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Abe M, Hoshi N, Hoshi S, Hirabayashi K, Kikuta K, Hirozane T, Nakagawa R, Mizuno T, Nakamura H, Inoue K, Yamaguchi T. A Case of GATA3 Positive Pleomorphic Liposarcoma, Epithelioid Variant: A Diagnostic Pitfall. Case Rep Pathol 2023; 2023:9443027. [PMID: 37007224 PMCID: PMC10065854 DOI: 10.1155/2023/9443027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/22/2023] [Accepted: 02/24/2023] [Indexed: 04/04/2023] Open
Abstract
Pleomorphic liposarcoma is a rare malignant adipocytic tumor showing undifferentiated pleomorphic sarcoma morphology with various degrees of epithelioid features. It is sometimes difficult to distinguish from carcinoma metastasis. Immunohistochemical panel is very important for differential diagnosis; however, there is a risk that unexpected staining could lead to misinterpretation. We report a pleomorphic liposarcoma, epithelioid variant, in an 88-year-old man, with tricky-positive staining for GATA3. Histological examination revealed a tumor with epithelioid morphology. The tumor consists of solid sheets of epithelioid tumor cells with focal aggregates of pleomorphic lipoblasts. Immunohistochemically, the adipocytic tumor cell areas were positive for S100 protein, and the epithelioid tumor cells showed CAM 5.2 positivity. GATA3 was diffusely positive. The combination of CAM 5.2 and GATA3 staining suggested the possibility of metastatic cancer, but systemic clinical examinations did not detect any presence of a primary tumor, including urinary bladder, breasts, and salivary glands. The pathological diagnosis of pleomorphic liposarcoma, epithelioid variant, was made because of the presence of malignant lipoblasts. Our report may contribute for differential diagnosis of pleomorphic liposarcoma, epithelioid variant, with unexpected positive immunoreaction for GATA3.
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Affiliation(s)
- Makoto Abe
- Department of Pathology, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Nobuo Hoshi
- Department of Pathology, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Sayuri Hoshi
- Department of Pathology, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Kaoru Hirabayashi
- Department of Pathology, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Kazutaka Kikuta
- Department of Musculoskeletal Oncology and Orthopaedic Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Toru Hirozane
- Department of Musculoskeletal Oncology and Orthopaedic Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Rumi Nakagawa
- Department of Musculoskeletal Oncology and Orthopaedic Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Tsukasa Mizuno
- Department of Musculoskeletal Oncology and Orthopaedic Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Hiroshi Nakamura
- Department of Musculoskeletal Oncology and Orthopaedic Surgery, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Koichi Inoue
- Department of Radiation Oncology and Image-Applied Therapy, Tochigi Cancer Center, 4-9-13, Yohnan, Utsunomiya, 320-0834 Tochigi, Japan
| | - Takehiko Yamaguchi
- Department of Pathology, Nikko Medical Center, Dokkyo Medical University, 145-1 Moritomo, Nikko, 321-1298 Tochigi, Japan
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102
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Quinn C, Maguire A, Rakha E. Pitfalls in breast pathology. Histopathology 2023; 82:140-161. [PMID: 36482276 PMCID: PMC10107929 DOI: 10.1111/his.14799] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/11/2022] [Accepted: 09/12/2022] [Indexed: 12/13/2022]
Abstract
Accurate pathological diagnosis is the cornerstone of optimal clinical management for patients with breast disease. As non-operative diagnosis has now become the standard of care, histopathologists encounter the daily challenge of making definitive diagnoses on limited breast core needle biopsy (CNB) material. CNB samples are carefully evaluated using microscopic examination of haematoxylin and eosin (H&E)-stained slides and supportive immunohistochemistry (IHC), providing the necessary information to inform the next steps in the patient care pathway. Some entities may be difficult to distinguish on small tissue samples, and if there is uncertainty a diagnostic excision biopsy should be recommended. This review discusses (1) benign breast lesions that may mimic malignancy, (2) malignant conditions that may be misinterpreted as benign, (3) malignant conditions that may be incorrectly diagnosed as primary breast carcinoma, and (4) some IHC pitfalls. The aim of the review is to raise awareness of potential pitfalls in the interpretation of breast lesions that may lead to underdiagnosis, overdiagnosis, or incorrect classification of malignancy with potential adverse outcomes for individual patients.
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Affiliation(s)
- Cecily Quinn
- Irish National Breast Screening Programme and Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | - Aoife Maguire
- Irish National Breast Screening Programme and Department of Histopathology, St. Vincent's University Hospital, Dublin, Ireland
| | - Emad Rakha
- Department of Histopathology, The University of Nottingham, Nottingham City Hospital, Nottingham, UK
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103
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Hagag S, Kodous A, Shaaban HA. Molecular and Immunohistochemical Alterations in Breast Cancer Patients in Upper Egypt. Rep Biochem Mol Biol 2023; 11:532-546. [PMID: 37131903 PMCID: PMC10149126 DOI: 10.52547/rbmb.11.4.532] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 10/30/2022] [Indexed: 05/04/2023]
Abstract
Background Breast cancer (BC) plays a major public health in Egyptian woman. In Upper Egypt, there is an increase in incidence of BC compared to other Egyptian areas. Triple-negative BC, estrogen receptor (ER)-negative, progesterone receptor (PR)-negative, and HER2-neu-negative, is a high-risk BC that lacks the benefit of specific therapy that targets these proteins. Accurate determination of Caveolin-1(Cav-1), Caveolin-2 (Cav-2) and HER-2/neu status have become of major clinical significance in BC by focusing about its role as a tumor marker for response to different therapies. Methods The present study was performed on 73 female BC patients in the South Egypt Cancer Institute. Blood samples were used for Cav-1, Cav-2, and HER-2/neu genes amplification and expression. In addition, immunohistological analysis of mammaglobin, GATA3, ER, PR, and HER-2/neu was done. Results There was a statistically significant association between Cav-1, 2 and HER-2/neu genes expression and the age of patients (P< 0.001). There are increase in the level of Cav-1, 2 and increase in HER-2/neu mRNA expression in groups treated with chemotherapy and group treated with both chemotherapy and radiotherapy compared to each group baseline level of genes mRNA expression before treatment. On the contrary, the group treated with chemotherapy, radiotherapy and hormonal therapy revealed increase on the level of Cav-1, 2 and HER-2/neu mRNA expression when compared with their baseline for the same patients before treatment. Conclusions Noninvasive molecular biomarkers such as Cav-1 and Cav-2 have been proposed for use in the diagnosis and prognosis for women with BC.
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Affiliation(s)
- Sanaa Hagag
- Radiation Biology department, National Center for Radiation Research & Technology, Egyptian Atomic Energy Authority, Nasr City, 8029, Cairo, Egypt.
| | - Ahmad Kodous
- Radiation Biology department, National Center for Radiation Research & Technology, Egyptian Atomic Energy Authority, Nasr City, 8029, Cairo, Egypt.
- Corresponding author: Ahmad Kodous; Tel: +20 1144496363; E-mail:
| | - Hebat Aallh Shaaban
- Pathology department, National Cancer Institute, Cairo University, Giza, Egypt.
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104
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Williamson SR, Hes O, Trpkov K, Aggarwal A, Satapathy A, Mishra S, Sharma S, Sangoi A, Cheng L, Akgul M, Idrees M, Levin A, Sadasivan S, San Miguel Fraile P, Rogala J, Comperat E, Berney DM, Bulimbasic S, McKenney JK, Jha S, Sampat NY, Mohanty SK. Low-grade oncocytic tumour of the kidney is characterised by genetic alterations of TSC1, TSC2, MTOR or PIK3CA and consistent GATA3 positivity. Histopathology 2023; 82:296-304. [PMID: 36208048 DOI: 10.1111/his.14816] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/11/2022] [Accepted: 10/06/2022] [Indexed: 12/13/2022]
Abstract
Low-grade oncocytic tumour (LOT) of the kidney has recently emerged as a potential novel tumour type. Despite similarity to oncocytoma or eosinophilic chromophobe renal cell carcinoma, it shows diffuse keratin 7 immunohistochemistry (IHC) and negative KIT (CD117), which differs from both. We aimed to identify the molecular characteristics of these tumours. Seventeen tumours (one male, 16 female, nine previously published) fitting the original description of this entity (solid eosinophilic cell morphology, often with areas of tumour cells loosely stretched in oedematous stroma, and the above IHC features) were analysed with a next-generation sequencing panel of 324 cancer-associated genes from formalin-fixed, paraffin-embedded tissue. All tumours harboured at least one alteration in either TSC1 (n = 7, 41%), TSC2 (n = 2, 12%), MTOR (n = 5, 29%) or PIK3CA (n = 4, 24%). Four tumours harboured a second alteration, including two NF2, one each in conjunction with MTOR and TSC2 alterations, one PTEN with TSC1 alteration and one tumour with both MTOR and TSC1 alterations. No other renal cancer-related or recurring gene alterations were identified. In addition to the previously described IHC findings, 16 of 16 were positive for GATA3. Eleven patients with follow-up had no metastases or recurrent tumours. Recurrent tuberous sclerosis/MTOR pathway gene alterations in LOT support its consideration as a distinct morphological, immunohistochemical and genetic entity. PIK3CA is another pathway member that may be altered in these tumours. Further study will be necessary to determine whether tumour behaviour or syndromic associations differ from those of oncocytoma and chromophobe carcinoma, warranting different clinical consideration.
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Affiliation(s)
- Sean R Williamson
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Ondrej Hes
- Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Kiril Trpkov
- Department of Pathology and Laboratory Medicine, Alberta Precision Labs and University of Calgary, Calgary, Alberta, Canada
| | | | | | - Sourav Mishra
- Advanced Medical Research Institute, Bhubaneswar, Odisha, India
| | | | - Ankur Sangoi
- Department of Pathology, El Camino Hospital, Mountain View, CA, USA
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mahmut Akgul
- Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | - Muhammad Idrees
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Albert Levin
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | - Sudha Sadasivan
- Department of Public Health Sciences, Henry Ford Hospital, Detroit, MI, USA
| | | | | | - Eva Comperat
- Department of Pathology, Hôpital Tenon, Sorbonne University, Paris VI, Paris, France
| | - Daniel M Berney
- Department of Cellular Pathology, Bartshealth NHS Trust and Barts Cancer Institute, Queen Mary University of London, London, UK
| | | | - Jesse K McKenney
- Department of Pathology, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Shilpy Jha
- Advanced Medical Research Institute, Bhubaneswar, Odisha, India
| | - Nakul Y Sampat
- Advanced Medical Research Institute, Bhubaneswar, Odisha, India
| | - Sambit K Mohanty
- CORE Diagnostics, Gurgaon, Haryana, India.,Advanced Medical Research Institute, Bhubaneswar, Odisha, India
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105
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Miyauchi M, Akashi T, Furukawa A, Uchida K, Tamura T, Ando N, Kirimura S, Shintaku H, Yamamoto K, Ito T, Miura K, Kayamori K, Ariizumi Y, Asakage T, Kudo A, Tanabe M, Fujii Y, Ishibashi H, Okubo K, Murakami M, Yamada T, Takemoto A, Bae Y, Eishi Y, Ohashi K. PHOX2B is a Sensitive and Specific Marker for the Histopathological Diagnosis of Pheochromocytoma and Paraganglioma. Endocr Pathol 2022; 33:506-518. [PMID: 36029394 DOI: 10.1007/s12022-022-09730-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 11/28/2022]
Abstract
Pheochromocytomas (PCCs) and paragangliomas (PGLs) are non-epithelial neuroendocrine neoplasms originating from the adrenal medulla and paraganglion of the sympathetic and parasympathetic nervous system, respectively. PCCs and PGLs show histological similarities with other epithelial neuroendocrine neoplasms and olfactory neuroblastomas (ONBs), and the differential diagnosis of PGLs is particularly difficult. Therefore, we compared the sensitivity of PHOX2A, PHOX2B, and tyrosine hydroxylase (TH) in the histopathological diagnosis of PCCs and PGLs immunohistochemically using the tissue microarrays of 297 neoplasms including PCCs, PGLs, neuroblastomas, ganglioneuromas, epithelial neuroendocrine neoplasms, and ONBs. Using cutoff values of 25%, 5%, and 5% of tumor cells expressing PHOX2A, PHOX2B, and TH, respectively, as positive, 40 of 51 PCCs, 32 of 33 parasympathetic/head and neck PGLs (HNPGLs), 17 of 19 sympathetic/thoracoabdominal PGLs (TAPGLs), and 12 of 152 epithelial neuroendocrine neoplasms, including 123 well-differentiated and 29 poorly differentiated neuroendocrine neoplasms, were PHOX2A-positive. All 51 PCCs, 33 HNPGLs, and 19 TAPGLs were PHOX2B-positive, while all 152 epithelial neuroendocrine neoplasms were PHOX2B-negative. Moreover, 50 of 51 PCCs, 13 of 33 HNPGLs, all TAPGLs, and 12 of 152 epithelial neuroendocrine neoplasms were TH-positive. All ONBs were negative for PHOX2A, PHOX2B, and TH. PHOX2B was the most sensitive and specific diagnostic marker for PCCs and PGLs among PHOX2A, PHOX2B, and TH. PHOX2B can facilitate identification of PCCs and PGLs from epithelial neuroendocrine neoplasms and ONBs, especially in the case of HNPGLs, in which TH is often negative.
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Affiliation(s)
- Minami Miyauchi
- Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takumi Akashi
- Department of Diagnostic Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45, Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan.
| | - Asuka Furukawa
- Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keisuke Uchida
- Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Tomoki Tamura
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Noboru Ando
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Susumu Kirimura
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Hiroshi Shintaku
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Kurara Yamamoto
- Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Ito
- Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Miura
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Kou Kayamori
- Department of Oral Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yosuke Ariizumi
- Department of Head and Neck Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahiro Asakage
- Department of Head and Neck Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Kudo
- Department of Hepatobiliary and Pancreatic Surgery, Tokyo Medical and Dental University Hospital, Tokyo, Japan
| | - Minoru Tanabe
- Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Thoracic Surgery, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hironori Ishibashi
- Department of Urology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Okubo
- Department of Urology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Masanori Murakami
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Yamada
- Department of Molecular Endocrinology and Metabolism, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Akira Takemoto
- Division of Surgical Pathology, Tokyo Medical and Dental University Hospital, Tokyo, Japan
- Bioresource Research Center, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yuan Bae
- Department of Pathology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - Yoshinobu Eishi
- Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kenichi Ohashi
- Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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106
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Montella L, Riccio V, Ruocco R, Di Marino L, Ambrosino A, Capuozzo A, Della Corte CM, Esposito A, Coppola P, Liguori C, Facchini G, Ronchi A, Ruggiero A. Occult primary breast cancer and cognates: Atypical today's cases inside a centenarian history. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2022. [DOI: 10.1016/j.cpccr.2022.100191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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107
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Rohra P, Ding C, Yoon EC, Gan Q. A pilot study: Comparison of TRPS1 and GATA3 immunoperoxidase staining using cytologic smears in entities reportedly positive for GATA3. Cancer Cytopathol 2022; 130:930-938. [PMID: 35790088 DOI: 10.1002/cncy.22623] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 06/10/2022] [Accepted: 06/20/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Metastatic breast carcinoma (mBC) is frequently encountered and may be challenging to diagnose as the tumor cells can morphologically resemble carcinomas of other primary origins. An additional challenge is that direct smears are often the only sample type available for immunostaining studies in cytology. Trichorhinophalangeal syndrome GATA-binding type 1 1 (TRPS1) is a highly sensitive marker for BC compared to the commonly used marker GATA3, especially in triple-negative BC (TNBC), in histologic samples. However, its sensitivity and specificity in mBC and other GATA3-positive tumors have not been studied. METHODS The authors identified the following cytology cases: 37 GATA3-positive mBC cases and 19 available cases that were deemed mBC but were GATA3-negative during the original case workup and five cases of each of eight epithelioid entities known to have high rates of GATA3 positivity and commonly seen in cytology practice. Immunostainings of TRPS1 and GATA3 were performed on the chosen smears following standard protocols. RESULTS TRPS1 was positive in all 37 GATA3-positive mBC cases and in 18 of the 19 GATA3-negative mBC cases. TRPS1 was negative in all five of the seven frequently GATA3-positive epithelioid entities, with the exception of salivary duct carcinomas where GATA3 was positive in a rate ranging 60%-100% among them. CONCLUSIONS TRPS1 is as sensitive as GATA3 in GATA3-positive mBC and is more sensitive than GATA3 in TNBC. TRPS1 is negative in most GATA3-positive nonbreast tumors. Thus, the combination of TRPS1 and GATA3 could be used to differentiate breast primary from others in most situations.
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Affiliation(s)
- Prih Rohra
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Cady Ding
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Esther C Yoon
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Qiong Gan
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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108
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Li Y, Zhang L, Yu H, Xin X, He J, Yao Y, Liu B, Li R, Xie L. Case Report: Small intestinal metastatic breast cancer: A case report and literature review. Front Oncol 2022; 12:900832. [PMID: 36505863 PMCID: PMC9732937 DOI: 10.3389/fonc.2022.900832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 10/27/2022] [Indexed: 11/27/2022] Open
Abstract
Breast cancer is considered a malignant tumor with the highest incidence among women and is prone to develop distant metastasis. Small intestinal metastasis of breast cancer, however, is relatively rare. This case report describes a 49-year-old Chinese female patient who presented with small intestinal obstruction and was diagnosed with lobular breast cancer with small intestinal and contralateral breast metastasis. Clinical manifestations, clinicopathological features and potential mechanisms of metastasis, along with diagnosis and treatment, are discussed with a review of the relevant literature. Although small intestinal metastasis is rare in breast cancer, we should keep high alert on the possibility of gastrointestinal metastasis when treating lobular breast cancer patients.
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Affiliation(s)
- Yishan Li
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Lianru Zhang
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Huiping Yu
- Department of Pathology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiaoyan Xin
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Jian He
- Departments of Nuclear Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Yongzhong Yao
- Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Baorui Liu
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Rutian Li
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Li Xie
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
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Jovino Neves Santos T, De Brot M, Martins Bezerra S, Rodrigues Buniatti S, Piana de Andrade V, Soares FA, Alves de Castro JV, Bueno de Toledo Osório CA. Role of GATA3 as a potential adjunct marker in the differential diagnosis of Paget’s disease of the nipple. SURGICAL AND EXPERIMENTAL PATHOLOGY 2022. [DOI: 10.1186/s42047-022-00125-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Abstract
Aims
Paget’s disease of the nipple (PDN) is a rare type of cancer of the nipple-areola complex. We examined GATA3 protein expression in PDN to determine its potential value as an adjunct marker in the differential diagnosis with other nipple lesions.
Methods and results
Chart review documented clinicopathological data. H&E slides were re-evaluated and immunohistochemistry (IHC) for GATA3 was performed. Amongst 3614 breast cancer patients, 74 had PDN and 41 cases were selected for our study (mean age, 55 years). Amid PDN cases, 4 (10%) patients showed PDN alone, 22 (65%) had an underlying ductal carcinoma in situ and 15 (37%) had invasive breast carcinomas (IBC), including 11 invasive carcinoma of no special type, 2 lobular, 1 mucinous and 1 micropapillary carcinoma. Additionally, 9 cancers were classified as luminal B, 4 as HER2 overexpression and 2 as luminal A. GATA3 expression was detected in all 41 PDN cases and in all underlying cancers. Furthermore, IHC for S-100, HMB45 and Melan-A was performed in PDN-only, ensuing negative results. Positivity for cytokeratin 7 or AE1/AE3 was demonstrated in all cases and HER2 overexpression was seen in 2/4 lesions. GATA3 expression was noted in all lesions, including one CK7-negative case.
Conclusion
Our findings indicate that GATA3 is consistently expressed in PDN. Although not entirely specific, positivity for GATA3 reinforces the non-melanocytic nature of PDN and its mammary origin, thus representing a potential adjunct tool for the diagnosis of PDN in tricky situations, particularly PDN variants or unusual lesions.
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110
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Chen C, Hang J, Chen Y, Lin S, Chiu H, Hsu C, Lai C, Yang C. The diagnostic utility of trichorhinophalangeal syndrome type 1 immunohistochemistry for metastatic breast carcinoma in effusion cytology specimens. Cancer Cytopathol 2022; 131:226-233. [PMID: 36399408 DOI: 10.1002/cncy.22663] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 09/11/2022] [Accepted: 10/04/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Trichorhinophalangeal syndrome type 1 (TRPS1) is a novel immunohistochemical marker with excellent performance in distinguishing breast carcinoma from other cancers in surgical specimens. The aim of this study was to evaluate the diagnostic utility of TRPS1 compared with GATA3 for metastatic breast carcinoma in effusion cytology specimens. METHODS In total, 91 cell blocks of malignant effusion specimens, including 47 metastatic breast carcinomas (nine triple-negative breast carcinomas [TNBCs] and 38 non-TNBCs) and 44 nonmammary malignancies, were selected for TRPS1 and GATA3 immunohistochemistry. Modified H scores ≥ 200 were considered positive staining. RESULTS The positive rate of TRPS1 was similar between TNBC and non-TNBC (77.8% vs 73.3%, p = .802), whereas the positive rate of GATA3 was lower in TNBC than in non-TNBC (66.7% vs 89.5%, p = .087). The positive rate of TRPS1 was significantly higher in breast carcinoma than in urothelial carcinoma (74.5% vs 0%, p < .001), whereas the positive rate of GATA3 showed no difference between these two (85.1% vs 85.7%, p = .956). Notably, diffuse and strong aberrant expression of TRPS1 was observed in one lung adenocarcinoma and one serous adenocarcinoma in this series. The overall sensitivity, specificity, positive predictive value, and negative predictive value of TRPS1 immunohistochemistry for breast carcinoma were 74.5%, 95.5%, 94.6%, and 77.8%, respectively. CONCLUSION TRPS1 is a sensitive and specific marker for metastatic breast cancer in serous effusion cell-block specimens. It shows superior sensitivity and specificity compared with GATA3, especially in the TNBC setting and for excluding urothelial carcinoma.
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Affiliation(s)
- Chih‐Jung Chen
- Department of Pathology and Laboratory Medicine Taichung Veterans General Hospital Taichung Taiwan
- School of Medicine Chung Shan Medical University Taichung Taiwan
- Department of Post‐Baccalaureate Medicine College of Medicine National Chung Hsing University Taichung Taiwan
| | - Jen‐Fan Hang
- Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital Taipei Taiwan
- School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
- Institute of Clinical Medicine National Yang Ming Chiao Tung University Taipei Taiwan
| | - Yun‐An Chen
- Department of Pathology and Laboratory Medicine Taichung Veterans General Hospital Taichung Taiwan
| | - Shu‐Jiuan Lin
- Department of Pathology and Laboratory Medicine Taichung Veterans General Hospital Taichung Taiwan
| | - Hung‐Ming Chiu
- Department of Pathology and Laboratory Medicine Taichung Veterans General Hospital Taichung Taiwan
| | - Chih‐Yi Hsu
- Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital Taipei Taiwan
- School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
| | - Chiung‐Ru Lai
- Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital Taipei Taiwan
- School of Medicine National Yang Ming Chiao Tung University Taipei Taiwan
| | - Chi‐Shun Yang
- Department of Pathology and Laboratory Medicine Taichung Veterans General Hospital Taichung Taiwan
- Department of Medical Laboratory Science and Biotechnology Central Taiwan University of Science and Technology Taichung Taiwan
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111
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Contemporary Clinical Definitions, Differential Diagnosis, and Novel Predictive Tools for Renal Cell Carcinoma. Biomedicines 2022; 10:biomedicines10112926. [PMID: 36428491 PMCID: PMC9687297 DOI: 10.3390/biomedicines10112926] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/26/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022] Open
Abstract
Despite significant progress regarding clinical detection/imaging evaluation modalities and genetic/molecular characterization of pathogenesis, advanced renal cell carcinoma (RCC) remains an incurable disease and overall RCC mortality has been steadily rising for decades. Concomitantly, clinical definitions have been greatly nuanced and refined. RCCs are currently viewed as a heterogeneous series of cancers, with the same anatomical origin, but fundamentally different metabolisms and clinical behaviors. Thus, RCC pathological diagnosis/subtyping guidelines have become increasingly intricate and cumbersome, routinely requiring ancillary studies, mainly immunohistochemistry. Meanwhile, RCC-associated-antigen targeted systemic therapy has been greatly diversified and emerging, novel clinical applications for RCC immunotherapy have already reported significant survival benefits, at least in the adjuvant setting. Even so, systemically disseminated RCCs still associate very poor clinical outcomes, with currently available therapeutic modalities only being able to prolong survival. In lack of a definitive cure for advanced RCCs, integration of the amounting scientific knowledge regarding RCC pathogenesis into RCC clinical management has been paramount for improving patient outcomes. The current review aims to offer an integrative perspective regarding contemporary RCC clinical definitions, proper RCC clinical work-up at initial diagnosis (semiology and multimodal imaging), RCC pathological evaluation, differential diagnosis/subtyping protocols, and novel clinical tools for RCC screening, risk stratification and therapeutic response prediction.
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112
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Wang T, Ding X, Huang X, Ye J, Li H, Cao S, Gao Y, Ma X, Huang Q, Wang B. Papillary renal neoplasm with reverse polarity-a comparative study with CCPRCC, OPRCC, and PRCC1. Hum Pathol 2022; 129:60-70. [PMID: 35977593 DOI: 10.1016/j.humpath.2022.07.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/12/2022] [Indexed: 12/14/2022]
Abstract
Papillary renal neoplasm with reverse polarity (PRNRP) is a newly defined entity with distinct histomorphology and recurrent KRAS mutation. In this study, we aimed to identify and analyze the clinicopathological, immunohistochemical (IHC), and molecular features of PRNRP in our center and to evaluate its differential diagnosis with other tumors with which it is easily confused: clear cell papillary renal cell carcinoma (CCPRCC), oncocytic papillary renal cell carcinoma (OPRCC), and papillary renal cell carcinoma type 1 (PRCC1). Nephrectomy specimens of PRNRP (n = 15), CCPRCC (n = 11), and OPRCC (n = 12) were retrieved from our pathology archives. We also selected typical cases of PRCC1 (n = 15) as a control group. PRNRP accounted for 3.05% (15/492) of all PRCC cases at our center. The median follow-up period was 41.3 months. All PRNRP cases were pT1N0M0, and only one involved recurrence (1 year after surgery). IHC analysis showed diffuse staining of CK7, EMA, and GATA3 but weak or negative staining of CD10, CD117, p504s, and vimentin in the PRNRP samples and distinctive IHC features in the other three tumor types. KRAS mutation was detected in 4/10 PRNRP cases. Among the 40 most commonly mutated genes identified, 5 (BCLAF1, PDE4DIP, NCOR1, PARP4, and PABPC1) have actionable alterations. Our study supports the suggestion that PRNRP is an entity distinct from CCPRCC, OPRCC, and PRCC1.
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Affiliation(s)
- Tao Wang
- Department of Urology, The Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100039, China; Medical School of Chinese People's Liberation Army (PLA), Beijing, 100039, China
| | - Xiaohui Ding
- Department of Pathology, The First Medical Centre, Chinese PLA General Hospital, Beijing, 100039, China
| | - Xing Huang
- Department of Urology, The Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100039, China; Medical School of Chinese People's Liberation Army (PLA), Beijing, 100039, China
| | - Jiali Ye
- Department of Urology, The Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100039, China; Medical School of Chinese People's Liberation Army (PLA), Beijing, 100039, China
| | - Huaikang Li
- Department of Urology, The Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100039, China; Medical School of Chinese People's Liberation Army (PLA), Beijing, 100039, China
| | - Shouqing Cao
- Department of Urology, The Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100039, China; Medical School of Chinese People's Liberation Army (PLA), Beijing, 100039, China
| | - Yu Gao
- Department of Urology, The Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100039, China
| | - Xin Ma
- Department of Urology, The Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100039, China.
| | - Qingbo Huang
- Department of Urology, The Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100039, China.
| | - Baojun Wang
- Department of Urology, The Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, 100039, China.
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Kaczorowski M, Chłopek M, Kruczak A, Ryś J, Lasota J, Miettinen M. PRAME Expression in Cancer. A Systematic Immunohistochemical Study of >5800 Epithelial and Nonepithelial Tumors. Am J Surg Pathol 2022; 46:1467-1476. [PMID: 35973038 PMCID: PMC9588667 DOI: 10.1097/pas.0000000000001944] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Preferentially expressed antigen in melanoma (PRAME) is considered a useful marker in the differential diagnosis between malignant melanoma and its melanocytic mimics. Recently PRAME expression was documented in nonmelanocytic tumors, but much of the data are based on mRNA studies. This investigation evaluated PRAME expression in the spectrum of normal tissues and >5800 human tumors using immunohistochemistry and EP461 monoclonal antibody. In normal tissues, PRAME was expressed in the testis and proliferative endometrium. In tumors, PRAME was variably expressed in malignancies of different lineages. Among epithelial tumors, >50% of PRAME-positive lesions were found among endometrial carcinomas (82%), uterine serous carcinomas (82%), uterine carcinosarcomas (60%), ovarian clear cell carcinomas (90%), ovarian serous carcinomas (63%), adenoid cystic carcinomas (81%), seminomas (78%), thymic carcinomas (75%), and basal cell carcinomas (62%). In mesenchymal and neuroectodermal malignancies, PRAME was frequently expressed in synovial sarcoma (71%), myxoid liposarcoma (76%), neuroblastoma (61%) and metastatic melanoma (87%). Also, PRAME was consistently expressed in 4 melanomas that lacked all melanoma markers including S100 protein and SOX10 but harbored typical for melanoma BRAF or NRAS driver mutations. However, strong and diffuse PRAME immunoreactivity was seen in many types of nonmelanocytic poorly differentiated carcinomas and sarcomas. Based on this study, PRAME is a relatively unspecific immunohistochemical marker, which limits its use in diagnostic surgical pathology. However, immunohistochemistry is a reliable and unexpensive method useful in detecting PRAME-positive malignancies for potential immunotherapy.
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Affiliation(s)
- Maciej Kaczorowski
- Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland, USA
- Department of Clinical and Experimental Pathology, Wroclaw Medical University, Wrocław, Poland
| | - Małgorzata Chłopek
- Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland, USA
| | - Anna Kruczak
- Department of Tumor Pathology, Maria Skłodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland
| | - Janusz Ryś
- Department of Tumor Pathology, Maria Skłodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland
| | - Jerzy Lasota
- Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland, USA
| | - Markku Miettinen
- Laboratory of Pathology, National Cancer Institute, Bethesda, Maryland, USA
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Akgul M, Humble R, Osme A, Yuce S, Kocak EN, Najafzadeh P, Sangoi A, Pattnaik N, Mishra S, Sharma S, Shaker N, Kaushal S, Baisakh M, Lightle AR, Balzer BL, Xiao GQ, MacLennan GT, Osunkoya AO, Parwani A, Cheng L, Bellizzi A, Mohanty SK. GATA3 expression in clear cell adenocarcinoma of the lower urinary tract: a potential diagnostic pitfall. Diagn Pathol 2022; 17:87. [PMID: 36320040 PMCID: PMC9623977 DOI: 10.1186/s13000-022-01269-6] [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: 02/10/2022] [Revised: 10/06/2022] [Accepted: 10/07/2022] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Clear cell adenocarcinoma of the lower urinary tract (CCACLUT) is a rare primary malignant neoplasm with heterogenous morphology. There is a paucity of data in the literature regarding its immunohistochemical profile. METHODS The immunohistochemical features (extent and intensity) of a multinational cohort of CCACLUT were evaluated with comparison between clear cell adenocarcinoma of the female genital tract (CCACFGT, tissue microarray) and nephrogenic adenoma (NA). RESULTS 33 CCACLUT (24 female, 9 male; mean age 59 years) were collected. CCACLUT most commonly arose from the urinary bladder (26/33, 78%), particularly from the trigone (10/33, 30.3%) followed by the urethra (8/33, 22%). All 12 NA cases were located at the urinary bladder, whereas the most common CCACFGT location was the ovary (29/56, 52%). None of the CCACLUT patients had, intestinal metaplasia, NA, or urothelial carcinoma. One patient had concurrent endometriosis of the sigmoid colon. Most frequently observed morphology in CCACLUT was papillary/tubulocystic (9/3; 27.3%), followed by papillary/tubular (6/33; 18.2%) and papillary/solid (5/33; 15.2%). GATA3 expression was significantly higher in CCACLUT (18/33, 54.5%) and NA (6/12, 50%), when compared to CCACFGT cases 6/56, 11.7%)(p = 0.001 and p = 0.022, respectively). The extent of GATA3 was significantly higher in CCACLUT group (19.2 ± 16.6%) than the other groups (9.6 ± 22.5% in NA and 2.6 ± 9% in CCACFGT group) (p = 0.001). 4/33 patients (12.1) had weak, 10/33 patients (30.3%) had moderate, and 4/33 patients (12.1%) had strong GATA3 intensity in CCACLUT group. In NA group, one patient (8.3%, 1/12) had weak, one patient (8.3%, 1/12) had moderate and 4 patients (33.3%, 4/12) had strong GATA3 intensity. Most cases (CCACLUT 29/33, 88%; NA 11/12, 92%; CCACFGT 46/56, 82.1%) had positive Napsin A expression, by which CCACLUT had significantly more cases with Napsin A expression (p = 0.034). p63 was consistently negative in all cases (30/33 (91.9%) CCACLUT; 12/12 (100%) NA; 42/56 (75%) CCACFGT. Ki67 (MIB) proliferation index was significantly higher in CCACLUT group (54.6 ± 21%) when compared to NA group (4.5 ± 2.7%) and CCACFGT group (35.5 ± 25.8%) (p = 0.001). CONCLUSION CCACLUT has consistent GATA3 expression, which may cause challenge in the diagnosis of urothelial carcinoma but can be used to distinguish CCACLUT from CCACFGT.
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Affiliation(s)
- Mahmut Akgul
- grid.413558.e0000 0001 0427 8745Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | - Robert Humble
- grid.214572.70000 0004 1936 8294Department of Pathology and Laboratory Medicine, University of Iowa, Iowa City, IA, USA
| | - Abdullah Osme
- grid.443867.a0000 0000 9149 4843Department of Pathology and Laboratory Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Servet Yuce
- grid.9601.e0000 0001 2166 6619Department of Public Health, Istanbul University School of Medicine, Istanbul, Turkey
| | - Elif N. Kocak
- grid.9601.e0000 0001 2166 6619Department of Public Health, Istanbul University School of Medicine, Istanbul, Turkey
| | - Parisa Najafzadeh
- grid.42505.360000 0001 2156 6853Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Ankur Sangoi
- grid.461407.00000 0000 8933 2589Department of Pathology, El Camino Hospital, Mountain View, CA, USA
| | | | | | | | - Nada Shaker
- grid.412332.50000 0001 1545 0811Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | | | | | - Andrea R. Lightle
- grid.413558.e0000 0001 0427 8745Department of Pathology and Laboratory Medicine, Albany Medical Center, Albany, NY, USA
| | - Bonnie L. Balzer
- grid.50956.3f0000 0001 2152 9905Department of Pathology, Cedars-Sinai Hospital, Los Angeles, CA, USA
| | - Guang-Qian Xiao
- grid.42505.360000 0001 2156 6853Department of Pathology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Gregory T. MacLennan
- grid.443867.a0000 0000 9149 4843Department of Pathology and Laboratory Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Adeboye O. Osunkoya
- grid.189967.80000 0001 0941 6502Department of Pathology and Laboratory Medicine, Emory University, Atlanta, GA, USA
| | - Anil Parwani
- grid.412332.50000 0001 1545 0811Department of Pathology and Laboratory Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Liang Cheng
- grid.257410.50000 0004 0413 3089Department of Pathology and Urology, Indiana University, Indianapolis, IN, USA
| | - Andrew Bellizzi
- grid.214572.70000 0004 1936 8294Department of Pathology and Laboratory Medicine, University of Iowa, Iowa City, IA, USA
| | - Sambit K. Mohanty
- DCP, Core Diagnostics, Gurgaon, Haryana, India ,Oncologic Surgical and Molecular Pathology, Advanced Medical Research Institute, Senior Oncologic Surgical and Molecular Pathologist, CORE Diagnostics, 406, Udyog Vihar III, 122001 Gurgaon, Haryana, India
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115
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Lew M. An Approach to Nonurothelial Malignancies of the Urinary Bladder in Urine Cytology. Adv Anat Pathol 2022; 29:412-422. [PMID: 35687328 DOI: 10.1097/pap.0000000000000352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Urine cytology is an economical and convenient method of triaging patients who present with urinary symptoms as well as surveying those who have previously been diagnosed with urothelial carcinoma for recurrent or persistent disease. While the vast majority of malignancies diagnosed in urine cytology are urothelial carcinomas, it is important to recognize nonurothelial elements to inform patient prognosis and raise the possibility of involvement by a urothelial carcinoma variant, nonurothelial malignancy of the bladder, or a nonbladder primary, which may alter patient management pathways. As such, becoming familiar with morphologic features of nonurothelial malignancies in urine cytology as well as their related clinical risk factors, radiologic and cystoscopic features, differential diagnostic considerations, and the utility and pitfalls of ancillary tests can facilitate optimal patient care.
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Affiliation(s)
- Madelyn Lew
- Department of Pathology, University of Michigan Hospital and Health System, Ann Arbor, MI
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116
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Distinct Uroplakin II Staining Pattern in Apocrine Breast Carcinoma. Appl Immunohistochem Mol Morphol 2022; 30:681-686. [PMID: 36227121 DOI: 10.1097/pai.0000000000001072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 09/12/2022] [Indexed: 11/26/2022]
Abstract
Uroplakin II (UPII) has been shown as a highly specific marker of urothelial carcinoma; however, it can also stain subtypes of apocrine-differentiated breast carcinoma. Given that urothelium and breast epithelium share other common immunohistochemical markers, such as CK7 and GATA3, this can lead to a potential diagnostic pitfall. We stained a cohort of triple-negative breast cancer with UPII. Compared with the diffuse, cytoplasmic staining in urothelial carcinoma, UPII was positive in 38.9% of apocrine carcinoma (7/18) with a course, granular cytoplasmic staining pattern and negative in all nonapocrine triple-negative breast cancer cases. Furthermore, the same staining pattern was present in all apocrine metaplasia of the breast (4/4) and apocrine sweat glands in normal skin (6/6). This distinct subcellular localization of UPII staining in breast carcinoma can offer a potential solution to the above diagnostic pitfall.
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117
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Govoni VM, Pigoli C, Brambilla E, Ruiz Sueiro FA, Torres Neto R, Laufer-Amorim R, Gomes Quitzan J, Grieco V, Fonseca-Alves CE. Caveolin-1, GATA-3, and Ki67 expressions and their correlation with pathological findings in canine bladder urothelial carcinoma. Front Vet Sci 2022; 9:986269. [PMID: 36299636 PMCID: PMC9589490 DOI: 10.3389/fvets.2022.986269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/20/2022] [Indexed: 11/04/2022] Open
Abstract
The bladder urothelial carcinoma (UC) represents ~2% of malignant neoplasms in dogs and is a therapeutic challenge in veterinary medicine. Although it is considered the most common bladder cancer in dogs, few previous studies have investigated different markers that correlate with clinical and pathological parameters. Therefore, this study aimed to evaluate Caveolin-1, GATA-3, and Ki67 immunostaining in canine UC samples to evaluate their correlations with histopathological variables. Thirty tumor samples were obtained, and Caveolin-1, GATA-3, and Ki67 expression was assessed by immunohistochemistry and associated with pathological factors by univariate and multivariate analyses. Among the histopathological findings, lymphatic invasion was identified in 53.33% of the tumors, and the mean mitotic count (MC) was 31.82 ± 26.26. Caveolin-1 showed mild-to-high cytoplasmic expression in neoplastic cells, whereas GATA-3 showed mild-to-high nuclear expression. The Ki67 expression revealed a mean of 24.14 ± 16.88% positive cells. In the univariate analysis, no association was found between each marker and the pathological findings. On the other hand, in multivariate analysis, we identified a positive correlation between GATA-3 and MC and a negative correlation between Caveolin-1 and MC. Moreover, lymphatic invasion was positively correlated with histological type and grade, and negatively correlated with MC. In addition, the histological type was positively correlated with the histological grade. Overall, our results indicate that Caveolin-1 and GATA-3 expression could be promising markers for bladder UC aggressiveness.
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Affiliation(s)
- Verônica Mollica Govoni
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University – UNESP, Botucatu, Brazil
| | - Claudio Pigoli
- Laboratorio di Istologia, Sede Territoriale di Milano, Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna (IZSLER), Milan, Italy
| | - Eleonora Brambilla
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | | | | | - Renee Laufer-Amorim
- Department of Veterinary Clinic, School of Veterinary Medicine and Animal Science, São Paulo State University – UNESP, Botucatu, Brazil
| | - Juliany Gomes Quitzan
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University – UNESP, Botucatu, Brazil
| | - Valeria Grieco
- Department of Veterinary Medicine and Animal Sciences, Università degli Studi di Milano, Milan, Italy
| | - Carlos Eduardo Fonseca-Alves
- Department of Veterinary Surgery and Animal Reproduction, School of Veterinary Medicine and Animal Science, São Paulo State University – UNESP, Botucatu, Brazil
- Institute of Health Sciences, Paulista University – UNIP, Bauru, Brazil
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Mokhtari M, Safavi D, Soleimani N, Monabati A, Safaei A. Carcinoma of Unknown Primary Origin: Application of Immunohistochemistry With Emphasis to Different Cytokeratin 7 and 20 Staining Patterns. Appl Immunohistochem Mol Morphol 2022; 30:623-634. [PMID: 36036642 DOI: 10.1097/pai.0000000000001054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 07/12/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although the primary origin of some carcinomas may be obscure to clinicians, its identification is crucial as it affects prognosis and treatment (especially novel targeted therapies). Immunohistochemistry (IHC) may be helpful in identifying the primary origin of carcinomas. This retrospective survey aimed to evaluate the frequency and accuracy of each IHC marker used to determine the origin of carcinomas. METHODS The review of pathology department archives revealed 307 cases of cancer of unknown primary origin (CUP) between 2015 and 2020, which were accessible in the department archives. Demographic information, site of biopsy, clinical and pathologic diagnoses, and IHC results of the patients were collected. RESULTS The patients included 157 (51.15%) men and 150 (48.85%) women. The age of the patients ranged from 14 to 92 years, including 106 (34.5%) expired cases. In 27% of cases, the primary origin of carcinoma remained unknown. The agreement between pathologic and clinical diagnoses was 59%. The most common pattern of cytokeratin (CK) expression in CUP was CK7+/CK20- (55.3%), followed by CK7-/CK20- (19%), CK7+/CK20+ (15%), and CK7-/CK20+ (10.7%), respectively. CONCLUSION The IHC analysis may improve the diagnosis of CUPs. However, the origin of some cases remains unknown despite an IHC analysis, thereby necessitating the use of more diagnostic procedures or gene expression studies for reaching a definitive diagnosis.
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Affiliation(s)
- Maral Mokhtari
- Department of Pathology, Shiraz Medical School
- Department of Pathology, Shahid Faghihi Hospital
| | | | - Neda Soleimani
- Department of Pathology, Shiraz Medical School
- Department of pathology, Shiraz Transplant Center, Abu Ali Sina Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Monabati
- Department of Pathology, Shiraz Medical School
- Department of Pathology, Shahid Faghihi Hospital
| | - Akbar Safaei
- Department of Pathology, Shiraz Medical School
- Department of Pathology, Shahid Faghihi Hospital
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119
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Mazza S, Laurenza C, Elvo B, Tanzi G, Ungari M, Soro S, Verga MC, Drago A, Grassia R. Rectal linitis plastica as the first presentation of metastatic lobular breast cancer: an endoscopic ultrasound diagnosis. Clin J Gastroenterol 2022; 15:1072-1077. [DOI: 10.1007/s12328-022-01690-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/15/2022] [Indexed: 10/14/2022]
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120
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Rosa M. The Increasing Role of SOX10 in Diagnostic Breast Pathology. Am J Clin Pathol 2022; 158:557-558. [PMID: 36066419 DOI: 10.1093/ajcp/aqac095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marilin Rosa
- Department of Pathology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA
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121
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Thompson ED, Zhang ML, VandenBussche CJ. The Diagnostic Challenge of Evaluating Small Biopsies from the Pancreatobiliary System. Surg Pathol Clin 2022; 15:435-453. [PMID: 36049827 DOI: 10.1016/j.path.2022.05.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Examination of fine needle aspirations and small core biopsies of the pancreas can be an extremely difficult and treacherous area for the diagnostic pathologist. The pancreas often yields small and often fragmented specimens, which, in combination with the morphologic overlap between numerous neoplastic and nonneoplastic mimickers, generate multiple potential diagnostic pitfalls. The authors review this challenging topic and provide insight into resolving these pitfalls using morphologic pattern recognition and ancillary testing.
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Affiliation(s)
- Elizabeth D Thompson
- Department of Pathology, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, USA
| | - M Lisa Zhang
- Department of Pathology, Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 USA
| | - Christopher J VandenBussche
- Department of Pathology, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, USA; Department of Oncology, The Johns Hopkins University School of Medicine, 600 N. Wolfe St., Baltimore, MD, USA.
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122
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Do we need an updated classification of oncocytic renal tumors? : Emergence of low-grade oncocytic tumor (LOT) and eosinophilic vacuolated tumor (EVT) as novel renal entities. Mod Pathol 2022; 35:1140-1150. [PMID: 35273336 DOI: 10.1038/s41379-022-01057-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/07/2022] [Accepted: 02/14/2022] [Indexed: 02/07/2023]
Abstract
The category of "oncocytic renal tumors'' includes well-recognized entities, such as renal oncocytoma (RO) and eosinophilic variant of chromophobe renal cell carcinoma (eo-ChRCC), as well as a group of "gray zone" oncocytic tumors, with overlapping features between RO and eo-ChRCC that create ongoing diagnostic and classification problems. These types of renal tumors were designated in the past as "hybrid oncocytoma-chromophobe tumors". In a recent update, the Genitourinary Pathology Society (GUPS) proposed the term "oncocytic renal neoplasm of low malignant potential, not further classified", for such solitary and sporadic, somewhat heterogeneous, but relatively indolent tumors, with equivocal RO/eo-ChRCC features. GUPS also proposed that the term "hybrid oncocytic tumor" be reserved for tumors found in a hereditary setting, typically arising as bilateral and multifocal ones (as in Birt-Hogg-Dubé syndrome). More recent developments in the "gray zone" of oncocytic renal tumors revealed that potentially distinct entities may have been "hidden" in this group. Recent studies distinguished two new entities: "Eosinophilic Vacuolated Tumor" (EVT) and "Low-grade Oncocytic Tumor" (LOT). The rapidly accumulated evidence on EVT and LOT has validated the initial findings and has expanded the knowledge on these entities. Both are uniformly benign and are typically found in a sporadic setting, but rarely can be found in patients with tuberous sclerosis complex. Both have readily distinguishable morphologic and immunohistochemical features that separate them from similar renal tumors, without a need for detailed molecular studies. These tumors very frequently harbor TSC/MTOR mutations that are however neither specific nor restricted to these two entities. In this review, we outline a proposal for a working framework on how to classify such low-grade oncocytic renal tumors. We believe that such framework will facilitate their handling in practice and will stimulate further discussions and studies to fully elucidate their spectrum.
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123
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Moustafa M, Ismael M, Mohamed S, Hafez AM. Value of Proline, Glutamic Acid, and Leucine-Rich Protein 1 and GATA Binding Protein 3 Expression in Breast Cancer: An Immunohistochemical study. Indian J Surg 2022. [DOI: 10.1007/s12262-022-03535-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Abstract
AbstractGATA binding protein 3 was more sensitive than traditional markers such as gross cystic disease fluid protein 15 and mammaglobin for identifying primary and metastatic breast carcinomas, but its significance decreased in triple-negative breast cancer. Recent studies showed a high expression rate of proline glutamic acid and leucine-rich protein in breast cancer and their superiority over GATA3 in triple-negative breast cancer. Our study provided new insights into the diagnostic and prognostic roles of PELP1 and GATA3 in primary and metastatic breast cancer. An immunohistochemical assay was carried out using PELP1 and GATA3 in 60 cases of primary breast cancer and 15 metastatic. Invasive carcinoma of no special type was the predominant type (80%). The majority of cases were grade 3 (68.3%). GATA3 expression was 83.3% positive in primary breast carcinomas and 73.5% positive in metastatic breast carcinomas. In comparison, PELP1 had a 96.7% positive expression rate in primary breast carcinomas and an 86.7% positive expression rate in metastasis. There was a statistically significant agreement between GATA3 and PELP1 in the diagnosis of the cases. PELP1 is a significantly higher proportion of both primary and metastatic breast carcinomas than GATA3. In breast cancer, there was a strong association between favorable prognostic factors and GATA3 expression, with evidence of an inverse association with Ki-67 overexpression.
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Hobbs MM, Snow JT, Shachner TR, Sokumbi O. Cutaneous Metastases of Non‐cutaneous Neuroendocrine Neoplasms: A Histopathologic Review of 15 Cases. J Cutan Pathol 2022; 49:960-970. [DOI: 10.1111/cup.14294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Justin T. Snow
- Department of Pathology and Laboratory Medicine Dartmouth Hitchcock Medical Center Lebanon NH
| | - Tracy R. Shachner
- Department of Pathology University of Tennessee Medical Center Knoxville TN
| | - Olayemi Sokumbi
- Department of Dermatology Mayo Clinic Jacksonville FL
- Department of Laboratory Medicine and Pathology Mayo Clinic Jacksonville FL
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Reiswich V, Könemann S, Lennartz M, Höflmayer D, Menz A, Chirico V, Hube-Magg C, Fraune C, Bernreuther C, Simon R, Clauditz TS, Sauter G, Hinsch A, Kind S, Jacobsen F, Steurer S, Minner S, Büscheck F, Burandt E, Marx AH, Lebok P, Krech T. Large-scale human tissue analysis identifies Uroplakin 1a as a putative diagnostic marker for urothelial cancer. Pathol Res Pract 2022; 237:154028. [PMID: 35872365 DOI: 10.1016/j.prp.2022.154028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 07/12/2022] [Accepted: 07/16/2022] [Indexed: 11/27/2022]
Abstract
Uroplakin 1A (Upk1a) protein is relevant for stabilizing and strengthening urothelial cells and helps to prevent them from rupturing during bladder distension. Based on RNA expression data Upk1a is expressed in a limited number of normal tissues and tumors. To comprehensively evaluate the potential diagnostic and prognostic utility of Upk1a immunohistochemistry, a tissue microarray containing 6929 samples from 115 different tumor types and subtypes and 608 samples of 76 different normal tissue types was analyzed. Upk1a positivity was found in 34 (29.6 %) different tumor types including 9 (7.8 %) tumor types with at least one strongly positive case. The highest rates of Upk1a positivity were seen in various subtypes of urothelial neoplasms (42.6-98 %) including Brenner tumors of the ovary (64.9 %) followed by neoplasms of the thyroid (10.4-33.3 %). In urothelial tumors, Upk1a staining predominated at the cell membranes and staining intensity was often moderate to strong. In thyroidal neoplasms the staining was mostly purely cytoplasmic and of low to moderate intensity. Upk1a positivity was also seen in up to 15 % of cases in 25 additional tumor categories but the staining intensity was often cytoplasmic and the intensity was usually judged as weak and only rarely as moderate. Within non-invasive (pTa) tumors, the Upk1a positivity rate decreased from 94 % in pTa G2 (low grade) to 90.1 % in pTa G3 (p = 0.012) and was even lower in muscle-invasive carcinomas (41.5 %; p < 0.0001 vs pTaG3). Within muscle invasive carcinomas, Upk1a expression was unrelated to nodal metastasis (p > 0.05) and patient outcome (p > 0.05). In conclusion, Upk1a immunohistochemistry is a potentially useful and specific diagnostic marker for the distinction of urothelial carcinomas from other neoplasms. However, its sensitivity is less than 50 % in muscle-invasive cancers because Upk1a expression decreases during grade and stage progression.
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Affiliation(s)
- Viktor Reiswich
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi Könemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Doris Höflmayer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Viktoria Chirico
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Till S Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andrea Hinsch
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon Kind
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Büscheck
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas H Marx
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Pathology, Academic Hospital Fuerth, Fuerth, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
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Are We Ready to Implement Molecular Subtyping of Bladder Cancer in Clinical Practice? Part 1: General Issues and Marker Expression. Int J Mol Sci 2022; 23:ijms23147819. [PMID: 35887164 PMCID: PMC9319819 DOI: 10.3390/ijms23147819] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
Bladder cancer (BC) is a heterogeneous disease with highly variable clinical and pathological features, and resulting in different outcomes. Such heterogeneity ensues from distinct pathogenetic mechanisms and may consistently affect treatment responses in single patients. Thus, over the last few years, several groups have developed molecular classification schemes for BC, mainly based on their mRNA expression profiles. A “consensus” classification has recently been proposed to combine the published systems, agreeing on a six-cluster scheme with distinct prognostic and predictive features. In order to implement molecular subtyping as a risk-stratification tool in routine practice, immunohistochemistry (IHC) has been explored as a readily accessible, relatively inexpensive, standardized surrogate method, achieving promising results in different clinical settings. The first part of this review deals with the steps resulting in the development of a molecular subtyping of BC, its prognostic and predictive implications, and the main features of immunohistochemical markers used as surrogates to stratify BC into pre-defined molecular clusters.
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Histoséminaire : Ouf, c’est positif ! De l’usage salvateur des biomarqueurs en pathologie mammaire : cas n°7. Ann Pathol 2022; 42:325-328. [DOI: 10.1016/j.annpat.2022.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/01/2022] [Indexed: 11/19/2022]
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128
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Alaghehbandan R, Williamson SR, McKenney JK, Hes O. The Histologic Diversity of Chromophobe Renal Cell Carcinoma With Emphasis on Challenges Encountered in Daily Practice. Adv Anat Pathol 2022; 29:194-207. [PMID: 35470289 DOI: 10.1097/pap.0000000000000349] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Chromophobe renal cell carcinoma (ChRCC) is the third most common renal cell carcinoma in adults. The aim of this review is to provide a comprehensive overview highlighting the broad morphologic spectrum of ChRCC, and offer a practical approach for handling cases in daily practice. For the purpose of this review, we classify ChRCC subtypes as (1) classic, (2) eosinophilic, (3) sarcomatoid, and (4) other rare patterns. The concept of eosinophilic ChRCC has significantly evolved, yet it still is one of the major diagnostic challenges pathologists face in routine practice due to its morphologic overlap with renal oncocytoma. Rare patterns of ChRCC have been described over the last few decades, showing a wide histologic spectrum including those with adenomatoid microcystic pigmented, multicystic, neuroendocrine, small cell, and papillary features. ChRCC represents a heterogenous group of neoplasms, demonstrating varied but unique morphologic and genetic profiles. Although the field of ChRCC knowledge is still evolving, rare patterns can present diagnostic challenges if they are not known to pathologists and/or clinicians. Proper and generous tumor sampling along with careful histologic examination allow for recognition of these rare morphologies. The role of routine molecular testing appears to be limited. From a clinical management standpoint, the rare patterns of ChRCC seem to have no definite clinical implications at present and likely can be managed similarly to usual ChRCC. Finally, we will discuss distinctive novel/emerging renal neoplasms previously considered under the spectrum of ChRCC, low-grade oncocytic renal tumor and eosinophilic vacuolated tumor, with regard to their current significance and implications for future classification strategies.
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Affiliation(s)
- Reza Alaghehbandan
- Department of Pathology, Faculty of Medicine, Royal Columbian Hospital, University of British Columbia, Vancouver, BC, Canada
| | - Sean R Williamson
- Robert J. Tomsich Pathology and Laboratory Medicine Institute and Glickman Urological Institute, Cleveland Clinic, Cleveland, OH
| | - Jesse K McKenney
- Robert J. Tomsich Pathology and Laboratory Medicine Institute and Glickman Urological Institute, Cleveland Clinic, Cleveland, OH
| | - Ondrej Hes
- Department of Pathology, Faculty of Medicine and University Hospital in Plzen, Charles University in Prague, Plzen, Czech Republic
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129
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Röck R, Rizzo L, Lienkamp SS. Kidney Development: Recent Insights from Technological Advances. Physiology (Bethesda) 2022; 37:0. [PMID: 35253460 DOI: 10.1152/physiol.00041.2021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
The kidney is a complex organ, and how it forms is a fascinating process. New technologies, such as single-cell transcriptomics, and enhanced imaging modalities are offering new approaches to understand the complex and intertwined processes during embryonic kidney development.
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Affiliation(s)
- Ruth Röck
- Institute of Anatomy, University of Zurich, Zurich, Switzerland.,Swiss National Centres of Competence in Research (NCCR) Kidney Control of Homeostasis (Kidney.CH), Zurich, Switzerland
| | - Ludovica Rizzo
- Institute of Anatomy, University of Zurich, Zurich, Switzerland.,Swiss National Centres of Competence in Research (NCCR) Kidney Control of Homeostasis (Kidney.CH), Zurich, Switzerland.,PhD program "Molecular and Translational Biomedicine," Life Science Zurich Graduate School, Zurich, Switzerland
| | - Soeren S Lienkamp
- Institute of Anatomy, University of Zurich, Zurich, Switzerland.,Swiss National Centres of Competence in Research (NCCR) Kidney Control of Homeostasis (Kidney.CH), Zurich, Switzerland
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130
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Lee MY. Embryonic Programs in Cancer and Metastasis—Insights From the Mammary Gland. Front Cell Dev Biol 2022; 10:938625. [PMID: 35846378 PMCID: PMC9277484 DOI: 10.3389/fcell.2022.938625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 06/07/2022] [Indexed: 11/24/2022] Open
Abstract
Cancer is characterized as a reversion of a differentiated cell to a primitive cell state that recapitulates, in many aspects, features of embryonic cells. This review explores the current knowledge of developmental mechanisms that are essential for embryonic mouse mammary gland development, with a particular focus on genes and signaling pathway components that are essential for the induction, morphogenesis, and lineage specification of the mammary gland. The roles of these same genes and signaling pathways in mammary gland or breast tumorigenesis and metastasis are then summarized. Strikingly, key embryonic developmental pathways are often reactivated or dysregulated during tumorigenesis and metastasis in processes such as aberrant proliferation, epithelial-to-mesenchymal transition (EMT), and stem cell potency which affects cellular lineage hierarchy. These observations are in line with findings from recent studies using lineage tracing as well as bulk- and single-cell transcriptomics that have uncovered features of embryonic cells in cancer and metastasis through the identification of cell types, cell states and characterisation of their dynamic changes. Given the many overlapping features and similarities of the molecular signatures of normal development and cancer, embryonic molecular signatures could be useful prognostic markers for cancer. In this way, the study of embryonic development will continue to complement the understanding of the mechanisms of cancer and aid in the discovery of novel therapeutic targets and strategies.
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131
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Gastrointestinal bleeding caused by metastatic testicular choriocarcinoma: a case report and literature review. World J Surg Oncol 2022; 20:205. [PMID: 35710558 PMCID: PMC9202100 DOI: 10.1186/s12957-022-02670-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 06/02/2022] [Indexed: 11/13/2022] Open
Abstract
Background Testicular tumor is one of the common solid tumors in young men. Testicular choriocarcinoma is a non-spermatogonial germ cell tumor, which is the rarest of all testicular cancers. Choriocarcinoma usually shows bleeding at the metastatic site, while gastrointestinal involvement is rare. Methods Here, we report a case of testicular choriocarcinoma with gastrointestinal bleeding as the first diagnosis and summarize the similar cases all over the world in recent 20 years. Results A 28-year-old male was treated with repeated melena for 2 months. No bleeding foci of the stomach, duodenum, colon, and rectum were found in endoscopy, and no bleeding foci of digestive tract was found in selective angiography, but a space occupying lesions of the lung, liver, and upper jejunum were found in chest and abdominal CT. Considering the possibility of a metastatic tumor and the ineffectiveness of medical treatment, the patient was converted to surgical treatment. The postoperative pathology was consistent with testicular choriocarcinoma. The patient received a chemotherapy regimen of paclitaxel, ifosfamide, and cisplatin. At present, the chemotherapy regimen is well tolerated. Conclusions The case report confirmed that even if we cannot find the logical relationship between clinical manifestations and genital examination, genital examination should also be part of the patient’s systematic examination.
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132
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Clinicopathologic and Immunohistochemical Characterization of Sarcomatoid Chromophobe Renal Cell Carcinoma: An Analysis of 22 Cases. Am J Surg Pathol 2022; 46:1171-1179. [PMID: 35687360 DOI: 10.1097/pas.0000000000001926] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Sarcomatoid differentiation in chromophobe renal cell carcinoma (ChRCC) is a rare finding and a significant predictor of worse outcomes. When the sarcomatoid component overgrows the conventional component or is the only component on a biopsy, the differential diagnoses encompass a variety of entities. Therefore, we reviewed 22 sarcomatoid ChRCCs and characterized the immunophenotype. Given that renal carcinomas with sarcomatoid features may benefit from immune checkpoint inhibitor-based therapy we also assessed the programmed death-ligand 1 (PD-L1) (28-8) expression. DOG1, CD117, cytokeratin 7, and PAX8 were negative in 100%, 88%, 63%, and 44% of the sarcomatoid components, respectively. GATA3 was expressed in 31% of the conventional components and in 50% of the sarcomatoid components. One conventional and 3 sarcomatoid components expressed PD-L1. Sarcomatoid ChRCCs have a high propensity for metastases and cancer progression. Distant metastatic disease was seen in 73% of the cases and median survival in this cohort was <1 year. The sarcomatoid portion had increased expression of PD-L1 and frequent loss of expression of multiple immunohistochemical markers associated with ChRCC. Half of the sarcomatoid ChRCC exhibited GATA3 expression, 3 of which did not express PAX8.
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133
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Uccella S, Facco C, Chiaravalli AM, Pettenon F, La Rosa S, Turri-Zanoni M, Castelnuovo P, Cerati M, Sessa F. Transcription Factor Expression in Sinonasal Neuroendocrine Neoplasms and Olfactory Neuroblastoma (ONB): Hyams' Grades 1-3 ONBs Expand the Spectrum of SATB2 and GATA3-Positive Neoplasms. Endocr Pathol 2022; 33:264-273. [PMID: 35522392 PMCID: PMC9135868 DOI: 10.1007/s12022-022-09715-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/13/2022] [Indexed: 11/29/2022]
Abstract
Sinonasal neuroendocrine neoplasms (SN-NENs) are rare and mostly include neuroendocrine carcinoma (NEC), whereas neuroendocrine tumor (NET) is exceptional in this site. Olfactory neuroblastoma (ONB) is a malignant neuroectodermal neoplasm arising in the nasal cavity. Albeit crucial for correct patients' management, the distinction of high grade ONB from NEC is challenging and requires additional diagnostic markers. The transcription factor SATB2 has been recently introduced in routine diagnostics as an immunohistochemical marker of distal intestine differentiation. No specific data are available about SATB2 and GATA3 expression in SN-NENs. GATA3, SATB2, and, for comparison, CDX2 expression were investigated in a series of epithelial and non-epithelial SN-NENs. We collected 26 cases of ONB and 7 cases of epithelial SN-NENs diagnosed and treated in our Institution. ONBs were graded according to Hyams' system and epithelial NENs were reclassified into 5 NECs, 1 MiNEN, and 1 amphicrine carcinoma. Immunohistochemistry was performed using standard automated protocols. Hyams' grades 1-3 ONBs stained diffusely and intensely for SATB2, whereas grade 4 ONBs and NECs were globally negative. The non-neuroendocrine component of MiNEN and the amphicrine carcinoma were strongly positive. GATA3 was heterogeneously and unpredictably expressed in Hyams' grades 1-3 ONBs, whereas grade 4 ONBs and NECs were completely negative. CDX2 was negative in all cases. Our study identifies, for the first time, SATB2 and GATA3 expression as features of Hyams' grades 1-3 ONBs, expands the spectrum of SATB2 and GATA3-positive neoplasms, and suggests that Hyams' grade 4 ONBs are not only clinically but also biologically different from low graded ONBs.
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Affiliation(s)
- Silvia Uccella
- Unit of Pathology, Dept. of Medicine and Surgery, University of Insubria, via O. Rossi 9, 21100, Varese, Italy.
| | - Carla Facco
- Dept. of Pathology, ASST Dei Sette Laghi, Varese, Italy
| | | | - Fabiana Pettenon
- Unit of Pathology, Dept. of Medicine and Surgery, University of Insubria, via O. Rossi 9, 21100, Varese, Italy
| | - Stefano La Rosa
- Unit of Pathology, Dept. of Medicine and Surgery, University of Insubria, via O. Rossi 9, 21100, Varese, Italy
| | - Mario Turri-Zanoni
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - Paolo Castelnuovo
- Unit of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | | | - Fausto Sessa
- Unit of Pathology, Dept. of Medicine and Surgery, University of Insubria, via O. Rossi 9, 21100, Varese, Italy
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Sun H, Dai S, Xu J, Liu L, Yu J, Sun T. Primary Neuroendocrine Tumor of the Breast: Current Understanding and Future Perspectives. Front Oncol 2022; 12:848485. [PMID: 35692784 PMCID: PMC9174548 DOI: 10.3389/fonc.2022.848485] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/14/2022] [Indexed: 02/05/2023] Open
Abstract
Primary neuroendocrine carcinoma of the breast (NECB) is characterized with heterogeneity, rarity, and poor differentiation, which is probably an underestimated subtype of breast cancer, including small cell NECs and large cell NECs. The diagnostic criteria for NECB have been constantly updated as the disease changes and the understanding increases. According to the latest WHO Classification, primary neuroendocrine neoplasm (NEN) of the breast consists of well-differentiated neuroendocrine tumors (NET), extremely aggressive neuroendocrine carcinomas (NEC) as well as invasive breast cancers of no special type (IBCs-NST) with neuroendocrine differentiation. The accurate diagnosis of NECB remains a challenge for its low incidence, which needs multi-disciplinary methods. For the rarity of the disease, there is a lack of large samples and prospective clinical research. For these invasive tumors, there are no standardized therapeutic guidelines or norms, and the treatment often refers to nonspecific breast cancer. In addition, the prognosis of such patients remains unknown. In 2003, the World Health Organization (WHO) listed NECB as an independent entity for the first time, while few features of NECB were clarified. In this review, it presents the WHO Classification, clinicopathologic characteristics, diagnosis, treatment, and prognosis of these patients. In addition, it summarizes the latest studies on molecular features of NECB, aiming to provide new therapeutic perspectives for the disease.
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Affiliation(s)
- Hongna Sun
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Shuang Dai
- Department of Medical Oncology, Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, China
| | - Junnan Xu
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Linan Liu
- Department of Pathology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital and Institute, Shenyang, Liaoning, China
| | - Jiaxing Yu
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
| | - Tao Sun
- Department of Medical Oncology, Cancer Hospital of China Medical University, Liaoning Cancer Hospital & Institute, Shenyang, China
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135
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Wang BG, Woodward K, Menezes G, Wang ZQ, He R, Li W. Pleural fluid metastasis of plasmacytoid urothelial carcinoma in comparison to micropapillary and conventional high-grade urothelial carcinoma: Cytologic and immuonohistochemical findings. Diagn Cytopathol 2022; 50:E248-E254. [PMID: 35560555 DOI: 10.1002/dc.24975] [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: 03/26/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/10/2022]
Abstract
Plasmacytoid urothelial carcinoma (PUC) is a rare but clinically aggressive variant of high-grade urothelial carcinoma (HGUC). Cytological features include single plasmacytoid neoplastic cells with N:C ratio around 0.5, eccentric nuclei, nuclear hyperchromasia, irregular nuclear membrane, and vacuolated cytoplasm. Micropapillary urothelial carcinoma (MPUC) is another clinically aggressive variant of HGUC that shares some overlapping features of PUC. The diagnosis of these two aggressive variants in pleural effusions can be challenging due to features mimicking adenocarcinoma, unusual immunochemistry profile, and confusion with differential diagnoses, especially when pertinent clinical information is unavailable. We present report on one case each of pleural fluid metastasis of PUC and MPUC respectively, and compare the findings with that of a metastatic conventional HGUC originally thought to be metastatic adenocarcinoma. The diagnosis of PUC was confirmed with immunohistochemical studies showing expression for cytokeratin, GATA-3, uroplakin II, and CD138, diminished or loss of E-cadherin membranous expression, negative expression for p63, p53, Epicam-BerEP4, Epicam-MOC31, and p120. The diagnosis of MPUC was confirmed with immunostain profile similar to that of PUC except positive stain for E-cadherin, p120, and p53. The diagnosis of HGUC was confirmed with immunohistochemical studies showing expression for cytokeratin, GATA-3, uroplakin II, p63, Epicam-BerEP4 (focal weak), and Epicam-MOC31. Our cases of metastatic urothelial carcinoma showed features mimicking adenocarcinoma and others, especially the MPUC and HGUC were diagnosed without prior tissue diagnosis of urothelial carcinoma. This report emphasizes the cytohistological and immunohistochemical details of urothelial carcinoma involving effusion fluid and discusses potential pitfalls in diagnosis.
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Affiliation(s)
- Brant G Wang
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Kimberly Woodward
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Geetha Menezes
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Zoe Q Wang
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Rui He
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
| | - Wenping Li
- Department of Pathology, Inova Fairfax Hospital, Falls Church, Virginia, USA
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136
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Hardy CS, Ghaedi H, Slotman A, Sjödahl G, Gooding RJ, Berman DM, Jackson CL. Immunohistochemical Assays for Bladder Cancer Molecular Subtyping: Optimizing Parsimony and Performance of Lund Taxonomy Classifiers. J Histochem Cytochem 2022; 70:357-375. [PMID: 35437049 PMCID: PMC9058369 DOI: 10.1369/00221554221095530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 04/01/2022] [Indexed: 11/28/2022] Open
Abstract
Transcriptomic and proteomic profiling classify bladder cancers into luminal and basal molecular subtypes, with controversial prognostic and predictive associations. The complexity of published subtyping algorithms is a major impediment to understanding their biology and validating or refuting their clinical use. Here, we optimize and validate compact algorithms based on the Lund taxonomy, which separates luminal subtypes into urothelial-like (Uro) and genomically unstable (GU). We characterized immunohistochemical expression data from two muscle-invasive bladder cancer cohorts (n=193, n=76) and developed efficient decision tree subtyping models using 4-fold cross-validation. We demonstrated that a published algorithm using routine assays (GATA3, KRT5, p16) classified basal/luminal subtypes and basal/Uro/GU subtypes with 86%-95% and 67%-86% accuracies, respectively. KRT14 and RB1 are less frequently used in pathology practice but achieved the simplest, most accurate models for basal/luminal and basal/Uro/GU discrimination, with 93%-96% and 85%-86% accuracies, respectively. More complex models with up to eight antibodies performed no better than simpler two- or three-antibody models. We conclude that simple immunohistochemistry classifiers can accurately identify luminal (Uro, GU) and basal subtypes and are appealing options for clinical implementation.
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Affiliation(s)
- Céline S.C. Hardy
- Division of Cancer Biology and Genetics, Queen’s Cancer Research Institute
- Department of Pathology and Molecular Medicine
| | - Hamid Ghaedi
- Division of Cancer Biology and Genetics, Queen’s Cancer Research Institute
- Department of Pathology and Molecular Medicine
| | - Ava Slotman
- Division of Cancer Biology and Genetics, Queen’s Cancer Research Institute
- Department of Pathology and Molecular Medicine
| | - Gottfrid Sjödahl
- Queen’s University, Kingston, Canada; and Division of Urologic Research, Department of Translational Medicine, Lund University, Lund, Sweden
| | - Robert J. Gooding
- Division of Cancer Biology and Genetics, Queen’s Cancer Research Institute
| | - David M. Berman
- Division of Cancer Biology and Genetics, Queen’s Cancer Research Institute
- Department of Pathology and Molecular Medicine
| | - Chelsea L. Jackson
- Division of Cancer Biology and Genetics, Queen’s Cancer Research Institute
- Department of Pathology and Molecular Medicine
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Zarrilli G, Angerilli V, Cappellesso R, Galuppini F, Pennelli G, Farinati F, Nicolè L, Savarino E, Realdon S, Griguolo G, Bottosso M, Dieci MV, Guarneri V, Dei Tos AP, Lo Mele M, Fassan M. Gastric metastases of breast cancer: Histopathological and molecular characterization of a single Institution case series. Pathol Res Pract 2022; 233:153872. [PMID: 35390634 DOI: 10.1016/j.prp.2022.153872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/25/2022] [Accepted: 03/30/2022] [Indexed: 11/19/2022]
Abstract
The metastatic spread of breast carcinoma to the stomach is a rare event and often represents a diagnostic challenge. In the present study, 23 cases of gastric metastases from breast cancer were retrospectively identified dating back until 2007. Primitive histotype, localization, gross appearance, microscopic architecture were analyzed. Cytokeratins 7 and 20, sex hormones, HER2 and Ki67 expression was evaluated. According to the results, the series was characterized by an enrichment of lobular primitive histotype (43.7%). In most cases gastric metastases were described as parietal nodules, polypoid masses or ulcerated lesions, mainly involving the antro-angular region. In a relatively high rate (10.5%) of cases, endoscopic examinations resulted negative for macroscopic lesions. More than half of the cases (52.2%) microscopically resembled primitive poorly cohesive gastric cancer. Because gross and histological findings can be deceiving, immunohistochemistry may be essential for the diagnosis of gastric metastases from breast cancer. Accordingly with the results of our analysis and literature review, an immunohistochemical panel composed of cytokeratins 7 and 20, Estrogen and Progesteron Receptors would drastically improve diagnostic accuracy. Interaction among the clinician, endoscopist and the pathologist is also essential to provide the patient the best therapeutic option.
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Affiliation(s)
- Giovanni Zarrilli
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy
| | - Valentina Angerilli
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy
| | | | - Francesca Galuppini
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy
| | - Gianmaria Pennelli
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy
| | - Fabio Farinati
- Department of Surgical Oncology and Gastroenterology Sciences (DiSCOG), Gastroenterology Unit, University of Padua, Padua, Italy
| | - Lorenzo Nicolè
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy
| | - Edoardo Savarino
- Department of Surgical Oncology and Gastroenterology Sciences (DiSCOG), Gastroenterology Unit, University of Padua, Padua, Italy
| | - Stefano Realdon
- Gastroenterology Unit, Veneto Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Veneto, Italy
| | - Gaia Griguolo
- Department of Surgery, Oncology and Gastroenterology (DISCOG), Oncology Unit, University of Padua, Padua, Italy; Medical Oncology 2, Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Veneto, Italy
| | - Michele Bottosso
- Department of Surgery, Oncology and Gastroenterology (DISCOG), Oncology Unit, University of Padua, Padua, Italy
| | - Maria Vittoria Dieci
- Department of Surgery, Oncology and Gastroenterology (DISCOG), Oncology Unit, University of Padua, Padua, Italy; Medical Oncology 2, Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Veneto, Italy
| | - Valentina Guarneri
- Department of Surgery, Oncology and Gastroenterology (DISCOG), Oncology Unit, University of Padua, Padua, Italy; Medical Oncology 2, Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Veneto, Italy
| | - Angelo Paolo Dei Tos
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy
| | - Marcello Lo Mele
- University Hospital of Padua, Surgical Pathology Unit, Padua, Italy
| | - Matteo Fassan
- Department of Medicine (DIMED), Surgical Pathology Unit, University of Padua, Padua, Italy; Veneto Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Padua, Veneto, Italy.
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138
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Mansoor M, Siadat F, Trpkov K. Low-grade oncocytic tumor (LOT) - a new renal entity ready for a prime time: An updated review. Histol Histopathol 2022; 37:405-413. [PMID: 35156688 DOI: 10.14670/hh-18-435] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Low-grade oncocytic tumor (LOT) of kidney has been recently proposed as a new renal entity. LOT was identified in the spectrum of oncocytic renal tumors with overlapping features between oncocytoma and eosinophilic chromophobe renal cell carcinoma, or it has been labelled as one of those entities in prior studies and in practice. LOT is often a single, relatively small tumor, found in a non-syndromic setting, but rare examples of multiple LOTs or admixed with other tumors have been found in patients with tuberous sclerosis complex. LOT typically has solid architecture, and it is composed of eosinophilic cells, with round to oval 'low-grade' nuclei, lacking irregularities and showing focal perinuclear halos. Sharp transition into edematous stromal areas, with scattered or loosely arranged cells are frequently found. LOT has a consistent immunohistochemical profile with diffuse reactivity for cytokeratin 7 and absent (or rarely weak) expression for CD117, a profile different from oncocytoma and eosinophilic chromophobe renal cell carcinoma. Similarly, in contrast to those entities, it also lacks or shows only weak expression for FOXI1. Recent studies have shown that LOT has a molecular/genetic profile different from other renal tumors, with frequent alterations affecting the MTOR/TSC pathway genes. LOT demonstrates either disomic pattern or deletions of 19p13, 19q13 and 1p36, and lacks complete chromosomal losses or gains. In all published studies to date, LOT has shown benign behavior. In this review, we summarize the evidence from recently published studies, which strongly supports the conclusion that LOT is a distinct and unique renal entity.
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Affiliation(s)
- Mehdi Mansoor
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary and Alberta Precision Laboratories, Calgary, AB, Canada
| | - Farshid Siadat
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary and Alberta Precision Laboratories, Calgary, AB, Canada
| | - Kiril Trpkov
- Department of Pathology and Laboratory Medicine, Cumming School of Medicine, University of Calgary and Alberta Precision Laboratories, Calgary, AB, Canada.
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Willner J, Zhou F, Moreira AL. Diagnostic Challenges in the Cytology of Thymic Epithelial Neoplasms. Cancers (Basel) 2022; 14:cancers14082013. [PMID: 35454918 PMCID: PMC9024685 DOI: 10.3390/cancers14082013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 02/04/2023] Open
Abstract
Simple Summary Thymic epithelial neoplasms, including thymoma, thymic carcinoma, and thymic neuroendocrine neoplasms, constitute the majority of anterior mediastinal masses. Fine needle aspirations (FNA) of mediastinal masses are infrequently encountered and are highly challenging to interpret. Thymic neoplasms display a significant degree of histologic diversity and have overlapping morphologic features with tumors from other sites. However, when properly interpreted alongside ancillary studies and radiologic findings, FNAs can yield clinically actionable results. This review aims to illustrate the usefulness and diagnostic pitfalls of thymic FNAs to assist pathologists in analyzing these specimens. Abstract Thymic epithelial neoplasms are rare tumors that constitute the majority of anterior mediastinal masses. They are classified as thymomas, thymic carcinomas, and thymic neuroendocrine neoplasms. Biopsy diagnosis is not common, and most tumors are surgically resected. Biopsy, including cytology, is indicated when a non-surgical entity is suspected or in cases of locally advanced disease. Smears of thymomas consist of round or spindle epithelial cells admixed with varying amounts of lymphocytes depending on the type of thymoma. Smears of thymic carcinoma and thymic neuroendocrine neoplasms are often indistinguishable from corresponding tumor types from other organs. Accurate cytological diagnosis can be difficult due to the histological diversity of thymomas, as well as the morphological features that certain thymic tumors share with similar tumors from other organs. However, fine needle aspiration (FNA) of anterior mediastinal masses can provide clinically actionable information and can be used to determine whether lesions require surgical, systemic, or local noninvasive treatments. Ancillary studies, namely, immunocytochemical stains, flow cytometry, and radiology, are important tools in the evaluation of thymic aspirates. This review discusses the utility and limitations of thymic FNAs and illustrates the diagnostic features and pitfalls of these specimens.
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Takano GHS, Amorim RF, Ferreira VM, Vianna LMDS, de Castro TMML, Carneiro MDV, Oliveira ÍDA, Motoyama AB, Carneiro FP. Initial panel of immunocytochemical markers for identification of primary carcinoma site for effusions and peritoneal washings from women. INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL PATHOLOGY 2022; 15:191-200. [PMID: 35535203 PMCID: PMC9077109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 02/08/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION In women, most malignant effusions are from breast and ovary primary carcinomas that have metastasized to body cavity fluids (pleural, peritoneal and pericardial). When carcinoma is diagnosed in effusions, it is not possible to identify its site of origin solely by cytology (morphology); therefore, immunocytochemistry is used as a complementary method. There are no immunocytochemical markers with 100% sensitivity and specificity for identifying carcinoma primary site. The markers most used are TTF-1 for the lung, GATA-3 for the breast, and PAX-8 for the ovary. The aim of this study was to evaluate the sensitivity and specificity of a panel including these markers for detecting the primary site of carcinoma in effusions. METHODS Samples of pleural, pericardial, and peritoneal effusions and peritoneal washings with carcinoma of known primary site from women (n = 60) and men (n = 18) were prepared by using the cell block method, and immunocytochemistry was performed to evaluate the expression of primary site markers (TTF-1, PAX-8, and GATA-3). RESULTS In women, the breast was the most frequent primary site of metastatic carcinoma to both pleural and pericardial cavities, followed by the lung, whereas the ovary was the most frequent primary site of carcinoma within peritoneal effusions and washings, followed by the gastrointestinal tract (stomach or intestine). The expected profiles for carcinomas of the most common primary sites were: breast (GATA-3 (+), PAX-8 (-), TTF-1 (-)), ovary (PAX-8 (+), GATA-3 (-), TTF-1 (-)), lung (TTF-1 (+), PAX-8 (-) GATA-3 (-)) and gastrointestinal tract (PAX-8 (-), GATA-3 (-), TTF-1 (-)). These were observed in 88.23% (45/51) of women's samples with carcinoma from these primary sites. By using TTF-1 as the sole primary site marker, 6.25% of carcinomas of primary site other than the lung would have been misdiagnosed. CONCLUSION An initial panel of markers including GATA-3, PAX-8, and TTF-1 allows, with high sensitivity and specificity, the identification or exclusion of frequent primary sites of carcinoma in effusions from women. Our results highlight the importance of using a panel of markers to avoid misidentification of the primary site of tumor.
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Affiliation(s)
- Gustavo Henrique Soares Takano
- Pathological Anatomy Unit of University Hospital of BrasiliaBrasília 999074, Brazil
- Pathology Department of Brasília UniversityBrasília 999074, Brazil
| | | | | | | | | | | | | | | | - Fabiana Pirani Carneiro
- Pathological Anatomy Unit of University Hospital of BrasiliaBrasília 999074, Brazil
- Pathology Department of Brasília UniversityBrasília 999074, Brazil
- Institute of Psychology of Brasília UniversityBrasília 999074, Brazil
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141
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Kong X, Wang Q, Li J, Li M, Deng F, Li C. Mammaglobin, GATA-binding protein 3 (GATA3), and epithelial growth factor receptor (EGFR) expression in different breast cancer subtypes and their clinical significance. Eur J Histochem 2022; 66. [PMID: 35388661 PMCID: PMC9012142 DOI: 10.4081/ejh.2022.3315] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 03/31/2022] [Indexed: 11/22/2022] Open
Abstract
Increasing evidence has shown that mammaglobin, GATA-binding protein 3 (GATA3), and epithelial growth factor receptor (EGFR) have unique clinical implications for breast cancer subtyping and classification, as well as for breast cancer targeted therapy. It is particularly important to clarify the correlation between their expression and different molecular breast carcinoma subtypes to better understand the molecular basis of the subtypes and to identify effective therapeutic targets for the disease. This study aimed to evaluate mammaglobin, GATA3, and EGFR expression in different breast cancer subtypes, as well as their clinical significance. Subjects of the study included 228 patients with breast cancer at The First Affiliated Hospital of University of Science and Technology of China. They were divided into triple negative (TN), Luminal A, Luminal B, and HER-2 positive (HER-2.P) breast cancer groups based on molecular classification. Immunohistochemical methods were used to detect mammaglobin, GATA3, and EGFR expression in cases of different molecular subtypes before determining the correlation between protein expression and subtype. Mammaglobin and GATA3 expression levels were found to significantly vary with respect to histopathological grade, lymph node status, and molecular subtype; EGFR expression was significantly correlated with breast cancer histopathological grade and molecular subtype. For breast cancer, the expression levels of mammaglobin and GATA3, as well as mammaglobin and EGFR, were significantly correlated. In addition, there was a significantly negative correlation between the expression levels of GATA3 and EGFR in breast cancer tissue samples, especially in HER-2.P samples. These findings provide a theoretical basis for assessing breast cancer clinical prognosis based on the cancer subtype, and hence, have significant practical value.
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Affiliation(s)
- Xin Kong
- Department of Pathology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei.
| | - Qi Wang
- Department of Pathology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei.
| | - Jie Li
- Department of Pathology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei.
| | - Ming Li
- Department of Pathology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei.
| | - Fusheng Deng
- Department of General Surgery, The First Affiliated Hospital of University of Science and Technology of China, Hefei.
| | - Chuanying Li
- Department of Pathology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei.
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Shen T, Zhao J, Zhao M, Taggart MW, Ramalingam P, Gong Y, Wu Y, Liu H, Zhang J, Resetkova E, Wang WL, Ding Q, Huo L, Yoon E. Unusual Staining of Immunohistochemical Markers PAX8 and CDX2 in Breast Carcinoma: A Potential Diagnostic Pitfall. Hum Pathol 2022; 125:35-47. [DOI: 10.1016/j.humpath.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/04/2022] [Accepted: 04/05/2022] [Indexed: 11/16/2022]
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143
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Ding Q, Huo L, Peng Y, Yoon EC, Li Z, Sahin AA. Immunohistochemical Markers for Distinguishing Metastatic Breast Carcinoma from Other Common Malignancies: Update and Revisit. Semin Diagn Pathol 2022; 39:313-321. [DOI: 10.1053/j.semdp.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/02/2022] [Accepted: 04/11/2022] [Indexed: 11/11/2022]
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144
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Yoon EC, Wang G, Parkinson B, Huo L, Peng Y, Wang J, Salisbury T, Wu Y, Chen H, Albarracin CT, Resetkova E, Middleton LP, Krishnamurthy S, Gan Q, Sun H, Huang X, Shen T, Chen W, Parwani AV, Sahin AA, Li Z, Ding Q. TRPS1, GATA3, and SOX10 expression in triple-negative breast carcinoma. Hum Pathol 2022; 125:97-107. [DOI: 10.1016/j.humpath.2022.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 04/04/2022] [Indexed: 12/12/2022]
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145
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García-Porrero G, Paricio Martínez JJ, Álvarez Gigli L, Abengózar Muela M. Osteoclast-rich undifferentiated carcinoma of the bladder and the diagnostic usefulness of immunohistochemistry. A case report. REVISTA ESPAÑOLA DE PATOLOGÍA 2022; 56:132-135. [PMID: 37061241 DOI: 10.1016/j.patol.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/28/2021] [Accepted: 01/05/2022] [Indexed: 11/26/2022]
Abstract
Osteoclast-rich undifferentiated carcinoma (ORUC) of the urinary tract is a rare variant of urothelial carcinoma, first described in 1985 by Kitazawa et al. It has a worse prognosis compared to other histological variants of invasive urothelial carcinoma and its diagnosis may prove challenging due to the variability in its immunohistochemical profile. We present a case of ORUC in which GATA3 immunostaining was a useful diagnostic tool.
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146
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Mirzaei M, Eshraghi A, Ghoddoosi M, Fatemi MA, Eshraghi A, Shenavaei S, Fazilat‐panah D. Axillary lymph-node metastases as the primary presentation of high-grade serous ovarian carcinoma: A case report. Clin Case Rep 2022; 10:e05724. [PMID: 35441016 PMCID: PMC9010726 DOI: 10.1002/ccr3.5724] [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: 12/07/2021] [Revised: 03/10/2022] [Accepted: 03/28/2022] [Indexed: 12/02/2022] Open
Abstract
We reported a female presented with an initial diagnosis of metastatic axillary lymph-node carcinoma that comprehensive assessments revealed a definitive diagnosis of high-grade serous ovarian carcinoma as the primary tumor.
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Affiliation(s)
- Monire Mirzaei
- Clinical Research Development CenterNekouei‐Forghani HospitalQom University of Medical SciencesQomIran
| | - Abbas Eshraghi
- Clinical Research Development CenterQom University of Medical SciencesQomIran
| | - Mahdiieh Ghoddoosi
- Department of PathologyShahid Beheshti HospitalQom University of Medical SciencesQomIran
| | | | | | - Sara Shenavaei
- Student Research CommitteeMashhad University of Medical SciencesMashhadIran
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Alarcón-Molero L, Martínez-Ciarpaglini C, Puglia V, Ferrández-Izquierdo A. [Three cases of urachal cyst in adults]. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2022; 55:135-138. [PMID: 35483769 DOI: 10.1016/j.patol.2019.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/16/2019] [Accepted: 07/18/2019] [Indexed: 06/14/2023]
Abstract
The urachus is a thick fibrous cord that appears in the fifth month of pregnancy as a result of the allantois obliteration. Urachal cysts occur as a result of a defect in the obliteration of the duct, anomaly detected mainly in children and very rarely in adults. We present three cases of urachal cysts in adults, one of them detected during the study of abdominal pain and the other two, found incidentally during the study of other pathologies. In any case the possibility of urachal cysts was clinically suspected. Histologically, these lesions are lined by epithelium of urothelial type with expression of CK7, CK20, CK5/6, P63 and GATA3. The diagnosis of urachal cysts certainty lies in the histopathological study where the morphology, immunohistochemistry and a proper clinical-pathological correlation, allow to differentiate it from other more frequent abdominal cystic lesions in adults.
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Affiliation(s)
- Lorena Alarcón-Molero
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Valencia, España.
| | | | - Victor Puglia
- Servicio de Anatomía Patológica, Hospital de Sagunto, Sagunto, Valencia, España
| | - Antonio Ferrández-Izquierdo
- Servicio de Anatomía Patológica, Hospital Clínico Universitario de Valencia, Valencia, España; Servicio de Anatomía Patológica, Hospital de Sagunto, Sagunto, Valencia, España; Departamento de Patología, Universidad de Valencia, Valencia, España
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148
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Chung T, Park YN. Up-to-Date Pathologic Classification and Molecular Characteristics of Intrahepatic Cholangiocarcinoma. Front Med (Lausanne) 2022; 9:857140. [PMID: 35433771 PMCID: PMC9008308 DOI: 10.3389/fmed.2022.857140] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 03/07/2022] [Indexed: 12/26/2022] Open
Abstract
Intrahepatic cholangiocarcinoma (iCCA) is an aggressive primary liver malignancy with an increasing incidence worldwide. Recently, histopathologic classification of small duct type and large duct type iCCA has been introduced. Both these types of tumors exhibit differences in clinicopathological features, mutational profiles, and prognosis. Small duct type iCCA is composed of non-mucin-producing cuboidal cells, whereas large duct type iCCA is composed of mucin-producing columnar cells, reflecting different cells of origin. Large duct type iCCA shows more invasive growth and poorer prognosis than small duct type iCCA. The background liver of small duct type iCCA often shows chronic liver disease related to hepatitis B or C viral infection, or alcoholic or non-alcoholic fatty liver disease/steatohepatitis, in contrast to large duct type iCCA that is often related to hepatolithiasis and liver fluke infection. Cholangiolocarcinoma is a variant of small duct type iCCA composed of naïve-looking cuboidal cells forming cords or ductule-like structures, and shows better prognosis than the conventional small duct type. Fibrous tumor stroma, one of the characteristic features of iCCA, contains activated fibroblasts intermixed with innate and adaptive immune cells. The types of stroma (mature versus immature) are related to tumor behavior and prognosis. Low tumor-infiltrating lymphocyte density, KRAS alteration, and chromosomal instability are related to immune-suppressive tumor microenvironments with resistance to programmed death 1/ programmed death ligand 1 blockade. Data from recent large-scale exome analyses have revealed the heterogeneity in the molecular profiles of iCCA, showing that small duct type iCCA exhibit frequent BAP1, IDH1/2 hotspot mutations and FGFR2 fusion, in contrast to frequent mutations in KRAS, TP53, and SMAD4 observed in large duct type iCCA. Multi-omics analyses have proposed several molecular classifications of iCCA, including inflammation class and proliferation class. The inflammation class is enriched in inflammatory signaling pathways and expression of cytokines, while the proliferation class has activated oncogenic growth signaling pathways. Diverse pathologic features of iCCA and its associated multi-omics characteristics are currently under active investigation, thereby providing insights into precision therapeutics for patients with iCCA. This review provides the latest knowledge on the histopathologic classification of iCCA and its associated molecular features, ranging from tumor microenvironment to genomic and transcriptomic research.
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Affiliation(s)
- Taek Chung
- Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul, South Korea
| | - Young Nyun Park
- Department of Pathology, Graduate School of Medical Science, Brain Korea 21 Project, Yonsei University College of Medicine, Seoul, South Korea
- *Correspondence: Young Nyun Park,
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Salama M, Khairy DA. Diagnostic Value of GATA3 and Uroplakin 3 in Differentiating Urothelial Carcinoma from Prostatic and Colorectal Carcinoma. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8282] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Prostate involvement by urothelial carcinoma (UC) can occur from direct invasion. Involvement of the urinary bladder by prostate adenocarcinoma (PAC) may similarly occur, representing a common diagnostic problem especially in high-grade tumors. Furthermore, colorectal carcinoma (CRC) invades the urinary bladder which represents another challenging task for the pathologists, a problem not only in the urinary bladder but also in lymph node metastasis. Uroplakin 3 has been used for differentiation but unfortunately, its sensitivity is not so high especially in high-grade cases. Recently, GATA3 was recognized as being involved in development of urothelium.
AIM: Few studies elaborated its expression in high-grade UC; therefore, this study aimed at evaluating GATA3 and comparing it to uroplakin 3 expression in differentiating the three tumors from each other.
MATERIALS AND METHODS: Sixty paraffin blocks collected and distributed as 20 cases of invasive UC, 20 cases of PAC, and 20 cases of CRC, all high grade, to be studied immunohistochemically against GATA3 and uroplakin 3.
RESULTS: GATA3 expression was positive in 80% of UC compared to none of the cases of PAC or CRC. The sensitivity of GATA3 in diagnosing UC was 80% whereas the specificity was 100%. Uroplakin 3 was positive in 50% of UC compared to none of the cases of PAC or CRC. The sensitivity of uroplakin 3 in diagnosing UC was 50% whereas the specificity was 100%. GATA3 and uroplakin 3 showed statistically significant inverse relation with lymphovascular and muscle invasion.
CONCLUSION: GATA3 is more sensitive than uroplakin 3 for UC that can be effectively used to exclude PAC and CRC. Moreover, GATA3 and uroplakin 3 expression significantly decreases with lymphovascular invasion as well as muscle proper invasion which emphasizes their good prognostic role.
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150
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Hara N, Sawada Y. Epigenetics of Cutaneous T-Cell Lymphomas. Int J Mol Sci 2022; 23:ijms23073538. [PMID: 35408897 PMCID: PMC8998216 DOI: 10.3390/ijms23073538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/16/2022] [Accepted: 03/23/2022] [Indexed: 02/05/2023] Open
Abstract
Epigenetic modifications rarely occur in isolation (as single “epigenetic modifications”). They usually appear together and form a network to control the epigenetic system. Cutaneous malignancies are usually affected by epigenetic changes. However, there is limited knowledge regarding the epigenetic changes associated with cutaneous lymphomas. In this review, we focused on cutaneous T-cell lymphomas such as mycosis fungoides, Sézary syndrome, and anaplastic large cell lymphoma. With regard to epigenetic changes, we summarize the detailed chemical modifications categorized into DNA methylation and histone acetylation and methylation. We also summarize the epigenetic modifications and characteristics of the drug for cutaneous T-cell lymphoma (CTCL). Furthermore, we discuss current research on epigenetic-targeted therapy against cutaneous T-cell lymphomas. Although the current method of treatment with histone deacetylase inhibitors does not exhibit sufficient therapeutic benefits in all cases of CTCL, epigenetic-targeted combination therapy might overcome this limitation for patients with CTCL.
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