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Vermassen T, De Keukeleire S, Saerens M, Heerwegh S, Debacker JM, Huvenne W, Deron P, Creytens D, Ferdinande L, Rottey S, Bachert C, Duprez F, Van Zele T. Choice of surgery in intestinal-type adenocarcinoma of the sinonasal tract: a long-term comparative study. Eur Arch Otorhinolaryngol 2024; 281:2993-3004. [PMID: 38228884 DOI: 10.1007/s00405-024-08447-w] [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] [Received: 08/30/2023] [Accepted: 12/29/2023] [Indexed: 01/18/2024]
Abstract
PURPOSE Intestinal-type adenocarcinoma (ITAC) is a rare sinonasal malignancy. Curative treatment requires multidisciplinary approach, with surgical options consist of the endonasal endoscopic approach (EEA) and external surgery (EXTS). Here, we provide the post-operative and survival results from a single-center long-term follow-up. METHODS We report long-term follow-up of 92 ITAC cases treated between 1998 and 2018, treated with EEA (n = 40) or EXTS (n = 52). Survival estimates, post-operative complications and duration of hospitalization were compared between surgical modalities. RESULTS Baseline characteristics were similar. A higher number of T4b tumors (16%), and subsequently more tumoral invasion (39%), was present in patients undergoing EXTS compared to EEA (3% and 18%, respectively). No difference in Barnes histology subtypes was noticed. Patients undergoing EEA had a shorter post-operative hospitalization stay versus EXTS (4 versus 7 days). Use of EEA was associated to improved disease-specific survival (DSS; 11.4 versus 4.4 years; HREEA = 0.53), especially for patients with T3-4a tumors (11.4 versus 3.0 years; HREEA = 0.41). Patients with T3-4 stage, tumoral invasion, positive surgical margins, mucinous or mixed histology, and prolonged post-operative hospital stay showed poor local relapse-free, disease-free, overall, and DSS. CONCLUSIONS Long-term follow-up in locally advanced ITAC demonstrates that resection by EEA is correlated with improved DSS compared to EXTS, especially for T3-4 tumors. No significant differences between both treatment modalities was observed regarding per- and post-operative complications, although hospitalization in patients undergoing EEA was shorter than for patients treated with EXTS. These results confirm that EEA should remain the preferred surgical procedure in operable cases of sinonasal ITAC.
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Affiliation(s)
- Tijl Vermassen
- Department Medical Oncology, University Hospital Ghent, Corneel Heymanslaan 10, Ghent, Belgium.
- Biomarkers in Cancer, Ghent University, Ghent, Belgium.
- Cancer Research Institute Ghent, Ghent, Belgium.
| | - Stijn De Keukeleire
- Department Internal Medicine, University Hospital Brussels, Brussels, Belgium
| | - Michael Saerens
- Department Medical Oncology, University Hospital Ghent, Corneel Heymanslaan 10, Ghent, Belgium
- Biomarkers in Cancer, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
| | - Sylvester Heerwegh
- Department Medical Oncology, University Hospital Ghent, Corneel Heymanslaan 10, Ghent, Belgium
| | - Jens M Debacker
- Cancer Research Institute Ghent, Ghent, Belgium
- Laboratory for Molecular Imaging and Therapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium
| | - Wouter Huvenne
- Cancer Research Institute Ghent, Ghent, Belgium
- Department Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium
- Upper Airway Research Laboratory, Ghent University, Ghent, Belgium
| | - Philippe Deron
- Department Head and Neck Surgery, University Hospital Ghent, Ghent, Belgium
| | - David Creytens
- Cancer Research Institute Ghent, Ghent, Belgium
- Department Pathology, University Hospital Ghent, Ghent, Belgium
- Department Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Liesbeth Ferdinande
- Department Pathology, University Hospital Ghent, Ghent, Belgium
- Department Diagnostic Sciences, Ghent University, Ghent, Belgium
| | - Sylvie Rottey
- Department Medical Oncology, University Hospital Ghent, Corneel Heymanslaan 10, Ghent, Belgium
- Biomarkers in Cancer, Ghent University, Ghent, Belgium
- Cancer Research Institute Ghent, Ghent, Belgium
| | - Claus Bachert
- Upper Airway Research Laboratory, Ghent University, Ghent, Belgium
- Department Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
| | - Fréderic Duprez
- Cancer Research Institute Ghent, Ghent, Belgium
- Department Radiation Oncology, University Hospital Ghent, Ghent, Belgium
- Department Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Thibaut Van Zele
- Upper Airway Research Laboratory, Ghent University, Ghent, Belgium
- Department Otorhinolaryngology, University Hospital Ghent, Ghent, Belgium
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Lehtinen N, Suhonen J, Rice K, Välimäki E, Toriseva M, Routila J, Halme P, Rahi M, Irjala H, Leivo I, Kallajoki M, Nees M, Kuopio T, Ventelä S, Rantala JK. Assessment of targeted therapy opportunities in sinonasal cancers using patient-derived functional tumor models. Transl Oncol 2024; 44:101935. [PMID: 38522153 PMCID: PMC10973676 DOI: 10.1016/j.tranon.2024.101935] [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: 12/13/2023] [Revised: 02/26/2024] [Accepted: 03/07/2024] [Indexed: 03/26/2024] Open
Abstract
Malignant tumors derived from the epithelium lining the nasal cavity region are termed sinonasal cancers, a highly heterogeneous group of rare tumors accounting for 3 - 5 % of all head and neck cancers. Progress with next-generation molecular profiling has improved our understanding of the complexity of sinonasal cancers and resulted in the identification of an increasing number of distinct tumor entities. Despite these significant developments, the treatment of sinonasal cancers has hardly evolved since the 1980s, and an advanced sinonasal cancer presents a poor prognosis as targeted therapies are usually not available. To gain insights into potential targeted therapeutic opportunities, we performed a multiomics profiling of patient-derived functional tumor models to identify molecular characteristics associated with pharmacological responses in the different subtypes of sinonasal cancer. METHODS Patient-derived ex vivo tumor models representing four distinct sinonasal cancer subtypes: sinonasal intestinal-type adenocarcinoma, sinonasal neuroendocrine carcinoma, sinonasal undifferentiated carcinoma and SMARCB1 deficient sinonasal carcinoma were included in the analyses. Results of functional drug screens of 160 anti-cancer therapies were integrated with gene panel sequencing and histological analyses of the tumor tissues and the ex vivo cell cultures to establish associations between drug sensitivity and molecular characteristics including driver mutations. RESULTS The different sinonasal cancer subtypes display considerable differential drug sensitivity. Underlying the drug sensitivity profiles, each subtype was associated with unique molecular features. The therapeutic vulnerabilities correlating with specific genomic background were extended and validated with in silico analyses of cancer cell lines representing different human cancers and with reported case studies of sinonasal cancers treated with targeted therapies. CONCLUSION The results demonstrate the importance of understanding the differential biology and the molecular features associated with the different subtypes of sinonasal cancers. Patient-derived ex vivo tumor models can be a powerful tool for investigating these rare cancers and prioritizing targeted therapeutic strategies for future clinical development and personalized medicine.
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Affiliation(s)
| | | | | | | | - Mervi Toriseva
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; FICAN West Cancer Centre, Turku, Finland
| | - Johannes Routila
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | - Perttu Halme
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | - Melissa Rahi
- Department of Neurosurgery, Neurocenter, Turku University Hospital, Turku, Finland; Clinical Neurosciences, University of Turku, Turku, Finland
| | - Heikki Irjala
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
| | - Ilmo Leivo
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Markku Kallajoki
- Department of Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Matthias Nees
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; FICAN West Cancer Centre, Turku, Finland; Department of Biochemistry and Molecular Biology, Medical University of Lublin, Lublin, Poland
| | - Teijo Kuopio
- Department of Biological and Environmental Science, University of Jyväskylä, Jyväskylä, Finland; Wellbeing Services County of Central Finland, Jyväskylä, Finland
| | - Sami Ventelä
- Turku Bioscience Centre, University of Turku and Åbo Akademi University, Turku, Finland; FICAN West Cancer Centre, Turku, Finland; Department for Otorhinolaryngology - Head and Neck Surgery, University of Turku and Turku University Hospital, Turku, Finland
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Lépine C, Trinquet A, Laé M, Costes-Martineau V. [Translocated sinonasal tumors]. Ann Pathol 2024:S0242-6498(24)00007-5. [PMID: 38355380 DOI: 10.1016/j.annpat.2023.12.013] [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: 11/04/2023] [Accepted: 12/25/2023] [Indexed: 02/16/2024]
Abstract
In recent years, several nasal cavity and sinus entities have been described with fusion genes. Salivary gland tumors with fusion genes will not be discussed in this article, but it should be kept in mind that accessory salivary glands are present in the nasal cavity and sinuses and can therefore lead to tumoral lesions. Entities with specific or more frequently described rearrangements in the nasal cavities and sinuses are DEK::AFF2 squamous cell carcinomas,;non-intestinal and non-salivary nasosinusal adenocarcinomas, some of which displaying ETV6 gene rearrangements; biphenotypic nasosinusal sarcomas, most of which displaying PAX3 gene rearrangements; and Ewing's adamantinoma-like sarcomas, which display the same rearrangements as conventional Ewing's sarcomas, mainly the EWSR1::FLI1 rearrangement. Each entity will be described morphologically, immunohistochemically, and prognostically.
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Affiliation(s)
- Charles Lépine
- Service d'anatomie et cytologie pathologiques, Nantes université, CHU de Nantes, 44000 Nantes, France; Inserm, CNRS, Immunology and New Concepts in ImmunoTherapy (INCIT), UMR 1302/EMR6001, Nantes, France.
| | - Aude Trinquet
- Service d'anatomie et cytologie pathologiques, CHU de Montpellier, 34295 Montpellier, France
| | - Marick Laé
- Service d'anatomie et cytologie pathologiques, centre Henri-Becquerel, 1, rue d'Amiens, 76038 Rouen, France
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Gioacchini FM, Di Stadio A, De Luca P, Camaioni A, Pace A, Iannella G, Rubini C, Santarelli M, Tomassetti M, Scarpa A, Olivieri F, Re M. A pilot study to evaluate the expression of microRNA‑let‑7a in patients with intestinal‑type sinonasal adenocarcinoma. Oncol Lett 2024; 27:69. [PMID: 38192674 PMCID: PMC10773186 DOI: 10.3892/ol.2023.14202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/25/2023] [Indexed: 01/10/2024] Open
Abstract
Despite its histological resemblance to colorectal adenocarcinoma, there is little information about the molecular events involved in the pathogenesis of intestinal-type sinonasal adenocarcinoma (ITAC). The present study investigated the possible role and clinical value of microRNA (miR)-let-7a, a head and neck squamous cell carcinoma-related miR, in a well-characterized and homogeneous cohort of patients with ethmoidal ITAC associated with occupational exposure, treated by primary surgery. miR-let-7a expression levels were analyzed in 23 pairs of ethmoidal ITAC and adjacent normal formalin-fixed paraffin-embedded tissues by reverse transcription-quantitative PCR. The expression was evaluated in tumor and healthy tissues according to: Tumor grade (G) of differentiation and extension, and pTNM stage, and presence/absence of recurrence. Comparisons within and between groups were performed using two-tailed Student's paired t-test and one-way ANOVA with Tukey's post hoc test. P<0.05 was considered to indicate a statistically significant difference. miR-let-7a expression in ethmoidal ITAC tissues was significantly lower than that in adjacent normal tissues (P<0.05; mean expression level ± SD, 1.452707±1.4367189 vs. 4.094017±2.7465375). miR expression varied with pT stage. miR-let-7a was downregulated (P<0.05) in advanced stages (pT3-pT4) compared with earlier stages (pT1-pT2). Furthermore, downregulation of miR-let-7a in ITAC was associated with poorly-differentiated (G3) cancer (P<0.05). No other associations were observed between miR-let-7a expression and the other clinicopathological parameters, including disease-free survival. In conclusion, downregulation of miR-let-7a in ITAC was associated with advanced-stage (pT3 and pT4) and poorly-differentiated (G3) disease, suggesting that the mutation of this gene, combined with additional genetic events, could serve a role in ITAC pathogenesis.
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Affiliation(s)
- Federico Maria Gioacchini
- Ear, Nose and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona Joint Hospitals, I-60020 Ancona, Italy
| | - Arianna Di Stadio
- Gian Filippo Ingrassia Department, Otolaryngology Unit, University of Catania, I-95121 Catania, Italy
| | - Pietro De Luca
- Department of Otolaryngology, Fatebenefratelli Isola Tiberina-Gemelli Hospital, I-00100 Rome, Italy
| | - Angelo Camaioni
- Head and Neck Department, San Giovanni-Addolorata Hospital, I-00189 Rome, Italy
| | - Annalisa Pace
- Department of Sense Organs, University La Sapienza of Rome, I-00161 Rome, Italy
| | - Giannicola Iannella
- Department of Sense Organs, University La Sapienza of Rome, I-00161 Rome, Italy
| | - Corrado Rubini
- Pathology and Histopathology Division, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, I-60020 Ancona, Italy
| | - Marco Santarelli
- Pathology and Histopathology Division, Department of Biomedical Sciences and Public Health, Polytechnic University of Marche, I-60020 Ancona, Italy
| | - Marco Tomassetti
- Department of Clinical and Molecular Sciences, Section of Occupational Medicine, Polytechnic University of Marche, I-60020 Ancona, Italy
| | - Alfonso Scarpa
- Department of Medicine and Surgery, University of Salerno, I-84084 Fisciano, Italy
| | - Fabiola Olivieri
- Clinic of Laboratory and Precision Medicine, IRCCS INRCA, I-60121 Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica Delle Marche, I-60126 Ancona, Italy
| | - Massimo Re
- Ear, Nose and Throat Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona Joint Hospitals, I-60020 Ancona, Italy
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Israel AK, Cracolici V, Griffith CC. Challenging differential diagnoses in small biopsies from the sinonasal tract. Semin Diagn Pathol 2023; 40:321-332. [PMID: 37085435 DOI: 10.1053/j.semdp.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/23/2023]
Abstract
Sinonasal biopsy specimens are a challenging area in anatomic pathology. The small, often fragmented or crushed nature of these biopsies can hinder morphologic assessment. Additionally, many of the tumors in this area are rare and share morphologic, and sometime immunophenotypic similarities. In many cases, immunohistochemistry is helpful if not necessary to reach a specific diagnosis. In other cases, a specific diagnosis is not possible and a differential diagnosis must be given on a biopsy specimen despite access to a well-equipped immunohistochemistry laboratory. This review article groups some of the more challenging entities in the sinonasal region based on morphologic patterns. These include low grade squamoid lesions such as sinonasal (Schneiderian) papilloma and DEK::AFF2 rearranged carcinoma, glandular neoplasms such as intestinal and non-intestinal type sinonasal adenocarcinoma, high-grade carcinomas such as HPV-related multiphenotypic sinonasal carcinoma, NUT carcinoma and SWI/SNF deficient carcinomas, small round blue cell tumors such as teratocarcinosarcoma, neuroendocrine carcinoma and olfactory neuroblastoma, and finally, low grade spindle cell neoplasms such as glomangiopericytoma, biphenotypic sinonasal sarcoma and solitary fibrous tumor.
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Affiliation(s)
- Anna-Karoline Israel
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY, USA
| | - Vincent Cracolici
- Department of Anatomic Pathology, Robert. J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 9500 Euclid Ave, L2, Cleveland, OH 44195, USA
| | - Christopher C Griffith
- Department of Anatomic Pathology, Robert. J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, 9500 Euclid Ave, L2, Cleveland, OH 44195, USA.
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Lucidi D, Cantaffa C, Miglio M, Spina F, Alicandri Ciufelli M, Marchioni A, Marchioni D. Tumors of the Nose and Paranasal Sinuses: Promoting Factors and Molecular Mechanisms-A Systematic Review. Int J Mol Sci 2023; 24:ijms24032670. [PMID: 36768990 PMCID: PMC9916834 DOI: 10.3390/ijms24032670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/22/2023] [Accepted: 01/29/2023] [Indexed: 02/01/2023] Open
Abstract
Sinonasal neoplasms are uncommon diseases, characterized by heterogeneous biological behavior, which frequently results in challenges in differential diagnosis and treatment choice. The aim of this review was to examine the pathogenesis and molecular mechanisms underlying the regulation of tumor initiation and growth, in order to better define diagnostic and therapeutic strategies as well as the prognostic impact of these rare neoplasms. A systematic review according to Preferred Reporting Items for Systematic Review and Meta-Analysis criteria was conducted between September and November 2022. The authors considered the three main histological patterns of sinonasal tumors, namely Squamous Cell Carcinoma, Intestinal-Type Adenocarcinoma, and Olfactory Neuroblastoma. In total, 246 articles were eventually included in the analysis. The genetic and epigenetic changes underlying the oncogenic process were discussed, through a qualitative synthesis of the included studies. The identification of a comprehensive model of carcinogenesis for each sinonasal cancer subtype is needed, in order to pave the way toward tailored treatment approaches and improve survival for this rare and challenging group of cancers.
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Affiliation(s)
- Daniela Lucidi
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Carla Cantaffa
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
- Correspondence: ; Tel.: +39-3385313850; Fax: +39-0594222402
| | - Matteo Miglio
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Federica Spina
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Matteo Alicandri Ciufelli
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
| | - Alessandro Marchioni
- Respiratory Diseases Unit, Department of Medical and Surgical Sciences, University Hospital of Modena, 41124 Modena, Italy
| | - Daniele Marchioni
- Department of Otolaryngology, Head and Neck Surgery, University Hospital of Modena, 41124 Modena, Italy
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CDX2 expression in primary skin tumors-case series and review of the literature. Hum Pathol 2022; 129:1-10. [PMID: 35926811 DOI: 10.1016/j.humpath.2022.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 12/14/2022]
Abstract
CDX2 expression characterizes tumors of gastrointestinal origin, including those of intestinal-type differentiation. In dermatopathology, CDX2 expression is reported in 4 settings: cutaneous metastases from carcinomas of intestinal origin or differentiation, extramammary Paget's disease associated with an underlying colorectal or urothelial tumor, pilomatricomas and pilomatrical carcinomas, and rare primary cutaneous (adeno)squamous carcinomas with intestinal immunophenotype. Over 4 years (10/2017-10/2021), 252 dermatopathology cases with CDX2 immunostain were reviewed, revealing 46 cases with confirmed positive staining. Among them, 11 cases confirmed as primary nonintestinal type cutaneous carcinoma with definitively positive CDX2 nuclear staining were further studied. All cases demonstrated basaloid morphology with atypia, variable necrosis, and brisk mitotic activity. Cases 1-5 had heterogeneous features that cannot be further classified, including 2 cases with neuroendocrine or pseudoglandular/pseudopapillary features, and 1 case with human papillomavirus high-risk E6/E7 ISH positivity. In cases 6 through 11, the diagnosis of pilomatrical carcinoma was supported morphologically. This study substantiates the association of CDX2 with pilomatrical carcinoma. In addition, CDX2 positivity was observed in a subset of basaloid cutaneous carcinomas of ambiguous classification. However, this finding also raises a diagnostic pitfall in clinical diagnostic specificity of the CDX2 immunostain in skin cancers, which can be observed in rare while heterogeneous subsets of primary cutaneous carcinomas with primitive cytomorphology.
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Patel S, Snyderman CH, Müller SK, Agaimy A, Seethala RR. Sinonasal mixed transitional epithelial-seromucinous papillary glandular neoplasms with BRAF p.V600E mutations - sinonasal analogues to the sialadenoma papilliferum family tumors. Virchows Arch 2022; 481:565-574. [PMID: 35715530 DOI: 10.1007/s00428-022-03359-8] [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] [Received: 01/31/2022] [Revised: 05/20/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022]
Abstract
Sinonasal non-intestinal type adenocarcinoma (non-ITAC) is a heterogeneous category that may benefit from improved taxonomy. With the recognition that most non-ITAC are phenotypically seromucinous, stratification may be improved by applying salivary type morphologic criteria and molecular findings. We report two cases of papillary seromucinous adenocarcinoma with sinonasal papilloma-like surface components that show histologic and molecular features analogous to the salivary sialadenoma papilliferum family of tumors. Case 1 concerns a 50-year-old female who presented with a left anterior nasoethmoid polyp, while case 2 is that of a 74 year old female with nasal polyposis. Histologically, both cases demonstrated a surface transitional sinonasal papilloma-like component (more prominent in case 2) with a deeper bilayered glandular component showing papillary and tufted micropapillary growth of monomorphic columnar to cuboidal cells with eosinophilic cytoplasm. Case 1 also showed a deep cribriform/microcystic component. Immunostains showed a delimiting p63/p40 positive basal layer around the SOX-10 positive glandular elements, while the transitional sinonasal papilloma-like components were diffusely p63/p40 positive. Like sialadenoma papilliferum and related tumors, both cases demonstrated BRAF p.V600E mutations in both components and no other alterations. The patients remain disease free at 9 and 19 months respectively. Our cases illustrate a novel sinonasal lesion and suggest that improved morphologic and molecular categorization may refine and reduce the category of non-ITAC.
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Affiliation(s)
- Simmi Patel
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
| | - Carl H Snyderman
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Sarina K Müller
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Erlangen, Friedrich-Alexander- Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Abbas Agaimy
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nürnberg, University Hospital, Erlangen, Germany
| | - Raja R Seethala
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
- Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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Thompson LDR, Bishop JA. Update from the 5th Edition of the World Health Organization Classification of Head and Neck Tumors: Nasal Cavity, Paranasal Sinuses and Skull Base. Head Neck Pathol 2022; 16:1-18. [PMID: 35312976 PMCID: PMC9018924 DOI: 10.1007/s12105-021-01406-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/17/2021] [Indexed: 12/31/2022]
Abstract
The World Health Organization Classification of Head and Neck Tumours recently published the 5th edition. There are new entities, emerging entities, and significant updates to the taxonomy and characterization of tumor and tumor-like lesions, specifically in this article as it relates to nasal cavity, paranasal sinuses and skull base. Importantly, the number of diagnostic entries has been reduced by creating category-specific chapters for soft tissue, hematolymphoid, melanocytic, neuroectodermal, and metastatic tumors. Bone and salivary gland tumors are also not separately reported in the sinonasal tract, but included in the jaw and salivary gland sections, respectively. Repetition of characteristic entities in each anatomic site was also reduced, instead highlighting only the unique features in each anatomic site. Two new entities (SWI/SNF complex-deficient sinonasal carcinomas and HPV-related multiphenotypic sinonasal carcinoma) will be highlighted in this review, with a discussion of several emerging entities. There is a short description of updated information for all 24 diagnostic entities included in this edition to allow the reader a snapshot of current state of knowledge, but to encourage more investigation and further broaden understanding of these diverse and rare entities.
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Affiliation(s)
- Lester D. R. Thompson
- Head and Neck Pathology Consultations, 22543 Ventura Boulevard, Ste 220 PMB1034, Woodland Hills, CA 91364 USA
| | - Justin A. Bishop
- University of Texas Southwestern Medical Center, Clements University Hospital, UH04.250, 6201 Harry Hines Blvd., Dallas, TX 75390 USA
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Meerwein CM, Brada MD, Soyka MB, Holzmann D, Rupp NJ. Reappraisal of Grading in Intestinal-Type Sinonasal Adenocarcinoma: Tumor Budding as an Independent Prognostic Parameter. Head Neck Pathol 2022; 16:670-678. [PMID: 35015192 PMCID: PMC9424375 DOI: 10.1007/s12105-022-01410-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 12/31/2021] [Indexed: 12/01/2022]
Abstract
Since sinonasal intestinal-type adenocarcinomas (ITAC) show resemblance to colorectal adenocarcinomas, we aimed to investigate novel prognostic factors of outcome, with particular focus on the role of tumor budding (TB). Retrospective clinico-pathological single-institution study on consecutive ITAC patients between 1996 and 2020. Histopathological parameters including conventional subtypes and TB features (low, intermediate, high) were evaluated with the aid of pancytokeratin (AE1/AE3) immunohistochemical staining. Parameters were correlated to clinical data and outcome. A total of 31 ITAC patients were included. Overall, 19/31 patients (61.3%) presented with stage III/IV disease. Presence of lymph node or distant metastases was rare (1/31 patient, 3.2%). Treatment protocols consisted of tumor resection in 30/31 patients (96.8%) and primary radiochemotherapy in 1/31 patient (3.2%). Adjuvant radiation therapy was conducted in 20/30 surgically treated patients (66.7%). The 3- and 5-year overall survival (OS) was 83.9% and 78.3% and the 3- and 5-years disease-specific survival (DSS) 83.7% % and 78.5%, respectively. The presence of intermediate/high TB (defined as ≥ 5 buds) was associated with both, worse DSS (log rank p = 0.03) and OS (log rank p = 0.006). No patient with low TB revealed progressive disease or died of the disease. No association between TB and tumor stage or conventional tumor subtype was found. Tumor budding seems to be an independent prognostic factor of worse outcome in ITAC.
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Affiliation(s)
- Christian M. Meerwein
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - Muriel D. Brada
- Department of Molecular Pathology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland
| | - Michael B. Soyka
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - David Holzmann
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital of Zurich and University of Zurich, Frauenklinikstrasse 24, 8091 Zurich, Switzerland
| | - Niels J. Rupp
- Department of Molecular Pathology, University Hospital of Zurich and University of Zurich, Zurich, Switzerland ,Faculty of Medicine, University of Zurich, Zurich, Switzerland
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Sjöstedt S, Schmidt AY, Vieira FG, Woller NC, Nielsen FC, von Buchwald C. Intestinal metaplasia is a precursor lesion for sinonasal intestinal-type adenocarcinoma: genomic investigation of a case proving this hypothesis. APMIS 2021; 130:53-56. [PMID: 34741541 DOI: 10.1111/apm.13187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 09/30/2021] [Indexed: 11/29/2022]
Affiliation(s)
- Sannia Sjöstedt
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Ane Yde Schmidt
- Department of Genomic Medicine, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Filipe Garrett Vieira
- Department of Genomic Medicine, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Nina Claire Woller
- Department of Pathology, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Finn Cilius Nielsen
- Department of Genomic Medicine, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
| | - Christian von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery, and Audiology, Copenhagen University Hospital/Rigshospitalet, Copenhagen Ø, Denmark
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Gallet P, Oussalah A, Pouget C, Dittmar G, Chery C, Gauchotte G, Jankowski R, Gueant JL, Houlgatte R. Integrative genomics analysis of nasal intestinal-type adenocarcinomas demonstrates the major role of CACNA1C and paves the way for a simple diagnostic tool in male woodworkers. Clin Epigenetics 2021; 13:179. [PMID: 34563241 PMCID: PMC8467244 DOI: 10.1186/s13148-021-01122-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 06/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background Nasal intestinal-type adenocarcinomas (ITAC) are strongly related to chronic wood dust exposure: The intestinal phenotype relies on CDX2 overexpression but underlying molecular mechanisms remain unknown. Our objectives were to investigate transcriptomic and methylation differences between healthy non-exposed and tumor olfactory cleft mucosae and to compare transcriptomic profiles between non-exposed, wood dust-exposed and ITAC mucosa cells.
Methods We conducted a prospective monocentric study (NCT0281823) including 16 woodworkers with ITAC, 16 healthy exposed woodworkers and 13 healthy, non-exposed, controls. We compared tumor samples with healthy non-exposed samples, both in transcriptome and in methylome analyses. We also investigated wood dust-induced transcriptome modifications of exposed (without tumor) male woodworkers’ samples and of contralateral sides of woodworkers with tumors. We conducted in parallel transcriptome and methylome analysis, and then, the transcriptome analysis was focused on the genes highlighted in methylome analysis. We replicated our results on dataset GSE17433. Results Several clusters of genes enabled the distinction between healthy and ITAC samples. Transcriptomic and IHC analysis confirmed a constant overexpression of CDX2 in ITAC samples, without any specific DNA methylation profile regarding the CDX2 locus. ITAC woodworkers also exhibited a specific transcriptomic profile in their contralateral (non-tumor) olfactory cleft, different from that of other exposed woodworkers, suggesting that they had a different exposure or a different susceptibility. Two top-loci (CACNA1C/CACNA1C-AS1 and SLC26A10) were identified with a hemimethylated profile, but only CACNA1C appeared to be overexpressed both in transcriptomic analysis and in immunohistochemistry. Conclusions Several clusters of genes enable the distinction between healthy mucosa and ITAC samples even in contralateral nasal fossa thus paving the way for a simple diagnostic tool for ITAC in male woodworkers. CACNA1C might be considered as a master gene of ITAC and should be further investigated. Trial registration: NIH ClinicalTrials, NCT0281823, registered May 23d 2016, https://www.clinicaltrials.gov/NCT0281823. Supplementary Information The online version contains supplementary material available at 10.1186/s13148-021-01122-5.
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Affiliation(s)
- Patrice Gallet
- INSERM U1256, NGERE-Nutrition, Genetics, and Environmental Risk Exposure, Faculty of Medicine of Nancy, University of Lorraine, 54000, Nancy, Vandoeuvre-lès-Nancy, France. .,ENT Department, CHRU NANCY, 54511, Vandoeuvre-lès-Nancy, France.
| | - Abderrahim Oussalah
- INSERM U1256, NGERE-Nutrition, Genetics, and Environmental Risk Exposure, Faculty of Medicine of Nancy, University of Lorraine, 54000, Nancy, Vandoeuvre-lès-Nancy, France
| | - Celso Pouget
- Pathology Department, CHRU NANCY, 54511, Vandoeuvre-lès-Nancy, France
| | - Gunnar Dittmar
- Proteome and Genome Research Unit, Department of Oncology, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | - Celine Chery
- INSERM U1256, NGERE-Nutrition, Genetics, and Environmental Risk Exposure, Faculty of Medicine of Nancy, University of Lorraine, 54000, Nancy, Vandoeuvre-lès-Nancy, France
| | - Guillaume Gauchotte
- INSERM U1256, NGERE-Nutrition, Genetics, and Environmental Risk Exposure, Faculty of Medicine of Nancy, University of Lorraine, 54000, Nancy, Vandoeuvre-lès-Nancy, France
| | - Roger Jankowski
- ENT Department, CHRU NANCY, 54511, Vandoeuvre-lès-Nancy, France
| | - Jean Louis Gueant
- INSERM U1256, NGERE-Nutrition, Genetics, and Environmental Risk Exposure, Faculty of Medicine of Nancy, University of Lorraine, 54000, Nancy, Vandoeuvre-lès-Nancy, France
| | - Rémi Houlgatte
- INSERM U1256, NGERE-Nutrition, Genetics, and Environmental Risk Exposure, Faculty of Medicine of Nancy, University of Lorraine, 54000, Nancy, Vandoeuvre-lès-Nancy, France
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13
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Laprovitera N, Riefolo M, Ambrosini E, Klec C, Pichler M, Ferracin M. Cancer of Unknown Primary: Challenges and Progress in Clinical Management. Cancers (Basel) 2021; 13:cancers13030451. [PMID: 33504059 PMCID: PMC7866161 DOI: 10.3390/cancers13030451] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 12/11/2022] Open
Abstract
Simple Summary Patients with cancer of unknown primary site suffer the burden of an uncertain disease, which is characterized by the impossibility to identify the tissue where the tumor has originated. The identification of the primary site of a tumor is of great importance for the patient to have access to site-specific treatments and be enrolled in clinical trials. Therefore, patients with cancer of unknown primary have reduced therapeutic opportunities and poor prognosis. Advancements have been made in the molecular characterization of this tumor, which could be used to infer the tumor site-of-origin and thus broaden the diagnostic outcome. Moreover, we describe here the novel therapeutic opportunities that are based on the genetic and immunophenotypic characterization of the tumor, and thus independent from the tumor type, which could provide most benefit to patients with cancer of unknown primary. Abstract Distant metastases are the main cause of cancer-related deaths in patients with advanced tumors. A standard diagnostic workup usually contains the identification of the tissue-of-origin of metastatic tumors, although under certain circumstances, it remains elusive. This disease setting is defined as cancer of unknown primary (CUP). Accounting for approximately 3–5% of all cancer diagnoses, CUPs are characterized by an aggressive clinical behavior and represent a real therapeutic challenge. The lack of determination of a tissue of origin precludes CUP patients from specific evidence-based therapeutic options or access to clinical trial, which significantly impacts their life expectancy. In the era of precision medicine, it is essential to characterize CUP molecular features, including the expression profile of non-coding RNAs, to improve our understanding of CUP biology and identify novel therapeutic strategies. This review article sheds light on this enigmatic disease by summarizing the current knowledge on CUPs focusing on recent discoveries and emerging diagnostic strategies.
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Affiliation(s)
- Noemi Laprovitera
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40126 Bologna, Italy; (N.L.); (M.R.); (E.A.)
- Department of Life Sciences and Biotechnologies, University of Ferrara, 44121 Ferrara, Italy
| | - Mattia Riefolo
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40126 Bologna, Italy; (N.L.); (M.R.); (E.A.)
| | - Elisa Ambrosini
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40126 Bologna, Italy; (N.L.); (M.R.); (E.A.)
| | - Christiane Klec
- Division of Oncology, Medical University of Graz, 8036 Graz, Austria; (C.K.); (M.P.)
| | - Martin Pichler
- Division of Oncology, Medical University of Graz, 8036 Graz, Austria; (C.K.); (M.P.)
| | - Manuela Ferracin
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40126 Bologna, Italy; (N.L.); (M.R.); (E.A.)
- Correspondence: ; Tel.: +39-051-209-4714
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14
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Compagnoni IM, Lamounier LA, Fontanini L, Silveira GT, Faria FM, Reis MBFD, Valera FCP. Complete endoscopic resection of low-grade nasopharyngeal papillary adenocarcinoma: a case report. Braz J Otorhinolaryngol 2020; 87:237-240. [PMID: 33272840 PMCID: PMC9422480 DOI: 10.1016/j.bjorl.2020.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 12/04/2022] Open
Affiliation(s)
- Inaê M Compagnoni
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Otorrinolaringologia, Ribeirão Preto, SP, Brazil.
| | - Lorena A Lamounier
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Otorrinolaringologia, Ribeirão Preto, SP, Brazil
| | - Letícia Fontanini
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Pediatria, Ribeirão Preto, SP, Brazil
| | - Gabriela T Silveira
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Otorrinolaringologia, Ribeirão Preto, SP, Brazil
| | - Francesca M Faria
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Patologia, Ribeirão Preto, SP, Brazil
| | - Maristella B Francisco Dos Reis
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Departamento de Pediatria, Ribeirão Preto, SP, Brazil
| | - Fabiana C P Valera
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Hospital das Clínicas, Divisão de Otorrinolaringologia, Ribeirão Preto, SP, Brazil
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15
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Singh GK, Bajpai J, Joshi S, Prabhash K, Choughule A, Patil A, Gupta S, Badwe RA. Excellent response to erlotinib in breast carcinoma with rare EGFR mutation-a case report. Ecancermedicalscience 2020; 14:1092. [PMID: 33014134 PMCID: PMC7498275 DOI: 10.3332/ecancer.2020.1092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Indexed: 12/24/2022] Open
Abstract
Triple negative breast carcinoma is a problematic subtype with poor outcomes. Many clinical trials are underway to find possible target to increase treatment options. Epidermal growth factor receptor (EGFR) has emerged as one such molecule which is over expressed in some of these patients and can be targeted by tyrosine kinase inhibitors. We describe a diagnostically challenging case of metastatic breast carcinoma, with extensive lung disease and poor Eastern Cooperative Oncology Group (ECOG) performance status, which expressed an uncommon EGFR mutation (Exon 21L861Q) and which benefitted from erlotinib following failure of all primary treatment modalities. The case uncovers the presence of these unusual mutations in breast carcinoma and highlights the importance of performing molecular analysis and the appropriate targeted therapy. This approach can be an important problem-solving tool, especially in cases where the patient is not fit for the other standard treatment options.
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Affiliation(s)
- Gunjesh Kumar Singh
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - Jyoti Bajpai
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - Shalaka Joshi
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - Kumar Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - Anuradha Choughule
- Department of Molecular Biology, Tata Memorial Hospital, Mumbai 400012, India
| | - Asawari Patil
- Department of Pathology, Tata Memorial Hospital, Mumbai 400012, India
| | - Sudeep Gupta
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
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Baněčková M, Michal M, Laco J, Leivo I, Ptáková N, Horáková M, Michal M, Skálová A. Immunohistochemical and genetic analysis of respiratory epithelial adenomatoid hamartomas and seromucinous hamartomas: are they precursor lesions to sinonasal low-grade tubulopapillary adenocarcinomas? Hum Pathol 2019; 97:94-102. [PMID: 31698004 DOI: 10.1016/j.humpath.2019.09.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/11/2019] [Accepted: 09/11/2019] [Indexed: 01/05/2023]
Abstract
Respiratory epithelial adenomatoid hamartoma (REAH) and seromucinous hamartoma (SH) are rare tumor-like lesions of the nasal cavity, paranasal sinuses, and nasopharynx. The pathogenesis of REAH/SH is still unclear. Neoplastic proliferation, chronic mechanical irritation, inflammation, or possible embryological tissue misplacement are speculated as possible mechanisms of their development. Low-grade tubulopapillary adenocarcinoma (LGTA) is a rare variant of nonsalivary, nonintestinal type sinonasal adenocarcinoma. The aim of this study was to evaluate the immunohistochemical and genetic profiles of 10 cases of REAH/SH, with serous, mucinous, and respiratory components evaluated separately and to compare these findings with the features of 9 cases of LGTA. All cases of REAH/SH and LGTA were analyzed immunohistochemically with a cocktail of mucin antigens (MUC1, MUC2, MUC4, MUC5AC, MUC6) and with epithelial (CK7, CK20, CDX2, SATB2) and myoepithelial markers (S100 protein, p63, SOX10). The next-generation sequencing assay was performed using FusionPlex Solid Tumor Kit (ArcherDx) in 10 cases of REAH/SH, and the EGFR-ZNF267 gene fusion was detected in 1 of them. Two female REAH/SH cases were assessed for the presence of clonality. Using the human androgen receptor assay, 1 case was proved to be clonal. The serous component of REAH/SH was positive for CK7/MUC1 and SOX10 similarly to LGTA. Although REAH/SH and LGTA are histopathologically and clinically separate entities, the overlap in their morphological and immunohistochemical profiles suggests that REAH/SH might be a precursor lesion of LGTA.
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Affiliation(s)
- Martina Baněčková
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen 30605, Czech Republic; Bioptic Laboratory, ltd, Plzen 32600, Czech Republic.
| | - Michael Michal
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen 30605, Czech Republic; Bioptic Laboratory, ltd, Plzen 32600, Czech Republic; Biomedical Center, Charles University, Faculty of Medicine in Plzen, Plzen 32300, Czech Republic
| | - Jan Laco
- The Fingerland Department of Pathology, Charles University, Faculty of Medicine and University Hospital, Hradec Kralove 50005, Czech Republic
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, and Turku University Hospital, Turku 50521, Finland
| | | | - Markéta Horáková
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen 30605, Czech Republic; Bioptic Laboratory, ltd, Plzen 32600, Czech Republic
| | - Michal Michal
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen 30605, Czech Republic; Bioptic Laboratory, ltd, Plzen 32600, Czech Republic
| | - Alena Skálová
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen 30605, Czech Republic; Bioptic Laboratory, ltd, Plzen 32600, Czech Republic
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Kei S, Adeyi OA. Practical Application of Lineage-Specific Immunohistochemistry Markers: Transcription Factors (Sometimes) Behaving Badly. Arch Pathol Lab Med 2019; 144:626-643. [PMID: 31385722 DOI: 10.5858/arpa.2019-0226-ra] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Transcription factors (TFs) are proteins that regulate gene expression and control RNA transcription from DNA. Lineage-specific TFs have increasingly been used by pathologists to determine tumor lineage, especially in the setting of metastatic tumors of unknown primary, among other uses. With experience gathered from its daily application and increasing pitfalls reported from immunohistochemical studies, these often-touted highly specific TFs are not as reliable as once thought. OBJECTIVES.— To summarize the established roles of many of the commonly used TFs in clinical practice and to discuss known and potential sources for error (eg, false-positivity from cross-reactivity, aberrant, and overlap "lineage-specific" expression) in their application and interpretation. DATA SOURCES.— Literature review and the authors' personal practice experience were used. Several examples selected from the University Health Network (Toronto, Ontario, Canada) are illustrated. CONCLUSIONS.— The application of TF diagnostic immunohistochemistry has enabled pathologists to better assess the lineage/origin of primary and metastatic tumors. However, the awareness of potential pitfalls is essential to avoid misdiagnosis.
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Affiliation(s)
- Si Kei
- From the Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (Dr Lou); and the Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis (Dr Adeyi)
| | - Oyedele A Adeyi
- From the Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada (Dr Lou); and the Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis (Dr Adeyi)
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18
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Two Cases of Sinonasal Non-Intestinal-Type Adenocarcinoma with Squamoid Morules Expressing Nuclear β-Catenin and CDX2: A Curious Morphologic Finding Supported by Molecular Analysis. Case Rep Pathol 2018; 2018:8741017. [PMID: 30302299 PMCID: PMC6158946 DOI: 10.1155/2018/8741017] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 08/27/2018] [Indexed: 12/21/2022] Open
Abstract
Sinonasal non-intestinal-type adenocarcinoma (non-ITAC) is a rare, morphologically diverse neoplasm of the head and neck. Squamoid morular metaplasia has recently been reported as an occasional finding in non-ITAC. Interestingly, these squamoid morules often show aberrant expression of CDX2 as well as nuclear expression of β-catenin, similar to other tumors that show this type of metaplasia, but the underlying mechanism responsible for this finding is not completely understood. We present two cases of low-grade non-ITAC with squamoid morules coexpressing CDX2 and nuclear β-catenin by immunohistochemistry, both of which were found to harbor a mutation in CTNNB1, the gene encoding β-catenin. This finding provides support that an alteration in the β-catenin pathway, including mutations in the β-catenin gene itself, is responsible for this recently described morphologic phenomenon in non-ITAC.
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19
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Gallet P, Nguyen DT, Russel A, Jankowski R, Vigouroux C, Rumeau C. Intestinal and non-intestinal nasal cavity adenocarcinoma: Impact of wood dust exposure. Eur Ann Otorhinolaryngol Head Neck Dis 2018; 135:383-387. [PMID: 30201443 DOI: 10.1016/j.anorl.2018.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The aim of the present study was to investigate the role of wood dust exposure in intestinal (ITAC) and non-intestinal type (non-ITAC) nasal adenocarcinoma, so as to improve understanding of the oncogenic mechanisms in the light of the recent literature and of evo-devo concepts. MATERIALS AND METHODS All consecutive patients operated in our institution for nasal adenocarcinoma diagnosed on anatomopathology between May 2004 and February 2014 were included. Surgical specimens were examined twice by independent pathologists, blind to wood dust exposure status. Clinical and demographic data, including wood dust exposure, were collected for the two groups (ITAC and non-IATC). RESULTS 90 patients (84 ITAC, 6 non-ITAC) were included. No non-ITAC patients had history of wood dust exposure, versus 83/84 cases (99%) in ITAC (mean exposure duration: 30±16 years; range 2-65 years). Only 12 ITAC patients (18%) were still exposed at diagnosis. ITAC may develop long after the end of wood dust exposure (up to 60 years). Eight patients (12%) had exposure durations of less than 5 years. Latency between onset of exposure and onset of disease did not decrease with exposure duration. CONCLUSION Exposure to wood dust, even for short periods of time, incurs a risk of developing ITAC, usually after a long latency period. Any exposure requires lifetime follow-up, to ensure prompt treatment. Factors leading to the development of nasal ITAC and non-ITAC are probably different. The analogy with Barret's esophagus and esophageal adenocarcinoma may shed light on the oncogenesis of nasal ITAC.
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Affiliation(s)
- P Gallet
- Service d'ORL et de chirurgie cervico-faciale, hôpitaux de Brabois, institut Louis-Mathieu, CHRU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France; Unité Inserm U954, nutrition génétique et exposition aux risques environnementaux, 54505 Vandoeuvre-les-Nancy cedex, France.
| | - D T Nguyen
- Service d'ORL et de chirurgie cervico-faciale, hôpitaux de Brabois, institut Louis-Mathieu, CHRU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France
| | - A Russel
- Service d'ORL et de chirurgie cervico-faciale, hôpitaux de Brabois, institut Louis-Mathieu, CHRU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France
| | - R Jankowski
- Service d'ORL et de chirurgie cervico-faciale, hôpitaux de Brabois, institut Louis-Mathieu, CHRU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France
| | - C Vigouroux
- Service d'anatomopathologie, hôpital Central, CHRU de Nancy, 54000 Nancy, France
| | - C Rumeau
- Service d'ORL et de chirurgie cervico-faciale, hôpitaux de Brabois, institut Louis-Mathieu, CHRU de Nancy, rue du Morvan, 54511 Vandoeuvre-les-Nancy cedex, France
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20
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The Role of SATB2 as a Diagnostic Marker of Sinonasal Intestinal-type Adenocarcinoma. Appl Immunohistochem Mol Morphol 2018; 26:140-146. [PMID: 27258560 DOI: 10.1097/pai.0000000000000388] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Intestinal-type adenocarcinoma (ITAC) of the nasal cavity and paranasal sinuses is an uncommon tumor associated with exposure to wood and leather dust, nickel, and possibly smoking. ITAC shares phenotypical features with colorectal carcinoma. In contrast to most non-intestinal-type sinonasal adenocarcinomas, ITAC is an aggressive adenocarcinoma with poor clinical outcome; therefore, its reliable separation from non-ITAC is very important. AIM The use of a combination of immunohistochemical markers of intestinal differentiation was tested in a cohort of sinonasal carcinomas of different types. The aim of this study was to explore a new intestinal marker, SATB2, in conjunction with CDX2 and CK20 in differential diagnosis of sinonasal adenocarcinomas. MATERIALS AND METHODS Seven ITACs, 66 non-ITACs, and 1 case of extensive intestinal metaplasia (IM) of the nasal mucosa were included in the study and stained with SATB2, CK20, CDX2, and CK7 antibodies. Detection of mismatch repair proteins was performed in all cases of ITAC. All 7 sinonasal ITACs have been tested for KRAS, NRAS, and BRAF gene mutations. RESULTS All ITACs showed positive expression for SATB2, whereas all non-ITAC cases were negative. The only 1 case of IM was found to be positive for SATB2, whereas the same case showed negative expression of CK20 and only focal immunostaining for CDX2. The genetic analysis showed that only 1 sinonasal ITAC (1/7) showed KRAS c.35G>C, p.(Gly12Ala) mutation, whereas BRAF and NRAS genes were wild type. Four ITACs revealed wild-type KRAS, NRAS, and BRAF, and 2 remaining cases were not analyzable. All ITACs showed preserved nuclear expression of mismatch repair proteins. CONCLUSIONS SATB2 in combination with CDX2 and CK20 differentiates sinonasal ITAC from non-ITAC with increased diagnostic sensitivity and specificity and detects IM in the sinonasal tract more easily.
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Kikuchi K, Fukunaga S, Ide F, Hoshino M, Inoue H, Miyazaki Y, Li TJ, Kusama K. Primary intestinal-type adenocarcinoma of the buccal mucosa: A case report and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:e61-e70. [PMID: 29941401 DOI: 10.1016/j.oooo.2018.05.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 05/07/2018] [Accepted: 05/21/2018] [Indexed: 11/30/2022]
Abstract
Intestinal-type adenocarcinoma of the primary salivary glands is extremely rare. So far, only 11 cases of primary intestinal-type adenocarcinoma of the oral cavity and major salivary glands have been reported. Two of those tumors arose in the floor of mouth, 7 in the tongue, and 2 in the major salivary glands. However, it has remained unclear whether these tumors are derived from mature salivary glands, and primary intestinal-type adenocarcinoma of the buccal mucosa has not been reported previously. Here, we present the first documented case of primary intestinal-type adenocarcinoma arising in a minor salivary gland of the buccal mucosa. Histopathologically, the tumor resembled a well-differentiated or mucinous colonic adenocarcinoma. Immunohistochemically, the tumor cells were diffusely positive for AE1/AE3, CAM5.2, CK7, SATB2, β-catenin, p53, Ki-67, MUC2, and MUC5 AC. CK14 and CK20 were positive in some of the tumor cells. CDX2, CA19-9, SP-A, TTF-1, PSA, SMA, p63, and cyclin D1 were negative in the tumor cells. The tumor in the present case may have originated from salivary gland duct epithelium that underwent transformation to phenotypic intestinal-type epithelium. In this very rare case of primary intestinal-type adenocarcinoma of the buccal mucosa, we considered diagnostic markers that could be indicative of mature salivary gland origin.
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Affiliation(s)
- Kentaro Kikuchi
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan; Department of Oral Pathology, Peking University School of Stomatology, Beijing, China.
| | - Shuichi Fukunaga
- Department of dental and oral surgery, Hanyu General Hospital, Saitama, Japan
| | - Fumio Ide
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Miyako Hoshino
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Harumi Inoue
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Yuji Miyazaki
- Division of Basic Biology, Department of Oral Biology and Tissue Engineering, Meikai University School of Dentistry, Saitama, Japan
| | - Tie-Jun Li
- Department of Oral Pathology, Peking University School of Stomatology, Beijing, China
| | - Kaoru Kusama
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
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22
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Pure mucinous (colloid) adenocarcinoma of the conjunctiva. J Cutan Pathol 2017; 45:78-83. [DOI: 10.1111/cup.13060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/04/2017] [Accepted: 10/10/2017] [Indexed: 11/26/2022]
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23
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Zhang WL, Ma S, Havrilla L, Cai L, Yu CQ, Shen S, Xu HT, Wang L, Yu JH, Lin XY, Wang E, Yang LH. Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma: A case report and literature review. Medicine (Baltimore) 2017; 96:e8851. [PMID: 29381996 PMCID: PMC5708995 DOI: 10.1097/md.0000000000008851] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
RATIONALE Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare malignant nasopharyngeal tumor with features resembling papillary thyroid carcinoma including nuclear positive expression of thyroid transcription factor-1 (TTF-1). PATIENT CONCERNS A 64-year-old male presented with nasal bleeding and a foreign body sensation of the nasopharynx. Laryngoscopy revealed a 2.0-cm broad-based mass with a smooth surface on the posterior wall of the nasopharynx. A biopsy was obtained. DIAGNOSES Histopathologic examination demonstrated tumor cells arranged in both papillary and glandular architecture. The tumor cells express nuclear immunoreactivity for TTF-1. The diagnosis of TL-LGNPPA was made. INTERVENTIONS After the patient was diagnosed with TL-LGNPPA, he underwent complete surgical resection. OUTCOMES There was no recurrence or evidence of metastatic disease at the 12-month follow-up. LESSONS TL-LGNPPA is easy to misdiagnose as metastatic papillary thyroid carcinoma or other relative primary adenocarcinomas. It is important to have a broad differential diagnosis and know the key features of each entity because the prognosis and clinical treatment of each may differ.
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Affiliation(s)
- Wan-Lin Zhang
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Shuang Ma
- Department of Neurology, Sheng Jing Hospital of China Medical University, Shenyang, Liaoning, China
| | - Lauren Havrilla
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Lin Cai
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Cheng-Qian Yu
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Shuai Shen
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Hong-Tao Xu
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Liang Wang
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Juan-Han Yu
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Xu-Yong Lin
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
| | - Endi Wang
- Department of Pathology, Duke University Medical Center, Durham, NC
| | - Lian-He Yang
- Department of Pathology, First Affiliated Hospital and College of Basic Medical Sciences, China Medical University
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24
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Wang HL, Kim CJ, Koo J, Zhou W, Choi EK, Arcega R, Chen ZE, Wang H, Zhang L, Lin F. Practical Immunohistochemistry in Neoplastic Pathology of the Gastrointestinal Tract, Liver, Biliary Tract, and Pancreas. Arch Pathol Lab Med 2017; 141:1155-1180. [PMID: 28854347 DOI: 10.5858/arpa.2016-0489-ra] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
CONTEXT - Immunomarkers with diagnostic, therapeutic, or prognostic values have been increasingly used to maximize the benefits of clinical management of patients with neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. OBJECTIVES - To review the characteristics of immunomarkers that are commonly used in surgical pathology practice for neoplasms of the gastrointestinal tract, liver, biliary tract, and pancreas, and to summarize the clinical usefulness of immunomarkers that have been discovered in recent years in these fields. DATA SOURCES - Data sources include literature review, authors' research data, and personal practice experience. CONCLUSIONS - Immunohistochemistry is an indispensable tool for the accurate diagnosis of neoplastic diseases of the gastrointestinal tract, liver, biliary tract, and pancreas. Useful immunomarkers are available to help distinguish malignant neoplasms from benign conditions, determine organ origins, and subclassify neoplasms that are morphologically and biologically heterogeneous. Specific immunomarkers are also available to help guide patient treatment and assess disease aggressiveness, which are keys to the success of personalized medicine. Pathologists will continue to play a critical role in the discovery, validation, and application of new biomarkers, which will ultimately improve patient care.
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25
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Intestinal-Type Adenocarcinoma: Classification, Immunophenotype, Molecular Features and Differential Diagnosis. Head Neck Pathol 2017; 11:295-300. [PMID: 28321774 PMCID: PMC5550401 DOI: 10.1007/s12105-017-0800-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 02/06/2017] [Indexed: 11/04/2022]
Abstract
Intestinal-type adenocarcinoma is the second most frequent sinonasal adenocarcinoma. High incidence of these tumors is seen among workers with occupational wood dust exposure, particularly of hardwood dusts. Intestinal-type adenocarcinoma has striking histomorphologic and immunophenotypic similarities with colorectal adenocarcinomas, but on the level of molecular pathologic mechanisms these tumors have their own specific features different from gastrointestinal tumors. This article provides an update on current histopathologic classification of intestinal-type adenocarcinomas, their immunophenotypic properties, recent advances in molecular pathologic features and differential diagnostic considerations.
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26
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27
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Primary Intestinal-Type Adenocarcinoma of Tongue: A Case Report with Immunohistochemical and Molecular Profiles and Review of the Literature. Head Neck Pathol 2016; 11:186-191. [PMID: 27752836 PMCID: PMC5429281 DOI: 10.1007/s12105-016-0759-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 09/27/2016] [Indexed: 10/20/2022]
Abstract
Primary lingual intestinal-type adenocarcinomas are extremely rare with only a few cases described. A case with immunohistochemical expression of Androgen Receptor (AR) which was treated solely by chemo-radiotherapy is reported herein. A 54-year-old male was referred with symptoms of fullness in his tongue. Clinical examination showed an asymmetry of the tongue with a hard mass palpable within the middle of the tongue. Biopsy showed intestinal-type adenocarcinoma. The tumour showed positive staining with cytokeratin 7, cytokeratin 20, CDX2, AR, β-catenin and was mismatch repair proteins (MMR) proficient. The molecular analysis did not show mutations in the KRAS, NRAS, BRAF and PIK3CA genes. The patient was treated with radiochemotherapy and is in remission 3.5 years after the diagnosis. This is the first case of intestinal-type tongue adenocarcinoma which showed AR expression and was treated solely with radical chemoradiotherapy.
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28
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Mortuaire G, Leroy X, Vandenhende-Szymanski C, Chevalier D, Thisse AS. Comparison of endoscopic and external resections for sinonasal instestinal-type adenocarcinoma. Eur Arch Otorhinolaryngol 2016; 273:4343-4350. [PMID: 27363404 DOI: 10.1007/s00405-016-4181-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 06/25/2016] [Indexed: 10/21/2022]
Abstract
Endoscopic sinus surgery (ESS) is considered as a valid option in the management of nasal adenocarcinoma (ADC). Comparative studies with open approaches are still required. A monocentric retrospective study was carried out from May 2002 to December 2013, including 43 patients with intestinal-type adenocarcinoma of the ethmoid sinus. Non-resectable tumours or recurrences were excluded. Before 2008, open approach with lateral rhinotomy (LR) was performed as the gold standard of treatment. From 2008, ESS was systematically used as a first-line option as long as a complete resection was achievable. Adjuvant radiation therapy was delivered (RT) for all the patients. LR and ESS were performed in, respectively, 23 and 20 patients. The two groups were comparable in terms of age, occupational dust exposure, histopathological subtypes, and T stage based on the pathological assessment of the specimen (10 pT2, 26 pT3, 2 pT4a, and 5 pT4b). The tumour origin was mainly located in the olfactory cleft with the involvement of the cribriform plate in 60 % of patients. No major complication was observed in ESS group with a reduced hospital stay (5.6 vs 7.6 days). The disease-free survival was not different between LR and ESS groups over a mean follow-up period of 6.6 years. Even for local advanced stages with skull base involvement, we confirm the reliability and the advantages of ESS in terms of oncological outcomes and morbidity. We advocate complete excision of the olfactory cleft to ensure an appropriate control of the tumoral origin.
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Affiliation(s)
- Geoffrey Mortuaire
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital, Lille, France. .,Université de Lille 2, Lille, France. .,Service d'ORL de chirurgie cervico-faciale, Hôpital Huriez CHRU Lille, Lille, 59000, France.
| | - Xavier Leroy
- Université de Lille 2, Lille, France.,Pathology Department, University Hospital, Lille, France
| | | | - Dominique Chevalier
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital, Lille, France.,Université de Lille 2, Lille, France
| | - Anne-Sophie Thisse
- Otorhinolaryngology-Head and Neck Surgery Department, University Hospital, Lille, France
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29
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Hoeben A, van de Winkel L, Hoebers F, Kross K, Driessen C, Slootweg P, Tjan-Heijnen VCG, van Herpen C. Intestinal-type sinonasal adenocarcinomas: The road to molecular diagnosis and personalized treatment. Head Neck 2016; 38:1564-70. [PMID: 27224655 DOI: 10.1002/hed.24416] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2015] [Revised: 11/03/2015] [Accepted: 12/29/2015] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Sinonasal intestinal-type adenocarcinomas (ITACs) are epithelial tumors of the nasal cavity and the paranasal sinuses, often related to professional exposure to organic dust, mainly wood or leather. It is a rare cancer. If resectable, surgery is the treatment of choice. Postoperative radiotherapy is often indicated to increase local control. Systemic treatment (chemotherapy, targeted agents, or immunotherapy) of irresectable ITACs and/or metastasized disease is less standardized. METHODS Articles on ITAC histopathology, molecular profile, and current treatment options of this specific tumor were identified and reviewed, using the electronic databases Pubmed, Medline, Cochrane, and Web of Science. RESULTS This article reviews what is currently known on the histopathology, tumorigenesis, molecular characteristics, and standardized treatment options of ITAC. CONCLUSION More translational research is needed to identify druggable targets that may lead to a personalized treatment plan in order to improve long-term outcome in patients with locally advanced and/or metastasized ITAC. © 2016 Wiley Periodicals, Inc. Head Neck 38: First-1570, 2016.
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Affiliation(s)
- Ann Hoeben
- Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - Linda van de Winkel
- Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Frank Hoebers
- Department of Radiation Oncology (MAASTRO), GROW - School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Kenneth Kross
- Department of Otolaryngology/Head and Neck Surgery, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Chantal Driessen
- Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Pieter Slootweg
- Department of Pathology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Vivianne C G Tjan-Heijnen
- Division of Medical Oncology, GROW - School for Oncology and Developmental Biology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Carla van Herpen
- Department of Medical Oncology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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30
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Donhuijsen K, Kollecker I, Petersen P, Gaßler N, Wolf J, Schroeder HG. Clinical and morphological aspects of adenocarcinomas of the intestinal type in the inner nose: a retrospective multicenter analysis. Eur Arch Otorhinolaryngol 2016; 273:3207-13. [PMID: 27040559 DOI: 10.1007/s00405-016-3987-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 03/13/2016] [Indexed: 11/29/2022]
Abstract
Clinical and histological parameters from 117 patients with wood dust-related sinonasal adenocarcinomas of intestinal type (ITAC) were analyzed and correlated with a follow-up period of 5 years at least. The rate of survival for 5 years was 53.1 % and for 10 years 30.2 %. Only 33 patients were free of disease. 74.2 % of patients with recurrences died in relation to ITAC. As expected, tumors of T4-category had the worst prognosis. The mucus content of a tumor was the most important histological parameter. Endonasal methods of surgery had no more positive survival rates after 5 years. An effect of radiotherapy has to be in discussion. The high incidence of tumor recurrences requires control examinations consistently.
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Affiliation(s)
- K Donhuijsen
- Institute of Pathology, Academic Hospital Braunschweig, Braunschweig, Germany
| | - I Kollecker
- Institute of Pathology, Academic Hospital Braunschweig, Braunschweig, Germany
| | - P Petersen
- Institute of Special Pharmacotherapy, Helios-Clinic of Oncology, Duisburg, Germany
| | - N Gaßler
- Institute of Pathology, Academic Hospital Braunschweig, Braunschweig, Germany
| | - J Wolf
- Professional Trade Association for Wood and Metal, Munich, Germany
| | - H-G Schroeder
- ENT-Clinic, Academic Hospital Braunschweig, Braunschweig, Germany.
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31
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Leivo I. Sinonasal Adenocarcinoma: Update on Classification, Immunophenotype and Molecular Features. Head Neck Pathol 2016; 10:68-74. [PMID: 26830399 PMCID: PMC4746143 DOI: 10.1007/s12105-016-0694-9] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 10/27/2015] [Indexed: 11/25/2022]
Abstract
Adenocarcinomas of the sinonasal tract may originate from respiratory surface epithelium or the underlying seromucinous glands. These malignancies are divided into salivary-type adenocarcinomas and non-salivary-type adenocarcinomas. The latter are further divided into intestinal-type and nonintestinal-type adenocarcinomas. This review provides an update on tumor classification, differential diagnostic considerations and molecular features, as well as new adenocarcinoma entities in the sinonasal area.
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Affiliation(s)
- Ilmo Leivo
- Department of Pathology and Forensic Medicine, University of Turku, Turku, Finland.
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32
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Kandalaft PL, Gown AM. Practical Applications in Immunohistochemistry: Carcinomas of Unknown Primary Site. Arch Pathol Lab Med 2015; 140:508-23. [PMID: 26457625 DOI: 10.5858/arpa.2015-0173-cp] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT -Identification of the site of origin of carcinoma of unknown primary using immunohistochemistry is a frequent requirement of anatomic pathologists. Diagnostic accuracy is crucial, particularly in the current era of targeted therapies and smaller sample sizes. OBJECTIVES -To provide practical guidance and suggestions for classifying carcinoma of unknown primary using both proven and new antibodies, as well as targeting panels based on integration of morphologic and clinical features. DATA SOURCES -Literature review, the authors' practice experience, and authors' research. CONCLUSIONS -With well-performed and interpreted immunohistochemistry panels, anatomic pathologists can successfully identify the site of origin of carcinoma of unknown primary. It is crucial to understand not only the diagnostic uses of the many available antibodies but also the potential limits and pitfalls.
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Affiliation(s)
- Patricia L Kandalaft
- Department of Immunohistochemistry and Anatomic Services, Pacific Pathology Partners, Seattle, Washington (Dr Kandalaft); PhenoPath Laboratories, Seattle (Dr Gown); and Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada (Dr Gown)
| | - Allen M Gown
- Department of Immunohistochemistry and Anatomic Services, Pacific Pathology Partners, Seattle, Washington (Dr Kandalaft); PhenoPath Laboratories, Seattle (Dr Gown); and Department of Pathology, University of British Columbia, Vancouver, British Columbia, Canada (Dr Gown)
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33
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Martínez-Girón R, Mosquera-Martínez J, Martínez-Torre S. Leptomeningeal dissemination from an ethmoidal sinus adenocarcinoma in cerebrospinal fluid cytology. QJM 2015; 108:821-2. [PMID: 25614610 DOI: 10.1093/qjmed/hcv004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Indexed: 11/14/2022] Open
Affiliation(s)
- R Martínez-Girón
- From the CFGS Anatomic Pathology and Cytology, Institute of Piedras Blancas, 33450 Asturias, Spain,
| | - J Mosquera-Martínez
- Medical Oncology Departament, Complejo Hospitalario Universitario de A Coruña, As Xubias, 84, 15006, A Coruña, Spain and
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34
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Ogawa H, Wu X, Kawamoto K, Nishida N, Konno M, Koseki J, Matsui H, Noguchi K, Gotoh N, Yamamoto T, Miyata K, Nishiyama N, Nagano H, Yamamoto H, Obika S, Kataoka K, Doki Y, Mori M, Ishii H. MicroRNAs Induce Epigenetic Reprogramming and Suppress Malignant Phenotypes of Human Colon Cancer Cells. PLoS One 2015; 10:e0127119. [PMID: 25970424 PMCID: PMC4430240 DOI: 10.1371/journal.pone.0127119] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 04/10/2015] [Indexed: 11/18/2022] Open
Abstract
Although cancer is a genetic disease, epigenetic alterations are involved in its initiation and progression. Previous studies have shown that reprogramming of colon cancer cells using Oct3/4, Sox2, Klf4, and cMyc reduces cancer malignancy. Therefore, cancer reprogramming may be a useful treatment for chemo- or radiotherapy-resistant cancer cells. It was also reported that the introduction of endogenous small-sized, non-coding ribonucleotides such as microRNA (miR) 302s and miR-369-3p or -5p resulted in the induction of cellular reprogramming. miRs are smaller than the genes of transcription factors, making them possibly suitable for use in clinical strategies. Therefore, we reprogrammed colon cancer cells using miR-302s and miR-369-3p or -5p. This resulted in inhibition of cell proliferation and invasion and the stimulation of the mesenchymal-to-epithelial transition phenotype in colon cancer cells. Importantly, the introduction of the ribonucleotides resulted in epigenetic reprogramming of DNA demethylation and histone modification events. Furthermore, in vivo administration of the ribonucleotides in mice elicited the induction of cancer cell apoptosis, which involves the mitochondrial Bcl2 protein family. The present study shows that the introduction of miR-302s and miR-369s could induce cellular reprogramming and modulate malignant phenotypes of human colorectal cancer, suggesting that the appropriate delivery of functional small-sized ribonucleotides may open a new avenue for therapy against human malignant tumors.
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Affiliation(s)
- Hisataka Ogawa
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Xin Wu
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Koichi Kawamoto
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Naohiro Nishida
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Masamitsu Konno
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Jun Koseki
- Department of Cancer Profiling Discovery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | | | - Kozou Noguchi
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Noriko Gotoh
- Division of Cancer Cell Biology, Cancer Research Institute of Kanazawa University, Kakuma-machi, Kanazawa, Japan
| | - Tsuyoshi Yamamoto
- Department of Bioorganic Chemistry, Osaka University Graduate School of Pharmaceutical Science, Suita, Osaka, Japan
| | - Kanjiro Miyata
- Department of Materials Engineering, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Nobuhiro Nishiyama
- Department of Materials Engineering, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Tokyo Institute of Technology, Chemical Resources Laboratory, Yokohama, Midori-ku, Japan
| | - Hiroaki Nagano
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hirofumi Yamamoto
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Satoshi Obika
- Department of Bioorganic Chemistry, Osaka University Graduate School of Pharmaceutical Science, Suita, Osaka, Japan
| | - Kazunori Kataoka
- Department of Materials Engineering, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yuichiro Doki
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Masaki Mori
- Department of Gastroenterological Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- * E-mail: (HI); (MM)
| | - Hideshi Ishii
- Department of Frontier Science for Cancer and Chemotherapy, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Cancer Profiling Discovery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- * E-mail: (HI); (MM)
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35
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Purgina B, Bastaki JM, Duvvuri U, Seethala RR. A Subset of Sinonasal Non-Intestinal Type Adenocarcinomas are Truly Seromucinous Adenocarcinomas: A Morphologic and Immunophenotypic Assessment and Description of a Novel Pitfall. Head Neck Pathol 2015; 9:436-46. [PMID: 25690258 PMCID: PMC4651926 DOI: 10.1007/s12105-015-0615-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2014] [Accepted: 02/11/2015] [Indexed: 02/03/2023]
Abstract
While sinonasal intestinal type adenocarcinoma (ITAC) is defined by an intestinal phenotype, non-intestinal type adenocarcinoma (non-ITAC) is traditionally viewed as a diagnosis of exclusion, despite previous implication of a seromucinous phenotype and similarity to sinonasal seromucinous hamartomas (SSH). We performed a comparison of clinicopathologic and immunophenotypic features of ITAC, non-ITAC and SSH using traditional discriminatory markers and new markers of seromucinous differentiation. Twenty-three non-ITAC, 17 ITAC, and 5 SSH were retrieved (1987-2014). As expected, ITAC occurred predominantly in the nasal cavity in elderly patients (mean age 65 years) with a striking male predilection (15:2). Regardless of grade/subtype, all ITAC were invariably CK20 and CDX2 positive, and many (11/15) showed some CK7 positivity. Non-ITAC occurred in younger individuals (mean age 51 years) with a slight female predilection (male to female ratio: 10:13) and showed diverse morphologic patterns and grades, some with morphologic similarity to SSH. SSH occurred in younger individuals (mean age 33 years). Non-ITAC and SSH were invariably CK7 positive and CK20 negative, however, 4/22 non-ITAC and 2/5 SSH showed squamoid morular metaplasia that aberrantly expressed CDX2 and co-expressed nuclear β-catenin. Markers of seromucinous differentiation (S100, DOG1, and SOX10) were essentially absent in ITAC, but present to varying degrees in the majority of non-ITAC and all SSH. Thus, the term 'seromucinous adenocarcinoma' is the more appropriate designation for non-ITAC. Squamoid morules in non-ITAC and SSH may be an immunophenotypic pitfall given the aberrant CDX2 expression.
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Affiliation(s)
- Bibianna Purgina
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, ON, K1H 8L6, Canada
| | - Jassem M Bastaki
- Department of Pathology, Presbyterian-Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, 15232, USA
| | - Umamaheswar Duvvuri
- Department of Otolaryngology, Presbyterian-Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, 15232, USA
- Section of Otolaryngology, VA Pittsburgh Health System, Pittsburgh, PA, 15240, USA
| | - Raja R Seethala
- Department of Pathology, Presbyterian-Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, 15232, USA.
- Department of Otolaryngology, Presbyterian-Shadyside Hospital, University of Pittsburgh Medical Center, Pittsburgh, PA, 15232, USA.
- A614.X Presbyterian University Hospital, 200 Lothrop St, Pittsburgh, PA, 15213, USA.
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36
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Jessurun J. Intra-Alveolar Intestinal Epithelium: A Reappraisal of the So-Called Mucinous Goblet-Cell Rich Carcinoma Apropos of Two Cases With Prolonged Follow-up and Literature Review. Int J Surg Pathol 2015; 23:196-201. [PMID: 25627070 DOI: 10.1177/1066896915568992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Primary pulmonary mucin-rich lesions with abundant goblet cells growing within alveolar spaces are either classified as mucinous adenocarcinoma (previously called mucinous bronchioloalveolar carcinoma) or colloid carcinoma. Some of these lesions display a morphologic pattern characterized by paucicellular discontinuous patches of nonatypical colonic type epithelium attached to alveolar walls without evidence of invasion. Immunohistochemically, these epithelial patches express an intestinal immunophenotype (CD20+, CDX-2+, CK7-, TTF-1-). None of the lesions so far reported with these histological and immunohistochemical characteristics have recurred or metastasized. Herein we describe 2 patients with this type of intra-alveolar mucinous lesions who have been meticulously followed-up for 9 and 14 years, respectively, without evidence of disease progression. Based on their histologic appearance, immunoreactivity, and on the presence of occasional CDX-2 expressing cells in terminal airways adjacent to the lesions, we propose alternative interpretations of the mucin-producing epithelium. More important, a separate provisional category for these lesions is suggested that eliminates their force inclusion as adenocarcinomas.
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Affiliation(s)
- Jose Jessurun
- New York Presbyterian Hospital, Weill Cornell Medical Center, New York, NY, USA
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Caselhos S, Ferreira C, Jácome M, Monteiro E. Liver metastasis of ethmoid sinus adenocarcinoma. Eur Ann Otorhinolaryngol Head Neck Dis 2015; 132:157-9. [PMID: 25577139 DOI: 10.1016/j.anorl.2014.07.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 12/02/2013] [Accepted: 07/30/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Sinonasal cancer is an uncommon neoplasm, often associated with exposure to occupational hazards and delayed diagnosis. CASE REPORT The authors report a rare case of solitary liver metastasis from ethmoid sinus adenocarcinoma treated by surgical resection. No clinical or radiological sign of recurrence was observed with a follow-up of 3 months. DISCUSSION Adenocarcinoma of the ethmoid sinus is characterized by its aggressiveness and its tendency to recurrence. Metastases are rare and can be found in unexpected organs due to dissemination via collateral venous plexuses. The role of chemotherapy has not been clearly established. Due to their rarity, the treatment of metastases has not yet been defined.
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Affiliation(s)
- S Caselhos
- Service ORL et chirurgie cervico-faciale, centre hospitalier Alto Ave, rue dos Cutileiros, Creixomil, Guimarães, Portugal.
| | - C Ferreira
- Service radiothérapie, institut Portugais d'oncologie, Porto, Portugal
| | - M Jácome
- Service d'anatomie pathologique, institut Portugais d'oncologie, Porto, Portugal
| | - E Monteiro
- Service ORL et chirurgie cervico-faciale, institut Portugais d'oncologie, Porto, Portugal
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Franchi A, Palomba A, Miligi L, Ranucci V, Innocenti DRD, Simoni A, Pepi M, Santucci M. Intestinal metaplasia of the sinonasal mucosa adjacent to intestinal-type adenocarcinoma. A morphologic, immunohistochemical, and molecular study. Virchows Arch 2014; 466:161-8. [PMID: 25431194 DOI: 10.1007/s00428-014-1696-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2014] [Revised: 11/05/2014] [Accepted: 11/17/2014] [Indexed: 01/27/2023]
Abstract
It has been hypothesized that the development of sinonasal intestinal-type adenocarcinoma (ITAC) occurs through intestinal metaplasia (IM) of the respiratory and/or glandular epithelium. The aim of this study was to characterize the histological, immunohistochemical, and molecular features of sinonasal IM. Histologic slides from 29 consecutive surgical specimens of ITAC were retrieved. Sections were stained for CDX2, cytokeratin 20 (CK20), MUC2, and p53. The status of TP53 gene exons 4-9 was assessed separately in areas of IM and in ITAC. Foci of IM were detected in eight cases (27.5%). They were all positive for CK20 and CDX2, while MUC2 was detected in six cases (75%). In six cases (75%), the metaplastic foci showed signs of dysplasia, including nuclear enlargement with increased nucleus to cytoplasm ratio, nuclear hyperchromasia, loss of nuclear polarity, and presence of prominent nucleoli. P53 nuclear immunoreactivity was observed in four cases. TP53 gene sequencing was successfully performed in six cases and revealed the same mutation in both IM and ITAC in two cases (c.832C > T and c.215G > C), while another ITAC showed a mutation that was not present in the adjacent IM (c.536A > G). In conclusion, our study suggests a possible clonal relationship between areas of sinonasal IM and ITAC, indicating that IM may represent a precursor lesion of ITAC. Improving the knowledge on the morphological and molecular features of IM is a key step to identify reliable biomarkers to determine the risk of sinonasal ITAC development.
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Affiliation(s)
- Alessandro Franchi
- Section of Anatomic Pathology, Department of Surgery and Translational Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, Italy,
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Abstract
The sinonasal cavities represent an anatomical region affected by a variety of tumours with clinical, aetiological, pathological, and genetic features distinct from tumours at the main head and neck cancer localizations. Together, squamous-cell carcinoma and adenocarcinoma account for 80% of all sinonasal tumours, and are aetiologically associated with professional exposure to wood and leather dust particles and other industrial compounds, and therefore, are officially recognized as an occupational disease. Owing to their distinctive characteristics, sinonasal tumours should be considered as separate entities, not to be included in the miscellany of head and neck cancers. Sinonasal tumours are rare, with an annual incidence of approximately 1 case per 100,000 inhabitants worldwide, a fact that has hampered molecular-genetic studies of the tumorigenic pathways and the testing of alternative treatment strategies. Nevertheless, the clinical management of sinonasal cancer has improved owing to advances in imaging techniques, endoscopic surgical approaches, and radiotherapy. Genetic profiling and the development of in vitro cell lines and animal models currently form the basis for future targeted anticancer therapies. We review these advances in our understanding and treatment of sinonasal tumours.
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Trail overexpression inversely correlates with histological differentiation in intestinal-type sinonasal adenocarcinoma. Int J Surg Oncol 2013; 2013:203873. [PMID: 24223304 PMCID: PMC3816053 DOI: 10.1155/2013/203873] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Accepted: 09/19/2013] [Indexed: 12/29/2022] Open
Abstract
Introduction. Despite their histological resemblance to colorectal adenocarcinoma, there is some information about the molecular events involved in the pathogenesis of intestinal-type sinonasal adenocarcinomas (ITACs). To evaluate the possible role of TNF-related apoptosis-inducing ligand (TRAIL) gene defects in ITAC, by investigating the immunohistochemical expression of TRAIL gene product in a group of ethmoidal ITACs associated with occupational exposure. Material and Methods. Retrospective study on 23 patients with pathological diagnosis of primary ethmoidal ITAC. Representative formalin-fixed, paraffin-embedded block from each case was selected for immunohistochemical studies using the antibody against TRAIL. Clinicopathological data were also correlated with the staining results. Results. The immunohistochemical examination demonstrated that poorly differentiated cases showed a higher percentage of TRAIL expressing cells compared to well-differentiated cases. No correlation was found with other clinicopathological parameters, including T, stage and relapses. Conclusion. The relationship between upregulation of TRAIL and poorly differentiated ethmoidal adenocarcinomas suggests that the mutation of this gene, in combination with additional genetic events, could play a role in the pathogenesis of ITAC.
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Tilson MP, Gallia GL, Bishop JA. Among sinonasal tumors, CDX-2 immunoexpression is not restricted to intestinal-type adenocarcinomas. Head Neck Pathol 2013; 8:59-65. [PMID: 23846317 PMCID: PMC3950377 DOI: 10.1007/s12105-013-0475-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 07/03/2013] [Indexed: 12/14/2022]
Abstract
Intestinal-type adenocarcinoma (ITAC) is a rare form of sinonasal cancer characterized by an association with exposure to industrial dusts, aggressive clinical behavior, and histologic/immunophenotypic similarity to tumors of the gastrointestinal tract. ITAC is sometimes very poorly differentiated and difficult to distinguish from other sinonasal neoplasms, particularly in a limited biopsy. CDX-2 and cytokeratin 20 are consistently immunoreactive in ITAC and as a result, these immunostains are often used to support the diagnosis. However, CDX-2 and cytokeratin 20 have not been tested on a broad range of sinonasal tumors, so their specificities remain unknown. Immunohistochemistry for CDX-2 and cytokeratin 20 was performed on 6 sinonasal ITACs as well as 176 non-intestinal-type sinonasal neoplasms. CDX-2 and cytokeratin 20 were positive in all 6 cases of ITAC. CDX-2 immunoexpression was also observed in 17 of 176 (10 %) non-intestinal-type tumors including 6 of 16 (38 %) sinonasal undifferentiated carcinomas, 8 of 81 (10 %) squamous cell carcinomas (including 5 of 39 non-keratinizing variants), 2 of 20 (10 %) salivary-type adenocarcinomas, and 1 of 2 (50 %) small cell carcinomas. In contrast, among non-intestinal types of sinonasal tumors, cytokeratin 20 was only focally observed in 1 of 176 non-intestinal tumors (a non-keratinizing squamous cell carcinoma). All cases of non-intestinal surface-derived adenocarcinoma and esthesioneuroblastoma were negative for both markers. Both CDX-2 and cytokeratin 20 are highly sensitive for the diagnosis of sinonasal ITAC, but cytokeratin 20 is more specific. CDX-2 staining may be observed in other high grade tumor types, especially sinonasal undifferentiated carcinoma and non-keratinizing squamous cell carcinoma. As a result, in the setting of a poorly differentiated sinonasal carcinoma the diagnosis of ITAC should not be based on CDX-2 immunoexpression alone. Clear-cut glandular differentiation and cytokeratin 20 immunoexpression are more reliable features.
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Affiliation(s)
- Matthew P. Tilson
- grid.21107.350000000121719311Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Gary L. Gallia
- grid.21107.350000000121719311Department of Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, MD USA ,grid.21107.350000000121719311Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD USA
| | - Justin A. Bishop
- grid.21107.350000000121719311Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, MD USA ,grid.21107.350000000121719311Johns Hopkins University School of Medicine, 401 N. Broadway, Weinberg 2249, Baltimore, MD 21231 USA
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López F, Llorente JL, Costales M, García-Inclán C, Pérez-Escuredo J, Álvarez-Marcos C, Hermsen M, Suárez C. Molecular Characterisation of Sinonasal Carcinomas and Their Clinical Implications. ACTA ACUST UNITED AC 2013. [DOI: 10.1016/j.otoeng.2013.08.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Cimino S, Russo GI, Favilla V, Fragala E, Collura Z, Zanghi A, Castelli T, Madonia M, Morgia G. Expression of CD7, CD20 and CDX-2 in a secondary signet-ring cell tumor of the prostate: a case report. Int J Immunopathol Pharmacol 2013; 26:269-72. [PMID: 23527733 DOI: 10.1177/039463201302600130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
As is well-known, signet ring cell carcinoma (SRCC) rarely appears as a histological finding in the prostatic tissue. Nevertheless, a differentiation should be made between a primary tumor and a metastatic disease. We describe the case of a 52-year-old man with lower urinary tract symptoms, serum total PSA of 0.2 ng/ml, elevated serum CEA and CA19-9 levels. Two years prior to presentation, he underwent total gastrectomy with histological findings indicating poor differentiated adenocarcinoma with signet-ring cell. A palpable nodule was found on digital rectal examination and for this reason he underwent 12-core transperineal prostate biopsy with a diagnosis of poor differentiated adenocarcinoma with signet-ring cell and adipose tissue infiltration. Immunohistochemical examinations revealed positivity for PAS, CK7 and CDX-2, focal positivity for CK20 and negativity for PSA and PSAP. The diagnosis of a prostatic secondary SRCC was possible given the positivity to CK7, CDX-2, focal positivity to CK20 and negativity to PSA.
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Senchenko VN, Kisseljova NP, Ivanova TA, Dmitriev AA, Krasnov GS, Kudryavtseva AV, Panasenko GV, Tsitrin EB, Lerman MI, Kisseljov FL, Kashuba VI, Zabarovsky ER. Novel tumor suppressor candidates on chromosome 3 revealed by NotI-microarrays in cervical cancer. Epigenetics 2013; 8:409-20. [PMID: 23478628 DOI: 10.4161/epi.24233] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Genetic and epigenetic alterations in cervical carcinomas were investigated using NotI-microarrays containing 180 cloned sequences flanking all NotI-sites associated with genes on chromosome 3. In total, 48 paired normal/tumor DNA samples, specifically enriched in NotI-sites, were hybridized to NotI-microarrays. Thirty genes, including tumor suppressors or candidates (for example, VHL, RBSP3/CTDSPL, ITGA9, LRRC3B, ALDH1L1, EPHB1) and genes previously unknown as cancer-associated (ABHD5, C3orf77, PRL32, LOC285375, FGD5 and others), showed methylation/deletion in 21-44% of tumors. The genes were more frequently altered in squamous cell carcinomas (SCC) than in adenocarcinomas (ADC, p<0.01). A set of seven potential markers (LRRN1, PRICKLE2, VHL, BHLHE40, RBSP3, CGGBP1 and SOX14) is promising for discrimination of ADC and SCC. Alterations of more than 20 genes simultaneously were revealed in 23% of SCC. Bisulfite sequencing analysis confirmed methylation as a frequent event in SCC. High down-regulation frequency was shown for RBSP3, ITGA9, VILL, APRG1/C3orf35 and RASSF1 (isoform A) genes (3p21.3 locus) in SCC. Both frequency and extent of RASSF1A and RBSP3 mRNA level decrease were more pronounced in tumors with lymph node metastases compared with non-metastatic ones (p ≤ 0.05). We confirmed by bisulfite sequencing that RASSF1 promoter methylation was a rare event in SCC and, for the first time, demonstrated RASSF1A down-regulation at both the mRNA and protein levels without promoter methylation in tumors of this histological type. Thus, our data revealed novel tumor suppressor candidates located on chromosome 3 and a frequent loss of epigenetic stability of 3p21.3 locus in combination with down-regulation of genes in cervical cancer.
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Affiliation(s)
- Vera N Senchenko
- Engelhardt Institute of Molecular Biology; Russian Academy of Sciences; Moscow, Russia
| | - Natalia P Kisseljova
- N.N. Blokhin Russian Cancer Research Center; Russian Academy of Medical Sciences; Moscow, Russia
| | - Tatyana A Ivanova
- N.N. Blokhin Russian Cancer Research Center; Russian Academy of Medical Sciences; Moscow, Russia; Karolinska Institute; Department of Microbiology, Tumour and Cell Biology; Stockholm, Sweden
| | - Alexey A Dmitriev
- Engelhardt Institute of Molecular Biology; Russian Academy of Sciences; Moscow, Russia
| | - George S Krasnov
- Engelhardt Institute of Molecular Biology; Russian Academy of Sciences; Moscow, Russia; I.I.Mechnikov Scientific Research Institute of Vaccines and Sera; Russian Academy of Medical Sciences; Moscow, Russia
| | - Anna V Kudryavtseva
- Engelhardt Institute of Molecular Biology; Russian Academy of Sciences; Moscow, Russia
| | - Grigory V Panasenko
- Institute of Molecular Biology and Genetics; Ukrainian Academy of Sciences; Kiev, Ukraine
| | - Evgeny B Tsitrin
- Koltzov Institute of Developmental Biology; Russian Academy of Sciences; Moscow, Russia
| | | | - Fyodor L Kisseljov
- N.N. Blokhin Russian Cancer Research Center; Russian Academy of Medical Sciences; Moscow, Russia
| | - Vladimir I Kashuba
- Institute of Molecular Biology and Genetics; Ukrainian Academy of Sciences; Kiev, Ukraine
| | - Eugene R Zabarovsky
- Karolinska Institute; Department of Microbiology, Tumour and Cell Biology; Stockholm, Sweden
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Vivanco Allende B, Perez-Escuredo J, Fuentes Martínez N, Fresno Forcelledo MF, Llorente Pendás JL, Hermsen M. Adenocarcinomas nasosinusales tipo intestinal. Perfil inmunohistoquímico de 66 casos. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2013; 64:115-23. [DOI: 10.1016/j.otorri.2012.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2012] [Revised: 08/29/2012] [Accepted: 09/04/2012] [Indexed: 01/09/2023]
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46
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Vivanco Allende B, Perez-Escuredo J, Fuentes Martínez N, Fresno Forcelledo MF, Llorente Pendás JL, Hermsen M. Intestinal-type Sinonasal Adenocarcinomas. Immunohistochemical Profile of 66 Cases. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2013. [DOI: 10.1016/j.otoeng.2013.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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47
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[Cancers of the nasal cavity and paranasal sinuses: clinicopathological, etiological and therapeutic aspects]. Bull Cancer 2013; 99:963-77. [PMID: 23041309 DOI: 10.1684/bdc.2012.1646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Sinonasal cancers are rare and are often associated with occupational exposure that should be researched. Their diagnosis is often delayed. Carcinomas are the most common histological variety. The aim of the present report is to review the main scientific literature about sinonasal cancer to identify their clinicopathological features, and their main causes and treatment modalities. The treatment of these tumors is surgical, usually followed by radiotherapy.
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48
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López F, Llorente JL, Costales M, García-Inclán C, Pérez-Escuredo J, Alvarez-Marcos C, Hermsen M, Suárez C. Molecular characterisation of sinonasal carcinomas and their clinical implications. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2012; 64:289-96. [PMID: 22621788 DOI: 10.1016/j.otorri.2012.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Accepted: 03/22/2012] [Indexed: 11/28/2022]
Abstract
Sinonasal carcinomas are rare tumours with an unfavourable prognosis whose management is difficult and complex, leading to high morbidity and mortality despite improvements in the field of surgery and radiotherapy. An elevated number of these tumours can be attributed to occupational exposure. In comparison with other head and neck malignancies, studies of molecular changes in these tumours are infrequent. This review was focused on findings about the epidemiology and molecular and phenotypic characterisation of sinonasal carcinomas, which can potentially be useful for diagnosis and treatment. The increasing knowledge about the molecular biology that underlies their carcinogenesis may help to identify precursor lesions, prognostic markers and markers that predict chemoradiotherapy response and, finally, to identify potential molecular targets that will expand treatment options.
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Affiliation(s)
- Fernando López
- Servicio de Otorrinolaringología, Instituto Universitario de Oncología del Principado de Asturias, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
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Chu YT, Yue CT. Nasopharyngeal papillary adenocarcinoma: A case report and clinicopathologic review. Tzu Chi Med J 2012. [DOI: 10.1016/j.tcmj.2011.11.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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50
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Re M, Magliulo G, Tarchini P, Mallardi V, Rubini C, Santarelli A, Lo Muzio L. p53 and BCL-2 over-expression inversely correlates with histological differentiation in occupational ethmoidal intestinal-type sinonasal adenocarcinoma. Int J Immunopathol Pharmacol 2011; 24:603-9. [PMID: 21978692 DOI: 10.1177/039463201102400306] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Despite their histological resemblance to colorectal adenocarcinoma, there is little information on the molecular events involved in the pathogenesis of intestinal-type sinonasal adenocarcinoma (ITACs). The aim of this paper is to evaluate the possible role of TP53 and Bcl-2 gene defects in ITAC by investigating the immunohistochemical expression of TP53 and Bcl-2 gene products in a group of ethmoidal ITACs associated with occupational exposure. A retrospective study on 15 patients with pathological diagnosis of primary ethmoidal ITAC was conducted. Representative formalin-fixed, paraffin wax-embedded block from each case was selected for immunohistochemical studies using the antibodies against p53 and Bcl-2. Clinical-pathological data were also correlated with the staining results. The results of immunohistochemical examination demonstrated that poorly differentiated cases showed a higher percentage of p53 and Bcl-2 expressing cells in comparison to well-differentiated cases. No correlation was found with other clinico-pathological parameters, including T, stage and relapses. The relationship between up-regulation of p53 and Bcl-2 and poorly differentiated ethmoidal adenocarcinoma suggests a role of these genes, in combination with additional genetic events, in the pathogenesis of ITAC.
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Affiliation(s)
- M Re
- Department of Otorhinolaryngology, Marche Polytechnic University, Ancona, Italy
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