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Goto K, Kukita Y, Hishima T, Matsushita S, Tsuyuki T, Makihara K, Koga K, Mukumoto S, Honma K. Primary Cutaneous NUT Carcinoma: Clinicopathologic and Genetic Study of 4 Cases. Am J Surg Pathol 2024; 48:942-952. [PMID: 38708710 DOI: 10.1097/pas.0000000000002240] [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: 05/07/2024]
Abstract
WHO Classification of Skin Tumors, fifth edition (2023) has newly described primary cutaneous NUT carcinoma; however, information on this cancer type remains scarce. Herein, we performed clinicopathologic and genetic analyses of 4 cases. Four elderly women (median age 77 y, range: 68 to 82 y) were included. The median tumor size was 12.5 (10 to 40 mm). Tumors were located on the scalp, temple, thigh, and palm. Two (50%) patients presented with regional lymph node metastases. Neither distant metastasis nor mortality was observed during patient follow-up of 10.5 (3 to 15) months. Sanger, panel DNA and whole-exome RNA sequencing revealed BRD3::NUTM1 (n=2) and BRD4::NUTM1 (n=2) fusions. Histology of BRD3 -rearranged tumors revealed an epidermal connection, relatively small tumor nests, and ductal or intracytoplasmic luminal formation, whereas that of BRD4 -rearranged tumors revealed large solid nests comprising discohesive tumor cells. NUT, cytokeratins, p63, EMA, TRPS1, c-MYB, CD56, and INSM1 were immunoexpressed to varying degrees in all (100%) tumors. Furthermore, diffuse SOX10 expression was common (3/4, 75%). The literature review of five previously described cases revealed women predominance, no recurrence, frequent BRD3::NUTM1 fusions, and histology of ductoglandular structures. Our study findings and literature suggest elderly women predominance, relatively frequent BRD3::NUTM1 fusions, histopathologic ductoglandular differentiation, absence of abrupt keratinisation, and a characteristic immunoprofile in primary cutaneous NUT carcinoma, unlike in that of other organ. No distant metastasis or disease-associated mortality was seen in all cases with limited follow-up.
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Affiliation(s)
- Keisuke Goto
- Department of Diagnostic Pathology and Cytology
- Laboratory of Genomic Pathology, Research Center, Osaka International Cancer Institute
- Department of Diagnostic Pathology, Osaka National Hospital, Osaka
- 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 Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima
- Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto
- Department of Diagnostic Pathology, Chutoen General Medical Center, Kakegawa
| | - Yoji Kukita
- Department of Dermatology, Hyogo Cancer Center, Akashi
| | - Tsunekazu Hishima
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital
| | - Shigeto Matsushita
- Department of Dermato-Oncology/Dermatology, National Hospital Organization Kagoshima Medical Center, Kagoshima
| | - Takuji Tsuyuki
- Department of Diagnostic Pathology, Kainan Hospital, Yatomi
| | - Kosuke Makihara
- Department of Surgical Pathology, Kyushu Rosai Hospital, Kitakyushu
| | - Kaori Koga
- Department of Pathology, Fukuoka University Hospital, Fukuoka
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2
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Kervarrec T, Battistella M, Macagno N. [Cutaneous adnexal tumours: Development and synthesis of diagnostic fusion genes]. Ann Pathol 2024:S0242-6498(24)00118-4. [PMID: 38839526 DOI: 10.1016/j.annpat.2024.05.002] [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: 01/13/2024] [Revised: 04/24/2024] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
Cutaneous adnexal tumours are a heterogeneous group of epithelial lesions that includes tumours with follicular, sudoral and/or sebaceous differentiation, or even several combined lines of differentiation. Over the last few years, molecular analysis of these lesions has allowed to identify specific molecular events responsible for tumour development in an increasing number of tumour types. Like other rare neoplasms, such as soft tissue tumours, adnexal tumours display fusion genes resulting from chromosomal translocations that may be specific for the diagnosis if molecular data are properly integrated in the clinical and morphological setting. Molecular testing of adnexal tumours is valuable as it allows to strengthen the robustness of the diagnosis for a group of tumours displaying a wide morphological spectrum. It has allowed to refine the diagnostic criteria and to develop increasingly specific diagnostic immunostainings. Finally, molecular testing has been responsible for the identification of new entities or morphological subtypes of previously known entities. The aim of this review is to provide an update on cutaneous adnexal tumours associated with fusion genes and to evaluate the impact of molecular data on the diagnosis of these lesions.
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Affiliation(s)
- Thibault Kervarrec
- Department of Pathology, université de Tours, hôpital Trousseau, CHRU de Tours, 37044 Tours, France; « Biologie des infections à polyomavirus » team, UMR Inra ISP 1282, université de Tours, Tours, France; CARADERM Network, Lille, France.
| | - Maxime Battistella
- CARADERM Network, Lille, France; Department of Pathology, hôpital Saint-Louis, université Paris 7, AP-HP, Paris, France
| | - Nicolas Macagno
- CARADERM Network, Lille, France; Department of Pathology, Timone University Hospital, Marseille, France
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3
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Sy AL, Hoang MP. SOX10. J Clin Pathol 2023; 76:649-653. [PMID: 37336549 DOI: 10.1136/jcp-2023-208924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2023] [Indexed: 06/21/2023]
Abstract
The SOX gene encodes for transcription factors that are involved in embryogenesis and cell differentiation. Specifically, SOX10 aids with neural crest shuttling and development. In diagnostic histopathology, Sox10 immunostain is a helpful ancillary test due to its high sensitivity for melanocytic and peripheral nerve sheath neoplasms, and its role in distinguishing triple-negative breast carcinomas from gynaecological carcinoma, cutaneous adnexal neoplasms and salivary glands neoplasms from histological mimics.
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Affiliation(s)
- Albert L Sy
- Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Mai P Hoang
- Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
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4
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Kervarrec T, Sohier P, Pissaloux D, de la Fouchardiere A, Cribier B, Battistella M, Macagno N. Genetics of adnexal tumors: An update. Ann Dermatol Venereol 2023; 150:202-207. [PMID: 37270318 DOI: 10.1016/j.annder.2023.03.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 03/07/2023] [Indexed: 06/05/2023]
Abstract
Cutaneous adnexal tumors form a vast heterogeneous group that include frequent entities that are mostly benign, as well as rare tumors that are occasionally malignant. In contrast to cutaneous tumors arising from the interfollicular epidermis that develop as a result of accumulation of UV-induced DNA damage (basal cell carcinoma, squamous cell carcinoma), the oncogenesis of adnexal tumors is related to a broad spectrum of genetic mechanisms (e.g., point mutation, fusion genes, viral integration, etc.). In this setting, specific and recurrent genetic alterations have been progressively reported, and these allow better classification of these entities. For certain of them, immunohistochemical tools are now available, enabling precise integrated histological and molecular diagnosis since certain entities are linked to well-defined alterations. In this context, we aim in this review to summarize the main molecular tools currently available for the classification of adnexal tumors.
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Affiliation(s)
- T Kervarrec
- CARADERM Network, Lille, France; Department of Pathology, University Hospital Center of Tours, Tours, France.
| | - P Sohier
- CARADERM Network, Lille, France; Department of Pathology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, AP-HP Centre - University of Paris Cité, Paris, France; Faculty of Medicine, University of Paris Cité, Paris, France
| | - D Pissaloux
- Department of Pathology, Centre Léon Bérard, Lyon, France
| | | | - B Cribier
- CARADERM Network, Lille, France; Dermatology Clinic, University Hospital of Strasbourg, Hôpital Civil, Strasbourg, France
| | - M Battistella
- CARADERM Network, Lille, France; Department of Pathology, Saint Louis Hospital, Assistance Publique-Hôpitaux de Paris, AP-HP Centre - Paris 7, Paris, France
| | - N Macagno
- CARADERM Network, Lille, France; Department of Pathology, AP-HM, University Hospital of la Timone, Marseille, France; University of Aix-Marseille, INSERM U1251, MMG, Marseille, France
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5
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The Utility of Myoepithelial Cell Layer Identification in Adnexal Carcinomas. Am J Dermatopathol 2022; 44:155-162. [PMID: 35171883 DOI: 10.1097/dad.0000000000001844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The distinction of metastatic carcinomas to the skin (MCS) from cutaneous adnexal carcinomas can pose a significant diagnostic challenge. The differentiation between (MCS) from a primary cutaneous adnexal tumor is one of the most difficult tasks in the field of dermatopathology, and immunohistochemistry has only been partially helpful in solving this problem. In routine diagnostic surgical pathology, it is essential to identify the myoepithelial cell layer by immunohistochemistry to distinguish between an in situ and invasive breast carcinomas and when establishing the presence of microinvasion. The purpose of this study was to evaluate the role of myoepithelial cell layer expression in difficult cases of cutaneous adnexal carcinomas in which histologically it was challenging to separate them from MCS. We studied 38 adnexal carcinomas and evaluated them for myoepithelial markers to confirm the primary nature of the neoplasm. The used markers to search for myoepithelial cell layer retention included calponin, p63, and smooth muscle actin. Of the 38 cases, we found that 13 cases showed myoepithelial layer retention, confirming the primary cutaneous origin of the neoplastic process. The results of our study suggest that the presence of an identifiable retention of the myoepithelial cell layer in adnexal carcinomas could be a useful adjunct observation in the diagnosis of primary adnexal carcinomas, especially in the clinical setting of a questionable primary adnexal versus metastatic neoplasm.
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Mitsui Y, Ogawa K, Koga K, Goto K, Takai T, Anan T, Fukumoto T, Asada H. Trichilemmal cysts with proteinaceous material: A potential diagnostic pitfall. J Cutan Pathol 2022; 49:515-524. [PMID: 35166386 DOI: 10.1111/cup.14214] [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: 06/16/2021] [Revised: 01/08/2022] [Accepted: 02/10/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cysts of the skin are observed frequently and their diagnoses are generally straightforward. However, atypical cystic lesions for which differentiation is indistinct have been noted. METHODS We examined five cases of trichilemmal cyst with proteinaceous material (TCPM), which required differentiation from sweat duct/gland tumors. We investigated the histopathological findings of TCPMs and evaluated the immunohistochemical expression of cytokeratin (CK) 10, CK13, CK17, CK19, CD8, and CD117. Immunohistochemical analysis was performed on the five TCPMs, 10 trichilemmal cysts (TCs), five clear cell hidradenomas, five poroid hidradenomas, and cutaneous normal adnexa. RESULTS Apoptotic cells were present in the cyst wall with a small amount of keratin or calcification in the cavity of TCPMs. The TCPMs and TCs were negative for CK19 and CD117, whereas clear cell hidradenoma and poroid hidradenoma were positive for CK19 and CD117. The restricted positivity for CK10 was detected in the suprabasal layers of the cyst walls of TCPMs and TCs. The immunostaining patterns of TCPMs and TCs were similar to those of normal follicular isthmus. CONCLUSIONS The histopathological findings with characteristics of TCs and a panel of immunohistochemical antibodies including CD117, CK19, and CK10 contributed to a correct diagnosis of TCPM. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Yasuhiro Mitsui
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Kohei Ogawa
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Kaori Koga
- Department of Pathology, Fukuoka University School of medicine, Fukuoka, Japan
| | - Keisuke Goto
- Department of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan.,Department of Pathology, Itabashi Central Clinical Laboratory, Tokyo, Japan.,Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.,Department of Diagnostic Pathology, Shizuoka Cancer Center Hospital, Sunto, Japan.,Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Osaka, Japan.,Department of Diagnostic Pathology, Osaka National Hospital, Osaka, Japan.,Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
| | - Toshihiro Takai
- Department of Dermatology, Hyogo Cancer Center, Akashi, Japan
| | - Takashi Anan
- Sapporo Dermatopathology Institute, Sapporo, Japan
| | | | - Hideo Asada
- Department of Dermatology, Nara Medical University School of Medicine, Kashihara, Japan
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7
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Recent Advances on Immunohistochemistry and Molecular Biology for the Diagnosis of Adnexal Sweat Gland Tumors. Cancers (Basel) 2022; 14:cancers14030476. [PMID: 35158743 PMCID: PMC8833812 DOI: 10.3390/cancers14030476] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/11/2022] [Accepted: 01/12/2022] [Indexed: 01/27/2023] Open
Abstract
Simple Summary Cutaneous sweat gland tumors form an extremely diverse and heterogeneous group of neoplasms that show histological differentiation to the sweat apparatus. Due to their rarity, wide diagnostic range, and significant morphological overlap between entities, their accurate diagnosis remains challenging for pathologists. Until recently, little was known about the molecular pathogenesis of adnexal tumors. Recent findings have revealed a wide range of gene fusions and other oncogenic factors that can be used for diagnostic purposes and, for some, can be detected by immunohistochemistry. Among other organs containing exocrine glands, such as salivary glands, breasts, and bronchi, most of these biomarkers have been reported in homologous neoplasms that share morphological features with their cutaneous counterparts. This review aims to describe these recent molecular and immunohistochemical biomarkers in the field of sweat gland tumors. Abstract Cutaneous sweat gland tumors are a subset of adnexal neoplasms that derive or differentiate into the sweat apparatus. Their great diversity, rarity, and complex terminology make their pathological diagnosis challenging. Recent findings have revealed a wide spectrum of oncogenic drivers, several of which are of diagnostic interest for pathologists. Most of these molecular alterations are represented by gene fusions, which are shared with other homologous neoplasms occurring in organs containing exocrine glands, such as salivary and breast glands, which show similarities to the sweat apparatus. This review aims to provide a synthesis of the most recent immunohistochemical and molecular markers used for the diagnosis of sweat gland tumors and to highlight their relationship with similar tumors in other organs. It will cover adenoid cystic carcinoma (NFIB, MYB, and MYBL1 fusion), cutaneous mixed tumor (PLAG1 fusion), cylindroma and spiradenoma and their carcinomas thereof (NF-κB activation through CYLD inactivation or ALKP1 hotspot mutation), hidradenoma and hidradenocarcinoma (MAML2 fusion), myoepithelioma (EWSR1 and FUS fusion), poroma and porocarcinoma (YAP1, MAML2, and NUTM1 fusion), secretory carcinoma (ETV6, NTRK3 fusion), tubular adenoma and syringo-cystadenoma papilliferum (HRAS and BRAF activating mutations). Sweat gland tumors for which there are no known molecular abnormalities will also be briefly discussed, as well as potential future developments.
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8
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Shiomi T, Matsuno T, Nishimura H, Moriya T. Cutaneous adenomyoepithelioma with histopathological heterogeneity: A case report. Pathol Int 2021; 71:783-788. [PMID: 34473865 DOI: 10.1111/pin.13157] [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: 06/07/2021] [Accepted: 08/17/2021] [Indexed: 12/01/2022]
Abstract
Some skin adnexal tumors display both epithelial and myoepithelial cell populations and can be broadly categorized as biphasic tumors. These include apocrine hidrocystoma, mixed tumor, adenomyoepithelioma (AME), and adenoid cystic carcinoma (ACC). Myoepithelioma is the myoepithelial cell-predominant type in this category. Cutaneous AME is exceedingly rare and usually has a benign prognosis, but it is considered to have the potential for local recurrence and metastasis. We report the case of a 57-year-old man with a 1-year history of an ulcerated nodule on his scalp. Microscopically, it was a defined cutaneous nodule with a focal lobulated architecture, composed of epithelial cells forming ducts and myoepithelial cells distributed around the ducts. In addition to these findings of typical AME, the present case focally revealed atypical features, such as increased mitotic activity (7/10 high power fields), invasive growth, and necrosis. However, cytological atypia was not significant. We conclusively diagnosed cutaneous AME with atypical features, suggesting malignant potential. Moreover, areas showing appearances similar to apocrine hidrocystoma, mixed tumor, myoepithelioma, and ACC were focally observed. We present a unique case of cutaneous AME exhibiting histopathological heterogeneity. The recognition of morphological variation could be helpful in appropriately diagnosing and treating AME of the skin.
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Affiliation(s)
- Tatsushi Shiomi
- Tottori Health Service Association, Tottori, Japan.,Department of Pathology, Kawasaki Medical School, Kurashiki, Japan
| | - Takeshi Matsuno
- Department of Pathology, Kawasaki Medical School, Kurashiki, Japan
| | | | - Takuya Moriya
- Department of Pathology, Kawasaki Medical School, Kurashiki, Japan
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9
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Hile G, Harms PW. Update on Molecular Genetic Alterations of Cutaneous Adnexal Neoplasms. Surg Pathol Clin 2021; 14:251-272. [PMID: 34023104 DOI: 10.1016/j.path.2021.03.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Cutaneous adnexal tumors recapitulate follicular, sweat gland, and/or sebaceous epithelia, and range from benign tumors to aggressive carcinomas. Adnexal tumors can be hallmarks for inherited tumor syndromes. Oncogenic drivers of adnexal neoplasms modulate intracellular pathways including mitogen-activated protein kinase, phosphoinositide-3-kinase, Wnt/β-catenin, Hedgehog, nuclear factor κB, and Hippo intracellular signaling pathways, representing potential therapeutic targets. Malignant progression can be associated with tumor suppressor loss, especially TP53. Molecular alterations drive expression of specific diagnostic markers, such as CDX2 and LEF1 in pilomatricomas/pilomatrical carcinomas, and NUT in poromas/porocarcinomas. In these ways, improved understanding of molecular alterations promises to advance diagnostic, prognostic, and therapeutic possibilities for adnexal tumors.
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Affiliation(s)
- Grace Hile
- Department of Dermatology, University of Michigan, 1910 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5314, USA
| | - Paul W Harms
- Department of Dermatology, University of Michigan, 1910 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-5314, USA; Department of Pathology, University of Michigan, 2800 Plymouth Road, Building 35, Ann Arbor, MI 48109 - 2800, USA.
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10
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Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation. Int J Mol Sci 2021; 22:ijms22105077. [PMID: 34064849 PMCID: PMC8151110 DOI: 10.3390/ijms22105077] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022] Open
Abstract
Adnexal tumors of the skin are a rare group of benign and malignant neoplasms that exhibit morphological differentiation toward one or more of the adnexal epithelium types present in normal skin. Tumors deriving from apocrine or eccrine glands are highly heterogeneous and represent various histological entities. Macroscopic and dermatoscopic features of these tumors are unspecific; therefore, a specialized pathological examination is required to correctly diagnose patients. Limited treatment guidelines of adnexal tumor cases are available; thus, therapy is still challenging. Patients should be referred to high-volume skin cancer centers to receive an appropriate multidisciplinary treatment, affecting their outcome. The purpose of this review is to summarize currently available data on pathogenesis, diagnosis, and treatment approach for apocrine and eccrine tumors.
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11
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CYLD mutation characterizes a subset of HPV-positive head and neck squamous cell carcinomas with distinctive genomics and frequent cylindroma-like histologic features. Mod Pathol 2021; 34:358-370. [PMID: 32892208 PMCID: PMC7817524 DOI: 10.1038/s41379-020-00672-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/20/2020] [Accepted: 08/20/2020] [Indexed: 12/15/2022]
Abstract
Mutations in the tumor suppressor CYLD, known to be causative of cylindromas, were recently described in a subset of high-risk (hr) HPV-positive head and neck squamous cell carcinomas (HNSCC). Pathologic and genetic characterization of these CYLD-mutant carcinomas, however, remains limited. Here, we investigated whether CYLD mutations characterize a histopathologically and genomically distinct subset of hrHPV-positive HNSCC. Comprehensive genomic profiling via hybrid capture-based DNA sequencing was performed on 703 consecutive head and neck carcinomas with hrHPV sequences, identifying 148 unique cases (21%) harboring CYLD mutations. Clinical data, pathology reports, and histopathology were reviewed. CYLD mutations included homozygous deletions (n = 61/148; 41%), truncations (n = 52; 35%), missense (n = 26; 18%) and splice-site (n = 9; 6%) mutations, and in-frame deletion (n = 1; 1%). Among hrHPV-positive HNSCC, the CYLD-mutant cohort showed substantially lower tumor mutational burden than CYLD-wildtype cases (n = 555) (median 2.6 vs. 4.4 mut/Mb, p < 0.00001) and less frequent alterations in PIK3CA (11% vs. 34%, p < 0.0001), KMT2D (1% vs. 16%, p < 0.0001), and FBXW7 (3% vs. 11%, p = 0.0018). Male predominance (94% vs. 87%), median age (58 vs. 60 years), and detection of HPV16 (95% vs. 89%) were similar. On available histopathology, 70% of CYLD-mutant HNSCC (98/141 cases) contained hyalinized material, consistent with basement membrane inclusions, within crowded aggregates of tumor cells. Only 7% of CYLD-wildtype cases demonstrated this distinctive pattern (p < 0.0001). Histopathologic patterns of CYLD-mutant HNSCC lacking basement membrane inclusions included nonkeratinizing (n = 22, 16%), predominantly nonkeratinizing (nonkeratinizing SCC with focal maturation; n = 10, 7%), and keratinizing (n = 11, 8%) patterns. The latter two groups showed significantly higher frequency of PTEN alterations compared with other CYLD-mutant cases (38% [8/21] vs. 7% [8/120], p = 0.0004). Within our cohort of hrHPV-positive HNSCCs, CYLD mutations were frequent (21%) and demonstrated distinctive clinical, histopathologic, and genomic features that may inform future study of prognosis and treatment.
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12
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Nasser H, Siddiqui S. Endocrine Mucin-Producing Sweat Gland Carcinoma: Two New Eyelid Cases and Review of the Literature. Int J Surg Pathol 2020; 28:653-657. [PMID: 32188317 DOI: 10.1177/1066896920913940] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare low-grade sweat gland carcinoma. It is clinically often mistaken for basal cell carcinoma and presents a low rate of local recurrence. In this article, we present 2 new cases of EMPSGC arising in a similar location (left lower eyelid) and review the literature on this topic. One patient is a 72-year-old male with complete excision and no evidence of recurrence after 17 months of surveillance. The second patient is a 77-year-old female with incomplete initial excision and local recurrence after 38 months. p63 immunostain was negative in both cases. EMPSGC should be suspected in elderly patients with lesions of eyelids. Histologically, it should be considered and worked up if the lesion is separated from the overlying epidermis and presents a mucinous component. Complete excision is advised to avoid local recurrences.
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Affiliation(s)
- Haitham Nasser
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
| | - Sami Siddiqui
- Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario, Canada
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13
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Hu Y, Song Z, Chen J, Caulin C. Overexpression of MYB in the Skin Induces Alopecia and Epidermal Hyperplasia. J Invest Dermatol 2019; 140:1204-1213.e5. [PMID: 31758945 DOI: 10.1016/j.jid.2019.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 10/01/2019] [Accepted: 10/22/2019] [Indexed: 12/12/2022]
Abstract
Skin homeostasis is controlled by a complex interplay between tightly regulated transcription factors and signaling pathways. MYB is a transcription factor expressed in hair follicle progenitor cells and found overexpressed in adnexal skin tumors. However, the biological consequences of deregulated MYB expression in the skin remain poorly understood. To address this, we generated transgenic mice that overexpress MYB in epidermal and follicular keratinocytes. These mice exhibited a normal hair coat after birth but gradually developed alopecia, accompanied by altered follicular differentiation, disrupted hair cycle, and a marked depletion of hair follicle stem cells. Additionally, transgenic mice developed massive epidermal hyperplasia and hyperkeratosis. Global expression profiling not only confirmed that the skin of these mice exhibited transcriptomic features of alopecia and epidermal differentiation, but also revealed features of psoriasis and the inflammatory response. The latter was further confirmed by the increased T-cell infiltration found in the skin of transgenic mice. Overall, these results suggest that tight regulation of MYB expression in the skin is critical to maintain skin homeostasis.
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Affiliation(s)
- Yuan Hu
- Department of Otolaryngology - Head & Neck Surgery, The University of Arizona, Tucson, Arizona; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas; Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhongya Song
- Department of Pathology, Stony Brook Medicine, Stony Brook University School of Medicine, Stony Brook, New York; Department of Dermatology, Peking University First Hospital, Beijing, China
| | - Jiang Chen
- Department of Pathology, Stony Brook Medicine, Stony Brook University School of Medicine, Stony Brook, New York
| | - Carlos Caulin
- Department of Otolaryngology - Head & Neck Surgery, The University of Arizona, Tucson, Arizona; Department of Head and Neck Surgery, The University of Texas MD Anderson Cancer Center, Houston, Texas; The University of Arizona Cancer Center, Tucson, Arizona.
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14
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Bell AH, Prieto VG, Ferrarotto R, Goepfert RP, Myers JN, Weber R, Bell D. Magnifying glass on spiradenoma and cylindroma histogenesis and tumorigenesis using systematic transcriptome analysis. Ann Diagn Pathol 2019; 41:14-23. [PMID: 31128548 DOI: 10.1016/j.anndiagpath.2019.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 04/28/2019] [Indexed: 10/26/2022]
Abstract
Spiradenoma and cylindroma are related sweat gland tumors. To delineate their histogenesis, gene profiles, and their potential drivers, we performed a whole-transcriptome sequencing analysis of fourteen samples of spiradenoma/cylindroma in comparison to normal samples. A total of 12 spiradenomas, 5 cylindromas, 3 hybrid spiradenomas/cylindromas and 2 adnexal carcinomas were included in this study. 1335 characteristic genes and transcripts expressed over all 14 spiradenoma/cylindroma tumors were identified, and two groups of expression profiles were observed. Highest upregulated top 7 gene signatures characterized benign tumors with developmental and differentiation related genes, and carcinomas with top 7 genes mainly related to signaling, reorganization and metabolism of membranes. Immunohistochemistry of protein expressions validated 4 upregulated genes (ODAM, HOXB13, MYB and SOX10) considered important and as potential biomarkers for spiradenomas and cylindromas. We further compared the transcriptome of eccrine adnexal tumors with the transcriptome of adenoid cystic carcinoma (ACC) to identify the overlapping genes that may indicate histogenesis. There were 36 specific genes overlapping between adnexal carcinomas and the epithelial-dominant subtype of ACC, and 27 specific genes overlapping benign adnexal tumors with the myoepithelial-dominant subtype of ACC, At this point there is no known specific biomarker to aid in the diagnosis of eccrine spiradenoma and cylindroma in small samples or biopsies within the context of morphological overlap with ACC. In conclusion, spiradenomas and cylindromas are characterized by overexpressed developmental genes, where LHX2 and activated WNT signaling possibly drive associated carcinomas.
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Affiliation(s)
- Achim H Bell
- Department of Research Pathology, MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Victor G Prieto
- Department of Pathology, MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Renata Ferrarotto
- Department of Thoracic Head and Neck Oncology, MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Ryan P Goepfert
- Department of Head and Neck Surgery, MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Jeffrey N Myers
- Department of Head and Neck Surgery, MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Randal Weber
- Department of Head and Neck Surgery, MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA
| | - Diana Bell
- Department of Pathology, MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA; Department of Head and Neck Surgery, MD Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030, USA.
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Merelo Alcocer V, Flamm A, Chen G, Helm K. SOX10 Immunostaining in granulomatous dermatoses and benign reactive lymph nodes. J Cutan Pathol 2019; 46:586-590. [PMID: 30957251 DOI: 10.1111/cup.13470] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 03/26/2019] [Accepted: 04/01/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND SOX10 immunostaining has been considered a highly sensitive and specific marker for melanoma. But there is evidence suggesting that SOX10 positive cells can be present in dermal scars. Therefore, we investigated whether non-melanocytic cell types present in chronic inflammatory processes or benign lymph nodes express SOX10. METHODS We retrospectively selected 20 benign lymph nodes and 20 cutaneous granulomatous dermatoses. SOX10, CD68, and Melan-A immunohistochemistry was performed in all cases. RESULTS Scattered SOX10 positivity was found in 85% of lymph nodes, specifically in subcapsular and medullary sinuses and in 85% of granulomatous dermatoses. In granulomatous dermatoses, the Melan-A stain did not label the scattered SOX10 positive cells and it was difficult to determine if CD68 was co-expressed on the SOX10 positive cells. In the lymph nodes, the SOX10 positive cells did not co-express Melan-A or CD68. CONCLUSIONS We report SOX10 positive cells detected in granulomatous dermatoses and benign lymph nodes. In lymph nodes, SOX10 positive cells were exclusively in subcapsular and medullary sinuses. Therefore, SOX10 is an excellent stain for evaluation of metastatic melanoma with the caveat that positivity in subcapsular and medullary sinuses can be of non-melanocytic origin; the use of additional melanocytic markers is recommended in this situations.
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Affiliation(s)
- Veronica Merelo Alcocer
- Department of Pathology and Laboratory Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Alexandra Flamm
- Department of Pathology and Laboratory Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.,Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Guoli Chen
- Department of Pathology and Laboratory Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
| | - Klaus Helm
- Department of Pathology and Laboratory Medicine, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania.,Department of Dermatology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania
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17
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Yu S, Zheng C, Zhou F, Baillie DL, Rose AM, Deng Z, Chu JSC. Genomic identification and functional analysis of essential genes in Caenorhabditis elegans. BMC Genomics 2018; 19:871. [PMID: 30514206 PMCID: PMC6278001 DOI: 10.1186/s12864-018-5251-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 11/14/2018] [Indexed: 11/27/2022] Open
Abstract
Background Essential genes are required for an organism’s viability and their functions can vary greatly, spreading across many pathways. Due to the importance of essential genes, large scale efforts have been undertaken to identify the complete set of essential genes and to understand their function. Studies of genome architecture and organization have found that genes are not randomly disturbed in the genome. Results Using combined genetic mapping, Illumina sequencing, and bioinformatics analyses, we successfully identified 44 essential genes with 130 lethal mutations in genomic regions of C. elegans of around 7.3 Mb from Chromosome I (left). Of the 44 essential genes, six of which were genes not characterized previously by mutant alleles, let-633/let-638 (B0261.1), let-128 (C53H9.2), let-511 (W09C3.4), let-162 (Y47G6A.18), let-510 (Y47G6A.19), and let-131 (Y71G12B.6). Examine essential genes with Hi-C data shows that essential genes tend to cluster within TAD units rather near TAD boundaries. We have also shown that essential genes in the left half of chromosome I in C. elegans function in enzyme and nucleic acid binding activities during fundamental processes, such as DNA replication, transcription, and translation. From protein-protein interaction networks, essential genes exhibit more protein connectivity than non-essential genes in the genome. Also, many of the essential genes show strong expression in embryos or early larvae stages, indicating that they are important to early development. Conclusions Our results confirmed that this work provided a more comprehensive picture of the essential gene and their functional characterization. These genetic resources will offer important tools for further heath and disease research. Electronic supplementary material The online version of this article (10.1186/s12864-018-5251-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Shicheng Yu
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China. .,Wuhan Frasergen Bioinformatics, Wuhan East Lake High-tech Zone, Wuhan, 430075, China.
| | - Chaoran Zheng
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China
| | - Fan Zhou
- Wuhan Frasergen Bioinformatics, Wuhan East Lake High-tech Zone, Wuhan, 430075, China
| | - David L Baillie
- Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, V5A 1S6, Canada
| | - Ann M Rose
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, V6T 1Z4, Canada
| | - Zixin Deng
- Key Laboratory of Combinatorial Biosynthesis and Drug Discovery, Ministry of Education, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China.
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Held L, Ruetten A, Kutzner H, Palmedo G, John R, Mentzel T. Endocrine mucin-producing sweat gland carcinoma: Clinicopathologic, immunohistochemical, and molecular analysis of 11 cases with emphasis on MYB immunoexpression. J Cutan Pathol 2018; 45:674-680. [PMID: 29882219 DOI: 10.1111/cup.13290] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 05/20/2018] [Accepted: 06/01/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare low-grade primary cutaneous sweat gland carcinoma with predilection for the periorbital skin in elderly female patients. METHODS We describe 11 cases of EMPSGC using a broad panel of immunohistochemical markers including BerEP4, cytokeratin 7, CAM 5.2, synaptophysin, chromogranin, cytokeratin 20, Ki67, progesterone receptor, and estrogen receptor. Calponin (1A4) and p63 were used to detect surrounding myoepithelial cells. We also examined staining with a relatively new marker, MYB. Previous studies of MYB on EMPSGC remain limited. As mucin-rich basal cell carcinoma (BCC) represents a main differential diagnosis and primary cutaneous mucinous carcinoma (PCMC) could appear synchronous with EMPSGC, these lesions were also stained for MYB. RESULTS We found strong and homogenous nuclear MYB-expression in 10 EMPSGC cases stained for MYB. MYB staining was not performed in one case. Furthermore, PCMC and mucin-rich BCCs did not express MYB. CONCLUSION The strong nuclear MYB-positivity in EMPSGC could be useful as a new surrogate marker, especially in mucin-poor EMPSGC cases. Additionally, the staining of PCMC revealed absent MYB-expression leading to the conclusion that EMPSGC might not represent a precursor lesion for primary cutaneous mucinous carcinoma.
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Affiliation(s)
- Laura Held
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Arno Ruetten
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | - Heinz Kutzner
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
| | | | - Rahel John
- Department of Pathology, Advocate Lutheran General Hospital, Park Ridge, Illinois
| | - Thomas Mentzel
- Dermatopathology Friedrichshafen, Friedrichshafen, Germany
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Utility of Immunohistochemistry in Distinguishing Primary Adnexal Carcinoma From Metastatic Breast Carcinoma to Skin and Squamous Cell Carcinoma. Am J Dermatopathol 2018; 40:389-396. [DOI: 10.1097/dad.0000000000001025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Cutaneous Adnexal Cylindroma of Breast: Epithelial Immunoreactivities for GATA-3, Mammaglobin, and E-Cadherin Do Not Equate to a Mammary Ductal Neoplasm. Case Rep Pathol 2018; 2018:4039545. [PMID: 29651355 PMCID: PMC5831977 DOI: 10.1155/2018/4039545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 01/18/2018] [Indexed: 11/18/2022] Open
Abstract
Cylindromas are benign epithelial neoplasms derived from cutaneous eccrine adnexal structures. These tumors are most commonly encountered on the head, neck, and scalp of older women. In rare instances, solitary cylindromas may arise at other body sites. In the current case, a cylindroma of the skin of the breast was diagnosed by complete excision. Immunohistochemical studies confirmed the tumor cells to be immunoreactive with cytokeratin AE1/3, cytokeratin 5/6, cytokeratin 7, p63, and SOX10. The neoplastic cells were also noted to be immunoreactive with markers typically expected to be positive in ductal epithelium of the breast including GATA3, mammaglobin, and E-cadherin. The case emphasizes the importance of correlating clinical setting, imaging studies, patient history, and careful microscopic evaluation in arriving at an accurate diagnosis. This case also illustrates the point that not all “breast” tumors that are confirmed to be positive for GATA3, mammaglobin, and E-cadherin are derived from mammary ducts.
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Panse G, McNiff JM, Ko CJ. CD117 expression in adenosquamous carcinoma. J Cutan Pathol 2017; 44:905-906. [PMID: 28766737 DOI: 10.1111/cup.13001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 06/26/2017] [Accepted: 07/02/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Gauri Panse
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut
| | - Jennifer M McNiff
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Christine J Ko
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut.,Department of Pathology, Yale School of Medicine, New Haven, Connecticut
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