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Yao Q, Bai Q, Zhang X, Ji G, Chang H, Cai X, Yu L, Wang J, Zhu X, Zhou X. Assessment of ALK Fusions in Uncommon Inflammatory Myofibroblastic Tumors With ALK IHC Positivity but FISH-Equivocal Findings by Targeted RNA Sequencing. Arch Pathol Lab Med 2022; 146:1234-1242. [PMID: 35041745 DOI: 10.5858/arpa.2021-0230-oa] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) are common methods to detect ALK status in inflammatory myofibroblastic tumors (IMTs). However, equivocal ALK FISH signals and inconsistency between FISH and IHC are occasionally observed. OBJECTIVE.— To study the inconsistency between FISH and IHC, and clarify ALK status in IMT by targeted RNA sequencing (RNAseq). DESIGN.— In this study, 12 consultation cases preliminarily diagnosed as uncommon IMTs with ALK IHC positivity but FISH negativity, plus 3 ALK-positive and 3 ALK-negative IMTs, were re-analyzed by IHC, FISH, and RNAseq. RESULTS.— As a result, 1 case with FUS-TFCP2 fusion was detected by RNAseq, which was previously misdiagnosed as IMT. In the other 11 uncommon IMTs, 90.9% (10 of 11) showed equivocal ALK FISH signals, and all were confirmed to harbor ALK fusion by RNAseq, except for 1 failure, suggesting that a low threshold for ALK FISH might be proposed in IMT. Furthermore, RNAseq also identified IGFBP5-ALK in 1 case with ALK IHC positivity but typical FISH negativity, suggesting the possibility of false negatives for ALK FISH. For the typical IMTs, ALK fusion was identified by RNAseq in all 3 ALK-positive IMTs as expected, and additionally FN1-ROS1 fusions were identified in 2 of 3 ALK-negative IMTs. CONCLUSIONS.— These findings indicated that RNAseq can simultaneously detect multiple gene fusions and provide fusion forms and breakpoints, which is of great value for differential diagnosis, especially for those uncommon IMTs with equivocal FISH findings, or inconsistency between IHC and FISH.
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Affiliation(s)
- Qianlan Yao
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Qianming Bai
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Xin Zhang
- Department of Pathology, Fudan University, Zhongshan Hospital, Shanghai, China (Zhang)
| | - Gang Ji
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Heng Chang
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Xu Cai
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Lin Yu
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Jian Wang
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Xiaoli Zhu
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
| | - Xiaoyan Zhou
- From the Department of Pathology, Shanghai Cancer Center, the Department of Oncology, Shanghai Medical College, and the Institute of Pathology, Fudan University, Shanghai, China (Yao, Bai, Ji, Chang, Cai, Yu, Wang, Zhu, Zhou)
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Bertz S, Stöhr R, Gaisa NT, Wullich B, Hartmann A, Agaimy A. TERT promoter mutation analysis as a surrogate to morphology and immunohistochemistry in problematic spindle cell lesions of the urinary bladder. Histopathology 2020; 77:949-962. [PMID: 32645760 DOI: 10.1111/his.14206] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 07/05/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022]
Abstract
AIMS Pseudosarcomatous myofibroblastic proliferations (PSMPs) of the urinary bladder are diagnostically challenging. Diagnostic difficulties are mainly due to frequent cytokeratin expression, variable ALK expression and worrisome morphological features suggestive of malignancy. Conversely, sarcomatoid urothelial carcinoma (UC) may show bland inflammatory myofibroblastic tumour (IMT)-like morphology. TERT promoter mutations are characteristic events in urothelial cancers, but have not been studied in PSMPs. METHODS AND RESULTS We compared histomorphological and immunohistochemical features and TERT promoter status in 16 PSMPs and 18 sarcomatoid UC. In a subset of PSMPs, RNA sequencing was performed. At least focal IMT-like morphology was seen in nine of 17 sarcomatoid UC. Atypical mitoses, differentiated urothelial component and heterologous elements were the most reliable distinguishing histomorphological features of sarcomatoid UC, if present. A panel of immunohistochemistry (IHC) including ALK (clone D5F3), p53 pattern, p63 and GATA3 reliably distinguished PSMP from sarcomatoid UC. GATA3 (P = 0.001) and p53 patterns (mutant versus wild-type; P < 0.001) were differentially expressed between PSMPs and sarcomatoid UC. Diffuse pancytokeratin staining was significantly associated with PSMPs (10 of 13) compared to four of 14 sarcomatoid UCs (P = 0.012). TERT promoter mutations were found in 17 of 18 sarcomatoid UC versus none of 16 PSMPs (P < 0.001). RNA sequencing revealed ALK genetic rearrangements in one of two ALK-positive and one of 10 ALK-negative PSMPs, which revealed a novel FN1/RET gene fusion. CONCLUSION Careful histomorphological analysis and differential IHC reliably distinguish the majority of PSMPs and sarcomatoid UC. In equivocal cases, TERT promoter mutation analysis and/or detection of ALK expression/rearrangements are valuable additional diagnostic adjuncts, strongly supporting sarcomatoid UC and PSMP, respectively.
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Affiliation(s)
- Simone Bertz
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Robert Stöhr
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | | | - Bernd Wullich
- Department of Urology and Pediatric Urology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
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Ding R, Li X, Zhu XM, Song QX, Fan QH, Zhang ZH, Gong QX. Inflammatory myofibroblastic tumor arising from soft tissues of extremities harboring a novel CLIP2-ALK fusion. Pathol Int 2020; 70:798-803. [PMID: 32716129 DOI: 10.1111/pin.12988] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/27/2020] [Accepted: 07/10/2020] [Indexed: 02/06/2023]
Abstract
A 34-year-old Chinese woman found a lump in her left leg for more than 3 weeks without any discomfort. Grossly, the tumor was relatively well delineated with focal infiltration. Histopathologic evaluation showed a compact fascicular spindle cell proliferation with variable myxoid and collagenous stroma and scattered inflammatory infiltrate. Immunohistochemically, the tumor cells showed positive expression of ALKD5F3 and SMA and negative expression of CD34, desmin, and cytokeretin. Fluorescence in situ hybridization analysis of the ALK locus showed break-apart signals in 20% of tumor cells, and DNA sequencing discovered a novel CLIP2-ALK fusion gene. The lesion was diagnosed as an inflammatory myofibroblastic tumor (IMT). To the best of our knowledge, this is the first case with CLIP2-ALK gene fusion in the somatic soft tissue IMTs.
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Affiliation(s)
- Ru Ding
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xiao Li
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xiao-Mei Zhu
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Quo-Xing Song
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Qin-He Fan
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhi-Hong Zhang
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Qi-Xing Gong
- Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
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Jebastin JAS, Smith SC, Perry KD, Gupta NS, Alanee S, Carskadon S, Chitale DA, Palanisamy N, Williamson SR. Pseudosarcomatous myofibroblastic proliferations of the genitourinary tract are genetically different from nodular fasciitis and lack USP6, ROS1 and ETV6 gene rearrangements. Histopathology 2018; 73:321-326. [PMID: 29617048 DOI: 10.1111/his.13526] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Accepted: 03/29/2018] [Indexed: 01/14/2023]
Abstract
AIMS Pseudosarcomatous myofibroblastic proliferations of the genitourinary tract have a debatable relationship with inflammatory myofibroblastic tumour (generally lacking ALK rearrangement); however, they share several overlapping features with nodular fasciitis of soft tissue. As rearrangement of the USP6 gene has been recently recognised as a recurrent alteration in soft tissue nodular fasciitis, and several other alternative gene fusions have been recently recognised in inflammatory myofibroblastic tumour, the aim of this study was to investigate whether USP6, ROS1 or ETV6 rearrangements were present in these lesions (12 cases). METHODS AND RESULTS Fluorescence in-situ hybridisation analysis was performed by the use of bacterial artificial chromosome-derived break-apart probes against USP6, ROS1, and ETV6. Two cases with adequate genetic material from recent paraffin tissue blocks were also tested by use of a solid tumour gene fusion detection assay via next-generation sequencing, targeting >50 known genes involved in recurrent fusions. None of the genitourinary pseudosarcomatous myofibroblastic proliferations was found to harbour USP6 (0/12), ROS1 (0/8) or ETV6 (0/7) rearrangements, and no gene fusions were detected in two cases studied by sequencing. CONCLUSIONS Despite overlap in histological and immunohistochemical features between pseudosarcomatous myofibroblastic proliferation and nodular fasciitis, these tumours lack the recently recognised USP6 rearrangements that occur in nodular fasciitis, as well as alternative fusions found in ALK-negative inflammatory myofibroblastic tumours. At present, this diagnosis remains based primarily on clinical, histological and immunohistochemical features.
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Affiliation(s)
- Judith A S Jebastin
- Department of Pathology and Laboratory Medicine and Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, USA
| | - Steven C Smith
- Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kyle D Perry
- Department of Pathology and Laboratory Medicine and Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, USA
| | - Nilesh S Gupta
- Department of Pathology and Laboratory Medicine and Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, USA
| | - Shaheen Alanee
- Vattikutti Urology Institute, Henry Ford Health System, Detroit, MI, USA
| | - Shannon Carskadon
- Vattikutti Urology Institute, Henry Ford Health System, Detroit, MI, USA
| | - Dhananjay A Chitale
- Department of Pathology and Laboratory Medicine and Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, USA
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Nallasivam Palanisamy
- Vattikutti Urology Institute, Henry Ford Health System, Detroit, MI, USA
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Sean R Williamson
- Department of Pathology and Laboratory Medicine and Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, USA
- Department of Pathology, Wayne State University School of Medicine, Detroit, MI, USA
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Lopez-Beltran A, Montironi R, Raspollini MR, Cheng L, Netto GJ. Iatrogenic pathology of the urinary bladder. Semin Diagn Pathol 2018; 35:218-227. [DOI: 10.1053/j.semdp.2018.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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6
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Bennett JA, Nardi V, Rouzbahman M, Morales-Oyarvide V, Nielsen GP, Oliva E. Inflammatory myofibroblastic tumor of the uterus: a clinicopathological, immunohistochemical, and molecular analysis of 13 cases highlighting their broad morphologic spectrum. Mod Pathol 2017; 30:1489-1503. [PMID: 28664932 DOI: 10.1038/modpathol.2017.69] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 05/08/2017] [Accepted: 05/09/2017] [Indexed: 12/20/2022]
Abstract
Inflammatory myofibroblastic tumors of the uterus are rare, and although most have a favorable prognosis, a small subset exhibit extrauterine disease, recur, or cause death. In this study, we evaluated the morphology and immunoprofile of 13 uterine inflammatory myofibroblastic tumors, including four with aggressive behavior. ALK rearrangements were detected by fluorescence in situ hybridization and fusion partners by anchored multiplex assay. Patients ranged from 8 to 63 (mean 39) years and tumors from 2.5 to 20 (mean 7.4) cm. Myxoid, compact, and hyalinized patterns were noted in 13, 12, and 2 tumors, ranging from 1 to 100%, 5 to 99%, and 0 to 5%, respectively. Nuclear atypia was mild in six (46%), moderate in five (38%), and severe in two (15%), with ganglion-like cells in two tumors. Mitoses ranged from 0 to 24 (mean 5) per 10 high-power fields. Inflammation was mild in five (38%), moderate in three (23%), and marked in five (38%), consisting of a lymphoplasmacytic infiltrate that was lymphocyte-predominant in six (46%). Lymphovascular invasion was noted in two (15%) and necrosis in eight (62%). All but one tumor were ALK-positive by immunohistochemistry, with granular cytoplasmic staining in nine (82%). ALK rearrangements (tested in 10) were detected in eight and was absent in one. The remaining tumor showed an isolated green 5' ALK signal. Fusion partners were identified in 10 (77%) and included THBS1 (n=3), IGFBP5 (n=2), DES (n=2), SEC31 (n=1), TPM3 (n=1), and TIMP3 (n=1). Size ≥8 cm was predictive of aggressive behavior (P<0.01), with increased mitoses (≥7 per 10 high-power fields), lymphovascular invasion, and compact-predominance approaching statistical significance. These data show that inflammatory myofibroblastic tumors of the uterus are morphologically heterogenous with frequent ALK expression and a variety of ALK fusion partners. Recognition of this rare mesenchymal neoplasm is crucial as those with aggressive behavior can potentially be treated with tyrosine kinase inhibitors.
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Affiliation(s)
- Jennifer A Bennett
- Department of Pathology and Laboratory Medicine, Lahey Hospital and Medical Center, Burlington, MA, USA
| | - Valentina Nardi
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Marjan Rouzbahman
- Department of Laboratory Medicine and Pathobiology, Toronto General Hospital, Toronto, ON, Canada
| | | | - G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - Esther Oliva
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
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7
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Cheng L, Zhang S, Wang L, MacLennan GT, Davidson DD. Fluorescence in situ hybridization in surgical pathology: principles and applications. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2017; 3:73-99. [PMID: 28451457 PMCID: PMC5402181 DOI: 10.1002/cjp2.64] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Revised: 12/16/2016] [Accepted: 12/20/2016] [Indexed: 02/06/2023]
Abstract
Identification of recurrent tumour‐specific chromosomal translocations and novel fusion oncogenes has important diagnostic, therapeutic and prognostic implications. Over the past decade, fluorescence in situ hybridization (FISH) analysis of tumour samples has been one of the most rapidly growing areas in genomic medicine and surgical pathology practice. Unlike traditional cytogenetics, FISH affords a rapid analysis of formalin‐fixed, paraffin‐embedded cells within a routine pathology practice workflow. As more diagnostic and treatment decisions are based on results of FISH, demand for the technology will become more widespread. Common FISH‐detected alterations are chromosome deletions, gains, translocations, amplifications and polysomy. These chromosome alterations may have diagnostic and therapeutic implications for many tumour types. Integrating genomic testing into cancer treatment decisions poses many technical challenges, but rapid progress is being made to overcome these challenges in precision medicine. FISH assessment of chromosomal changes relevant to differential diagnosis and cancer treatment decisions has become an important tool for the surgical pathologist. The aim of this review is to provide a theoretical and practical survey of FISH detected translocations with a focus on strategies for clinical application in surgical pathology practice.
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Affiliation(s)
- Liang Cheng
- Department of Pathology and Laboratory MedicineIndiana University School of MedicineIndianapolisINUSA.,Department of UrologyIndiana University School of MedicineIndianapolisINUSA
| | - Shaobo Zhang
- Department of Pathology and Laboratory MedicineIndiana University School of MedicineIndianapolisINUSA
| | - Lisha Wang
- Michigan Center for Translational PathologyUniversity of MichiganAnn ArborMIUSA
| | - Gregory T MacLennan
- Departments of Pathology and Laboratory MedicineCase Western Reserve UniversityClevelandOHUSA
| | - Darrell D Davidson
- Department of Pathology and Laboratory MedicineIndiana University School of MedicineIndianapolisINUSA
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8
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Lopez-Beltran A, Paner GP, Montironi R, Raspollini MR, Cheng L. Iatrogenic changes in the urinary tract. Histopathology 2016; 70:10-25. [DOI: 10.1111/his.13090] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 09/16/2016] [Accepted: 09/18/2016] [Indexed: 12/20/2022]
Affiliation(s)
- Antonio Lopez-Beltran
- Department of Pathology and Surgery; Faculty of Medicine; Cordoba Spain
- Champalimaud Clinical Center; Lisbon Portugal
| | - Gladell P Paner
- Departments of Pathology and Surgery; Section of Urology; University of Chicago; Chicago IL USA
| | - Rodolfo Montironi
- Section of Pathological Anatomy; Polytechnic University of the Marche Region; School of Medicine; Ancona Italy
| | - Maria R Raspollini
- Histopathology and Molecular Diagnostics. University Hospital Careggi; Florence Italy
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine; Indiana University School of Medicine; Indianapolis IN USA
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For staining of ALK protein, the novel D5F3 antibody demonstrates superior overall performance in terms of intensity and extent of staining in comparison to the currently used ALK1 antibody. Virchows Arch 2016; 469:345-50. [DOI: 10.1007/s00428-016-1969-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Revised: 05/09/2016] [Accepted: 05/31/2016] [Indexed: 12/31/2022]
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10
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[Mesenchymal tumors of the urinary bladder]. DER PATHOLOGE 2016; 37:61-70. [PMID: 26746411 DOI: 10.1007/s00292-015-0122-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Mesenchymal tumors and tumor-like lesions of the urinary bladder are rare. They encompass a heterogeneous group of reactive pseudosarcomatous tumor-like changes and benign neoplastic lesions as well as malignant neoplasms (sarcomas) with variable biological behavior. The well-known differential diagnostic difficulties related to these conditions are mainly due to their rarity and thus limited experience and familiarity with their histological features and due to the significant morphological overlap between fully benign reactive conditions and aggressive malignant neoplasms. The distinction between them may on occasion represent a real challenge and is associated with several pitfalls. This overview summarizes the clinicopathological and differential diagnostic aspects of the most important lesions and discuss their differential diagnosis in the light of current knowledge.
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Leguellec S, Tournier E, Karanian M, Brousset P, Mazereeuw J, Coindre JM, Lamant L. Cutaneous inflammatory myofibroblastic tumours can be anaplastic lymphoma kinase-positive: report of the first four cases. Histopathology 2015; 68:297-302. [DOI: 10.1111/his.12759] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 06/18/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Sophie Leguellec
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
| | - Emilie Tournier
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
| | - Marie Karanian
- Department of Dermatology; Larrey Hospital; CHU de Toulouse; Toulouse France
| | - Pierre Brousset
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
| | - Juliette Mazereeuw
- Department of Dermatology; Larrey Hospital; CHU de Toulouse; Toulouse France
| | | | - Laurence Lamant
- Department of Pathology; Institut Universitaire du Cancer Toulouse Oncopole; Toulouse France
- Université Paul-Sabatier; Toulouse France
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