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Soukup J, Valtr O, Brtkova J, Zoul Z, Staniczkova-Zambo I, Hojny J, Kamaradova K. Soft tissue sarcoma with ZC3H7B::BCOR fusion in a male mimicking low-grade fibromyxoid sarcoma - A case report. Pathol Res Pract 2023; 251:154831. [PMID: 37837859 DOI: 10.1016/j.prp.2023.154831] [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: 07/30/2023] [Revised: 09/18/2023] [Accepted: 09/23/2023] [Indexed: 10/16/2023]
Abstract
Diagnosis of soft tissue tumors is often challenging, given the large number of entities, often with non-specific or overlapping morphology. Although morphology still plays an important part in diagnostic process, additional studies including immunohistochemistry and molecular genetics are often needed to arrive at correct diagnosis. We report a case of 61-year-old male with subcutaneous tumor in right hip area, that was surgically removed. The tumor was composed of uniform bland spindle cells in mild to moderately cellular myxoid nodules, with limited areas of collagenization and the diagnosis of low grade fibromyxoid sarcoma was made. The tumor recurred 3 years after the initial diagnosis and the new sample showed a high-grade round cell sarcoma with limited residual low-grade areas and non-specific immunoprofile after extended immunohistochemical work-up. Molecular analysis demonstrated ZC3H7B::BCOR fusion. Sarcomas with ZC3H7B::BCOR fusion occurring outside of uterus are exceedingly rare. A comprehensive review of previously published cases and a short discussion about classification of the entity is provided, together with data about morphology and immunoprofile of the lesions. The case also underscores the necessity of extended work up of soft tissue tumors with unusual immunohistochemical or morphological features in order to accurately assess their biological potential.
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Affiliation(s)
- Jiri Soukup
- Department of Pathology, Military University Hospital Prague, U Vojenske Nemocnice 1200, Praha 6, Prague 16902, Czech Republic; The Fingerland Department of Pathology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolska 581, Hradec Kralove 50005, Czech Republic; Department of Pathology, Charles University, First Faculty of Medicine and General University Hospital in Prague, Studnickova 2039, Nové Mesto, Prague 12800, Czech Republic.
| | - Ondrej Valtr
- Department of Orthopedic Surgery, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Czech Republic
| | - Jindra Brtkova
- Department of Radiology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolska 581, Hradec Kralove 50005, Czech Republic
| | - Zdenek Zoul
- Department of Oncology and Radiotherapy, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolska 581, Hradec Kralove 50005, Czech Republic
| | - Iva Staniczkova-Zambo
- 1st Department of Pathology, St. Anne´s University Hospital and Faculty of Medicine Masaryk University, Pekarská 664/53, Brno-stred, Brno 60200, Czech Republic
| | - Jan Hojny
- Department of Pathology, Charles University, First Faculty of Medicine and General University Hospital in Prague, Studnickova 2039, Nové Mesto, Prague 12800, Czech Republic
| | - Katerina Kamaradova
- The Fingerland Department of Pathology, Charles University, Faculty of Medicine in Hradec Králové and University Hospital Hradec Králové, Sokolska 581, Hradec Kralove 50005, Czech Republic; Unilabs Pathology k.s., Evropská 2589/33B, Praha 6, Dejvice, Prague 16000, Czech Republic
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Dundr P, Machado-Lopez A, Mas A, Věcková Z, Mára M, Richtárová A, Matěj R, Stružinská I, Kendall Bártů M, Němejcová K, Dvořák J, Hojný J. Uterine leiomyoma with RAD51B::NUDT3 fusion: a report of 2 cases. Virchows Arch 2023:10.1007/s00428-023-03603-9. [PMID: 37466765 DOI: 10.1007/s00428-023-03603-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/04/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023]
Abstract
Three main uterine leiomyoma molecular subtypes include tumors with MED12 mutation, molecular aberrations leading to HMGA2 overexpression, and biallelic loss of FH. These aberrations are mutually exclusive and can be found in approximately 80-90% of uterine leiomyoma, in which they seem to be a driver event. Approximately 10% of uterine leiomyoma, however, does not belong to any of these categories. Uterine leiomyoma with HMGA2 overexpression is the most common subtype in cellular and second most common category of usual leiomyoma. In some of these tumors, rearrangement of HMGA2 gene is present. The most common fusion partner of HMGA2 gene is RAD51B. Limited data suggests that RAD51B fusions with other genes may be present in uterine leiomyoma. In our study, we described two cases of uterine leiomyoma with RAD51B::NUDT3 fusion, which occur in one case of usual and one case of highly cellular leiomyoma. In both cases, no other driver molecular aberrations were found. The results of our study showed that RAD51::NUDT3 fusion can occur in both usual and cellular leiomyoma. RAD51B may be a fusion partner of multiple genes other than HMGA2 and HMGA1. In these cases, RAD51B fusion seems to be mutually exclusive with other driver aberrations defining molecular leiomyoma subtypes. RAD51B::NUDT3 fusion should be added to the spectrum of fusions which may occur in uterine leiomyoma, which can be of value especially in cellular leiomyoma in the context of differential diagnosis against endometrial stromal tumors.
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Affiliation(s)
- Pavel Dundr
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic.
| | - Alba Machado-Lopez
- Carlos Simon Foundation, INCLIVA Health Research Institute, 46010, Valencia, Spain
| | - Aymara Mas
- Carlos Simon Foundation, INCLIVA Health Research Institute, 46010, Valencia, Spain
| | - Zuzana Věcková
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
| | - Michal Mára
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Adéla Richtárová
- Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Radoslav Matěj
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
- Department of Pathology, Charles University, 3rd Faculty of Medicine, University Hospital Kralovske Vinohrady, Prague, Czech Republic
- Department of Pathology and Molecular Medicine, Third Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Ivana Stružinská
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
| | - Michaela Kendall Bártů
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
| | - Kristýna Němejcová
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
| | - Jiří Dvořák
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
| | - Jan Hojný
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic
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Stružinská I, Hájková N, Hojný J, Krkavcová E, Michálková R, Dvořák J, Němejcová K, Matěj R, Laco J, Drozenová J, Fabian P, Hausnerová J, Méhes G, Škapa P, Švajdler M, Cibula D, Frühauf F, Bártů MK, Dundr P. A comprehensive molecular analysis of 113 primary ovarian clear cell carcinomas reveals common therapeutically significant aberrations. Diagn Pathol 2023; 18:72. [PMID: 37303048 DOI: 10.1186/s13000-023-01358-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 05/22/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND Molecular aberrations occurring in primary ovarian clear cell carcinoma (OCCC) can be of diagnostic, predictive, and prognostic significance. However, a complex molecular study including genomic and transcriptomic analysis of large number of OCCC has been lacking. METHODS 113 pathologically confirmed primary OCCCs were analyzed using capture DNA NGS (100 cases; 727 solid cancer related genes) and RNA-Seq (105 cases; 147 genes) in order to describe spectra and frequency of genomic and transcriptomic alterations, as well as their prognostic and predictive significance. RESULTS The most frequent mutations were detected in genes ARID1A, PIK3CA, TERTp, KRAS, TP53, ATM, PPP2R1A, NF1, PTEN, and POLE (51,47,27,18,13,10,7,6,6, and 4%, respectively). TMB-High cases were detected in 9% of cases. Cases with POLEmut and/or MSI-High had better relapse-free survival. RNA-Seq revealed gene fusions in 14/105 (13%) cases, and heterogeneous expression pattern. The majority of gene fusions affected tyrosine kinase receptors (6/14; four of those were MET fusions) or DNA repair genes (2/14). Based on the mRNA expression pattern, a cluster of 12 OCCCs characterized by overexpression of tyrosine kinase receptors (TKRs) AKT3, CTNNB1, DDR2, JAK2, KIT, or PDGFRA (p < 0.00001) was identified. CONCLUSIONS The current work has elucidated the complex genomic and transcriptomic molecular hallmarks of primary OCCCs. Our results confirmed the favorable outcomes of POLEmut and MSI-High OCCC. Moreover, the molecular landscape of OCCC revealed several potential therapeutical targets. Molecular testing can provide the potential for targeted therapy in patients with recurrent or metastatic tumors.
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Affiliation(s)
- Ivana Stružinská
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, Prague 2, 12800, Czech Republic.
| | - Nikola Hájková
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jan Hojný
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Eva Krkavcová
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Romana Michálková
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiří Dvořák
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Kristýna Němejcová
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Radoslav Matěj
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
- Department of Pathology, Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, 3rd, Czech Republic
- Department of Pathology and Molecular Medicine, Third Faculty of Medicine, Charles University, Thomayer University Hospital, Prague, Czech Republic
| | - Jan Laco
- The Fingerland Department of Pathology, Faculty of Medicine in Hradec Kralove, Charles University, University Hospital Hradec Kralove, Prague, Czech Republic
| | - Jana Drozenová
- Department of Pathology, Faculty of Medicine, Charles University, University Hospital Kralovske Vinohrady, Prague, 3rd, Czech Republic
| | - Pavel Fabian
- Department of Oncological Pathology, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Jitka Hausnerová
- Department of Pathology, University Hospital Brno and Medical Faculty, Masaryk University, Brno, Czech Republic
| | - Gábor Méhes
- Department of Pathology, Faculty of Medicine, University of Debrecen, Debrecen, 4032, Hungary
| | - Petr Škapa
- Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Marián Švajdler
- Šikl's Department of Pathology, The Faculty of Medicine, Faculty Hospital in Pilsen, Charles University, Pilsen, Czech Republic
| | - David Cibula
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic
| | - Filip Frühauf
- Gynecologic Oncology Center, Department of Obstetrics and Gynecology, First Faculty of Medicine, Charles University in Prague, General University Hospital in Prague, Prague, Czech Republic
| | - Michaela Kendall Bártů
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Pavel Dundr
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
- Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, Prague 2, 12800, Czech Republic.
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Jakša R, Stružinská I, Kendall Bártů M, Trča S, Matěj R, Dundr P. Clear cell stromal tumor of the lung with multinucleated giant cells: a report of a case with YAP1-TFE3 fusion. Diagn Pathol 2023; 18:9. [PMID: 36707859 PMCID: PMC9881279 DOI: 10.1186/s13000-023-01304-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Clear cell (hemangioblastoma-like) stromal tumor of the lung (CCSTL) is a rare pulmonary neoplasm. Recently, 9 cases of CCSTL harboring the YAP1-TFE3 gene fusion have been described, and it has been suggested that this aberration could be a characteristic feature of this tumor. CASE PRESENTATION We here report another case of CCSTL in a 57-year-old male, which presented as a solitary lung nodule 45 mm in the greatest dimension. Microscopically, the tumor consisted of epithelioid to spindled cells with mild-to-moderate nuclear atypia, finely granular or vesicular chromatin, and small nucleoli. Nuclear indentations were a common finding. There were up to 3 mitoses per 10 HPF. The cytoplasm was slightly eosinophilic or clear. Scattered non-tumor large multinucleated cells were present. Immunohistochemically, the tumor cells showed diffuse positivity for TFE3, CD10, vimentin, and IFITM1. Other markers examined were negative, and the expression of lineage-specific markers was not found. NGS analysis revealed a fusion transcript of the YAP1 and TFE3 genes, and a pathogenic variant of the MUTYH gene. CONCLUSION Our finding supports the recent data suggesting that CCSTL represents a distinct entity characterized by the recurrent YAP1-TFE3 fusion.
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Affiliation(s)
- Radek Jakša
- grid.411798.20000 0000 9100 9940Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00 Prague 2, Czech Republic
| | - Ivana Stružinská
- grid.411798.20000 0000 9100 9940Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00 Prague 2, Czech Republic
| | - Michaela Kendall Bártů
- grid.411798.20000 0000 9100 9940Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00 Prague 2, Czech Republic
| | - Stanislav Trča
- grid.411798.20000 0000 9100 9940Department of Abdominal, Thoracic Surgery and Traumatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 2, 128 00 Prague 2, Czech Republic
| | - Radoslav Matěj
- grid.411798.20000 0000 9100 9940Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00 Prague 2, Czech Republic ,grid.4491.80000 0004 1937 116XDepartment of Pathology, Charles University, 3rd Faculty of Medicine, University Hospital Kralovske Vinohrady, Prague, Czech Republic ,grid.4491.80000 0004 1937 116XDepartment of Pathology and Molecular Medicine, Third Faculty of Medicine, Charles University, Thomayer Hospital, Prague, Czech Republic
| | - Pavel Dundr
- grid.411798.20000 0000 9100 9940Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00 Prague 2, Czech Republic
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Gauduchon T, Vanacker H, Pissaloux D, Cassier P, Dufresne A, Karanian M, Meurgey A, Bouhamama A, Gouin F, Ray-Coquard I, Blay JY, Tirode F, Brahmi M. Expanding the molecular spectrum of tenosynovial giant cell tumors. Front Oncol 2022; 12:1012527. [PMID: 36439507 PMCID: PMC9691341 DOI: 10.3389/fonc.2022.1012527] [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: 08/05/2022] [Accepted: 10/24/2022] [Indexed: 11/11/2022] Open
Abstract
Background While great advances in clinical and pathological description of tenosynovial giant cell tumors (TGCT) have been made, TGCT molecular heterogeneity represents an ongoing challenge. The canonical oncogenic fusion CSF1::COL6A3 is not systematically observed, suggesting that other oncogenic mechanisms are involved in tumorigenesis. This study aims to explore by RNA sequencing a retrospective series of tumors diagnosed as TGCT, in order to provide a better description of their molecular landscape and to correlate molecular features with clinical data. Methods We analyzed clinicopathological data and performed whole-exome RNA sequencing on 41 TGCT samples. Results RNAseq analysis showed significant higher CSF1 and CSF1-R expression than a control panel of 2642 solid tumors. RNA sequencing revealed fusion transcripts in 14 patients including 6 not involving CSF1 and some previously unreported fusions. Unsupervised clustering on the expression profiles issued from this series suggested two distinct subgroups: one composed of various molecular subtypes including CSF1 and FN1 rearranged samples and one composed of four tumors harboring an HMGA2::NCOR2 fusion, suggesting distinct tumor entities. Overall, 15 patients received at least one systemic anti-CSF1R treatment and clinical improvement was observed in 11 patients, including patients from both clusters. Discussion This study reported molecular heterogeneity in TGCT, contrasting with the clinical and pathological homogeneity and the ubiquitous high CSF1 and CSF1R expression levels. Whether molecular diversity may impact the efficacy of systemic treatments needs to be further investigated.
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Affiliation(s)
- Thibault Gauduchon
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
- *Correspondence: Thibault Gauduchon,
| | - Helene Vanacker
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
- Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS5286, Lyon, France
| | - Daniel Pissaloux
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
| | - Philippe Cassier
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
| | - Armelle Dufresne
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
| | - Marie Karanian
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
| | - Alexandra Meurgey
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
| | - Amine Bouhamama
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
| | - François Gouin
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
| | - Isabelle Ray-Coquard
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
- Université Claude Bernard Lyon 1, Faculté de médecine Lyon-Est, Lyon, France
| | - Jean-Yves Blay
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
- Université Claude Bernard Lyon 1, Faculté de médecine Lyon-Est, Lyon, France
| | - Franck Tirode
- Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS5286, Lyon, France
| | - Mehdi Brahmi
- Département d’oncologie médicale, Centre de lutte contre le cancer Léon-Bérard, Lyon, France
- Centre de Recherche en Cancérologie de Lyon, INSERM U1052-CNRS5286, Lyon, France
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Nava HJ. Highly Cellular Leiomyoma Mixed With a Focus of Adenomyosis. Cureus 2022; 14:e28129. [PMID: 35999995 PMCID: PMC9390799 DOI: 10.7759/cureus.28129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/18/2022] [Indexed: 11/23/2022] Open
Abstract
The purpose of this case presentation was to highlight the importance of an adequate evaluation of images when suspicious of atypical leiomyoma and the importance of performing an extemporaneous biopsy during surgery to ensure the lesion is a benign muscular cell tumor. Here, we present a case of a 34-year-old nulliparous woman who presented with a history of infertility and irregular menstrual cycles. A highly vascularized pelvic mass was visualized by Doppler ultrasound and a contrast MRI suggestive of uterine fibroid. Intraoperatively, the lesion was found adjacent to the uterus, with a second lesion deeper into the myometrium. The pathology reported a highly cellular leiomyoma with a focus of adenomyosis. Both lesions were extirpated without complications. The patient recuperated favorably within three months of follow-up. This case shows an example of a variety of the typical histology that can be found in uterine fibroids. Although the management of atypical leiomyomas could vary in different scenarios, conservative treatment is recommended if fertility wishes are present. In all cases, it is mandatory to exclude any possibilities of malignancy, like sarcoma, which would completely change the intraoperative management.
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Griffin BB, Feng Y, Saini P, Lu X, Bulun S, Chakravarti D, Wei J. Histologic and Molecular Analysis of Cellular Leiomyoma with Sclerosis: Linked to HMGA2 Overexpression. Histopathology 2022; 81:587-599. [DOI: 10.1111/his.14732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Brannan B. Griffin
- Department of Pathology Northwestern University Feinberg School of Medicine Chicago IL USA
- Department of Pathology, Microbiology and Immunology Vanderbilt University Medical Center Nashville TN USA
| | - Yue Feng
- Department of Pathology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Priyanka Saini
- Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Xinyan Lu
- Department of Pathology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Serdar Bulun
- Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Debabrata Chakravarti
- Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago IL USA
| | - Jian‐Jun Wei
- Department of Pathology Northwestern University Feinberg School of Medicine Chicago IL USA
- Department of Obstetrics and Gynecology Northwestern University Feinberg School of Medicine Chicago IL USA
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The cytokeratin 17 expression in primary ovarian tumors has diagnostic but not prognostic significance. Virchows Arch 2022; 481:201-212. [PMID: 35554675 DOI: 10.1007/s00428-022-03338-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 04/16/2022] [Accepted: 05/10/2022] [Indexed: 10/18/2022]
Abstract
We assessed the value of cytokeratin 17 (CK17) expression for the differential diagnosis between primary ovarian mucinous tumors and metastases from the gastrointestinal tract (GIT) and the significance of CK17 expression in a broad spectrum of primary ovarian tumors with respect to their prognosis. The sample set consisted of 554 primary ovarian tumors and 255 GIT tumors. In the primary ovarian tumors, a higher CK17 expression (in > 10% of tumors cells) was present only in 0-11.4% of all tumors (including mucinous tumors, micropapillary serous borderline tumors, clear cell, endometrioid, and high-grade serous carcinomas). The only exception was low-grade serous carcinoma, where higher CK17 expression was present in 24% of cases. Concerning GIT tumors, the higher levels of CK 17 expression (in > 10% of tumor cells) were observed in the upper GIT tumors (68.5% of pancreatic ductal adenocarcinoma, 61.6% of gallbladder adenocarcinoma, and 46% of gastric adenocarcinoma), which differs substantially not only from most of the primary ovarian tumors, but also from colorectal carcinoma (3.7%; p < 0.001). The results of our study suggest that expression of CK17 can potentially be used as an adjunct marker in differential diagnosis between primary ovarian mucinous tumors and metastases from the upper GIT, but not from colorectal carcinoma. However, in GIT tumors, CK17 can be used in the differential diagnosis between adenocarcinomas of the upper and lower GIT. Statistical analysis did not reveal strong association of CK17 expression with clinicopathological variables or patient outcomes in any primary ovarian tumors.
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Dundr P, Drozenová J, Matěj R, Bártů M, Němejcová K, Robová H, Rob L, Hojný J, Stružinská I. Desmoplastic Small Round Cell Tumor of the Uterus: A Report of Molecularly Confirmed Case with EWSR1-WT1 Fusion. Diagnostics (Basel) 2022; 12:diagnostics12051184. [PMID: 35626339 PMCID: PMC9140206 DOI: 10.3390/diagnostics12051184] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 11/16/2022] Open
Abstract
We report a case of a 49-year-old female with desmoplastic small round cell tumor of the uterus (DSRCT). Histologically, in some areas the tumor showed typical features with ample desmoplastic stroma, while in other areas the tumor cells diffusely infiltrated myometrium with only focal desmoplastic reaction. Immunohistochemically, the tumor cells showed diffuse positivity for desmin, CD56, CD57, EMA and cyclin D1. Focal positivity was present for antibodies against cytokeratin AE1/3, BerEP4, NSE, IFITM1 and CD10. The WT-1 antibody (against the N-terminus) showed cytoplasmic positivity in some tumor cells, while the nuclei were negative. P53 expression was wild-type. The Ki-67 index (MIB1 antibody) was about 55%. Other markers examined including transgelin, myogenin, synaptophysin, chromogranin, h-caldesmon, PAX8, and CD117 were all negative. NGS analysis revealed a fusion transcript of the EWSR1 and WT1 genes. DSRCT of the uterus is a rare neoplasm, as only two cases have been reported so far. However, only one of these cases was examined molecularly with a confirmation of the characteristic EWSR1-WT1 fusion. We report a second case of molecularly confirmed DSRCT of the uterus and discuss its clinical features, differential diagnosis and the significance of molecular testing.
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Affiliation(s)
- Pavel Dundr
- Department of Pathology, First Faculty of Medicine, General University Hospital in Prague, Charles University, 12808 Prague, Czech Republic; (R.M.); (M.B.); (K.N.); (J.H.); (I.S.)
- Correspondence:
| | - Jana Drozenová
- Department of Pathology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, 10034 Prague, Czech Republic;
| | - Radoslav Matěj
- Department of Pathology, First Faculty of Medicine, General University Hospital in Prague, Charles University, 12808 Prague, Czech Republic; (R.M.); (M.B.); (K.N.); (J.H.); (I.S.)
- Department of Pathology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, 10034 Prague, Czech Republic;
- Department of Pathology and Molecular Medicine, Third Faculty of Medicine, Thomayer Hospital, Charles University, 14059 Prague, Czech Republic
| | - Michaela Bártů
- Department of Pathology, First Faculty of Medicine, General University Hospital in Prague, Charles University, 12808 Prague, Czech Republic; (R.M.); (M.B.); (K.N.); (J.H.); (I.S.)
| | - Kristýna Němejcová
- Department of Pathology, First Faculty of Medicine, General University Hospital in Prague, Charles University, 12808 Prague, Czech Republic; (R.M.); (M.B.); (K.N.); (J.H.); (I.S.)
| | - Helena Robová
- Department of Obstetrics and Gynecology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, 10034 Prague, Czech Republic; (H.R.); (L.R.)
| | - Lukáš Rob
- Department of Obstetrics and Gynecology, Third Faculty of Medicine, University Hospital Kralovske Vinohrady, Charles University, 10034 Prague, Czech Republic; (H.R.); (L.R.)
| | - Jan Hojný
- Department of Pathology, First Faculty of Medicine, General University Hospital in Prague, Charles University, 12808 Prague, Czech Republic; (R.M.); (M.B.); (K.N.); (J.H.); (I.S.)
| | - Ivana Stružinská
- Department of Pathology, First Faculty of Medicine, General University Hospital in Prague, Charles University, 12808 Prague, Czech Republic; (R.M.); (M.B.); (K.N.); (J.H.); (I.S.)
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Maňáková T, Hojný J, Sedlář M, Vočka M, Chrz K, Mitáš P, Beneš J, Holaj R. Epithelioid sarcoma with retained INI1 expression as a cause of a chronic leg ulcer. SAGE Open Med Case Rep 2022; 10:2050313X221106259. [PMID: 35783671 PMCID: PMC9248042 DOI: 10.1177/2050313x221106259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 05/24/2022] [Indexed: 12/02/2022] Open
Abstract
Epithelioid sarcoma is a rare soft-tissue sarcoma typically presenting itself as
a subcutaneous or deep dermal mass in distal portions of the extremities of
adolescents and young adults. They are frequently mistaken for ulcers,
abscesses, or infected warts resistant to standard medical treatment. Patients
often develop multiple local recurrences with subsequent metastases. We report a
case of a 66-year-old patient with chronic leg ulcer who died of generalization
of an epithelioid sarcoma.
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Affiliation(s)
- Tatjana Maňáková
- Institute of Pathology, General University Hospital in Prague, Prague, Czech Republic
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jan Hojný
- Institute of Pathology, General University Hospital in Prague, Prague, Czech Republic
| | - Martin Sedlář
- 1st Department of Surgery, General University Hospital in Prague, Prague, Czech Republic
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Michal Vočka
- Department of Oncology, General University Hospital in Prague, Prague, Czech Republic
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Kristian Chrz
- 1st Department of Surgery, General University Hospital in Prague, Prague, Czech Republic
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Petr Mitáš
- 2nd Department of Cardiovascular Surgery, General University Hospital in Prague, Prague, Czech Republic
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Jiří Beneš
- Department of Radiodiagnostics, General University Hospital in Prague, Prague, Czech Republic
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
| | - Robert Holaj
- 3rd Department of Medicine, General University Hospital in Prague, Prague, Czech Republic
- 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic
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