NOS. In addition, we assessed the clonal relationship between the HDT and the associated lymphoid malignancy in three cases for which matched samples were available. We found mutations in RAS/MAPK pathway genes in 14/16 cases of sHDT associated with diverse mature and precursor B-cell and T-cell neoplasms, involving KRAS (8/16), BRAF (2/16), NRAS (2/16), MAP2K1 (1/16), and NF1 (1/16). In addition, we note that FL-associated sHDT frequently shares a similar mutational profile to the associated malignancy, identifying mutations in CREBBP or KMT2D in all cases and "aberrant" somatic hypermutation in 5/6 cases. Our study confirms the role of the RAS/MAPK pathway in the pathogenesis of sHDT, provides further evidence of a common neoplastic precursor and, in the case of FL, gives additional insight into the stage in lymphomagenesis at which transdifferentiation may occur.
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Nicola M, Onorati M, Lancia M, Varca V, Di Nuovo F. Original Observation of Primary Bladder Histiocytic Sarcoma: First Case Report. Cureus 2021; 13:e12771. [PMID: 33614360 PMCID: PMC7888511 DOI: 10.7759/cureus.12771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Histiocytic sarcoma (HS) is a rare malignant lymphohematopoietic neoplasm; it has been cited in the recent World Health Organization (WHO) classification as a malignant proliferation of cells exhibiting morphological and immunophenotypic features of mature histiocytes. To our knowledge, the present case is the first to be described in the bladder of a patient without a history of lymphoma. Only one case has been reported so far regarding a secondary bladder presentation in the setting of a previous diffuse large B-cell lymphoma. We discuss the case of a 68-year-old male who presented with hematuria and dysuria. CT scan revealed a 4-cm intravesical mass that histological examination defined as HS. Our objective was to describe the clinical, histological, immunophenotypical, molecular characteristics and discuss the differential diagnoses of this first case of primary bladder HS. Our research was based on a review of selected articles obtained via the PubMed database. This extremely rare experience provided us with the opportunity to depict an interesting case, highlight its uniqueness, and build up new pathological evidence.
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Affiliation(s)
- Marta Nicola
- Pathology, ASST Rhodense, Garbagnate Milanese, ITA
| | | | - Mauro Lancia
- Pathology, ASST Rhodense, Garbagnate Milanese, ITA
| | | | - Franca Di Nuovo
- Pathology, ASST Rhodense, Garbagnate Milanese, ITA.,Pathology, G. Salvini Hospital, Garbagnate Milanese, ITA
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Ohe R, Kabasawa T, Utsunomiya A, Urano Y, Kitaoka T, Suzuki K, Aung NY, Kawamura I, Tajima K, Ishiyama T, Yamakawa M. Nodal histiocytic sarcoma with prominent eosinophilic infiltration: expression of eotaxin-2 on tumor cells. Diagn Pathol 2021; 16:6. [PMID: 33436014 PMCID: PMC7805230 DOI: 10.1186/s13000-020-01061-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 12/21/2020] [Indexed: 11/16/2022] Open
Abstract
Background Histiocytic sarcoma (HS) is a rare neoplasm showing morphological and immunophenotypic features of mature tissue histiocytes. We report a patient with nodal HS exhibiting prominent reactive eosinophilic infiltration. Case presentation A 68-year-old man presented with intermittent left lower abdominal pain and weight loss over 3 months. A computed tomography scan revealed multiple abdominal nodules. Open biopsy of the mesenteric tumors was performed for definitive diagnosis. Histologically, the tumor was comprised of a diffuse noncohesive proliferation of pleomorphic large cells, including multinucleated cells. Neoplastic cells were positive for histiocytic markers (CD68, CD163, and LIGHT) and PD-L1 but lacked markers of Langerhans cells, follicular dendritic cells, and epithelial cells. Frequent reactive inflammatory cells were intermingled in the background. Interestingly, prominent eosinophilic infiltration was also noted. Spindle neoplastic cells were prone to be present around areas with little to no eosinophilic infiltration and exhibiting fibrosis and lymphatic vessel proliferation. Conversely, polygonal neoplastic cells were prone to be present around areas with relatively large amounts of eosinophilic infiltration without fibrosis or lymphatic vessel proliferation. Immunohistochemically, the tumor cells and reactive eosinophils expressed eotaxin-2 and eotaxin-3, respectively. Conclusion We revealed that eotaxins induced the selective migration of eosinophils into tissues in this case. These eosinophils may affect the tumor remodeling and tumor biology characteristics of HS, such as fibrosis and lymphatic vessel proliferation. Supplementary Information The online version contains supplementary material available at 10.1186/s13000-020-01061-4.
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Affiliation(s)
- Rintaro Ohe
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan.
| | - Takanobu Kabasawa
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Aya Utsunomiya
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Yuka Urano
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Takumi Kitaoka
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Kazushi Suzuki
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Naing Ye Aung
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Ichiro Kawamura
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
| | - Katsushi Tajima
- Department of Hematology, Yamagata Prefectural Central Hospital, Yamagata, Japan
| | - Tomoharu Ishiyama
- Division of Surgery, Yamagata Prefectural Shinjo Hospital, Shinjo, Japan
| | - Mitsunori Yamakawa
- Department of Pathological Diagnostics, Yamagata University Faculty of Medicine, Yamagata University, 2-2-2 Iida-Nishi, Yamagata, 990-9585, Japan
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Cannatella J, Ganapathi K, Horvai A. Hematolymphoid Neoplasms Rarely Mimic Undifferentiated Pleomorphic Sarcoma of Soft Tissue. Arch Pathol Lab Med 2021; 144:1547-1552. [PMID: 32167380 DOI: 10.5858/arpa.2019-0580-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Undifferentiated pleomorphic sarcoma (UPS) of soft tissue is defined as a sarcoma with no recognizable line of differentiation. During the past few decades, advances in ancillary studies and review of prior UPS diagnoses have narrowed the category of UPS by excluding more-specific malignancies. However, few of those studies have specifically targeted pleomorphic hematolymphoid neoplasms. OBJECTIVE.— To determine what fraction of UPS cases are misclassified pleomorphic hematolymphoid neoplasms, such as anaplastic large cell lymphoma, diffuse large B-cell lymphoma, histiocytic sarcoma (HS), myeloid sarcoma, and follicular dendritic cell sarcoma. DESIGN.— Sixty-one UPS cases were screened by tissue microarray and an immunostain panel with subsequent analysis on whole block sections for suspicious cases. RESULTS.— Five of 61 tumors (8%) were suggestive of HS based on the screening panel and were further evaluated with additional immunostains (PU.1, CD45, CD163) using whole sections. The 5 candidate HS cases were only focally positive for at most one stain with most staining in smaller, less-pleomorphic cells. Ultimately, no UPS met criteria for anaplastic large cell lymphoma, diffuse large B-cell lymphoma, myeloid sarcoma, follicular dendritic cell sarcoma, or HS. CONCLUSIONS.— Our results suggest that a UPS of somatic soft tissue is unlikely to represent a misclassified hematopoietic malignancy. Exclusion of HS is most challenging, but immunostaining for PU.1, a nuclear transcription factor, may be easier to interpret in this context.
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Affiliation(s)
- John Cannatella
- From the Department of Pathology (Cannatella, Horvai), University of California, San Francisco, San Francisco.,Cannatella is now with the Department of Pathology, University of Arkansas for Medical Sciences, Little Rock
| | - Karthik Ganapathi
- Department of Laboratory Medicine (Ganapathi), University of California, San Francisco, San Francisco
| | - Andrew Horvai
- From the Department of Pathology (Cannatella, Horvai), University of California, San Francisco, San Francisco
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Kemps PG, Hebeda KM, Pals ST, Verdijk RM, Lam KH, Bruggink AH, de Lil HS, Ruiterkamp B, de Heer K, van Laar JAM, Valk PJM, Mutsaers P, Levin M, Hogendoorn PCW, van Halteren AGS. Spectrum of histiocytic neoplasms associated with diverse haematological malignancies bearing the same oncogenic mutation. J Pathol Clin Res 2021; 7:10-26. [PMID: 32852896 PMCID: PMC7737785 DOI: 10.1002/cjp2.177] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/18/2020] [Accepted: 06/25/2020] [Indexed: 12/14/2022]
Abstract
Histiocytic disorders are a spectrum of rare diseases characterised by the accumulation of macrophage-, dendritic cell-, or monocyte-differentiated cells in various tissues and organs. The discovery of recurrent genetic alterations in many of these histiocytoses has led to their recognition as clonal neoplastic diseases. Moreover, the identification of the same somatic mutation in histiocytic lesions and peripheral blood and/or bone marrow cells from histiocytosis patients has provided evidence for systemic histiocytic neoplasms to originate from haematopoietic stem/progenitor cells (HSPCs). Here, we investigated associations between histiocytic disorders and additional haematological malignancies bearing the same genetic alteration(s) using the nationwide Dutch Pathology Registry. By searching on pathologist-assigned diagnostic terms for the various histiocytic disorders, we identified 4602 patients with a putative histopathological diagnosis of a histiocytic disorder between 1971 and 2019. Histiocytosis-affected tissue samples of 187 patients had been analysed for genetic alterations as part of routine molecular diagnostics, including from nine patients with an additional haematological malignancy. Among these patients, we discovered three cases with different histiocytic neoplasms and additional haematological malignancies bearing identical oncogenic mutations, including one patient with concomitant KRAS p.A59E mutated histiocytic sarcoma and chronic myelomonocytic leukaemia (CMML), one patient with synchronous NRAS p.G12V mutated indeterminate cell histiocytosis and CMML, and one patient with subsequent NRAS p.Q61R mutated Erdheim-Chester disease and acute myeloid leukaemia. These cases support the existence of a common haematopoietic cell-of-origin in at least a proportion of patients with a histiocytic neoplasm and additional haematological malignancy. In addition, they suggest that driver mutations in particular genes (e.g. N/KRAS) may specifically predispose to the development of an additional clonally related haematological malignancy or secondary histiocytic neoplasm. Finally, the putative existence of derailed multipotent HSPCs in these patients emphasises the importance of adequate (bone marrow) staging, molecular analysis and long-term follow-up of all histiocytosis patients.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/genetics
- Erdheim-Chester Disease/genetics
- Erdheim-Chester Disease/pathology
- Erdheim-Chester Disease/therapy
- Fatal Outcome
- GTP Phosphohydrolases/genetics
- Genetic Predisposition to Disease
- Histiocytic Sarcoma/genetics
- Histiocytic Sarcoma/pathology
- Histiocytic Sarcoma/therapy
- Humans
- Leukemia, Myeloid, Acute/genetics
- Leukemia, Myeloid, Acute/pathology
- Leukemia, Myeloid, Acute/therapy
- Leukemia, Myelomonocytic, Chronic/genetics
- Leukemia, Myelomonocytic, Chronic/pathology
- Leukemia, Myelomonocytic, Chronic/therapy
- Male
- Membrane Proteins/genetics
- Middle Aged
- Mutation
- Phenotype
- Proto-Oncogene Proteins p21(ras)/genetics
- Retrospective Studies
- Treatment Outcome
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Affiliation(s)
- Paul G Kemps
- Department of PaediatricsLeiden University Medical CenterLeidenThe Netherlands
| | - Konnie M Hebeda
- Department of PathologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Steven T Pals
- Department of PathologyAmsterdam University Medical CentersAmsterdamThe Netherlands
| | - Robert M Verdijk
- Department of PathologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
- Department of PathologyLeiden University Medical CenterLeidenThe Netherlands
| | - King H Lam
- Department of PathologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Annette H Bruggink
- PALGA Foundation (Nationwide Network and Registry of Histopathology and Cytopathology)HoutenThe Netherlands
| | - Heleen S de Lil
- Department of HaematologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Bart Ruiterkamp
- Department of HaematologyRadboud University Medical CenterNijmegenThe Netherlands
| | - Koen de Heer
- Department of HaematologyAmsterdam University Medical CentersAmsterdamThe Netherlands
- Department of HaematologyFlevoziekenhuisAlmereThe Netherlands
| | - Jan AM van Laar
- Department of Internal MedicineErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
- Department of ImmunologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Peter JM Valk
- Department of HaematologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Pim Mutsaers
- Department of HaematologyErasmus MC University Medical Center RotterdamRotterdamThe Netherlands
| | - Mark‐David Levin
- Department of Internal MedicineAlbert Schweitzer ZiekenhuisDordrechtThe Netherlands
| | | | - Astrid GS van Halteren
- Department of PaediatricsLeiden University Medical CenterLeidenThe Netherlands
- Princess Máxima Center for Paediatric OncologyUtrechtThe Netherlands
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Said J. Genomic profiling of histiocytic sarcoma: new insights into pathogenesis and subclassification. Haematologica 2020; 105:854-855. [PMID: 32238464 DOI: 10.3324/haematol.2019.246314] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Jonathan Said
- Department of Pathology and Laboratory Medicine, UCLA Medical Center and David Geffen School of Medicine, Los Angeles, CA, USA
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Abstract
Synovial sarcoma (SS), an aggressive soft tissue sarcoma with a predilection for the extremities of young adults, harbors the pathognomonic t(X;18)(p11;q11) translocation, resulting in SS18-SSX rearrangements. SS includes monophasic, biphasic, and poorly differentiated variants, which show considerable histologic overlap with a range of other tumor types, making the diagnosis challenging on limited biopsies. Immunohistochemistry (IHC) is routinely used in the differential diagnosis; however, presently available markers lack specificity. Thus, cytogenetic or molecular genetic techniques are often employed to confirm the diagnosis. Here, we report the development and characterization of 2 novel antibodies: an SS18-SSX fusion-specific antibody (E9X9V, designed to the breakpoint) as well as an SSX-specific antibody (E5A2C, designed to the SSX C-terminus). We validated the selectivity and specificity of the antibodies using immunoblotting, immunoprecipitation, and chromatin immunoprecipitation followed by next-generation sequencing in SS cell lines and demonstrated that both antibodies capture SS18-SSX on chromatin at established target sites (eg, TLE1 and BCL2) genome-wide. Using IHC in whole sections from 400 tumors including 100 genetically confirmed cases of SS and 300 histologic mimics, the SS18-SSX fusion-specific antibody revealed strong diffuse nuclear staining in 95 of 100 (95%) SS cases, whereas none of the 300 control tumors showed any staining. The SSX antibody showed strong diffuse nuclear staining in all 100 (100%) SS cases; 13 (4%) of the 300 other tumors were also positive, 5 of which displayed >50% nuclear staining. In summary, a novel SS18-SSX fusion-specific antibody is highly sensitive (95%) and specific (100%) for SS, and an antibody to the SSX C-terminus is also highly sensitive (100%), but slightly less specific (96%). IHC using the SS18-SSX antibody could replace molecular genetic or cytogenetic testing in most cases, and these reagents together will also provide the research community with valuable tools for further biochemical and genomic interrogation of the SS18-SSX fusion protein.
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