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Scarini JF, Egal ESA, de Lima-Souza RA, Crescencio LR, Emerick C, Kowalski LP, Altemani A, Mariano FV. Two sides of the same coin: Insights into the myoepithelial cells in carcinoma ex pleomorphic adenoma development. Crit Rev Oncol Hematol 2020; 157:103195. [PMID: 33307199 DOI: 10.1016/j.critrevonc.2020.103195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 11/11/2020] [Accepted: 12/06/2020] [Indexed: 11/16/2022] Open
Abstract
The myoepithelial cell seems to play an important role as a tumor suppressor in the development of carcinoma ex pleomorphic adenoma. Nevertheless, interesting aspects concerning the other side of the coin, i.e., the contribution of the myoepithelial cell to cell proliferation, were brought to light. Here we highlighted the studies in which myoepithelial cells were presented as tumor suppressors and promoters in the context of PA malignant transformation. In conclusion, even if in a paracrine way, divergent signals can alter the suppressor role of the myoepithelial cell and induce it to compose a microenvironment propitious to the tumor progression of the malignant cells. This would cause myoepithelial cells to succumb and malignant epithelial cells to initiate progression beyond the basal membrane.
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Affiliation(s)
- João Figueira Scarini
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil; Department of Oral Diagnosis, School of Dentistry, University of Campinas (FOP/UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Erika Said Abu Egal
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil; Department of Pathology, School of Medicine, University of Utah (UU), Salt Lake City, UT, United States
| | - Reydson Alcides de Lima-Souza
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil; Department of Oral Diagnosis, School of Dentistry, University of Campinas (FOP/UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Lívia Ramalho Crescencio
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil; Department of Oral Diagnosis, School of Dentistry, University of Campinas (FOP/UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Carolina Emerick
- Department of Oral Diagnosis, School of Dentistry, University of Campinas (FOP/UNICAMP), Piracicaba, Sao Paulo, Brazil
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Sao Paulo, Brazil
| | - Albina Altemani
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil
| | - Fernanda Viviane Mariano
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Sao Paulo, Brazil.
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2
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Gattuso P, Reddy VB, Green LK, Castelli MJ, Wick MR. Prognostic Factors for Carcinoma of the Male Breast. Int J Surg Pathol 2016. [DOI: 10.1177/106689699500200305] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Male mammary carcinoma (MMC) affects approximately 1000 men in the United States each year. Aside from the impact of estrogen-receptor positivity on the clinical course of this tumor, relatively little information exists in published form on the ability of special pathologic studies to predict its biologic behavior. The authors analyzed 26 cases of invasive ductal MMC, comparing overall survival with tumor size, histologic grade (Page and Anderson), immunohistologic estrogen receptor protein status, DNA ploidy, expression of S 100 and gross cystic disease fluid proteins, and immunohisto chemically-detected amplification of the c-erbB-2 (HER-2/neu) oncoprotein. Tumor size and amplification of c-erbB-2 oncoprotein emerged as the statistically significant predictors in this group; MMCs of <2 cm had a more favorable prognosis than large tumors. Estrogen receptor protein was seen in 80% of cases; c-erbB-2 amplification was present in 35%; 80% were DNA-aneuploid; and S 100 and gross cystic disease fluid were observed in 38% and 62% of cases, respectively. The latter data are virtually identical to those on histologically similar tumors in women, but all except c-erbB-2 failed to achieve statistical prognostic value in this study. Substrata of histologic grades among MMCs were numerically too small to subject to statistical assessment. These findings suggest that no substantive differences exist between the pathologic features of male and female breast cancers. They also indicate that adjunctive laboratory studies are currently unhelpful in the prognostication of MMC. Int J Surg Pathol 2(3):199-206, 1995
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Affiliation(s)
- Paolo Gattuso
- Departments of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Vijaya B. Reddy
- Departments of Pathology, Loyola University Medical Center, Maywood, Illinois
| | | | - Melanie J. Castelli
- Departments of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Mark R. Wick
- Barnes Hospital at Washington Univer sity Medical Center, St. Louis, Missouri
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3
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Mulligan AM. Encapsulated Papillary Carcinoma of the Breast. Surg Pathol Clin 2009; 2:319-50. [PMID: 26838325 DOI: 10.1016/j.path.2009.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Papillary lesions of the breast include a broad spectrum of entities, many of which can be diagnostically challenging for the pathologist. This article focuses on encapsulated papillary carcinoma, a recently proposed term used to describe papillary carcinoma occurring within a cystically dilated duct. Previously considered a variant of papillary ductal carcinoma in situ, the finding that these lesions typically lack myoepithelial cells at their periphery has raised questions about their true nature. This article presents a practical approach to the diagnosis of encapsulated papillary carcinoma with a review of its histologic mimics and clinical significance.
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Affiliation(s)
- Anna Marie Mulligan
- Department of Laboratory Medicine, St. Michael's Hospital and University of Toronto, 30 Bond Street, Room 2-089 CCW, Toronto, Ontario M5B 1W8, Canada.
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Ichihara S, Fujimoto T, Hashimoto K, Moritani S, Hasegawa M, Yokoi T. Double immunostaining with p63 and high-molecular-weight cytokeratins distinguishes borderline papillary lesions of the breast. Pathol Int 2007; 57:126-32. [PMID: 17295644 DOI: 10.1111/j.1440-1827.2006.02069.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Papillary breast lesions remain a source of diagnostic confusion because the full range of epithelial proliferations may arise within, or secondarily involve, papilloma. The expression of p63 and high-molecular-weight cytokeratins (HMWCK) was studied simultaneously in 33 papillary lesions including intraductal papilloma (IP, n = 10), atypical papilloma (AP, n = 8) and intraductal papillary carcinoma (IPC, n = 15) by double immunostaining. The myoepithelial cell nuclei were stained dark brown whereas the cytoplasms of usual ductal hyperplasia (UDH) and myoepithelium were stained purple. The myoepithelial layer was recognized as a dark brown dotted line at the epithelial stromal junction in all IP (10/10), most AP (7/8) and some IPC (7/15), suggesting that the retained myoepithelial layer in the papillary processes does not necessarily guarantee benignity. However, the malignant epithelial cells in AP and IPC were typically recognized as monotonous populations unstained with either chromogen. These monotonous cells contrasted with the proliferating cells of UDH in papilloma, which had intense purple cytoplasm in a mosaic-like fashion. The present data suggest that the double immunostaining with the two popular antibodies p63 and HMWCK is a useful tool for reproducible classification of papillary breast lesions.
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MESH Headings
- Adult
- Aged
- Biomarkers, Tumor/metabolism
- Breast Neoplasms/classification
- Breast Neoplasms/metabolism
- Breast Neoplasms/pathology
- Carcinoma, Ductal, Breast/metabolism
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Intraductal, Noninfiltrating/metabolism
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Papillary/classification
- Carcinoma, Papillary/metabolism
- Carcinoma, Papillary/pathology
- DNA-Binding Proteins/metabolism
- Female
- Fluorescent Antibody Technique, Direct
- Humans
- Hyperplasia/metabolism
- Hyperplasia/pathology
- Immunoenzyme Techniques
- Keratins/metabolism
- Mammary Glands, Human/metabolism
- Mammary Glands, Human/pathology
- Middle Aged
- Molecular Weight
- Papilloma, Intraductal/classification
- Papilloma, Intraductal/metabolism
- Papilloma, Intraductal/pathology
- Retrospective Studies
- Trans-Activators/metabolism
- Transcription Factors
- Tumor Suppressor Proteins/metabolism
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Affiliation(s)
- Shu Ichihara
- Department of Pathology, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya 460-0001, Japan.
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Lacroix-Triki M, Mery E, Voigt JJ, Istier L, Rochaix P. Value of cytokeratin 5/6 immunostaining using D5/16 B4 antibody in the spectrum of proliferative intraepithelial lesions of the breast. A comparative study with 34betaE12 antibody. Virchows Arch 2003; 442:548-54. [PMID: 12712335 DOI: 10.1007/s00428-003-0808-0] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2002] [Accepted: 01/29/2003] [Indexed: 10/25/2022]
Abstract
Previous studies have shown that basal-type cytokeratins (CKs) can distinguish usual ductal hyperplasia (UDH) from the spectrum of atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS) and lobular carcinoma in situ (LCIS). Indeed, expression of these CKs is weak or absent in ADH, DCIS and LCIS. However, the diagnostic usefulness of D5/16B4 antibody (anti-CK5/6) has never been compared with that of 34betaE12 antibody (anti-CK1/5/10/14). We performed immunostaining of CK 5/6 and CK1/5/10/14 on 100 breast lesions, including UDH ( n=31), ADH ( n=5), DCIS ( n=54) and LCIS ( n=10). Abundant immunostaining was observed in all UDH using both antibodies. Four of five of the ADH cases showed less than 5% of CK5/6 stained cells, the remaining case showed 30% of labeled cells. With 34betaE12 antibody, three of five of the ADH cases showed less than 5% labeled cells, while two cases showed more than 30% of stained cells. None of the 54 DCIS or the 10 LCIS was labeled by D5/16B4, while a lack of 34betaE12 immunostaining was observed in only 15 of 54 DCIS and 2 of 10 LCIS. We confirmed that D5/16B4 antibody directed against CK5/6 is useful in distinguishing UDH from the spectrum of ADH/DCIS/LCIS. We also demonstrated that D5/16B4 is far a more specific marker than 34betaE12 antibody.
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Affiliation(s)
- Magali Lacroix-Triki
- Laboratoire d'Anatomie et de Cytologie Pathologiques, Institut Claudius Regaud, 20-24 rue du pont Saint Pierre, 31052, Toulouse Cedex, France
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Gal-Gombos EC, Esserman LE, Recine MA, Poppiti RJ. Large-needle core biopsy in atypical intraductal epithelial hyperplasia including immunohistochemical expression of high molecular weight cytokeratin: analysis of results of a single institution. Breast J 2002; 8:269-74. [PMID: 12199753 DOI: 10.1046/j.1524-4741.2002.08504.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The diagnosis of atypical intraductal epithelial hyperplasia (AIDH) constitutes 6.3% of the breast core biopsies performed at our institution. Seventy-nine cases that were diagnosed as AIDH on core biopsy and went through excisional biopsy were included. Sixty-four biopsies were performed by an image-guided 11-gauge vacuum device, 11 under sonographic guidance using 14-gauge needles and 4 by a sonographically guided 11-gauge vacuum device. The histopathology of the core biopsies and the surgical excisions were reviewed. Immunohistochemistry was performed on the consecutive sections of core biopsy specimens using high molecular weight cytokeratin (HMW-CK) (DAKO-Cytokeratin, 34betaE12). At interpretation of the stain, intensity and percentage of positive cells were taken into account. The immunoprofiles of AIDH were categorized into four groups showing negative (i.e., no staining) or low-, moderate-, high-, and very high-intensity staining. Surgical excision of the 79 lesions revealed carcinoma in only 3 cases (4%)-two infiltrating carcinomas and one intraductal carcinoma-residual AIDH in 44 cases (56%), and epithelial hyperplasia or other benign lesions without atypia in 32 cases (40%). The HMW-CK stain was performed retrospectively on all of the core biopsies and 66 of them contained residual areas with AIDH for staining. Forty-nine (74%) were CK negative or stained with low intensity, but 17 cases (26%) had a moderate- to high-intensity stain. Our study showed a lower incidence of carcinoma on surgical excision following core biopsy for AIDH than other studies. The HMW-CK stain helped to characterize the nature of the intraductal proliferation and to confirm the presence of atypia, as has been previously reported, but frequently was inconclusive. The low incidence of carcinoma brings into question the need for surgical excision of all cases of AIDH diagnosed by core biopsy.
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Affiliation(s)
- Eva C Gal-Gombos
- Department of Pathology and Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, Florida 33140, USA.
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Nayar R, Breland C, Bedrossian U, Masood S, DeFrias D, Bedrossian CW. Immunoreactivity of ductal cells with putative myoepithelial markers: A potential pitfall in breast carcinoma. Ann Diagn Pathol 1999; 3:165-73. [PMID: 10359852 DOI: 10.1016/s1092-9134(99)80044-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The identification of an intact layer of myoepithelial cells (MECs) located between epithelial cells and the basal lamina is useful in differentiating benign breast lesions and carcinoma in situ from invasive breast carcinoma. In the present study we used three antibodies considered to be putative markers of MECs (S100 protein, muscle-specific actin [HHF-35], and smooth muscle actin [SMA]) in 100 formalin-fixed, paraffin-embedded histologic sections of breast in an attempt to compare their value in demonstrating MECs in benign breast tissue and breast carcinomas. We concluded that for identifying MECs in benign breast tissue, SMA appears to be the most reliable, followed closely by HHF-35, but S100 is very unreliable for this purpose. In breast carcinoma, all three stains showed variable cross-reactivity with myofibroblasts, being greatest with SMA. A significant number of tumor cells in ductal carcinoma, both intraductal and invasive, stain with these markers and this "cross-reactivity" is extremely high with HHF-35. Thus, immunohistochemistry should be interpreted cautiously in differentiating benign, in situ, and invasive breast neoplasms. The "cross-reactivity" also suggests the possibility of myoepithelial differentiation and/or high actin content of breast tumor cells.
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Affiliation(s)
- R Nayar
- Department of Pathology, Northwestern University, Chicago, IL, USA
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