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Goto K, Kiniwa Y, Kukita Y, Ohe S, Hiraki T, Hishima T, Takai T, Honma K. Recurrent GATA3 P409Afs*99 Frameshift Extension Mutations in Sweat-gland Carcinoma With Neuroendocrine Differentiation. Am J Surg Pathol 2024; 48:528-537. [PMID: 38353459 DOI: 10.1097/pas.0000000000002195] [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: 02/16/2024]
Abstract
Sweat-gland carcinoma with neuroendocrine differentiation (SCAND) was recently proposed as a new cutaneous adnexal neoplasm with neuroendocrine differentiation; however, its genetics are not well known. Herein, we performed clinicopathologic and genetic analyses of 13 SCAND cases and 5 control cases of endocrine mucin-producing sweat gland carcinoma (EMPSGC). The SCAND group included 11 males and 2 females with a median age of 68 years (range, 50 to 80 y). All SCAND lesions occurred in the ventral trunk or genital area. Of the 13 SCAND cases, 9 and 5 exhibited lymph node and distant metastases, respectively. Three (23.1%) patients with SCAND died of the disease. In contrast, neither metastasis nor mortality was confirmed in the EMPSGC cases. Immunoexpression of the androgen receptor, c-Myb, and MUC2 was limited in SCAND, whereas EMPSGC frequently expressed these immunomarkers. GATA3 P409Afs*99 extension mutations were detected in 7 (53.8%) of the 13 SCAND cases, using Sanger or panel sequencing. All 7 SCAND cases with GATA3 mutations were located in the genital, inguinal, or lower abdominal regions, whereas 5 of the other 6 SCAND cases were located in the anterior upper to mid-trunk. No GATA3 mutations were detected in the EMPSGC cases (0/5, 0%). These clinicopathologic and genetic findings support SCAND as a tumor entity distinguishable from EMPSGC. In addition, the characteristic frameshift extension mutations in GATA3 contribute to the establishment of the tumor-type concept of SCAND.
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Affiliation(s)
- Keisuke Goto
- Department of Diagnostic Pathology and Cytology
- Department of Diagnostic Pathology, Osaka National Hospital, Osaka
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital
- Department of Pathology, Itabashi Central Clinical Laboratory
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo
- Department of Dermatology, Hyogo Cancer Center, Akashi
- Department of Diagnostic Pathology, Chutoen General Medical Center, Kakegawa
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima
| | - Yukiko Kiniwa
- Department of Dermatology, Shinshu University School of Medicine, Matsumoto, Japan
| | - Yoji Kukita
- Laboratory of Genomic Pathology, Research Center
| | - Shuichi Ohe
- Department of Dermatologic Oncology, Osaka International Cancer Institute
| | - Tsubasa Hiraki
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto
| | - Tsunekazu Hishima
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital
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Plaza JA, Pootrakul L, Raghavan SS, Sangueza M, Gru AA. Reproducible Histopathologic Features in Cases of Basal Cell Carcinoma With Neuroendocrine Expression: A Clinicopathologic Study of 24 Cases With a Potential Diagnostic Pitfall. Am J Dermatopathol 2021; 43:903-907. [PMID: 34783706 DOI: 10.1097/dad.0000000000002082] [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] [Indexed: 12/19/2022]
Abstract
ABSTRACT Basal cell carcinomas (BCCs) are common malignancies that usually show clear histomorphologic features, but in certain instances, it can display different patterns of differentiation leading to potential diagnostic confusion. BCCs with neuroendocrine differentiation/expression have been mentioned only briefly in the literature. In this study, we present cases of BCCs with neuroendocrine differentiation/expression that demonstrate reproducible histopathological features. Twenty-four cases were included in the study. All tumors showed conventional histopathologic features that are seen in BCCs, but in addition, all the tumors showed large, hyperchromatic, pleomorphic, mononuclear, and multinucleate cells with intracytoplasmic inclusions and intranuclear cytoplasmic invaginations, with rare cases showing stippled nuclei (salt-and-pepper appearance). These histologic features were somewhat concerning for a neuroendocrine carcinoma; thus, immunohistochemistry studies were performed in all cases at the time of diagnosis. By immunohistochemistry, all tumors showed expression of neuroendocrine markers. CD56 was expressed in all cases 24/24, chromogranin was positive in 17/24 cases, and synaptophysin 8/24 was positive in cases. This study confirms a subset of histopathologic features that are present in cases of BCC that are associated with neuroendocrine expression that can potentially be interpreted differently and can create a diagnostic pitfall. Neuroendocrine expression in BCCs is yet uncertain, and further studies are required to fully understand this phenomenon. To avoid diagnostic pitfalls, dermatopathologists must be aware of these unusual histopathologic features and aberrant immunostaining in such tumors; hence, it is advised to perform a thorough histologic inspection.
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Affiliation(s)
- Jose A Plaza
- Department of Pathology and Dermatology, Division of Dermatopathology, The Ohio State University Wexner Medical Center (OSUWMC), Columbus, OH
- Department of Pathology, Division of Dermatopathology, Hospital Obrero, La Paz, Bolivia ; and
- Department of Pathology, Division of Dermatopathology, The University of Virginia, Charlottesville, VA
| | - Llana Pootrakul
- Department of Pathology and Dermatology, Division of Dermatopathology, The Ohio State University Wexner Medical Center (OSUWMC), Columbus, OH
- Department of Pathology, Division of Dermatopathology, Hospital Obrero, La Paz, Bolivia ; and
- Department of Pathology, Division of Dermatopathology, The University of Virginia, Charlottesville, VA
| | - Shyam S Raghavan
- Department of Pathology and Dermatology, Division of Dermatopathology, The Ohio State University Wexner Medical Center (OSUWMC), Columbus, OH
- Department of Pathology, Division of Dermatopathology, Hospital Obrero, La Paz, Bolivia ; and
- Department of Pathology, Division of Dermatopathology, The University of Virginia, Charlottesville, VA
| | - Martin Sangueza
- Department of Pathology and Dermatology, Division of Dermatopathology, The Ohio State University Wexner Medical Center (OSUWMC), Columbus, OH
- Department of Pathology, Division of Dermatopathology, Hospital Obrero, La Paz, Bolivia ; and
- Department of Pathology, Division of Dermatopathology, The University of Virginia, Charlottesville, VA
| | - Alejandro A Gru
- Department of Pathology and Dermatology, Division of Dermatopathology, The Ohio State University Wexner Medical Center (OSUWMC), Columbus, OH
- Department of Pathology, Division of Dermatopathology, Hospital Obrero, La Paz, Bolivia ; and
- Department of Pathology, Division of Dermatopathology, The University of Virginia, Charlottesville, VA
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DeCoste RC, Carter MD, Barnes PJ, Andea AA, Wang M, Rayson D, Walsh NM. Independent primary cutaneous and mammary apocrine carcinomas with neuroendocrine differentiation: Report of a case and literature review. J Cutan Pathol 2021; 48:1397-1403. [PMID: 34152024 DOI: 10.1111/cup.14085] [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] [Received: 03/08/2021] [Revised: 05/25/2021] [Accepted: 06/17/2021] [Indexed: 11/29/2022]
Abstract
Cutaneous apocrine carcinomas share common features with their counterparts in the breast; hence, metastatic mammary carcinoma must be excluded before such lesions can be designated primary cutaneous neoplasms. Primary tumors from either source rarely exhibit neuroendocrine differentiation. We report a case of a 72-year-old female with a painless 1.2-cm scalp nodule. An incisional biopsy revealed dermal involvement by an invasive apocrine carcinoma juxtaposed to a benign apocrine cystic lesion. Immunohistochemically, the carcinoma expressed neuroendocrine proteins including synaptophysin, chromogranin, and CD56. A primary cutaneous apocrine carcinoma with neuroendocrine differentiation was favored, but additional investigations to exclude breast origin were recommended. These revealed a 1.1-cm nodule in the right breast, which proved to be an invasive ductal carcinoma, morphologically and immunophenotypically similar to the scalp lesion. This confounded the case, yet factors militating against metastatic breast carcinoma to skin included (a) the small size of the mammary tumor, (b) absence of other metastatic disease, and (c) juxtaposition of the scalp carcinoma to a putative benign precursor. Molecular studies were undertaken to resolve the diagnostic quandary. Single nucleotide polymorphism microarray analysis revealed distinct patterns of chromosomal copy number alterations in the two tumors, supporting the concept of synchronous and unusual primary neoplasms.
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Affiliation(s)
- Ryan C DeCoste
- Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada
| | - Michael D Carter
- Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Penelope J Barnes
- Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Aleodor A Andea
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Department of Dermatology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Min Wang
- Department of Pathology, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniel Rayson
- Division of Medical Oncology and Department of Medicine, Nova Scotia Health Authority (Central Zone) and Dalhousie University, Halifax, Nova Scotia, Canada
| | - Noreen M Walsh
- Department of Pathology and Laboratory Medicine, Nova Scotia Health Authority (Central Zone), Halifax, Nova Scotia, Canada.,Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.,Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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