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Patrichi AI, Gurzu S. Pathogenetic and molecular classifications of soft tissue and bone tumors: A 2024 update. Pathol Res Pract 2024; 260:155406. [PMID: 38878666 DOI: 10.1016/j.prp.2024.155406] [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: 04/24/2024] [Revised: 06/06/2024] [Accepted: 06/12/2024] [Indexed: 08/09/2024]
Abstract
Soft tissue and bone tumors comprise a wide category of neoplasms. Their diversity frequently raises diagnostic challenges, and therapeutic options are continuously developing. The therapeutic success rate and long-term prognosis of patients have improved substantially due to new advances in immunohistochemical and molecular biology techniques. A fundamental contribution to these achievements has been the study of the tumor microenvironment and the reclassification of new entities with the updating of the molecular pathogenesis in the revised 5th edition of the Classification of Soft Tissue Tumors, edited by the World Health Organization. The proposed molecular diagnostic techniques include the well-known in situ hybridization and polymerase chain reaction methods, but new techniques such as copy-number arrays, multiplex probes, single-nucleotide polymorphism, and sequencing are also proposed. This review aims to synthesize the most recent pathogenetic and molecular classifications of soft tissue and bone tumors, considering the major impact of these diagnostic tools, which are becoming indispensable in clinicopathological practice.
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Affiliation(s)
- Andrei Ionut Patrichi
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania; Research Center of Oncopathology and Translational Medicine (CCOMT), Targu-Mures, Romania
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Science and Technology, Targu-Mures, Romania; Research Center of Oncopathology and Translational Medicine (CCOMT), Targu-Mures, Romania; Romanian Academy of Medical Sciences, Romania.
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Paolisso P, Bergamaschi L, Angeli F, Belmonte M, Foà A, Canton L, Fedele D, Armillotta M, Sansonetti A, Bodega F, Amicone S, Suma N, Gallinoro E, Attinà D, Niro F, Rucci P, Gherbesi E, Carugo S, Musthaq S, Baggiano A, Pavon AG, Guglielmo M, Conte E, Andreini D, Pontone G, Lovato L, Pizzi C. Cardiac Magnetic Resonance to Predict Cardiac Mass Malignancy: The CMR Mass Score. Circ Cardiovasc Imaging 2024; 17:e016115. [PMID: 38502734 PMCID: PMC10949976 DOI: 10.1161/circimaging.123.016115] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/24/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Multimodality imaging is currently suggested for the noninvasive diagnosis of cardiac masses. The identification of cardiac masses' malignant nature is essential to guide proper treatment. We aimed to develop a cardiac magnetic resonance (CMR)-derived model including mass localization, morphology, and tissue characterization to predict malignancy (with histology as gold standard), to compare its accuracy versus the diagnostic echocardiographic mass score, and to evaluate its prognostic ability. METHODS Observational cohort study of 167 consecutive patients undergoing comprehensive echocardiogram and CMR within 1-month time interval for suspected cardiac mass. A definitive diagnosis was achieved by histological examination or, in the case of cardiac thrombi, by histology or radiological resolution after adequate anticoagulation treatment. Logistic regression was performed to assess CMR-derived independent predictors of malignancy, which were included in a predictive model to derive the CMR mass score. Kaplan-Meier curves and Cox regression were used to investigate the prognostic ability of predictors. RESULTS In CMR, mass morphological features (non-left localization, sessile, polylobate, inhomogeneity, infiltration, and pericardial effusion) and mass tissue characterization features (first-pass perfusion and heterogeneity enhancement) were independent predictors of malignancy. The CMR mass score (range, 0-8 and cutoff, ≥5), including sessile appearance, polylobate shape, infiltration, pericardial effusion, first-pass contrast perfusion, and heterogeneity enhancement, showed excellent accuracy in predicting malignancy (areas under the curve, 0.976 [95% CI, 0.96-0.99]), significantly higher than diagnostic echocardiographic mass score (areas under the curve, 0.932; P=0.040). The agreement between the diagnostic echocardiographic mass and CMR mass scores was good (κ=0.66). A CMR mass score of ≥5 predicted a higher risk of all-cause death (P<0.001; hazard ratio, 5.70) at follow-up. CONCLUSIONS A CMR-derived model, including mass morphology and tissue characterization, showed excellent accuracy, superior to echocardiography, in predicting cardiac masses malignancy, with prognostic implications.
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Affiliation(s)
- Pasquale Paolisso
- Clinical Cardiology and Cardiovascular Imaging Unit, Galeazzi-Sant’Ambrogio Hospital, IRCCS, Milan, Italy (P.P., E. Gallinoro, E.C., D.A.)
- Department of Biomedical and Clinical Sciences (P.P., E. Gallinoro, E.C., D.A.), University of Milan, Italy
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, Italy (P.P., M.B.)
| | - Luca Bergamaschi
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Francesco Angeli
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Marta Belmonte
- Department of Advanced Biomedical Sciences, University of Naples, Federico II, Italy (P.P., M.B.)
- Cardiovascular Center Aalst, OLV Hospital, Aalst, Belgium (M.B.)
| | - Alberto Foà
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Lisa Canton
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Damiano Fedele
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Matteo Armillotta
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Angelo Sansonetti
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Francesca Bodega
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Sara Amicone
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Nicole Suma
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Emanuele Gallinoro
- Clinical Cardiology and Cardiovascular Imaging Unit, Galeazzi-Sant’Ambrogio Hospital, IRCCS, Milan, Italy (P.P., E. Gallinoro, E.C., D.A.)
- Department of Biomedical and Clinical Sciences (P.P., E. Gallinoro, E.C., D.A.), University of Milan, Italy
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy (E. Gherbesi, S.C.)
| | - Domenico Attinà
- Clinical Cardiology and Cardiovascular Imaging Unit, Galeazzi-Sant’Ambrogio Hospital, IRCCS, Milan, Italy (P.P., E. Gallinoro, E.C., D.A.)
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Fabio Niro
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Paola Rucci
- Division of Hygiene and Biostatistics, Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum (P.R.), University of Bologna, Italy
| | - Elisa Gherbesi
- Department of Clinical Sciences and Community Health (E. Gherbesi, S.C., A.B., G.P.), University of Milan, Italy
| | - Stefano Carugo
- Department of Clinical Sciences and Community Health (E. Gherbesi, S.C., A.B., G.P.), University of Milan, Italy
- Department of Cardio-Thoracic-Vascular Diseases, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy (E. Gherbesi, S.C.)
| | - Saima Musthaq
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy (S.M., A.B.)
| | - Andrea Baggiano
- Department of Clinical Sciences and Community Health (E. Gherbesi, S.C., A.B., G.P.), University of Milan, Italy
- Department of Perioperative Cardiology and Cardiovascular Imaging, Centro Cardiologico Monzino IRCCS, Milan, Italy (S.M., A.B.)
| | - Anna Giulia Pavon
- Division of Cardiology, Cardiocentro Ticino Institute, Ente Ospedaliero Cantonale, Lugano, Switzerland (A.G.P.)
| | - Marco Guglielmo
- Department of Cardiology, Division of Heart and Lungs, Utrecht University, Utrecht University Medical Center, the Netherlands (M.G.)
| | - Edoardo Conte
- Clinical Cardiology and Cardiovascular Imaging Unit, Galeazzi-Sant’Ambrogio Hospital, IRCCS, Milan, Italy (P.P., E. Gallinoro, E.C., D.A.)
- Department of Biomedical and Clinical Sciences (P.P., E. Gallinoro, E.C., D.A.), University of Milan, Italy
| | - Daniele Andreini
- Department of Biomedical and Clinical Sciences (P.P., E. Gallinoro, E.C., D.A.), University of Milan, Italy
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
| | - Gianluca Pontone
- Department of Clinical Sciences and Community Health (E. Gherbesi, S.C., A.B., G.P.), University of Milan, Italy
- Department of Biomedical, Surgical and Dentals Sciences (G.P.), University of Milan, Italy
| | - Luigi Lovato
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
| | - Carmine Pizzi
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda Ospedaliera-Universitaria di Bologna (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Department of Medical and Surgical Sciences, DIMEC (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.)
- Alma Mater Studiorum (L.B., F.A., A.F., L.C., D.F., M.A., A.S., F.B., S.A., N.S., D.A., F.N., L.L., C.P.), University of Bologna, Italy
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Chowdhury Z, Mishrikotkar S, Nehra P, Patne S, Tripathi M. Exploring Solitary Fibrous Tumors at a Tertiary Cancer Center: Clinicopathological and Immunomorphologic Profile. Cureus 2024; 16:e56899. [PMID: 38659562 PMCID: PMC11042756 DOI: 10.7759/cureus.56899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2024] [Indexed: 04/26/2024] Open
Abstract
Background Solitary fibrous tumor (SFT) is a distinct fibroblastic tumor that can occur at any anatomical site and can manifest a variety of histopathological features. NAB2-STAT6 gene fusion has recently emerged as a sensitive and specific molecular marker and its surrogate on immunohistochemistry, STAT6 has also displayed considerable efficacy. Nevertheless, its histologic diversity can result in diagnostic challenges, especially when classic features are not apparent. Methods A retrospective study was conducted at a tertiary cancer centre in North India over 3 years to document the clinicopathologic and immunomorphologic profile of SFTs. Immunohistochemical analysis of BCOR and p53 were gauged additionally and patients were stratified according to Modified Demicco and Salas criteria for risk of metastasis. Results Sixteen patients of SFT were identified, affecting middle-aged men and women equally. Though lung/pleura are known to be involved commonly, SFT affects other sites such as the kidney, brain, buccal mucosa, liver, and penis as well. The majority endured localized disease while a lesser number suffered locoregional/distant spread. Two patients revealed features of a malignant profile. Risk stratification according to the Modified Demicco and Salas criteria evinced comparable results. No discernible relationship however was highlighted between the immunohistochemical expression of BCOR, p53, and any significant SFT parameter. Conclusion Although SFTs are very rare substantially benign mesenchymal neoplasms, pathologists must be conversant with their histological diversity and be vigilant of their malignant attributes. The worth of STAT6 immunohistochemistry for precise diagnosis and long-term studies for delineating clinical behavior cannot be overemphasized.
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Affiliation(s)
- Zachariah Chowdhury
- Oncopathology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
| | - Soumya Mishrikotkar
- Oncopathology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
| | - Pritika Nehra
- Oncopathology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
| | - Shashikant Patne
- Oncopathology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
| | - Mayank Tripathi
- Surgical Oncology, Mahamana Pandit Madan Mohan Malviya Cancer Centre (MPMMCC) and Homi Bhabha Cancer Hospital (HBCH) (Tata Memorial Hospital), Varanasi, IND
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Attallah KA, Albannan MS, Farid K, Rizk SM, Fathy N. HCC-Check: A Novel Diagnostic Tool for Early Detection of Hepatocellular Carcinoma Based on Cytokeratin-1 and Epithelial Membrane Antigen: A Cross-Sectional Study. Technol Cancer Res Treat 2024; 23:15330338241234790. [PMID: 38436112 PMCID: PMC10913511 DOI: 10.1177/15330338241234790] [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: 09/28/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 03/05/2024] Open
Abstract
Background: Hepatocellular carcinoma is frequently diagnosed in advanced stages, leading to a poorer prognosis. Therefore, early diagnosis and identification of biomarkers may significantly improve outcomes. Methods: This cross-sectional study enrolled 486 participants distributed among 3 groups: F1 to F3 = 184, F4 = 183, and hepatocellular carcinoma = 119. Liver fibrosis staging was performed using FibroScan, while imaging features were used for hepatocellular carcinoma detection. Epithelial membrane antigen and cytokeratin-1 levels in serum were quantified through Western blot and ELISA, respectively. Results: Patients diagnosed with hepatocellular carcinoma exhibited significantly elevated levels of epithelial membrane antigen and cytokeratin-1 compared to non-hepatocellular carcinoma patients, with a highly significant statistical difference (P < .0001). Epithelial membrane antigen demonstrated diagnostic performance with an area under the curve of 0.75, a sensitivity of 69.0%, and a specificity of 68.5%. Cytokeratin-1 for the identification of hepatocellular carcinoma showed a sensitivity of 79.0% and a specificity of 81.4%, resulting in an area under the curve of 0.87. The developed HCC-Check, which incorporates epithelial membrane antigen, cytokeratin-1, albumin, and alpha-fetoprotein, displayed a higher area under the curve of 0.95 to identify hepatocellular carcinoma, with a sensitivity of 89.8% and a specificity of 83.9%. Notably, HCC-Check values exceeding 2.57 substantially increased the likelihood of hepatocellular carcinoma, with an estimated odds ratio of 50.65, indicating a higher susceptibility to hepatocellular carcinoma development than those with lower values. The HCC-Check diagnostic test exhibited high precision in identifying patients with hepatocellular carcinoma, particularly those with small tumor sizes (<5 cm) and a single nodule, as reflected in area under the curve values of 0.92 and 0.85, respectively. HCC-Check was then applied to the validation study to test its accuracy and reproducibility, showing superior area under the curves for identifying different stages of hepatocellular carcinoma. These outcomes underscore the effectiveness of the test in the early detection of hepatocellular carcinoma. Conclusion: The HCC-Check test presents a highly accurate diagnostic method for detecting hepatocellular carcinoma in its early stages.
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Affiliation(s)
- Kareem A. Attallah
- Research and Development Department, Biotechnology Research Center, New Damietta, Egypt
- Clinical Research Department, Damietta Directorate for Health Affairs, Egyptian Ministry of Health and Population, Damietta, Egypt
| | - Mohamed S. Albannan
- Research and Development Department, Biotechnology Research Center, New Damietta, Egypt
| | - Khaled Farid
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Sherine M. Rizk
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Nevine Fathy
- Biochemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
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Hassan U, Saeed SM, Mushtaq S, Hussain M, Hameed M. The Expression of Mucin-4 (MUC4) in Sarcomas Apart From Sclerosing Epithelioid Fibrosarcoma and Low-Grade Fibromyxoid Sarcoma. Cureus 2023; 15:e49546. [PMID: 38156143 PMCID: PMC10753521 DOI: 10.7759/cureus.49546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
Background Low-grade fibromyxoid sarcoma (LGFMS) and sclerosing epithelioid fibrosarcoma (SEF) are two rare but aggressive soft tissue sarcomas that can be difficult to distinguish due to histopathological similarities. The present study examines the diagnostic capacities of mucin-4 (MUC4), a transmembrane mucin, in identifying different types of sarcomas and broadens its evaluation to include a wide range of sarcomas. Methods Immunohistochemical (IHC) examination of tissue samples from various sarcomas was performed using a mouse anti-MUC4 monoclonal antibody. IHC was conducted on 4-mm thick formalin-fixed paraffin-embedded tissue sections after pressure cooker antigen retrieval with a mouse anti-MUC4 monoclonal antibody. Results MUC4 was shown to be highly expressed in SEF (n=13) and LGFMS (n=10), while focal positivity in synovial sarcoma (n=1). Other sarcomas, such as malignant peripheral nerve sheath tumors, fibrosarcoma, leiomyosarcoma, liposarcoma, and myxofibrosarcoma, exhibited no expression (n=0). These findings are consistent with previous research and support MUC4 specificity as a SEF and LGFMS marker. This study provides information on the diagnostic efficacy of MUC4, particularly in the context of certain subtypes. It not only helps our understanding of these unique instances, but it also provides context for histopathological and IHC findings in soft tissue sarcoma. Furthermore, this study investigates the influence of age and gender on MUC4 expression in a range of sarcomas, which was typically understudied in the literature and found no relation with expression of MUC4. Conclusion In conclusion, this study adds to our understanding of soft tissue sarcomas by emphasizing the crucial role of MUC4 in certain sarcoma subtypes while acknowledging the complex variety of the sarcoma landscape. Further research is needed to understand the molecular mechanism that governs marker expression patterns, as well as the therapeutic implications.
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Affiliation(s)
- Usman Hassan
- Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Saad M Saeed
- Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Sajid Mushtaq
- Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Mudassar Hussain
- Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
| | - Maryam Hameed
- Pathology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, PAK
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6
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Challa B, Mohanty SK, Jha S, Sampat NY, Sardana R, Lobo A, Sharma S, Arora S, Rath D, Munjal G, Pattnaik N, Jain D, Jain E, Dewan A, Dixit M, Malik V, Shinde S, Balzer BL, Parwani A. SS18-SSX Expression in a Contemporary Cohort of Primary Renal Synovial Sarcoma: A Multi-Institutional Experience of Fourteen Patients. Int J Surg Pathol 2023; 31:1232-1243. [PMID: 36591871 DOI: 10.1177/10668969221143481] [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] [Indexed: 01/03/2023]
Abstract
Primary renal synovial sarcoma is a rare aggressive mesenchymal neoplasm of the kidney that accounts for less than 1% of renal sarcomas. Herein, we describe the clinicopathologic and molecular findings of 14 renal synovial sarcoma patients in one of the largest case series to date and to our knowledge, the only renal synovial sarcoma series to use novel SS18-SSX IHC. Clinicopathologic, IHC, molecular, management, and follow-up data were reviewed and analyzed. Macroscopically, the tumors had either homogeneous, tan-white, and solid (n = 10), variegated and solid (n = 3), or variegated and solid-cystic (n = 1) cut surfaces. Spindle cell (n = 10), round cell (n = 3), and round to epithelioid morphologies (n = 1) were observed. SS18-SSX IHC was positive in all 14 tumors (diffuse, n = 10; multifocal, n = 2; focal, n = 2). All the tumors harbored SS18::SSX1/2 gene rearrangement. Metastases to the liver, brain, and lung (n = 1); liver and bone (n = 1); liver and diaphragm (n = 1) were identified. Adjuvant chemotherapy was administered in 11/12 patients. Follow-up was available for 10 patients (time period range: 5 to 24 months). Four patients died of disease, and six patients are alive with no recurrence or metastasis. As SS18-SSX IHC showed an excellent concordance with the FISH results, this may reliably be used in the IHC panel of spindle/round cell sarcomas of the kidney and as a molecular surrogate for renal synovial sarcoma, particularly in a resource-limited setting. Also, the tumors with focal SS18-SSX expression had lower break apart signals in the FISH assay (19% and 23% in two tumors with focal SS18-SSX IHC positivity).
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Affiliation(s)
- Bindu Challa
- Departments of Pathology and Laboratory Medicine, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Sambit K Mohanty
- Departments of Pathology and Laboratory Medicine, Advanced Medical and Research Institute, Bhubaneswar, India
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Shilpy Jha
- Departments of Pathology and Laboratory Medicine, Advanced Medical and Research Institute, Bhubaneswar, India
| | - Nakul Y Sampat
- Departments of Pathology and Laboratory Medicine, Advanced Medical and Research Institute, Bhubaneswar, India
| | - Ruhani Sardana
- Departments of Pathology and Laboratory Medicine, Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Anandi Lobo
- Departments of Pathology and Laboratory Medicine, Kapoor Center of Urology and Pathology, Raipur, India
| | - Shivani Sharma
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Samriti Arora
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Debadarshi Rath
- Departments of Pathology and Laboratory Medicine, Advanced Urology Maxport Hospital, Bhubaneswar, India
| | - Gauri Munjal
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Niharika Pattnaik
- Departments of Pathology and Laboratory Medicine, Advanced Medical and Research Institute, Bhubaneswar, India
| | - Deepika Jain
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Ekta Jain
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Aditi Dewan
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Mallika Dixit
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Vipra Malik
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Sayali Shinde
- Departments of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, India
| | - Bonnie L Balzer
- Departments of Pathology and Laboratory Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Anil Parwani
- Departments of Pathology and Laboratory Medicine, Ohio State University Wexner Medical Center, Columbus, OH, USA
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7
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Doganyigit Z, Eroglu E, Okan A. Intermediate filament proteins are reliable immunohistological biomarkers to help diagnose multiple tissue-specific diseases. Anat Histol Embryol 2023; 52:655-672. [PMID: 37329162 DOI: 10.1111/ahe.12937] [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: 11/27/2022] [Revised: 05/18/2023] [Accepted: 05/31/2023] [Indexed: 06/18/2023]
Abstract
Cytoskeletal networks are proteins that effectively maintain cell integrity and provide mechanical support to cells by actively transmitting mechanical signals. Intermediate filaments, which are from the cytoskeleton family and are 10 nanometres in diameter, are unlike actin and microtubules, which are highly dynamic cytoskeletal elements. Intermediate filaments are flexible at low strain, harden at high strain and resist breaking. For this reason, these filaments fulfil structural functions by providing mechanical support to the cells through their different strain-hardening properties. Intermediate filaments are suitable in that cells both cope with mechanical forces and modulate signal transmission. These filaments are composed of fibrous proteins that exhibit a central α-helical rod domain with a conserved substructure. Intermediate filament proteins are divided into six groups. Type I and type II include acidic and basic keratins, type III, vimentin, desmin, peripheralin and glial fibrillary acidic protein (GFAP), respectively. Type IV intermediate filament group includes neurofilament proteins and a fourth neurofilament subunit, α-internexin proteins. Type V consists of lamins located in the nucleus, and the type VI group consists of lens-specific intermediate filaments, CP49/phakinin and filen. Intermediate filament proteins show specific immunoreactivity in differentiating cells and mature cells of various types. Various carcinomas such as colorectal, urothelial and ovarian, diseases such as chronic pancreatitis, cirrhosis, hepatitis and cataract have been associated with intermediate filaments. Accordingly, this section reviews available immunohistochemical antibodies to intermediate filament proteins. Identification of intermediate filament proteins by methodological methods may contribute to the understanding of complex diseases.
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Affiliation(s)
- Zuleyha Doganyigit
- Faculty of Medicine, Histology and Embryology, Yozgat Bozok University, Yozgat, Turkey
| | - Ece Eroglu
- Faculty of Medicine, Yozgat Bozok University, Yozgat, Turkey
| | - Aslı Okan
- Faculty of Medicine, Histology and Embryology, Yozgat Bozok University, Yozgat, Turkey
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8
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Li L, Bailiff OA, Blanchard B, Gardner JM. Primary Epithelioid Sarcoma of the Conchal Bowl in a 64-Year-Old Male: A Case Report and Review of the Literature. Am J Dermatopathol 2023; 45:383-387. [PMID: 37191372 DOI: 10.1097/dad.0000000000002423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
ABSTRACT Epithelioid sarcoma (ES) is a distinctive malignant mesenchymal neoplasm with atypical epithelioid cells palisading around a central zone of necrosis. ES is a rare entity even in soft tissue pathology. Immunohistochemically, tumors usually show diffuse epithelial membrane antigen and cytokeratin expression and loss of nuclear INI1 (SMARCB1) expression. Here, we report a case of a 64-year-old man with ES arising in the left conchal bowl. Given the clinical presentation including patient's age, sun-exposed area of skin, and slow-growing, asymptomatic, small pink pearly papule, this patient was initially misdiagnosed with basal cell carcinoma clinically and treated with topical imiquimod at an outside facility. The lesion continued to grow and eventually became symptomatic despite the treatment after which biopsy was obtained. Despite the unusual anatomic site and the patient's age, the microscopic and immunohistochemical findings were characteristic of conventional-type ES. Our case shows that ES can arise in rare locations and in older adults where it may be more easily misdiagnosed clinically and pathologically as a nonmelanoma skin cancer.
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Affiliation(s)
- Liping Li
- Department of Anatomic and Clinical Pathology, Geisinger Medical Center, Danville, PA
| | - Oksana A Bailiff
- Department of Dermatology, Geisinger Medical Center, Danville, PA; and
| | - Brielle Blanchard
- Department of Dermatology, Geisinger Medical Center Muncy, Muncy, PA
| | - Jerad M Gardner
- Department of Anatomic and Clinical Pathology, Geisinger Medical Center, Danville, PA
- Department of Dermatology, Geisinger Medical Center, Danville, PA; and
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Zhang YL, Ma Q, Hu Y, Wu MJ, Wei ZK, Yao QY, Li JM, Li A. Analysis on diagnostic failure of US-guided core needle biopsy for soft tissue tumors. RESEARCH IN DIAGNOSTIC AND INTERVENTIONAL IMAGING 2023; 5:100023. [PMID: 39076167 PMCID: PMC11265195 DOI: 10.1016/j.redii.2023.100023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/27/2022] [Indexed: 07/31/2024]
Abstract
Purpose To evaluate the diagnostic yield of ultrasonography (US)-guided core needle biopsy (CNB) in the diagnosis of soft tissue tumors (STTs) and to analyze the failure factors. Methods 139 patients with STTs that underwent both US-guided CNB and surgical resection were collected retrospectively. Compared with the histopathological results of surgical resection, the biopsy failure was defined as the following conditions: indefinitive diagnosis, including insufficient samples and unknown subtypes with correct biological potential classification; wrong diagnosis, including wrong biological potential classification and wrong subtypes with correct biological potential classification. Univariate and multivariate analyses from the perspectives of histopathological, demographic and US features together with biopsy procedures were performed to determine risk factors for diagnostic failure. Results The diagnostic yield of US-guided CNB for STTs in our study was 78.4%, but when only considering the correct biological potential classification of STTs, the diagnostic yield was 80.6%. The multivariate analysis showed that adipocytic tumors (odds ratio (OR) = 10.195, 95% confidence interval (CI): 1.062 - 97.861, p = 0.044), vascular tumors (OR = 41.710, 95% CI: 3.126 - 556.581, p = 0.005) and indeterminate US diagnosis (OR = 8.641, 95% CI: 1.852 - 40.303, p = 0.006) were correlated with the diagnostic failure. The grade III vascular density (OR = 0.019, 95% CI: 0.001 - 0.273, p = 0.007) enabled a higher diagnostic accuracy. Conclusion US-guided CNB can be an effective modality for the diagnosis of STTs. The diagnostic yield can be increased when the tumor vascular density was grade III in Color Doppler US, but can be decreased in adipocytic tumors, vascular tumors and masses with indeterminate US diagnosis.
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Affiliation(s)
- Ying-Lun Zhang
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, Gulou district, China
| | - Qian Ma
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, Gulou district, China
| | - Yu Hu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, Gulou district, China
| | - Meng-Jie Wu
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, Gulou district, China
| | - Zong-Kai Wei
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, Gulou district, China
| | - Qi-Yu Yao
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, Gulou district, China
| | - Ju-Ming Li
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, Gulou district, China
| | - Ao Li
- Department of Ultrasound, The First Affiliated Hospital of Nanjing Medical University, No. 300, Guangzhou Rd, Nanjing, Gulou district, China
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Metastatic sarcomas to pleural effusion: a 10-year large tertiary care center experience with emphasis on clinical features and cytomorphologic characteristics. J Am Soc Cytopathol 2023; 12:216-228. [PMID: 36858854 DOI: 10.1016/j.jasc.2023.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/28/2023] [Accepted: 01/31/2023] [Indexed: 02/10/2023]
Abstract
INTRODUCTION Metastatic sarcomas to pleural effusion are extremely rare, accounting for <1% of all malignant pleural effusions. We aim to present our experience with pleural effusion specimens containing metastatic sarcomas over a 10-year period. METHODS We performed a 10-year retrospective search of cytopathology archives to identify all pleural effusions that were involved by metastatic sarcoma. All available cytopathology and surgical pathology specimens were retrieved and reviewed. RESULTS Twenty-eight pleural fluids from 22 patients with metastatic sarcoma were identified in our search. The patients' ages ranged from 12 to 73 years. The pleural fluid volumes ranged from 10 to 1500 ml. Rhabdomyosarcoma was the most commonly encountered metastatic sarcoma to pleural effusion (n = 7). Other metastatic sarcomas were as follows: epithelioid angiosarcoma (n = 4), Ewing sarcoma (n = 3), clear cell sarcoma (n = 2), high grade conventional osteosarcoma (n = 2), undifferentiated pleomorphic sarcoma (n = 1), epithelioid sarcoma, proximal type (n = 1), dedifferentiated liposarcoma (n = 1), and conventional chondrosarcoma (n = 1). The time between initial diagnosis and effusion varied from 3 months to 25 years. Two patients are alive with disease at 6 and 21 months of follow-up. All other patients were dead of disease and the survival after a malignant pleural effusion ranged from <1 month to 18 months. CONCLUSIONS Metastatic bone and soft tissue sarcomas to pleural effusions are rare and their cytologic features can be mistaken for carcinoma, melanoma, or mesothelioma. Careful review of the patient's medical history, comparison of the previous pathology and the use of ancillary studies are crucial for the evaluation of pleural effusions involved by metastatic sarcomas.
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11
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Gutu C, Butnari V, Schiopu V. Giant retroperitoneal liposarcoma measuring 27 × 29 × 36 cm: a case report. J Surg Case Rep 2023; 2023:rjac608. [PMID: 36636659 PMCID: PMC9831642 DOI: 10.1093/jscr/rjac608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/11/2022] [Indexed: 01/12/2023] Open
Abstract
Retroperitoneal tumors are rare neoplasms that can reach great dimensions due to a slow growth pattern. Although these tumors rarely metastasize, they have a great risk of recurrence, and majority of times these lesions are a challenge for the surgeon. We report the case of a 63-year-old woman who presented with symptoms of large bowel obstruction and was diagnosed with a large heterogenous mass located in the retroperitoneal space. The fine needle biopsy revealed the histology of liposarcoma. The purpose of this article is to report our approach in management of this kind of tumor. Tumor size (27.1 × 29.1 × 36.1 cm) and involvement to the adjacent organs was a challenge for us in order to reach safe oncological margins. In these cases, the risk of recurrence is high; therefore, the patient should be screened at 6, 12 and 24 months post procedure. Chemotherapy or radiotherapy for this tumor is not yet defined, and if operable, surgery is the treatment of choice.
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Affiliation(s)
- Catalina Gutu
- Department of Oncology, Nicolae Testemitanu State University of Medicine and Pharmacy, Chișinău, Moldova
| | - Valentin Butnari
- General Surgery, Barking, Havering and Redbridge University NHS Trust, London, UK
| | - Victor Schiopu
- Correspondence address. Nicolae Testemitanu State University of Medicine and Pharmacy, Chișinău, Moldova. E-mail:
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12
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Grigoraş A, Amălinei C, Lovin CS, Grigoraş CC, Pricope DL, Costin CA, Chiseliţă IR, Crişan-Dabija RA. The clinicopathological challenges of symptomatic and incidental pulmonary hamartomas diagnosis. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:607-613. [PMID: 36808195 PMCID: PMC10028331 DOI: 10.47162/rjme.63.4.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Pulmonary hamartomas (PHs) are the most common benign lung tumors. Usually, they are asymptomatic and incidentally discovered during assessment for other diseases or during the autopsy exam. In this context, we have performed a retrospective analysis of surgical resections in a 5-year series of patients diagnosed with PHs in the Clinic of Pulmonary Diseases, Iaşi, Romania, aiming to evaluate their clinicopathological features. A total of 27 patients with PH (40.74% males and 59.26% females) were evaluated. 33.33% of patients were asymptomatic, while the others exhibited variable symptoms, such as chronic cough, dyspnea, chest pain or weight loss. In most cases, PHs presented as solitary nodules, predominantly disposed in the right upper lobe (40.74% of cases), followed by the right lower lobe (33.34%), and left lower lobe (18.51%). The microscopic examination revealed a mixture of mature mesenchymal tissue, such as hyaline cartilage, adipose tissue, fibromyxoid tissue, and smooth muscle bundles, in variable proportions, associated with clefts of entrapped benign epithelium. A dominant adipose tissue component was observed in one case. PH was associated with a history of extrapulmonary cancer diagnosis, in one patient. Although considered benign lung tumors, PHs diagnosis and therapy may be challenging. Having in mind the possibility of recurrence or their occurrence as a part of specific syndromes, PHs should be thoroughly investigated for an appropriate patients' management. Their complex significance and the correlation with other types of lesions, including malignancies, may be further studied, by more extensive studies of surgical and necroptic cases.
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Affiliation(s)
- Adriana Grigoraş
- Department of Morphofunctional Sciences I, Grigore T. Popa University of Medicine and Pharmacy, Iaşi, Romania; ; ,
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13
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Shih CH, Chang YC, Lai YC, Chiou HY. Investigating the role of signal transducer and activator of transcription 3 in feline injection site sarcoma. BMC Vet Res 2022; 18:276. [PMID: 35836213 PMCID: PMC9281114 DOI: 10.1186/s12917-022-03352-y] [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: 01/06/2022] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Feline injection-site sarcomas (FISSs) are malignant mesenchymal tumors of different histotypes. The pathogenesis of FISS has been correlated with chronic inflammation, resulting in neoplastic transformation. Activation of the Janus kinase-signal transducer and activator of transcription 3 (STAT3) have been demonstrated to play a critical role in tumor development by regulating signaling pathways involved in cell proliferation, survival, metastasis, and angiogenesis in human medicine. To characterize the role of STAT3 in FISS, we first detected STAT3 and phosphorylated STAT3 in formalin-fixed and paraffin-embedded (FFPE) FISS tissues using immunohistochemical staining. RESULTS STAT3 was detected in 88.9% (40/45) of FISS cases, and phosphorylated STAT3 was detected in 53.3% (24/45) of cases. However, the expression levels of both forms of STAT3 were not correlated with tumor grade. To study the role of STAT3 in tumor survival, two primary cells derived from FISSs of two cats exhibiting consistent immunophenotypes with their parental FFPE tissues were established. A dose-dependent inhibitory effect on cell proliferation was observed in both primary FISS cells treated with the STAT3 inhibitor, 5-hydroxy-9,10-dioxo-9,10-dihydroanthracene-1-sulfonamide. CONCLUSIONS The STAT 3 may play an important role in the tumorigenesis of FISS and be a potential molecular therapeutic target for FISS.
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Affiliation(s)
- Cheng-Hsin Shih
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, 10617, Taipei, Taiwan
| | - Yen-Chen Chang
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, 10617, Taipei, Taiwan
| | - Yun-Chiang Lai
- Graduate Institute of Molecular and Comparative Pathobiology, School of Veterinary Medicine, National Taiwan University, 10617, Taipei, Taiwan
| | - Hue-Ying Chiou
- Graduate Institute of Veterinary Pathobiology, College of Veterinary Medicine, National Chung Hsing University, 402, Taichung, Taiwan.
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14
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Winterboer J, Sander B, Korn P, Jehn P, Spalthoff S. Paediatric gingival extra-axial chordoma: an extremely rare entity. Int J Oral Maxillofac Surg 2022; 51:1525-1529. [PMID: 35339329 DOI: 10.1016/j.ijom.2022.02.017] [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: 11/25/2021] [Revised: 01/20/2022] [Accepted: 02/28/2022] [Indexed: 11/20/2022]
Abstract
Extra-axial chordomas are rare malignant tumours. As a subcategory of axial chordomas, these tumours arise outside the axial skeleton. This report describes the case of a 13-year-old male patient with a gingival mass in the left upper jaw, who was referred to Hannover Medical School with a preliminary diagnosis of a calcifying epithelial odontogenic tumour (CEOT). Pathological examination of the enucleated tumour led to the final diagnosis of a chordoma. Thereafter, a stepwise radical resection was performed with the aim of complete resection of the tumour with wide safety margins. The main tumour mass was found to be located on the maxillary gingiva, with focal infiltration into the maxillary bone. Following resection, reconstruction was performed with a free latissimus dorsi flap. Follow-up after 1 year revealed no signs of recurrence or metastasis. This case highlights that although extremely rare, extra-axial chordoma may occur at sites distant from the midline and as such must be included in the differential diagnosis of bone and soft tissue tumours in the maxillofacial region.
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Affiliation(s)
- J Winterboer
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany.
| | - B Sander
- Department of Pathology, Hannover Medical School, Hannover, Germany
| | - P Korn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - P Jehn
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
| | - S Spalthoff
- Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
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15
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Wang J, Wang WL, Sun H, Huo L, Wu Y, Chen H, Gan Q, Meis JM, Maloney N, Lazar AJ, Yoon EC, Albarracin CT, Krishnamurthy S, Middleton LP, Resetkova E, Yu W, Tan D, Lu W, Solis Soto LM, Wang S, Wistuba II, Parwani AV, Prieto VG, Sahin AA, Li Z, Ding Q. Expression of TRPS1 in phyllodes tumor and sarcoma of the breast. Hum Pathol 2022; 121:73-80. [DOI: 10.1016/j.humpath.2022.01.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/10/2022] [Accepted: 01/12/2022] [Indexed: 12/31/2022]
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16
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Nautiyal H, Egiz A, Farajzadeh S, Fazail AH, Nautiyal S. Epithelioid Variant of Pleomorphic Liposarcoma: A Rare Challenging Diagnosis Causing Severe Medial Thigh Pain. Cureus 2021; 13:e19531. [PMID: 34934551 PMCID: PMC8668048 DOI: 10.7759/cureus.19531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2021] [Indexed: 11/05/2022] Open
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17
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Spindle Cell Squamous Cell Carcinoma of Head and Neck Region: a Clinicopathological and Immunohistochemical Study. Indian J Surg Oncol 2021; 12:699-705. [DOI: 10.1007/s13193-021-01418-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 08/09/2021] [Indexed: 10/20/2022] Open
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18
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Kim Y, Malicki D, Levy M, Crawford JR. Rare orbital apex spindle cell proliferation presenting with subacute blindness in a child. BMJ Case Rep 2021; 14:14/8/e245118. [PMID: 34344661 PMCID: PMC8336173 DOI: 10.1136/bcr-2021-245118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Yongya Kim
- Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Denise Malicki
- Pathology, Rady Children's Hospital University of California San Diego, San Diego, California, USA
| | - Michael Levy
- Neurosurgery, University of California San Diego, San Diego, California, USA
| | - John Ross Crawford
- Neurosciences and Pediatrics, University of California San Diego, San Diego, California, USA .,Department of Neurosciences and Pediatrics, University of California San Diego and Rady Children's Hospital, San Diego, California, USA
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19
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Rakha EA, Brogi E, Castellano I, Quinn C. Spindle cell lesions of the breast: a diagnostic approach. Virchows Arch 2021; 480:127-145. [PMID: 34322734 PMCID: PMC8983634 DOI: 10.1007/s00428-021-03162-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/27/2021] [Accepted: 07/12/2021] [Indexed: 12/13/2022]
Abstract
Spindle cell lesions of the breast comprise a heterogeneous group of lesions, ranging from reactive and benign processes to aggressive malignant tumours. Despite their rarity, they attract the attention of breast pathologists due to their overlapping morphological features and diagnostic challenges, particularly on core needle biopsy (CNB) specimens. Pathologists should recognise the wide range of differential diagnoses and be familiar with the diverse morphological appearances of these lesions to make an accurate diagnosis and to suggest proper management of the patients. Clinical history, immunohistochemistry, and molecular assays are helpful in making a correct diagnosis in morphologically challenging cases. In this review, we present our approach for the diagnosis of breast spindle cell lesions, highlighting the main features of each entity and the potential pitfalls, particularly on CNB. Breast spindle cell lesions are generally classified into two main categories: bland-appearing and malignant-appearing lesions. Each category includes a distinct list of differential diagnoses and a panel of immunohistochemical markers. In bland-appearing lesions, it is important to distinguish fibromatosis-like spindle cell metaplastic breast carcinoma from other benign entities and to distinguish fibromatosis from scar tissue. The malignant-appearing category includes spindle cell metaplastic carcinoma, stroma rich malignant phyllodes tumour, other primary and metastatic malignant spindle cell tumours of the breast, including angiosarcoma and melanoma, and benign mimics such as florid granulation tissue and nodular fasciitis.
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Affiliation(s)
- Emad A Rakha
- Division of Cancer and Stem Cells, School of Medicine, The University of Nottingham and Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, NG5 1PB, UK.
| | - Edi Brogi
- Department of Pathology At Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Cecily Quinn
- Histopathology, BreastCheck, Irish National Breast Screening Programme and St. Vincent's University Hospital, Dublin, Ireland.,University College Dublin, Dublin, Ireland
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Panagopoulos I, Gorunova L, Andersen K, Tafjord S, Lund-Iversen M, Lobmaier I, Micci F, Heim S. Recurrent Fusion of the GRB2 Associated Binding Protein 1 ( GAB1) Gene With ABL Proto-oncogene 1 ( ABL1) in Benign Pediatric Soft Tissue Tumors. Cancer Genomics Proteomics 2021; 17:499-508. [PMID: 32859628 DOI: 10.21873/cgp.20206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 05/22/2020] [Accepted: 06/01/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND/AIM Fusions of the ABL proto-oncogene 1 gene (ABL1 in 9q34) are common in leukemias but rare in solid tumors. The most notable is the t(9;22)(q34;q11)/BCR-ABL1 coding for a chimeric tyrosine kinase. We herein report an ABL1-fusion in a pediatric tumor. MATERIALS AND METHODS G-banding, fluorescence in situ hybridization, reverse transcription polymerase chain reaction and Sanger sequencing were performed on a soft tissue perineurioma found in the left musculus erector spinae of a child. RESULTS A der(4)t(4;9)(q31;q34) and a fusion of the GRB2 associated binding protein 1 (GAB1 in 4q31) gene with ABL1 were found. A literature search revealed 3 more cases with similar genetic and clinicopathological characteristics: a soft tissue perineurioma with t(2;9;4)(p23;q34;q31) and ABL1 rearrangement, a soft tissue angiofibroma with a GAB1-ABL1 chimeric gene, and a solitary fibrous tumor carrying a der(4)t(4;9)(q31.1;q34). CONCLUSION GAB1-ABL1 is a recurrent fusion gene in benign pediatric tumors.
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Affiliation(s)
- Ioannis Panagopoulos
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Ludmila Gorunova
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Kristin Andersen
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Svetlana Tafjord
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Marius Lund-Iversen
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Ingvild Lobmaier
- Department of Pathology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Francesca Micci
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Sverre Heim
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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21
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Wei S, Siegal GP. Small Round Cell Tumors of Soft Tissue and Bone. Arch Pathol Lab Med 2021; 146:47-59. [PMID: 33635948 DOI: 10.5858/arpa.2020-0773-ra] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Small round cell tumors of soft tissue and bone constitute a divergent group of neoplasms. These lesions often demonstrate overlapping clinical and radiologic characteristics and share histomorphologic and sometimes immunophenotypic similarities, but they typically have diverse prognostic outcomes, thus warranting different clinical management. Recent advances in molecular and cytogenetic techniques have identified a number of novel molecular alterations contributing to the diversity of these lesions. This state-of-the-art knowledge has enhanced our understanding of these diseases. OBJECTIVE.— To provide an overview of the current concepts in the classification and diagnosis of small round cell tumors of soft tissue and bone, focusing on salient histologic features, key immunophenotypic characteristics, and recent molecular genetic advancements. DATA SOURCES.— Data were obtained from pertinent peer-reviewed English-language literature and firsthand experience from the authors as practicing bone and soft tissue pathologists. CONCLUSIONS.— Immunohistochemistry plays a vital role in rendering a specific diagnosis or narrowing the differential diagnosis in small round cell tumors of soft tissue and bone. Molecular genetic studies are often needed, especially for those lesions with unusual histologic features, an uncommon immunoprofile, and/or unusual clinical presentation. Accurate diagnosis of these tumors necessitates recognition of salient histologic features, judicious and astute use of ancillary studies, and correlation with the clinical and radiologic characteristics to guide clinical decision-making.
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Affiliation(s)
- Shi Wei
- From the Department of Pathology (Wei, Siegal), University of Alabama, Birmingham
| | - Gene P Siegal
- From the Department of Pathology (Wei, Siegal), University of Alabama, Birmingham.,Department of Genetics (Siegal), O'Neal Comprehensive Cancer Center, University of Alabama, Birmingham
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22
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Taseer R, Ahmed TT. Embryonal Rhabdomyosarcoma Presenting as Lung Metastasis in an Adult: An Uncommon Presentation. Cureus 2021; 13:e13545. [PMID: 33786248 PMCID: PMC7998057 DOI: 10.7759/cureus.13545] [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] [Indexed: 11/05/2022] Open
Abstract
Rhabdomyosarcoma (RMS) is one of the most common soft tissue sarcomas of adolescents and young adults. Histologically, rhabdomyosarcoma is classified into embryonal, alveolar, pleomorphic, and spindle cell/sclerosing rhabdomyosarcomas with further subcategorization. More than 50% of embryonal rhabdomyosarcoma occur within head and neck. The retroperitoneum and pelvis are less common sites of involvement. Embryonal rhabdomyosarcomas affect mainly, but not exclusively, children between birth and 15 years of age. Alveolar rhabdomyosarcoma tends to affect older patients. The usual metastatic sites include lung, lymph nodes, and bone marrow. We are presenting a case of a 25-year-old male patient with symptoms of breathlessness, easy fatigability, and weight loss. On chest imaging, there were multiple lung nodules. A primary diagnosis of undifferentiated malignant neoplasm was made on lung biopsy. On immunohistochemistry, the malignant cells were positive for myogenin, myoblast determination protein 1 (MyoD1), and desmin. They were negative for neuroendocrine, germ cell, epithelial, melanocytic, and lymphoid markers. Further workup showed an abdominopelvic retroperitoneal mass on abdominal computed tomography (CT) scan. The biopsy on the retroperitoneal mass showed similar morphology and immunohistochemical profile. Unfortunately, the patient's condition deteriorated rapidly in the following weeks, and he passed away.
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Affiliation(s)
- Rabia Taseer
- Histopathology, Shiekh Zaid Hospital, Lahore, PAK.,Histopathology, Obeid Specialized Hospital, Riyadh, SAU
| | - Tabeer T Ahmed
- Internal Medicine, Combined Military Hospital (CMH) Lahore Medical College and Institute of Dentistry, Lahore, PAK
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23
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Vijayan S, Mohammed AP, Kulkarni MS, Rao SK. Monophasic spindle cell myxoid synovial sarcoma of the hand: promising results with marginal resection. BMJ Case Rep 2021; 14:14/1/e238366. [PMID: 33509874 PMCID: PMC7845715 DOI: 10.1136/bcr-2020-238366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Synovial sarcomas are deep-seated, genetically distinct, malignant neoplasms seen in young adults, with a male preponderance. They have unusual clinical and pathological presentation and mimic many other sarcomas and carcinomas, making the diagnosis quite challenging. Although four variants are identified, occurrence in the hand is extremely rare and leads to significant morbidity. There is a high incidence of local recurrence and distant metastasis within the first 2 years. We report the case of an elderly woman with monophasic spindle cell synovial sarcoma who presented with painless swelling in her palm and underwent local excision of the neoplasm. At 2-year follow-up, she remains totally asymptomatic with normal function of the hand. We also attempt to give an overview about monophasic spindle cell synovial sarcoma with the differentials, which would help surgeons in prompt diagnosis and appropriate management.
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Affiliation(s)
- Sandeep Vijayan
- Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Afsal P Mohammed
- General Medicine, Dr TMA Pai Hospital, Udupi, Melaka-Manipal Medical College, Manipal Academy of Higher Education, Udupi, Karnataka, India
| | - Mahesh Suresh Kulkarni
- Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Sharath Kumar Rao
- Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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24
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Wu B, Tay JKX, Loh WS, Petersson F. Epithelioid Sarcoma of the External Auditory Canal: An Uncommon Tumor at an Unusual Site and a Brief Overview of the Literature. Head Neck Pathol 2021; 15:1328-1334. [PMID: 33394376 PMCID: PMC8633210 DOI: 10.1007/s12105-020-01275-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 12/12/2020] [Indexed: 01/01/2023]
Abstract
We present a case (41 years old pregnant female) with epithelioid sarcoma arising in the left external auditory canal. On immunohistochemistry, the tumor cell diffusely expressed cytokeratins and showed patchy expression of ERG and CD34. The neoplastic cells demonstrated uniform loss of INI1-expression. Epithelioid sarcoma arising in the external auditory canal is rare. Awareness that ES may rarely arise at unusual sites is of critical importance in order to apply a broad enough panel in the immunohistochemical study, so a misdiagnosis of carcinoma can be avoided.
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Affiliation(s)
- Bingcheng Wu
- grid.410759.e0000 0004 0451 6143Department of Pathology, National University Health System, 5 Lower Kent Ridge Road, Singapore, 119074 Singapore
| | - Joshua Kai Xun Tay
- grid.410759.e0000 0004 0451 6143Department of Otolaryngology, National University Health System, Singapore, Singapore
| | - Woei Shyang Loh
- grid.410759.e0000 0004 0451 6143Department of Otolaryngology, National University Health System, Singapore, Singapore
| | - Fredrik Petersson
- grid.410759.e0000 0004 0451 6143Department of Pathology, National University Health System, 5 Lower Kent Ridge Road, Singapore, 119074 Singapore
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25
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Immunohistochemistry in Bone and Soft Tissue Tumours. Sarcoma 2021. [DOI: 10.1007/978-981-15-9414-4_8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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26
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Rakha EA, Quinn CM, Foschini MP, Muñoz Martin M, Dabbs DJ, Lakhani S, Varga Z, Pinder SE, Schmitt FC, Reis-Filho JS, Fox SB, Ellis IO, Tan PH, Mihai R. Metaplastic carcinomas of the breast without evidence of epithelial differentiation: a diagnostic approach for management. Histopathology 2020; 78:759-771. [PMID: 33113154 DOI: 10.1111/his.14290] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/11/2020] [Accepted: 10/26/2020] [Indexed: 12/16/2022]
Abstract
AIMS Although rare, malignant sarcomatoid breast tumours without evidence of epithelial differentiation comprise a diagnostic challenge with management implications. Earlier studies have generally considered these to be primary breast sarcomas; however, supporting evidence is lacking and management remains variable. This study aimed to provide an evidence-based approach to improve the consistency of diagnosis and management for such cases. METHODS AND RESULTS A large series (n = 140) of metaplastic breast carcinoma (MBC) diagnosed in Nottingham over 18 years was analysed. Only cases with available data on immunohistochemical expression of cytokeratins (CKs) were included. The prevalence and pattern of expression for various CKs were assessed and details of tumours negative for CKs were collected. A diagnostic approach based on our experience is provided. Forty-seven cases (34%) showed foci of conventional type invasive breast carcinoma or ductal carcinoma in situ (DCIS), while 93 cases (66%) were diagnosed as MBC based on morphology and/or CK expression. Ninety-seven cases (69%) were negative for one or more CKs, with 18 cases (13%) negative for five or more CKs. Eight cases (6%) lacked expression of all CKs tested. Further examination showed evidence of carcinomatous nature in five cases, and three were diagnosed as MBC following extensive diagnostic work-up and based on our experience. CONCLUSION This study suggests that MBC represents a spectrum of neoplasms, with some lacking CK expression. Sarcomatoid neoplasms of the breast lacking evidence of carcinomatous morphology and CK expression may represent an extreme end of differentiation that can be considered as carcinomas rather than sarcomas for management purposes (following extensive work-up).
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Affiliation(s)
- Emad A Rakha
- Department of Histopathology, The University of Nottingham and the Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
| | - Cecily M Quinn
- Department of Histopathology, St Vincent's University Hospital, University College, Dublin, Ireland
| | - Maria Pia Foschini
- Department of Biomedical and Neuromotor Sciences, Section of Anatomic Pathology at Bellaria Hospital, University of Bologna, Bologna, Italy
| | - Monica Muñoz Martin
- Department of Histopathology, The University of Nottingham and the Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
| | - David J Dabbs
- John A. Burns University of Hawaii Cancer Center, Honolulu, HI, USA.,Department of Pathology, Magee-Women's Hospital of UPMC, Pittsburgh, PA, USA
| | - Sunil Lakhani
- Faculty of Medicine and Pathology Queensland, University of Queensland Centre for Clinical Research, Brisbane, Australia
| | - Zsuzsanna Varga
- Institute of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Sarah E Pinder
- Division of Cancer Studies, King's College London, Guy's Hospital, London, UK
| | - Fernando C Schmitt
- Institute of Molecular Pathology and Immunology (IPATIMUP) and Medical Faculty, University of Porto, Porto, Portugal
| | - Jorge S Reis-Filho
- Department of Pathology, Memorial Sloan Kettering Cancer Centre, New York, NY, USA
| | - Stephen B Fox
- Pathology Department, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
| | - Ian O Ellis
- Department of Histopathology, The University of Nottingham and the Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
| | - Puay-Hoon Tan
- Department of Pathology, Singapore General Hospital, Singapore, Singapore
| | - Raluca Mihai
- Department of Histopathology, The University of Nottingham and the Nottingham University Hospitals NHS Trust, Nottingham City Hospital, Nottingham, UK
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27
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Lali BS, Chowdhury Z, Gupta M, Mishra A. Primary angiosarcoma of the oral cavity in a young adult. AUTOPSY AND CASE REPORTS 2020; 11:e2020217. [PMID: 34277485 PMCID: PMC8101653 DOI: 10.4322/acr.2020.217] [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: 05/05/2020] [Accepted: 07/01/2020] [Indexed: 11/28/2022] Open
Abstract
Angiosarcoma is a rare neoplasm, constituting only 2% of all the soft tissue tumors and most frequently involves the skin of the head and neck region in elderly males. They are extremely aggressive tumors with high rates of metastasis and poor outcomes. We report a unique case of angiosarcoma involving an unusual site – upper alveolus and maxilla in a young patient highlighting the diagnostic challenges in such a scenario. A 29 years old female presented with a non-healing wound of the oral cavity, which had progressed to the current maximum size of 6.4 cm within one month. Magnetic resonance imaging (MRI) scan revealed the involvement of maxilla up to the floor of the orbit and adjacent soft tissue. However, no distant metastasis was detected on Positron Emission Tomography (PET) scan. Biopsy of the lesion showed an irregular, highly pleomorphic, and mitotically active epithelioid soft tissue tumor conclusively diagnosed as angiosarcoma.
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Affiliation(s)
- Bhagat Singh Lali
- Homi Bhabha Cancer Hospital, Department of Pathology, Varanasi, Uttar Pradesh, India
| | - Zachariah Chowdhury
- Homi Bhabha Cancer Hospital, Department of Pathology, Varanasi, Uttar Pradesh, India
| | - Monika Gupta
- Homi Bhabha Cancer Hospital, Department of Head and Neck Oncology, Varanasi, Uttar Pradesh, India
| | - Aseem Mishra
- Homi Bhabha Cancer Hospital, Department of Head and Neck Oncology, Varanasi, Uttar Pradesh, India
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28
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Wang P, Wu M, Li A, Ye X, Li C, Xu D. Diagnostic Value of Contrast-Enhanced Ultrasound for Differential Diagnosis of Malignant and Benign Soft Tissue Masses: A Meta-Analysis. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:3179-3187. [PMID: 32907771 DOI: 10.1016/j.ultrasmedbio.2020.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 07/22/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
This meta-analysis was aimed at investigating the value of using contrast-enhanced ultrasound (CEUS) in the differential diagnosis of benign and malignant soft tissue masses (STMs). Relevant studies published before March 24, 2020 were identified through a comprehensive search of PubMed, Ovid, Cochrane and Web of Science. According to the inclusion criteria, five studies were selected comprising 746 patients. In the differential diagnosis of benign and malignant STMs, the pooled sensitivity and specificity of CEUS were 76% (95% confidence interval [CI]: 71%-81%; heterogeneity [I2] = 74.5%) and 67% (95% CI: 62%-71%; I2 = 36.5%), respectively. The diagnostic odds ratio was 7.37 (95% CI: 3.78%-14.35; I2 = 66.6%). The overall area under the curve was 0.77 (standard error: 0.0392). Subgroup analysis revealed that different index tests of CEUS resulted in different diagnostic performance. Importantly, CEUS is an effective method for the differential diagnosis between benign and malignant STMs.
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Affiliation(s)
- Pingping Wang
- Department of Ultrasound, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Mengjie Wu
- Department of Ultrasound, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Ao Li
- Department of Ultrasound, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Xinhua Ye
- Department of Ultrasound, First Affiliated Hospital of Nanjing Medical University, Nanjing, China
| | - Cuiying Li
- Department of Ultrasound, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
| | - Di Xu
- Department of Ultrasound, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
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29
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Khairwa A. Amelanotic melanoma recurrence diagnosed by fine-needle aspiration cytology: A case report. Diagn Cytopathol 2020; 48:E7-E9. [PMID: 32558348 DOI: 10.1002/dc.24529] [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: 02/23/2020] [Revised: 05/14/2020] [Accepted: 06/03/2020] [Indexed: 11/06/2022]
Abstract
Amelanotic melanoma is a variant of malignant melanoma. Amelanotic melanoma has similar morphology of a wide variety of epithelial and non-epithelial malignant tumours, variable cytomorphology of melanoma has been described on exfoliative and fine-needle aspiration cytology (FNAC). Aim of index study to describe FNAC of a rare case of recurrent amelanotic melanoma of right lateral knee swelling. Case: A 37-year-old male presented right lateral knee multi-nodular swelling last for 1 month with history of similar swelling 6 months back and operated. Histologically it was reported amelanotic malignant melanoma. FNAC revealed mordantly pleomorphic malignant cells predominantly plasmacytoid, plump shaped, prominent single to multiple nucleoli along with bi-nucleated and multi-nucleated tumour giant cells were also noted. Histology and immunohistochemistry (IHC) slides were reviewed and confirm the diagnosis. Concluded amelanotic melanoma has highly varied cytomorphology with multiple differential diagnosis and IHC markers are of great value for final diagnosis of it.
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Affiliation(s)
- Anju Khairwa
- Department of Pathology, ESIC Model Hospital, Gurugram, Haryana, India
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30
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Natale S, Capparucci F, Abbate JM, Panebianco R, Puleio R, Iaria C. Testicular leiomyoma and spermatogenic failure syndrome in a seabass from broodstock. JOURNAL OF FISH DISEASES 2020; 43:1563-1569. [PMID: 32971568 DOI: 10.1111/jfd.13258] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 08/17/2020] [Accepted: 08/18/2020] [Indexed: 06/11/2023]
Abstract
Testicular leiomyomas and gonadal dysfunctions are not commonly reported in teleost and particularly in broodstock fish. In the present work, a testicular leiomyoma related to an unusual case of spermatogenic failure syndrome, in a broodstock seabass coming from an Italian aquaculture farm, is reported. At gross pathology, the circumscribed neoplasia showed several white nodular masses, originating from the gonad, deforming the anatomo-physiological shape. From light microscopy, the presence of neoplastic tissue islands with spindle cells with a whirling pattern and the low presence of connective tissue were evident and originated from smooth muscle cells. Seminiferous tubules showed severe azoospermia with the absence of sperm cells even closer to the neoplastic area. Immunohistochemical analysis was positive for alpha-SMA, desmin and vimentin but negative for S-100, confirming a diagnosis of leiomyoma. This is the first report of spermatogenic failure syndrome associated with a testicular leiomyoma in fish from broodstock. More efforts should be made in studying broodstock fish pathologies related to fish maintenance and hormonal treatments that could economically affect aquaculture production.
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Affiliation(s)
- Sabrina Natale
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale F. Stagno D'Alcontres, Messina, Italy
| | - Fabiano Capparucci
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale F. Stagno D'Alcontres, Messina, Italy
| | - Jessica Maria Abbate
- Department of Veterinary Sciences, University of Messina. Polo Universitario dell'Annunziata, Messina, Italy
| | | | - Roberto Puleio
- Zooprophylactic Institute of Sicily (IZS), Palermo, Italy
| | - Carmelo Iaria
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Viale F. Stagno D'Alcontres, Messina, Italy
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31
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Grünewald TGP, Alonso M, Avnet S, Banito A, Burdach S, Cidre‐Aranaz F, Di Pompo G, Distel M, Dorado‐Garcia H, Garcia‐Castro J, González‐González L, Grigoriadis AE, Kasan M, Koelsche C, Krumbholz M, Lecanda F, Lemma S, Longo DL, Madrigal‐Esquivel C, Morales‐Molina Á, Musa J, Ohmura S, Ory B, Pereira‐Silva M, Perut F, Rodriguez R, Seeling C, Al Shaaili N, Shaabani S, Shiavone K, Sinha S, Tomazou EM, Trautmann M, Vela M, Versleijen‐Jonkers YMH, Visgauss J, Zalacain M, Schober SJ, Lissat A, English WR, Baldini N, Heymann D. Sarcoma treatment in the era of molecular medicine. EMBO Mol Med 2020; 12:e11131. [PMID: 33047515 PMCID: PMC7645378 DOI: 10.15252/emmm.201911131] [Citation(s) in RCA: 138] [Impact Index Per Article: 34.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/20/2020] [Accepted: 07/24/2020] [Indexed: 12/14/2022] Open
Abstract
Sarcomas are heterogeneous and clinically challenging soft tissue and bone cancers. Although constituting only 1% of all human malignancies, sarcomas represent the second most common type of solid tumors in children and adolescents and comprise an important group of secondary malignancies. More than 100 histological subtypes have been characterized to date, and many more are being discovered due to molecular profiling. Owing to their mostly aggressive biological behavior, relative rarity, and occurrence at virtually every anatomical site, many sarcoma subtypes are in particular difficult-to-treat categories. Current multimodal treatment concepts combine surgery, polychemotherapy (with/without local hyperthermia), irradiation, immunotherapy, and/or targeted therapeutics. Recent scientific advancements have enabled a more precise molecular characterization of sarcoma subtypes and revealed novel therapeutic targets and prognostic/predictive biomarkers. This review aims at providing a comprehensive overview of the latest advances in the molecular biology of sarcomas and their effects on clinical oncology; it is meant for a broad readership ranging from novices to experts in the field of sarcoma.
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Affiliation(s)
- Thomas GP Grünewald
- Max‐Eder Research Group for Pediatric Sarcoma BiologyInstitute of PathologyFaculty of MedicineLMU MunichMunichGermany
- Division of Translational Pediatric Sarcoma ResearchGerman Cancer Research Center (DKFZ), Hopp Children's Cancer Center (KiTZ), German Cancer Consortium (DKTK)HeidelbergGermany
- Institute of PathologyHeidelberg University HospitalHeidelbergGermany
| | - Marta Alonso
- Program in Solid Tumors and BiomarkersFoundation for the Applied Medical ResearchUniversity of Navarra PamplonaPamplonaSpain
| | - Sofia Avnet
- Orthopedic Pathophysiology and Regenerative Medicine UnitIRCCS Istituto Ortopedico RizzoliBolognaItaly
| | - Ana Banito
- Pediatric Soft Tissue Sarcoma Research GroupGerman Cancer Research Center (DKFZ)HeidelbergGermany
| | - Stefan Burdach
- Department of Pediatrics and Children's Cancer Research Center (CCRC)Technische Universität MünchenMunichGermany
| | - Florencia Cidre‐Aranaz
- Max‐Eder Research Group for Pediatric Sarcoma BiologyInstitute of PathologyFaculty of MedicineLMU MunichMunichGermany
| | - Gemma Di Pompo
- Orthopedic Pathophysiology and Regenerative Medicine UnitIRCCS Istituto Ortopedico RizzoliBolognaItaly
| | | | | | | | | | | | - Merve Kasan
- Max‐Eder Research Group for Pediatric Sarcoma BiologyInstitute of PathologyFaculty of MedicineLMU MunichMunichGermany
| | | | | | - Fernando Lecanda
- Division of OncologyAdhesion and Metastasis LaboratoryCenter for Applied Medical ResearchUniversity of NavarraPamplonaSpain
| | - Silvia Lemma
- Orthopedic Pathophysiology and Regenerative Medicine UnitIRCCS Istituto Ortopedico RizzoliBolognaItaly
| | - Dario L Longo
- Institute of Biostructures and Bioimaging (IBB)Italian National Research Council (CNR)TurinItaly
| | | | | | - Julian Musa
- Max‐Eder Research Group for Pediatric Sarcoma BiologyInstitute of PathologyFaculty of MedicineLMU MunichMunichGermany
- Department of General, Visceral and Transplantation SurgeryUniversity of HeidelbergHeidelbergGermany
| | - Shunya Ohmura
- Max‐Eder Research Group for Pediatric Sarcoma BiologyInstitute of PathologyFaculty of MedicineLMU MunichMunichGermany
| | | | - Miguel Pereira‐Silva
- Department of Pharmaceutical TechnologyFaculty of PharmacyUniversity of CoimbraCoimbraPortugal
| | - Francesca Perut
- Orthopedic Pathophysiology and Regenerative Medicine UnitIRCCS Istituto Ortopedico RizzoliBolognaItaly
| | - Rene Rodriguez
- Instituto de Investigación Sanitaria del Principado de AsturiasOviedoSpain
- CIBER en oncología (CIBERONC)MadridSpain
| | | | - Nada Al Shaaili
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
| | - Shabnam Shaabani
- Department of Drug DesignUniversity of GroningenGroningenThe Netherlands
| | - Kristina Shiavone
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
| | - Snehadri Sinha
- Department of Oral and Maxillofacial DiseasesUniversity of HelsinkiHelsinkiFinland
| | | | - Marcel Trautmann
- Division of Translational PathologyGerhard‐Domagk‐Institute of PathologyMünster University HospitalMünsterGermany
| | - Maria Vela
- Hospital La Paz Institute for Health Research (IdiPAZ)MadridSpain
| | | | | | - Marta Zalacain
- Institute of Biostructures and Bioimaging (IBB)Italian National Research Council (CNR)TurinItaly
| | - Sebastian J Schober
- Department of Pediatrics and Children's Cancer Research Center (CCRC)Technische Universität MünchenMunichGermany
| | - Andrej Lissat
- University Children′s Hospital Zurich – Eleonoren FoundationKanton ZürichZürichSwitzerland
| | - William R English
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
| | - Nicola Baldini
- Orthopedic Pathophysiology and Regenerative Medicine UnitIRCCS Istituto Ortopedico RizzoliBolognaItaly
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Dominique Heymann
- Department of Oncology and MetabolismUniversity of SheffieldSheffieldUK
- Université de NantesInstitut de Cancérologie de l'OuestTumor Heterogeneity and Precision MedicineSaint‐HerblainFrance
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Dermawan JK, Cheng YW, Tu ZJ, Meyer A, Habeeb O, Zou Y, Goldblum JR, Billings SD, Kilpatrick SE, Reith JD, Shurtleff SA, Farkas DH, Rubin BP, Azzato EM. Diagnostic Utility of a Custom 34-Gene Anchored Multiplex PCR-Based Next-Generation Sequencing Fusion Panel for the Diagnosis of Bone and Soft Tissue Neoplasms With Identification of Novel USP6 Fusion Partners in Aneurysmal Bone Cysts. Arch Pathol Lab Med 2020; 145:851-863. [PMID: 33147323 DOI: 10.5858/arpa.2020-0336-oa] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/28/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— Bone and soft tissue tumors are heterogeneous, diagnostically challenging, and often defined by gene fusions. OBJECTIVE.— To present our experience using a custom 34-gene targeted sequencing fusion panel. DESIGN.— Total nucleic acid extracted from formalin-fixed, paraffin-embedded (FFPE) tumor specimens was subjected to open-ended, nested anchored multiplex polymerase chain reaction and enrichment of 34 gene targets, thus enabling detection of known and novel fusion partners. RESULTS.— During a 12-month period, 147 patients were tested as part of routine clinical care. Tumor percentage ranged from 10% to 100% and turnaround time ranged from 3 to 15 (median, 7.9) days. The most common diagnostic groups were small round blue cell tumors, tumors of uncertain differentiation, fibroblastic/myofibroblastic tumors, and adipocytic tumors. In-frame fusion transcripts were identified in 64 of 142 cases sequenced (45%): in 62 cases, the detection of a disease-defining fusion confirmed the morphologic impression; in 2 cases, a germline TFG-GPR128 polymorphic fusion variant was detected. Several genes in the panel partnered with multiple fusion partners specific for different diagnoses, for example, EWSR1, NR4A3, FUS, NCOA2, and TFE3. Interesting examples are presented to highlight how fusion detection or lack thereof was instrumental in establishing accurate diagnoses. Novel fusion partners were detected for 2 cases of solid aneurysmal bone cysts (PTBP1-USP6, SLC38A2-USP6). CONCLUSIONS.— Multiplex detection of fusions in total nucleic acid purified from FFPE specimens facilitates diagnosis of bone and soft tissue tumors. This technology is particularly useful for morphologically challenging entities and in the absence of prior knowledge of fusion partners, and has the potential to discover novel fusion partners.
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Affiliation(s)
- Josephine K Dermawan
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - Yu Wei Cheng
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - Zheng Jin Tu
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - Anders Meyer
- The Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City (Meyer)
| | - Omar Habeeb
- The Department of Anatomic Pathology, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand (Habeeb)
| | - Youran Zou
- The Department of Pathology, Kaiser Permanente Oakland Medical Center, Oakland, California (Zou)
| | - John R Goldblum
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - Steven D Billings
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - Scott E Kilpatrick
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - John D Reith
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - Sheila A Shurtleff
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - Daniel H Farkas
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - Brian P Rubin
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
| | - Elizabeth M Azzato
- From Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio (Dermawan, Cheng, Tu, Goldblum, Billings, Kilpatrick, Reith, Shurtleff, Farkas, Rubin, Azzato)
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Li P, Laskin W, Wang WL, Demicco EG, Panse G. Primary superficial synovial sarcoma: clinical and histopathological characteristics in eight cases with molecular confirmation. J Cutan Pathol 2020; 48:263-268. [PMID: 32996614 DOI: 10.1111/cup.13887] [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: 05/29/2020] [Revised: 09/12/2020] [Accepted: 09/18/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Synovial sarcoma (SS) is a spindled cell sarcoma demonstrating varying degrees of epithelial differentiation and characterized by a pathognomonic t(X;18) translocation. SS most frequently involves deep soft tissue of the extremities in young adults. Superficial SS involving dermis and/or subcutaneous tissue is exceedingly rare. METHODS AND RESULTS We identified eight cases of primary superficial synovial sarcomas across three tertiary institutions. All cases were confined to the dermis/subcutis based on imaging or gross and microscopic examination. The average patient age was 36 years (range 14-50). The average tumor size was 2.4 cm (range 0.9-3.9 cm) and lesions showed classic monophasic (n = 4) or biphasic (n = 4) morphology. All tumors expressed keratin AE1/AE3 and/or epithelial membrane antigen (EMA), but were negative for CD34. The diagnosis for each case was confirmed by molecular detection of t(X;18). Six of the eight cases were treated with curative excision while the other two received additional radiotherapy. Follow-up was available for six patients (mean 68 months, range 2-108 months) and no patient experienced recurrence or metastatic disease. CONCLUSIONS We present the largest series to date of primary superficial SS with molecular confirmation for all cases. SS should be considered when evaluating a cutaneous monomorphic spindle cell neoplasm.
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Affiliation(s)
- Philippa Li
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - William Laskin
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA
| | - Wei-Lien Wang
- Departments of Pathology and Translational Molecular Pathology, MD Anderson Cancer Center, Houston, Texas, USA
| | - Elizabeth G Demicco
- Department of Pathology and Laboratory Medicine, Sinai Health System, Toronto, Canada
| | - Gauri Panse
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, USA
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Dai A, Cai JP. Intravascular schwannoma: A review of a rare diagnosis. J Cutan Pathol 2020; 48:314-317. [PMID: 32623758 DOI: 10.1111/cup.13797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/23/2020] [Accepted: 07/01/2020] [Indexed: 12/12/2022]
Abstract
While schwannoma is one of the most common types of benign peripheral nerve tumors in adults, a very unique and specific variant of schwannoma, the intravascular variant, is exceedingly rare. There have only been three previously published cases of intravascular schwannomas. Here we describe a fourth case of an intravascular schwannoma in a 47-year-old man with an enlarging subcutaneous nodule on his posterior calf. This is the second case of an intravascular schwannoma contained within a vein. Also included is an overview of intravascular schwannomas, including a description and discussion of the histopathological diagnosis, differential diagnoses, and schwannoma variants.
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Affiliation(s)
- Annie Dai
- School of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Jian-Ping Cai
- Dermatopathology, Florida Division of Dianon Systems/LabCorp, Tampa, Florida, USA
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Hu J, Liu W, Xie S, Li M, Wang K, Li W. Abdominal perivascular epithelioid cell tumor (PEComa) without visible fat: a clinicopathologic and radiological analysis of 16 cases. Radiol Med 2020; 126:189-199. [PMID: 32562157 DOI: 10.1007/s11547-020-01241-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 06/07/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To retrospectively review the clinicopathological features and computed tomography (CT) and magnetic resonance imaging (MRI) findings of abdominal perivascular epithelioid cell tumor without visible fat (PEComawvf). MATERIALS AND METHODS Sixteen patients with surgically and pathologically confirmed perivascular epithelioid cell tumor without visible fat were enrolled. Their clinicopathological data and imaging findings were retrospectively reviewed. The CT and MRI features, including location, size, shape, margin, density, calcification, cystic necrosis and enhancement pattern, were analyzed. RESULTS There were 4 males and 12 females (median age, 46 years; range, 21-65 years) in this study. All 16 patients were diagnostic asymptomatic unenhanced CT or MRI and revealed a well-defined (n = 13), oval (n = 10), mass with heterogeneous (n = 6) or homogeneous density/signal intensity (n = 7), calcification and hemorrhage was no found in any cases. On enhanced CT/MRI, markedly enhancement patterns (n = 14) were observed. The "peripheral enhancement" sign was observed in 13 cases. One in 16 cases recurrence was discovered during the follow-up period. CONCLUSIONS Dynamic CT, MRI and pathology of PEComawvf had some characteristics of non-aggressive pattern of performance, and MRI would provide beneficial detection of microscopic fat. Enhanced imaging showed PEComawvf is characterized by a "peripheral enhancement" with a marked enhancement pattern. Knowing these characteristics could contribute to improving the understanding abdominal PEComawvf and related palliative care.
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Affiliation(s)
- Jiaxi Hu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Wenguang Liu
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Simin Xie
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Mengsi Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Kangtao Wang
- Department of Gastrointestinal Surgery, Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China
| | - Wenzheng Li
- Department of Radiology, Xiangya Hospital, Central South University, Changsha, 410011, Hunan, China.
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Akinyamoju AO, Adeyemi BF, Kolude B. Classification and Clinicopathologic Study of Orofacial Mesenchymal Tumors: A Retrospective Study. JOURNAL OF ADVANCED ORAL RESEARCH 2020. [DOI: 10.1177/2320206820925629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: To determine the prevalence of orofacial mesenchymal neoplasms and classify them using the WHO criteria while appraising its applicability. Materials and Methods: This was a retrospective study involving a total sample of 192 entries diagnosed as mesenchymal tumors for the period 1990-2018 at the Oral Pathology Department, University College Hospital, Ibadan. The histopathology records were examined and clinicopathological data were obtained. Hematoxylin and Eosin slides of the cases were assessed to confirm the diagnosis. Tumors were classified using the WHO 2013 classification. Data were analyzed and presented using descriptive statistics. Results: Orofacial mesenchymal tumors constituted 7.9% of 2402 biopsies. There were 26 diagnoses in 161 tumors of the WHO classification. Male-to-female ratio was 1.1:1. Peak age group was in the third decade. Soft tissue tumors were 61.5%, while bone tumors were 38.5%. Benign tumors constituted 49.5%, while sarcomas and intermediate tumors were 45.8% and 4.7%, respectively. The mandibular region (29.7%) was the most commonly affected site. Adipocytic and osteogenic tumors were the most prevalent tumors in the soft tissue and osteoarticular series, respectively, representing 19.8% and 32.3% of all cases, while orofacial sarcomas constituted 3.6% of all lesions seen. Conclusion: The findings in this study are in line with those of previous studies. However, the WHO classification may not be suited for the orofacial region. Crafting of a classification system for mesenchymal tumors of the orofacial region would thus be necessary.
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Affiliation(s)
| | - Bukola Folasade Adeyemi
- Department of Oral Pathology, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria
| | - Bamidele Kolude
- Department of Oral Pathology, University of Ibadan/University College Hospital, Ibadan, Oyo State, Nigeria
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Miller DL, Roy-Chowdhuri S, Illei P, James A, Hruban RH, Ali SZ. Primary pancreatic Ewing sarcoma: a cytomorphologic and histopathologic study of 13 cases. J Am Soc Cytopathol 2020; 9:502-512. [PMID: 32536453 DOI: 10.1016/j.jasc.2020.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 04/27/2020] [Accepted: 04/28/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Ewing sarcoma (ES) is a small, round cell sarcoma that rarely occurs in solid organs, including the pancreas. A diagnostic overlap exists with other primary pancreatic neoplasms, especially for specimens from small biopsies and fine needle aspiration (FNA). To improve the diagnosis of this rare pancreatic tumor, we have reported a series of 13 cases of primary pancreatic ES and reviewed the cytopathologic, surgical pathology, clinical, and radiologic features of these neoplasms. MATERIALS AND METHODS We performed a retrospective case review of 13 patients with a diagnosis of pancreatic ES from 2 tertiary academic medical centers. A combination of cytology and histopathologic slides were reviewed, and the patient demographics, clinical information, somatic genetics, and radiologic findings were obtained from the electronic medical records. RESULTS Five FNA specimens from 5 patients and 8 surgical biopsy or resection specimens were identified and reviewed. The patients included 9 males and 4 females, with a median age of 27 years (range, 15-78 years). The cytology smears were highly cellular and showed a combination of complex tissue fragments and singly dispersed small round blue cells. The final diagnosis was ES for all 5 FNA specimens in accordance with the characteristic cytomorphology, diffuse and/or strong membranous immunolabeling for CD99, membranous β-catenin, and molecular confirmation of EWSR1 using fluorescence in situ hybridization or reverse transcriptase polymerase chain reaction. CONCLUSIONS The cytologic diagnosis of ES is challenging, especially in unusual locations such as the pancreas. However, the correct cytologic diagnosis is important because these patients will require neoadjuvant therapy before surgery. Confirmatory molecular studies should be required to render the diagnosis of pancreatic ES.
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Affiliation(s)
- Daniel L Miller
- Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Sinchita Roy-Chowdhuri
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Peter Illei
- Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Aaaron James
- Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ralph H Hruban
- Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Oncology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Syed Z Ali
- Department of Pathology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Radiology, The Sol Goldman Pancreatic Cancer Research Center, The Johns Hopkins University School of Medicine, Baltimore, Maryland.
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38
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Ghoreishi S, Zargaran M, Baghaei F. Survey of pathology reports with no definitive diagnosis in oral lesions: the necessary skills for the clinicians. Heliyon 2020; 6:e03848. [PMID: 32368657 PMCID: PMC7184257 DOI: 10.1016/j.heliyon.2020.e03848] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 02/22/2020] [Accepted: 04/21/2020] [Indexed: 12/11/2022] Open
Abstract
Purpose Biopsy plays a crucial role in definitive diagnosis of lesions and consequently, appropriate treatment of them. Clinicians should correctly do the biopsy in accordance to the existing principles and guidelines to prevent adverse effects on the pathologist's diagnosis. This study aimed to determine the frequency and reasons for not providing definitive histopathological diagnosis of the biopsy samples belong to the laboratory of the Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Hamadan University of Medical Sciences. Methods Archival reports belong to 2006–2016 period of the related laboratory were studied to determine the reports with no definitive histopathological diagnosis. Results Out of 1018 archived reports; 90 reports (8.84%) had no definitive diagnosis. The most common reasons found were incompatibility between the clinical/radiographical diagnosis and histopathological findings for 42 cases (46.66%), absence of adequate information about the clinical/radiographical findings for 17 cases (18.88%) and inappropriate quality of samples for 13 cases (14.44%), respectively. Conclusion The reasons for not providing definitive histopathological diagnosis of the biopsy samples in present study indicated that preparation, assessment and diagnosis of microscopic slide by pathologists do not separate from the clinician performance.
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Affiliation(s)
- Soroush Ghoreishi
- Faculty of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Massoumeh Zargaran
- Department of Oral and Maxillofacial Pathology, Faculty of Dentistry, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Fahimeh Baghaei
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Iran
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Pagliuca F, Ronchi A, Cozzolino I, Montella M, Zito Marino F, Franco R. Mesenchymal neoplasms: Is it time for cytology? New perspectives for the pre-operative diagnosis of soft tissue tumors in the molecular era. Pathol Res Pract 2020; 216:152923. [PMID: 32303388 DOI: 10.1016/j.prp.2020.152923] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/08/2020] [Accepted: 03/14/2020] [Indexed: 12/26/2022]
Abstract
Soft tissue tumors comprise a great variety of common and rare entities with overlapping features. Their diagnosis is based on the evaluation of several histological parameters which are difficult to assess on small incisional biopsies. Useful diagnostic markers in the field of soft tissue tumors include: 1) molecular biomarkers detecting pathogenetically relevant, distinctive alterations; 2) immunohistochemical surrogate biomarkers of pathogenetically relevant, distinctive molecular alterations; 3) highly specific immunohistochemical biomarkers indicating tumor differentiation. Their introduction in clinical practice has revolutionized the pre-operative diagnosis of soft tissue tumors. Cytology has long been considered inadequate as a first-line approach in this setting. However, since the implementation of new immunohistochemical and molecular tests with high diagnostic specificity, fine needle aspiration cytology (FNAC) is starting to gain acceptance for the pre-operative assessment of soft tissue tumors. FNAC represents a versatile, poorly expensive and well-tolerated diagnostic strategy with relevant advantages over histological biopsies. Moreover, evidences suggest that, in expert hands, FNAC can also aim at a definite diagnosis, especially if a cell block is prepared, allowing the application of multiple ancillary techniques.
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Affiliation(s)
- Francesca Pagliuca
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Montella
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Federica Zito Marino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy.
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Bajaj G, Tirumani H, Whisman MK, Raichandani S, Ram R, Jambhekar K, Gardner JM, Pandey T. Comprehensive Review of Abdominopelvic Mesenchymal Tumors with Radiologic Pathologic Correlation and Update on Current Treatment Guidelines - Part 1. Semin Ultrasound CT MR 2020; 41:222-238. [PMID: 32446433 DOI: 10.1053/j.sult.2020.01.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Soft-tissue sarcomas are a diverse group of rare mesenchymal malignancies accounting for only 1% of all solid adult malignancies. These have been categorized in 12 broad groups by the World Health Organization (WHO) with their recent update in 2013. Majority of them lack specific imaging features serving as imaging conundrums for a radiologist. These are often large masses at presentation as they are asymptomatic or cause vague clinical symptoms. These tumors are challenging for surgeons as well as they find it difficult to achieve complete resection because of complex intra-abdominal anatomy and their close relationship with critical structures. Often, a multidisciplinary approach is required to decide on the most appropriate management for these complex cases so as to provide optimal patient care. Knowledge of the WHO classification, pathologic features and available treatment options will help the radiologist make a meaningful contribution in multidisciplinary discussions of such cases and overall patient care. Liposarcoma (well-differentiated and dedifferentiated liposarcomas), leiomyosarcoma, and gastrointestinal stromal tumor are the 3 most common primary intra-abdominal sarcomas. In part 1 of this article, general features of soft tissue sarcomas and some of the common tumors from WHO category 1-4 found in abdomen and pelvis are discussed. Part 2 will focus on common tumors from remainder of the WHO categories.
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Affiliation(s)
- Gitanjali Bajaj
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR.
| | - Harika Tirumani
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Michella K Whisman
- Department of Pathology and Clinical Laboratories, University of Michigan, Ann Arbor, MI
| | - Surbhi Raichandani
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Roopa Ram
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Kedar Jambhekar
- Department of Radiology and Orthopedics, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Jerad M Gardner
- Department of Pathology and Dermatology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Tarun Pandey
- Department of Radiology and Orthopedics, University of Arkansas for Medical Sciences, Little Rock, AR
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Tarchouli M, Essarghini M, Qamouss O, El Kharras A, Bounaim A. Abdominal wall schwannoma: a case report. GASTROENTEROLOGY AND HEPATOLOGY FROM BED TO BENCH 2020; 13:95-100. [PMID: 32190231 PMCID: PMC7069535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Schwannomas or neurilemmomas are benign and slow-growing tumors that arise exclusively from Schwann cells in peripheral nerve sheaths. These neoplasms theoretically can occur anywhere in the body, but they most frequently affect extremities, as well as head and neck region. However, their presentation in the abdominal wall is extremely rare and only few cases have been reported in the literature. Subcutaneous lesions may be asymptomatic and only incidentally discovered upon physical examination or imaging. However, occasionally they induce mass effects on surrounding large nerves. We present the case of a 34-year-old man with abdominal wall pain localized in the right iliac fossa and palpable subcutaneous mass. Ultrasound and CT scan revealed a solid well-defined mass of the abdominal wall. Following surgical excision under general anesthesia, histological examination was consistent with the diagnosis of benign schwannoma.
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Affiliation(s)
- Mohamed Tarchouli
- Department of Surgery, First Medical and Surgical Center, Agadir, Morocco
| | - Mohamed Essarghini
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
| | - Ouadie Qamouss
- Department of Visceral Surgery, Mohammed V Military Teaching Hospital, Rabat, Morocco
| | | | - Ahmed Bounaim
- Faculty of Medicine and Pharmacy, Sidi Mohamed Ben Abdellah University, Fez, Morocco
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Murthy SS, Challa S, Raju K, Rajappa SJ, Fonseca D, Gundimeda SD, Rao BV, Ahmed F, Kodandapani S, Nambaru L, Mundada MC, Sharma R, Mallavarapu KM, Koppula VC, Rao TS. Ewing Sarcoma With Emphasis on Extra-skeletal Ewing Sarcoma: A Decade's Experience From a Single Centre in India. CLINICAL PATHOLOGY (THOUSAND OAKS, VENTURA COUNTY, CALIF.) 2020; 13:2632010X20970210. [PMID: 33241208 PMCID: PMC7672761 DOI: 10.1177/2632010x20970210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/02/2020] [Indexed: 01/27/2023]
Abstract
INTRODUCTION The diagnosis of Ewing sarcoma family of tumours (ESFT) is challenging, especially in adults and in extra-skeletal or visceral location. Several morphologic mimics with varied treatment options and prognosis confer diagnostic dilemmas. Application of ancillary diagnostic modalities in surgical pathology in clinical routine has enabled accurate diagnosis of ESFT in bone, soft tissues, and viscera. AIM The study aims to assess the clinicopathological features including molecular test results of ESFT with emphasis on sex, age, and location, especially extra-skeletal soft tissue and visceral location. MATERIAL AND METHODS Data of clinicopathological, molecular tests (wherever performed), diagnosis rendered in 302 ESFT over a decade from our centre were reviewed. Statistical comparison of skeletal and extra-skeletal tumours with reference to age and sex was done using SPSS package. The P value of <.05 was considered significant. RESULTS The cohort included 302 ESFTs with 49% skeletal and 51% extra-skeletal tumours. Thigh was most common site among skeletal tumours; chest wall, paraspinal location, and retroperitoneum among soft tissues (39.4%); and kidney, ovary, and cervix among visceral tumours (11.3%). Fluorescence in situ hybridisation for EWSR1 gene rearrangement was positive in 54 patients and reverse-transcriptase polymerase chain reaction in 19 patients. Predominance of male sex, younger age and location in extremities among skeletal tumours and lack of gender predilection, higher age and axial location in extra-skeletal tumours were noted, which were statistically significant. Molecular tests were performed more frequently in extra-skeletal tumours, especially in visceral tumours to establish the diagnosis. CONCLUSIONS The study showed statistically significant differences in the age, sex, and location between skeletal and extra-skeletal ESFT. The increased percentage of extra-skeletal tumours especially in viscera was attributed to the increased awareness and availability of ancillary techniques.
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Affiliation(s)
- Sudha S Murthy
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - S Challa
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - Kvvn Raju
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - S J Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - D Fonseca
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - S D Gundimeda
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - B V Rao
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - F Ahmed
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - S Kodandapani
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - L Nambaru
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - M C Mundada
- Department of Pathology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - R Sharma
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - K M Mallavarapu
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - V C Koppula
- Department of Radiology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
| | - T S Rao
- Department of Radiology, Basavatarakam Indo American Cancer Hospital & Research Institute, Hyderabad, India
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43
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Layfield LJ. Soft tissue tumor diagnosis: A three prong approach utilizing pattern analysis, immunocytochemistry, and molecular diagnostics. Diagn Cytopathol 2019; 48:265-284. [PMID: 31868988 DOI: 10.1002/dc.24355] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 10/11/2019] [Accepted: 10/14/2019] [Indexed: 12/28/2022]
Abstract
Tissue diagnosis of a soft tissue neoplasm is of paramount importance for the development of an appropriate treatment plan. Biopsy technique including approach and biopsy method is important to the success of diagnosis and subsequent treatment. Histologic and cytologic diagnoses are difficult and complicated by the large number of soft tissue lesions described, distinctly different biopotential for morphologically similar lesions, often small biopsy specimen size, and the generally limited experience many pathologists have in the diagnosis of soft tissue neoplasms. While utilized less frequently than core-needle biopsies, fine-needle aspiration is a valuable initial approach for the classification of soft tissue neoplasms. The combination of pattern based morphologic analysis, immunohistochemistry, and molecular diagnostics represents a utilitarian and generally successful approach for the diagnosis of soft tissue lesions.
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Affiliation(s)
- Lester J Layfield
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri
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44
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Saggini A, Cerroni L, Casini B, Baciorri F, Cota C. Primary intrafascial desmoplastic melanoma with pseudoglandular differentiation and aberrant cytokeratins expression: An exceptional presentation. Pathol Res Pract 2019; 215:152668. [DOI: 10.1016/j.prp.2019.152668] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 09/22/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022]
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45
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Chen AL, Janko E, Pitman MB, Chebib I. Clinical, cytologic, and immunohistochemical features of sarcomas involving body cavity fluids. Cancer Cytopathol 2019; 127:778-784. [DOI: 10.1002/cncy.22197] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/09/2019] [Accepted: 09/16/2019] [Indexed: 12/22/2022]
Affiliation(s)
- Athena L. Chen
- Department of Pathology Massachusetts General Hospital Boston Massachusetts
- Harvard Medical School Boston Massachusetts
| | | | - Martha B. Pitman
- Department of Pathology Massachusetts General Hospital Boston Massachusetts
- Harvard Medical School Boston Massachusetts
| | - Ivan Chebib
- Department of Pathology Massachusetts General Hospital Boston Massachusetts
- Harvard Medical School Boston Massachusetts
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46
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Goel S, Ferreira CA, Dogra P, Yu B, Kutyreff CJ, Siamof CM, Engle JW, Barnhart TE, Cristini V, Wang Z, Cai W. Size-Optimized Ultrasmall Porous Silica Nanoparticles Depict Vasculature-Based Differential Targeting in Triple Negative Breast Cancer. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2019; 15:e1903747. [PMID: 31565854 PMCID: PMC6854296 DOI: 10.1002/smll.201903747] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2019] [Revised: 09/14/2019] [Indexed: 05/26/2023]
Abstract
Rapid sequestration and prolonged retention of intravenously injected nanoparticles by the liver and spleen (reticuloendothelial system (RES)) presents a major barrier to effective delivery to the target site and hampers clinical translation of nanomedicine. Inspired by biological macromolecular drugs, synthesis of ultrasmall (diameter ≈12-15 nm) porous silica nanoparticles (UPSNs), capable of prolonged plasma half-life, attenuated RES sequestration, and accelerated hepatobiliary clearance, is reported. The study further investigates the effect of tumor vascularization on uptake and retention of UPSNs in two mouse models of triple negative breast cancer with distinctly different microenvironments. A semimechanistic mathematical model is developed to gain mechanistic insights into the interactions between the UPSNs and the biological entities of interest, specifically the RES. Despite similar systemic pharmacokinetic profiles, UPSNs demonstrate strikingly different tumor responses in the two models. Histopathology confirms the differences in vasculature and stromal status of the two models, and corresponding differences in the microscopic distribution of UPSNs within the tumors. The studies demonstrate the successful application of multidisciplinary and complementary approaches, based on laboratory experimentation and mathematical modeling, to concurrently design optimized nanomaterials, and investigate their complex biological interactions, in order to drive innovation and translation.
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Affiliation(s)
- Shreya Goel
- Materials Science Program, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
| | - Carolina A. Ferreira
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
| | - Prashant Dogra
- Mathematics in Medicine Program, Houston Methodist Research Institute, Houston, Texas, USA, 77030
| | - Bo Yu
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
| | - Christopher J. Kutyreff
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
| | - Cerise M. Siamof
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
| | - Jonathan W. Engle
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
| | - Todd E. Barnhart
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
| | - Vittorio Cristini
- Mathematics in Medicine Program, Houston Methodist Research Institute, Houston, Texas, USA, 77030
| | - Zhihui Wang
- Mathematics in Medicine Program, Houston Methodist Research Institute, Houston, Texas, USA, 77030
| | - Weibo Cai
- University of Wisconsin Carbone Cancer Centre, Madison, Wisconsin 53705
- Materials Science Program, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
- Department of Biomedical Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
- Department of Radiology, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
- Department of Medical Physics, University of Wisconsin-Madison, Madison, Wisconsin, USA, 53705
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47
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Berro J, Abdul Halim N, Khaled C, Assi HI. Malignant melanoma with metaplastic cartilaginous transdifferentiation: A case report. J Cutan Pathol 2019; 46:935-941. [DOI: 10.1111/cup.13539] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Juliett Berro
- Department of Internal MedicineNaef K. Basile Cancer Institute, American University of Beirut Medical Center Beirut Lebanon
| | - Nour Abdul Halim
- Department of Internal MedicineNaef K. Basile Cancer Institute, American University of Beirut Medical Center Beirut Lebanon
| | - Chirine Khaled
- Department of PathologyAmerican University of Beirut Medical Center Beirut Lebanon
| | - Hazem I. Assi
- Department of Internal MedicineNaef K. Basile Cancer Institute, American University of Beirut Medical Center Beirut Lebanon
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48
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Caballero GA, Roitman PD. Pseudomyogenic Hemangioendothelioma (Epithelioid Sarcoma-Like Hemangioendothelioma). Arch Pathol Lab Med 2019; 144:529-533. [DOI: 10.5858/arpa.2018-0395-rs] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Pseudomyogenic hemangioendothelioma (PMH) is a rare vascular tumor that presents more frequently in young adults and has a male predominance. It is usually located in the superficial or deep soft tissues of the extremities, but concurrent bone involvement can be present. In approximately two-thirds of patients this disease is multifocal, often involving multiple tissue planes. It is a relapsing lesion with low metastatic potential. Given its clinical and morphologic characteristics (multifocality, epithelioid morphology, absence of clearly evident vascular differentiation on hematoxylin-eosin slides), PMH can be easily misinterpreted as other lesions, often with radically different treatment and prognosis. For this reason, we think it is important to recognize this entity, which has some unique features. Here, we will briefly describe the clinical and pathologic features of PMH, detailing its more relevant differential diagnoses.
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Affiliation(s)
- Gustavo A. Caballero
- From the Pathology Department, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
| | - Pablo D. Roitman
- From the Pathology Department, Italian Hospital of Buenos Aires, Buenos Aires, Argentina
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49
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Balao da Silva C, Gómez Gordo L, Cuesta Gerveno JM, Ortega-Ferrusola C, Martín-Muñoz P, Duque Carrasco FJ, Parejo C, Peña Vega F. A Rare Case of a Primary Unilateral Low-Grade Paratesticular Leiomyosarcoma in a 2 Years Old Dog. Front Vet Sci 2019; 6:83. [PMID: 30968032 PMCID: PMC6438921 DOI: 10.3389/fvets.2019.00083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 02/27/2019] [Indexed: 01/26/2023] Open
Abstract
A 2 years old dog was brought to the clinic with complains of testicular enlargement. The tissue was diffusely affected as confirmed by ultrasonographic examination, being the right testicle atrophied and the right epididymis enlarged, with loss of echotexture and presence of several anechogenic areas. The situation required the excision of the referred testicle and epididymis. Final diagnose made by histopathological analysis was primary unilateral low-grade paratesticular leiomyosarcoma. Scarce bibliography is found on this matter, with several cases reported on human, and none in dog. This case report is therefore an important milestone on the area of small animal oncology directly related to the reproductive tissue.
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Affiliation(s)
- Carolina Balao da Silva
- VALORIZA, Polytechnic Institute of Portalegre, Superior Agrarian School of Elvas, Elvas, Portugal
| | - Luis Gómez Gordo
- Pathological Anatomy Service, Veterinary Teaching Hospital, Caceres, Spain
| | | | - Cristina Ortega-Ferrusola
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, Caceres, Spain
| | - Patricia Martín-Muñoz
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, Caceres, Spain
| | | | - Carlos Parejo
- Pathological Anatomy Service, Hospital Espírito Santo E.P.E., Évora, Portugal
| | - Fernando Peña Vega
- Laboratory of Equine Reproduction and Equine Spermatology, Veterinary Teaching Hospital, Caceres, Spain
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50
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Primary low-grade fibromyxoid sarcoma of the large intestine with lung metastases: A case report and review of the literature. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2018.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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