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Mazibrada J, Jayatunge N, Domecq C, Witkowski L, Croce S, Foulkes WD, McCluggage WG. Unusual Aspects of Small Cell Carcinoma of the Ovary of Hypercalcaemic Type: Retained SMARCA4 Immunohistochemical Staining and Positive Staining With TLE1. Am J Surg Pathol 2023; 47:1261-1266. [PMID: 37345679 DOI: 10.1097/pas.0000000000002088] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Small cell carcinoma of the ovary of hypercalcaemic type (SCCOHT) is a rare and aggressive ovarian neoplasm that is most common in the second and third decades. Molecular studies have established inactivating SMARCA4 alterations as the driver of SCCOHT, these being present in over 95% of these neoplasms. SMARCA4 alterations almost always result in loss of immunoreactivity with SMARCA4 (BRG1) antibody, and this is an extremely useful adjunct in the diagnosis of SCCOHT. Herein, we report 7 cases of SCCOHT (2 from the same patient) with retention of nuclear immunoreactivity with SMARCA4, but with SMARCA4 alterations identified on molecular testing. All cases exhibited loss of SMARCA2 (BRM) immunoreactivity. In addition, following the identification of diffuse TLE1 immunoreactivity in one of these cases (which did not exhibit an SS18 gene rearrangement characteristic of synovial sarcoma), we stained a total of 63 cases of SCCOHT (14 on whole tissue sections: 49 on tissue microarray) with this marker and 7 of 14 (50%) and 22 of 49 (45%) were positive on whole sections and tissue microarray, respectively. Most cases were focally positive but occasional cases exhibited diffuse immunoreactivity. Our observations highlight the importance of SMARCA2 immunohistochemical staining and molecular testing in suspected cases of SCCOHT that exhibit retained SMARCA4 immunoreactivity. Th common expression of TLE1 in these neoplasms represents a potential diagnostic pitfall since synovial sarcoma may be considered in the differential, especially in cases with retained SMARCA4 immunohistochemistry.
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Affiliation(s)
- Jasenka Mazibrada
- Department of Pathology, Norfolk and Norwich University Hospital, Norwich
| | - Nishani Jayatunge
- Department of Pathology, Norfolk and Norwich University Hospital, Norwich
| | - Celine Domecq
- Cancer Research Program and the SCCOHT/SMARCA4 Registry and Biobank, Research Institute of the McGill University Health Centre, Montreal
| | - Leora Witkowski
- Cancer Research Program and the SCCOHT/SMARCA4 Registry and Biobank, Research Institute of the McGill University Health Centre, Montreal
- Departments of Human Genetics
- Medicine
- Oncology, McGill University, Montréal, QC, Canada
| | - Sabrina Croce
- Department of Biopathology, Institute Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - William D Foulkes
- Cancer Research Program and the SCCOHT/SMARCA4 Registry and Biobank, Research Institute of the McGill University Health Centre, Montreal
- Departments of Human Genetics
- Medicine
- Oncology, McGill University, Montréal, QC, Canada
| | - W Glenn McCluggage
- Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK
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Jeffus SK, Meena N, Lindberg M. Expression of TLE1 in a Carcinoid Tumor of the Lung With Spindle Cell Morphology-A Potential Diagnostic Pitfall. Appl Immunohistochem Mol Morphol 2023; 31:644-647. [PMID: 37668410 DOI: 10.1097/pai.0000000000001154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 08/04/2023] [Indexed: 09/06/2023]
Abstract
Tumors of the lung with a spindle cell morphology require consideration of many entities in the differential diagnosis, including metastases. Ancillary immunohistochemical stains but also molecular studies are typically required to arrive at the proper diagnosis. We present a case of a 71-year-old woman with multiple lung nodules, mediastinal lymphadenopathy, and a history of uterine cancer who underwent endobronchial ultrasound-guided fine needle aspiration and biopsy of the lung and mediastinal lymph nodes. A sampling of the lung lesion showed a cytologically bland neoplasm with spindle cell morphology, lacking necrosis or brisk mitotic activity. In conjunction with the cytomorphology, strong and diffuse Transducin-like enhancer of split 1 (TLE1) reactivity in the tumor cells initially raised the diagnosis of synovial sarcoma; however, subsequent results of additional testing showed strong and diffuse expression with AE1/AE3, CK 8/18, TTF-1, synaptophysin and chromogranin and focal or negative staining with a large number of other antibodies. This warranted a diagnosis of a carcinoid tumor. This is the first report of TLE1 staining in a carcinoid tumor of the lung. Therefore, when evaluating tumors of the lung with spindle cell morphology in which the differential diagnosis may include both carcinoid tumor and synovial sarcoma, TLE1 expression should be interpreted with caution and in conjunction with an expanded immunohistochemical staining panel.
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Affiliation(s)
- Susanne K Jeffus
- Department of Pathology, University of Arkansas for Medical Sciences
| | - Nikhil Meena
- Department of Internal Medicine, Division of Pulmonology and Critical Care, Little Rock, AR
| | - Matthew Lindberg
- Department of Pathology, University of Arkansas for Medical Sciences
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Morawitz J, Kirchner J, Martin O, Bruckmann NM, Dietzel F, Li Y, Rischpler C, Herrmann K, Umutlu L, Bittner AK, Mohrmann S, Ingenwerth M, Häberle L, Esposito I, Antoch G, Buchbender C, Sawicki LM. Prospective Correlation of Prognostic Immunohistochemical Markers With SUV and ADC Derived From Dedicated Hybrid Breast 18F-FDG PET/MRI in Women With Newly Diagnosed Breast Cancer. Clin Nucl Med 2021; 46:201-205. [PMID: 33351505 DOI: 10.1097/rlu.0000000000003488] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE The aim of this study was to correlate prognostically relevant immunohistochemical parameters of breast cancer with simultaneously acquired SUVs and apparent diffusion coefficient (ADC) values derived from hybrid breast PET/MRI. PATIENTS AND METHODS Fifty-six women with newly diagnosed, therapy-naive, histologically proven breast cancer (mean age, 54.1 ± 12.0 years) underwent dedicated prone 18F-FDG breast PET/MRI. Diffusion-weighted imaging (b-values: 0, 500, 1000 s/mm2) was performed simultaneously with the PET acquisition. A region of interest encompassing the entire primary tumor on each patient's PET/MRI scan was used to determine the glucose metabolism represented by maximum and mean SUV as well as into corresponding ADC maps to assess tumor cellularity represented by mean and minimum ADC values. Histopathological tumor grading and prognostically relevant immunohistochemical markers, that is, Ki67, progesterone receptor, estrogen receptor, and human epidermal growth factor receptor 2 (HER2), were assessed. Pearson correlation coefficients were calculated to compare SUV and ADC values as well as the immunohistochemically markers and molecular subtype. For the comparison with the tumor grading, a Wilcoxon test was used. RESULTS A significant inverse correlation between SUV and ADC values derived from breast PET/MRI (r = -0.49 for SUVmean vs ADCmean; r = -0.43 for SUVmax vs ADCmin; both P's < 0.001) was found. Tumor grading and Ki67 both showed a positive correlation with SUVmean from breast PET/MRI (r = 0.37 and r = 0.32, P < 0.01). For immunohistochemical markers, HER2 showed an inverse correlation with ADC values from breast PET/MRI (r = -0.35, P < 0.01). Molecular subtypes significantly correlate with SUVmax and SUVmean (r = 0.52 and r = 0.42, both P's < 0.05). In addition, estrogen receptor expression showed an inverse correlation with SUVmax and SUVmean from breast PET/MRI (r = -0.45 and r = -0.42, P < 0.001). CONCLUSIONS The present data show a correlation between increased glucose metabolism, cellularity, tumor grading, estrogen and HER2 expression, as well as molecular subtype of breast cancer primaries. Hence, simultaneous 18F-FDG PET and diffusion-weighted imaging from hybrid breast PET/MRI may serve as a predictive tool for identifying high-risk breast cancer patients in initial staging and guide-targeted therapy.
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Affiliation(s)
- Janna Morawitz
- From the Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf
| | - Julian Kirchner
- From the Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf
| | - Ole Martin
- From the Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf
| | - Nils-Martin Bruckmann
- From the Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf
| | - Frederic Dietzel
- From the Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf
| | - Yan Li
- Departments of Diagnostic and Interventional Radiology and Neuroradiology
| | | | | | - Lale Umutlu
- Departments of Diagnostic and Interventional Radiology and Neuroradiology
| | - Ann-Kathrin Bittner
- Gynecology and Obstetrics, Essen University Hospital, University of Duisburg-Essen, Essen
| | - Svjetlana Mohrmann
- Department of Gynecology, Medical Faculty, University Düsseldorf, Düsseldorf
| | - Marc Ingenwerth
- Institute of Pathology, West German Cancer Center, Essen University Hospital, University Duisburg-Essen and the German Cancer Consortium (DKTK), Essen
| | - Lena Häberle
- Institute of Pathology, Medical Faculty, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Irene Esposito
- Institute of Pathology, Medical Faculty, Heinrich Heine University and University Hospital Duesseldorf, Duesseldorf, Germany
| | - Gerald Antoch
- From the Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf
| | - Christian Buchbender
- From the Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf
| | - Lino M Sawicki
- From the Department of Diagnostic and Interventional Radiology, Medical Faculty, University Düsseldorf, Düsseldorf
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Martin O, Bruckmann NM, Kirchner J, Ullrich T, Ingenwerth M, Bogner S, Eze C, Nensa F, Herrmann K, Umutlu L, Antoch G, Sawicki LM. Is there a connection between immunohistochemical markers and grading of lung cancer with apparent diffusion coefficient (ADC) and standardised uptake values (SUV) of hybrid 18F-FDG-PET/MRI? J Med Imaging Radiat Oncol 2020; 64:779-786. [PMID: 32705779 DOI: 10.1111/1754-9485.13087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 06/21/2020] [Accepted: 06/28/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION To correlate tumour grading and prognostic immunohistochemical markers of lung cancer with simultaneously acquired standardised uptake values (SUV) and apparent diffusion coefficient (ADC) derived from hybrid PET/MRI. METHODS In this retrospective study, 55 consecutive patients (mean age 62.5 ± 9.2 years) with therapy-naïve, histologically proven lung cancer were included. All patients underwent whole-body PET/MRI using 18F-flourdeoxyglucose (18F-FDG) as a radiotracer. Diffusion-weighted imaging of the chest (DWI, b-values: 0, 500, 1000 s/mm2 ) was performed simultaneously with PET acquisition. Histopathological tumour grading was available in 43/55 patients. In 15/55 patients, immunohistochemical markers, that is, phospho-AKT Ser473 (pAKTS473), phosphorylated extracellular signal-regulated kinase (pERK), phosphatase and tensin homolog (PTEN), and human epidermal growth factor receptor 2 (erbB2) were available. RESULTS The average SUVmax, SUVmean, ADCmin and ADCmean in lung cancer primaries were 12.6 ± 5.9, 7.7 ± 4.6, 569.9 ± 96.1 s/mm2 and 825.8 ± 93.2 s/mm2 , respectively. We found a significant inverse correlation between the ADCmin and SUVmax (r = -0.58, P < 0.001) as well as between the ADCmin and SUVmean (r = -0.44, P < 0.001). Tumour grading showed a significant positive correlation with SUVmax and SUVmean (R = 0.34 and R = 0.31, both P < 0.05) and a significant inverse correlation with ADCmin and ADCmean (r = -0.30 and r = -0.40, both P < 0.05). In addition, erbB2 showed a significant inverse correlation with SUVmax and SUVmean (r = -0.50 and r = -0.49, both P < 0.05). The other immunohistochemical markers did not show any significant correlation. CONCLUSION 18F-FDG-PET/MRI showed weak to moderate correlations between SUV, ADC, tumour grading and erbB2-expression of lung cancer. Hence, 18F-FDG-PET/MRI may, to some extent, offer complementary information to the histopathology of lung cancer, for the evaluation of tumour aggressiveness and treatment response.
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Affiliation(s)
- Ole Martin
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Nils-Martin Bruckmann
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Julian Kirchner
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Tim Ullrich
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Marc Ingenwerth
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Simon Bogner
- Department of Medical Oncology, University Hospital Essen, West German Cancer Center, University of Duisburg-Essen, Essen, Germany
| | - Chukwuka Eze
- Department of Radiation Oncology, LMU Munich, Munich, Germany
| | - Felix Nensa
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ken Herrmann
- Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Lale Umutlu
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Gerald Antoch
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
| | - Lino M Sawicki
- Department of Diagnostic and Interventional Radiology, Medical Faculty, University Dusseldorf, Dusseldorf, Germany
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Marquez J, Flores J, Kim AH, Nyamaa B, Nguyen ATT, Park N, Han J. Rescue of TCA Cycle Dysfunction for Cancer Therapy. J Clin Med 2019; 8:jcm8122161. [PMID: 31817761 PMCID: PMC6947145 DOI: 10.3390/jcm8122161] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Revised: 11/30/2019] [Accepted: 12/04/2019] [Indexed: 02/07/2023] Open
Abstract
Mitochondrion, a maternally hereditary, subcellular organelle, is the site of the tricarboxylic acid (TCA) cycle, electron transport chain (ETC), and oxidative phosphorylation (OXPHOS)—the basic processes of ATP production. Mitochondrial function plays a pivotal role in the development and pathology of different cancers. Disruption in its activity, like mutations in its TCA cycle enzymes, leads to physiological imbalances and metabolic shifts of the cell, which contributes to the progression of cancer. In this review, we explored the different significant mutations in the mitochondrial enzymes participating in the TCA cycle and the diseases, especially cancer types, that these malfunctions are closely associated with. In addition, this paper also discussed the different therapeutic approaches which are currently being developed to address these diseases caused by mitochondrial enzyme malfunction.
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Affiliation(s)
- Jubert Marquez
- Department of Health Science and Technology, College of Medicine, Inje University, Busan 47392, Korea; (J.M.); (A.H.K.)
| | - Jessa Flores
- Department of Physiology, College of Medicine, Inje University, Busan 47392, Korea; (J.F.); (B.N.); (A.T.T.N.)
| | - Amy Hyein Kim
- Department of Health Science and Technology, College of Medicine, Inje University, Busan 47392, Korea; (J.M.); (A.H.K.)
| | - Bayalagmaa Nyamaa
- Department of Physiology, College of Medicine, Inje University, Busan 47392, Korea; (J.F.); (B.N.); (A.T.T.N.)
- Department of Hematology, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia
| | - Anh Thi Tuyet Nguyen
- Department of Physiology, College of Medicine, Inje University, Busan 47392, Korea; (J.F.); (B.N.); (A.T.T.N.)
| | - Nammi Park
- Cardiovascular and Metabolic Disease Center, Paik Hospital, Inje University, Busan 47392, Korea;
| | - Jin Han
- Department of Health Science and Technology, College of Medicine, Inje University, Busan 47392, Korea; (J.M.); (A.H.K.)
- Department of Physiology, College of Medicine, Inje University, Busan 47392, Korea; (J.F.); (B.N.); (A.T.T.N.)
- Cardiovascular and Metabolic Disease Center, Paik Hospital, Inje University, Busan 47392, Korea;
- Correspondence: ; Tel.: +8251-890-8748
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Saggini A, Cerroni L, Casini B, Baciorri F, Cota C. Primary intrafascial desmoplastic melanoma with pseudoglandular differentiation and aberrant cytokeratins expression: An exceptional presentation. Pathol Res Pract 2019; 215:152668. [DOI: 10.1016/j.prp.2019.152668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022]
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Abstract
Succinate dehydrogenase (SDH) is uniquely tasked with a dual role in the essential energy-producing processes of a cell. Although SDH subunits and assembly factors form part of the same enzyme complex, mutations in their respective genes lead to significantly different clinical phenotypes. Remarkable discoveries in the last 17 years have led to the delineation of the SDH complex deficiency syndrome and its multiple pathogenic branches. Here we provide an updated overview of SDH deficiency in order to raise awareness of its multiple connotations including nonneoplastic associations and pertinent features of the continually growing list of SDH-mutant tumors so as to better direct genetic counseling and predict prognosis.
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Affiliation(s)
- Mohamed Rizwan Haroon Al Rasheed
- From the Department of Pathology, University of Illinois at Chicago (Dr Haroon Al Rasheed); and the Department of Pathology, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois (Dr Tarjan)
| | - Gabor Tarjan
- From the Department of Pathology, University of Illinois at Chicago (Dr Haroon Al Rasheed); and the Department of Pathology, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois (Dr Tarjan)
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Pruksapong C, Satayasoontorn K. Alveolar soft part sarcoma of flexure tendon. J Surg Case Rep 2018; 2017:rjx240. [PMID: 29302306 PMCID: PMC5739037 DOI: 10.1093/jscr/rjx240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 11/15/2017] [Indexed: 11/29/2022] Open
Abstract
Alveolar soft part sarcoma (ASPS) is a very rare sarcoma, report <1% of all soft tissue tumor. Majority of cases were young adult and tumor occurred in lower extremities and trunk. Here, we present a case of 53-year-old Thai female with rapidly glowing mass over her right forearm. The magnetic resonance imaging scan demonstrated a hypervascular mass with multiple feeding vessels located in flexure tendon of right forearm. Ultrasound-guided biopsy revealed malignant poorly differentiated epithelioid neoplasm with clear cell feature and focal necrosis. Surgery may be considered the first-line treatment in localized ASPS and may potentially increase long-term survival. Complete surgical excision is the mainstay of treatment. TFE3 and Cathepsin K immunohistochemistry are useful in confirming a diagnosis of ASPS with a distinctive clinicopathologic features.
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Affiliation(s)
- Chatchai Pruksapong
- Department of Plastic and reconstructive, Phramongkutklao Hospital, Bangkok 10400, Thailand
| | - Kantang Satayasoontorn
- Department of Pathology and Laboratory Medicine, Phramongkutklao Hospital, Bangkok 10400,Thailand
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Roberts F, MacDuff E. An update on mesenchymal tumours of the orbit with an emphasis on the value of molecular/cytogenetic testing. Saudi J Ophthalmol 2018; 32:3-12. [PMID: 29755264 PMCID: PMC5944000 DOI: 10.1016/j.sjopt.2018.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/08/2018] [Accepted: 02/11/2018] [Indexed: 02/07/2023] Open
Abstract
Mesenchymal tumours of the orbit are uncommon. Beyond childhood primary sarcomas are extremely rare and the literature is limited to case reports and short case series. However there is a diverse assortment of benign and malignant soft tissue tumours that may involve the orbit. Techniques to identify tumour specific cytogenetic or molecular genetic abnormalities often resulting in over- expressed proteins are becoming an increasingly important ancillary technique for these tumours. This review focuses on 3 specific areas: 1. Orbital mesenchymal tumours where cytogenetics are important to reach the correct diagnosis. The majority of these are chromosomal translocations that often result in a fusion gene and protein product; 2. Orbital mesenchymal tumours where cytogenetics are important to identify patients who will do well versus those with a poorer prognosis. This is turn helps with therapeutic options. In some tumours e.g. synovial sarcoma the chromosomal translocations can occur with 2 different regions resulting in different fusion products that carry a different prognosis. Alternatively whilst the majority of alveolar rhadomyosarcomas are fusion positive a minority are fusion negative with a better prognosis; 3. Orbital mesenchymal tumours where the identification of specific cytogenetic abnormalities has resulted in overexpression of specfic proteins which are diagnostically useful biomarkers for immunohistochemistry.
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Affiliation(s)
- F. Roberts
- Department of Pathology, Queen Elizabeth University Hospital, Govan Road, Glasgow G51 4TF, United Kingdom
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Wei S, Henderson-Jackson E, Qian X, Bui MM. Soft Tissue Tumor Immunohistochemistry Update: Illustrative Examples of Diagnostic Pearls to Avoid Pitfalls. Arch Pathol Lab Med 2017; 141:1072-1091. [PMID: 28745570 DOI: 10.5858/arpa.2016-0417-ra] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
CONTEXT - Current 2013 World Health Organization classification of tumors of soft tissue arranges these tumors into 12 groups according to their histogenesis. Tumor behavior is classified as benign, intermediate (locally aggressive), intermediate (rarely metastasizing), and malignant. In our practice, a general approach to reaching a definitive diagnosis of soft tissue tumors is to first evaluate clinicoradiologic, histomorphologic, and cytomorphologic features of the tumor to generate some pertinent differential diagnoses. These include the potential line of histogenesis and whether the tumor is benign or malignant, and low or high grade. Although molecular/genetic testing is increasingly finding its applications in characterizing soft tissue tumors, currently immunohistochemistry still not only plays an indispensable role in defining tumor histogenesis, but also serves as a surrogate for underlining molecular/genetic alterations. Objective- To provide an overview focusing on the current concepts in the classification and diagnosis of soft tissue tumors, incorporating immunohistochemistry. This article uses examples to discuss how to use the traditional and new immunohistochemical markers for the diagnosis of soft tissue tumors. Practical diagnostic pearls, summary tables, and figures are used to show how to avoid diagnostic pitfalls. DATA SOURCES - Data were obtained from pertinent peer-reviewed English-language literature and the authors' first-hand experience as bone and soft tissue pathologists. CONCLUSIONS - -The ultimate goal for a pathologist is to render a specific diagnosis that provides diagnostic, prognostic, and therapeutic information to guide patient care. Immunohistochemistry is integral to the diagnosis and management of soft tissue tumors.
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Affiliation(s)
| | | | | | - Marilyn M Bui
- From the Department of Pathology, The University of Alabama at Birmingham, Birmingham (Dr Wei); the Departments of Anatomic Pathology (Drs Henderson-Jackson and Bui) and Sarcoma (Dr Bui), Moffitt Cancer Center, Tampa, Florida; Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, and Dana Farber Cancer Institute, Boston, Massachusetts (Dr Qian); and the Department of Cytopathology Fellowship, Morsani College of Medicine at the University of South Florida, Tampa (Dr Bui)
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Treatment of multifocal central nervous system AIDS-related Epstein Barr virus-associated malignant myopericytoma with bevacizumab. ACTA ACUST UNITED AC 2017. [DOI: 10.1016/j.jrid.2017.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Perspectives on Low-grade Sarcomas: The Extraordinary Contributions of Sharon W. Weiss, MD. Adv Anat Pathol 2017; 24:195-200. [PMID: 28291056 DOI: 10.1097/pap.0000000000000145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Soft-tissue pathology encompasses a wide spectrum of neoplasms that represent some of the most challenging and problematic tumors in surgical pathology. Owing to the intensive work of dedicated pathologists, this once esoteric field has become increasingly well defined. In this review, Dr Sharon Weiss' monumental contributions to low-grade sarcomas, including low-grade fibromyxoid sarcoma/so-called hyalinizing spindle cell tumor, atypical lipomatous tumor/well-differentiated liposarcoma and dedifferentiated liposarcoma, epithelioid hemangioendothelioma, and dermatofibrosarcoma protuberans with fibrosarcomatous transformation will be discussed.
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Ban LK, Tseng AH, Huang SH, Lee HHC. Low-grade fibromyxoid sarcoma of the external anal sphincter: a case report. World J Surg Oncol 2017; 15:109. [PMID: 28558780 PMCID: PMC5450221 DOI: 10.1186/s12957-017-1174-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 05/17/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Low-grade fibromyxoid sarcoma (LGFMS) is a rare soft tissue tumor that has a tendency to grow in the deep soft tissue of the trunk and extremities. Despite its benign appearance, the tumor has a high recurrence rate and metastatic potential. LGFMS in the perineal space is rare, and only a few cases have been reported. We present the first case of LGFMS to be located at the external anal sphincter. CASE PRESENTATION A 27-year-old male patient admitted to our Surgical Department with perianal pain and swollen for a year. The digital rectal examination revealed a perianal mass. Oral metronidazole and analgesia were prescribed on suspicion of perianal abscess failed to alleviate the symptom; hence, the patient was scheduled for surgery. Intraoperative diagnosis revealed an encapsulated tumor in the external anal sphincter that extended from the perianal region orally to the pararectal space. The results of immunohistochemistry (MUC4 staining) and FUS gene rearrangement by fluorescence in situ hybridization confirmed the diagnosis of LGFMS. CONCLUSIONS This case is unique in terms of the location of the rare soft tissue tumor. Although LGFMS is considered low grade, its unpredictable behavior necessitates a long-term follow-up.
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Affiliation(s)
- Lee-Kiat Ban
- Department of Surgery, Hsinchu Cathay General Hospital, Jhonghua Rd, Hsinchu, Taiwan.,College of Medical Technology, Nursing and Wellbeing, Yuanpei University of Medical Technology, Yuanpei Street, Hsinchu, Taiwan
| | - Ailun Heather Tseng
- Department of Surgery, Hsinchu Cathay General Hospital, Jhonghua Rd, Hsinchu, Taiwan
| | - Shih-Hung Huang
- Department of Pathology, Cathay General Hospital, Jen-Ai Road, Taipei, Taiwan
| | - Henry Hsin-Chung Lee
- Department of Surgery, Hsinchu Cathay General Hospital, Jhonghua Rd, Hsinchu, Taiwan. .,Graduate Institute of Translational and Interdisciplinary Medicine, College of Health Sciences and Technology, National Central University, Jung-Da Rd, Taoyuan, Taiwan. .,School of Medicine, Fu Jen Catholic University, Zhongzheng Rd, New Taipei, Taiwan.
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Pulford E, Hocking A, Griggs K, McEvoy J, Bonder C, Henderson DW, Klebe S. Vasculogenic mimicry in malignant mesothelioma: an experimental and immunohistochemical analysis. Pathology 2016; 48:650-659. [PMID: 27956272 DOI: 10.1016/j.pathol.2016.07.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 07/11/2016] [Accepted: 07/18/2016] [Indexed: 12/20/2022]
Abstract
Vasculogenic mimicry, the process in which cancer cells form angiomatoid structures independent of or in addition to host angiogenesis has been recorded in several otherwise non-endothelial malignant neoplasms. This study describes evidence of routine vascular mimicry by human mesothelioma cell lines in vitro, when the cell lines are cultured alone or co-cultured with human umbilical vascular endothelial cells, with the formation of angiomatoid tubular networks. Vasculogenic mimicry is also supported by immunohistochemical demonstration of human-specific anti-mitochondria antibody labelling of tumour-associated vasculature of human mesothelioma cells xenotransplanted into nude mice, and by evidence of vascular mimicry in some biopsy samples of human malignant mesotheliomas. These studies show mosaic interlacing of cells that co-label or label individually for immunohistochemical markers of endothelial and mesothelial differentiation. If vascular mimicry in mesothelioma can be characterised more fully, this may facilitate identification of more specific and targeted therapeutic approaches such as anti-angiogenesis in combination with chemotherapy and immunotherapy or other therapeutic approaches.
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Affiliation(s)
- Emily Pulford
- Department of Anatomical Pathology, Flinders University, Bedford Park, SA, Australia
| | - Ashleigh Hocking
- Department of Anatomical Pathology, Flinders University, Bedford Park, SA, Australia
| | - Kim Griggs
- Department of Anatomical Pathology, Flinders University, Bedford Park, SA, Australia
| | - James McEvoy
- Department of Anatomical Pathology, Flinders University, Bedford Park, SA, Australia
| | - Claudine Bonder
- Centre for Cancer Biology, University of South Australia, SA Pathology, and School of Medicine, University of Adelaide, Bedford Park, SA, Australia
| | - Douglas W Henderson
- Department of Anatomical Pathology, Flinders University, Bedford Park, SA, Australia; SA Pathology at Flinders Medical Centre, Bedford Park, SA, Australia
| | - Sonja Klebe
- Department of Anatomical Pathology, Flinders University, Bedford Park, SA, Australia; SA Pathology at Flinders Medical Centre, Bedford Park, SA, Australia.
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15
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[Protocol for the study of bone tumours and standardization of pathology reports]. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2016; 50:34-44. [PMID: 29179963 DOI: 10.1016/j.patol.2016.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 08/08/2016] [Accepted: 08/12/2016] [Indexed: 01/21/2023]
Abstract
Primary bone neoplasms represent a rare and heterogeneous group of mesenchymal tumours. The prevalence of benign and malignant tumours varies; the latter (sarcomas) account for less than 0.2% of all malignant tumours. Primary bone neoplasms are usually diagnosed and classified according to the criteria established and published by the World Health Organization (WHO 2013). These criteria are a result of advances in molecular pathology, which complements the histopathological diagnosis. Bone tumours should be diagnosed and treated in referral centers by a multidisciplinary team including pathologists, radiologists, orthopedic surgeons and oncologists. We analyzed different national and international protocols in order to provide a guide of recommendations for the improvement of pathological evaluation and management of bone tumours. We include specific recommendations for the pre-analytical, analytical, and post-analytical phases, as well as protocols for gross and microscopic pathology.
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16
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Black JO, Coffin CM, Parham DM, Hawkins DS, Speights RA, Spunt SL. Opportunities for Improvement in Pathology Reporting of Childhood Nonrhabdomyosarcoma Soft Tissue Sarcomas: A Report From Children's Oncology Group (COG) Study ARST0332. Am J Clin Pathol 2016; 146:328-38. [PMID: 27510717 DOI: 10.1093/ajcp/aqw114] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
OBJECTIVES Treatment of soft tissue tumors in young patients relies on the diagnostic information conveyed in the pathology report. We examined pathology reports from Children's Oncology Group ARST0332 for inclusion of data elements required in published guidelines. METHODS Pathology reports for 551 eligible patients were examined for required data elements defined by the College of American Pathologists, including tissue type, procedure, tumor site, tumor maximum diameter, macroscopic extent of tumor, histologic type, mitotic rate, extent of necrosis, tumor grade, margin status, use of ancillary studies, and pathologic stage. RESULTS Only 65 (12%) of 551 reports included all required data elements. Of reports containing synoptic templates, 57% were complete. CONCLUSIONS This study reveals significant opportunity to improve the quality of pathology reports in young patients with soft tissue tumors. Use of templates or checklists improves completeness of reports.
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Affiliation(s)
- Jennifer O Black
- From the Department of Pathology and Laboratory Medicine, Children's Hospital of Colorado, Aurora
| | - Cheryl M Coffin
- Department of Pathology, Microbiology, Immunology, Vanderbilt University, Nashville, TN
| | - David M Parham
- Department of Pathology and Laboratory Medicine, Children's Hospital, Los Angeles, CA
| | - Douglas S Hawkins
- Division of Hematology/Oncology, Seattle Children's Hospital, Seattle, WA
| | - Rose A Speights
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN
| | - Sheri L Spunt
- Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA
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17
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Alaggio R, Coffin CM. The Evolution of Pediatric Soft Tissue Sarcoma Classification in the Last 50 Years. Pediatr Dev Pathol 2015; 18:481-94. [PMID: 26701753 DOI: 10.2350/15-07-1666-misc.1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
This review discusses the history of the classification of soft tissue sarcomas in children and adolescents, the current transition toward integration of morphology and molecular genetics as new entities emerge, and future perspectives.
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Affiliation(s)
- Rita Alaggio
- 1 Department of Medicine-DIMED, Pathology Unit, University of Padova, Via Gabelli, 61 35124, Padova, Italy
| | - Cheryl M Coffin
- 2 Department of Pathology, Vanderbilt Medical Center, 1161 21st Avenue South, Nashville, TN 37232, USA
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