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Pérez JC, Salgado AC, Pérez-Mies B, Rullán JAD, Ajuria-Illarramendi O, Alia EMG, Serrano Domingo JJ. Extramammary Paget Disease: a Therapeutic Challenge, for a Rare Entity. Curr Oncol Rep 2023; 25:1081-1094. [PMID: 37421583 PMCID: PMC10556167 DOI: 10.1007/s11912-023-01434-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE OF REVIEW Extramammary Paget disease (EMPD) is a rare entity which is more frequently localized at the vulva, though it only accounts for 1-2% of vulvar neoplasms. It is a primary cutaneous adenocarcinoma whose cell of origin is still a matter of controversy: it can either arise from apocrine/eccrine glands or from stem cells. The diagnosis demands a biopsy and entails a histopathological analysis by which cells show similar characteristics as breast Paget disease. RECENT FINDINGS Treatment approach can entail surgery, radiotherapy, photodynamic therapy, systemic chemotherapy, and topical chemotherapy. For metastatic disease, many different chemotherapy regimens have been explored and even targeted therapy can play an important role in this disease. Since almost 30-40% of patients overexpress HER-2, trastuzumab and anti-HER-2 therapies can be employed in this setting. Due to its low incidence, there is almost no specific evidence on therapeutic interventions for this disease. Thus, there is a neat unmet need for molecular characterization of EMPD and diagnostic tools that allow clinicians to guide treatment both in the early and in the advanced disease settings. In this review, we aim to summarize available evidence about diagnosis and treatment of EMPD, both localized and metastatic, and to provide a comprehensive analysis that may help clinicians for therapeutic decisions.
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Affiliation(s)
- Jesús Chamorro Pérez
- Medical Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Alfonso Cortes Salgado
- Medical Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Belén Pérez-Mies
- Pathology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Jose Antonio Domínguez Rullán
- Radiation Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Odile Ajuria-Illarramendi
- Nuclear Medicine Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Eva María Guerra Alia
- Medical Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
| | - Juan José Serrano Domingo
- Medical Oncology Department, Ramón y Cajal University Hospital, Carretera de Colmenar Viejo, Km 9.100, 28034 Madrid, CP Spain
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Pizarro D, Romero I, Pérez-Mies B, Redondo A, Caniego-Casas T, Carretero-Barrio I, Cristóbal E, Gutiérrez-Pecharromán A, Santaballa A, D'Angelo E, Hardisson D, Vieites B, Matías-Guiu X, Estévez P, Guerra E, Prat J, Poveda A, López-Guerrero JA, Palacios J. The Prognostic Significance of Tumor-Infiltrating Lymphocytes, PD-L1, BRCA Mutation Status and Tumor Mutational Burden in Early-Stage High-Grade Serous Ovarian Carcinoma-A Study by the Spanish Group for Ovarian Cancer Research (GEICO). Int J Mol Sci 2023; 24:11183. [PMID: 37446361 DOI: 10.3390/ijms241311183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Early stages are under-represented in studies on the molecular and immune features of high-grade serous ovarian carcinoma (HGSOC), and specific studies focused on early-stage HGSOC are required for a better prognostic stratification and to personalize chemotherapy. The aim of this study was to determine the prognostic significance of CD8+ and CD4+ tumor-infiltrating lymphocytes (TILs), tumoral cell PD-L1 expression, BRCA mutational status and tumor mutation burden (TMB) in early-stage HGSOC. A retrospective study was performed on stage I and II HGSOC from the Molecular Reclassification of Early Stages of Ovarian Cancer (RECLAMO) cohort from the Spanish Group of Ovarian Cancer Research (GEICO). Centralized histological typing was performed based on morphological and immunohistochemical features. Intraepithelial (i) and stromal (s) CD8+ and CD4+ T cells and PD-L1 were evaluated on tissue microarrays by immunohistochemistry. BRCA1 and BRCA2 mutation status and TMB were analyzed in tumor DNA using next-generation sequencing. The study included 124 tumors. High iCD8+ (>20 TILs/core), low/intermediate CD4+ (<20 TILs/core) and high CD8+/CD4+ ratio (>35/core) were associated with favorable outcomes. Tumor cell PD-L1 expression (TPS ≥ 1) was present in only 8% of tumors. In total, 11 (16%) and 6 (9%) out of 69 HGSOC tested carried pathogenic or likely pathogenic BRCA1 or BRCA2 mutations, respectively. Median TMB of 40 tumors analyzed was 5.04 mutations/Mb and only 6 tumors had 10 or more mutations/Mb. BRCA status and TMB were not associated with TILs or prognosis. When compared with studies on advanced HGSOC, our results suggested that prognostic variables differed according to stage and that more studies focused on early stages of HGSOC are needed to better stratify these tumors.
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Affiliation(s)
- David Pizarro
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
| | - Ignacio Romero
- Instituto Valenciano de Oncología, 46009 Valencia, Spain
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
| | - Belén Pérez-Mies
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá, 28801 Alcalá de Henares, Spain
| | - Andrés Redondo
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Oncology Department, University Hospital La Paz, IdiPAZ, 28046 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz, 28029 Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
| | - Tamara Caniego-Casas
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá, 28801 Alcalá de Henares, Spain
| | - Eva Cristóbal
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Ana Santaballa
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Oncology Department, University Hospital La Fe, 46026 Valencia, Spain
| | - Emanuela D'Angelo
- Department of Medical, Oral, and Biotechnological Sciences, University "G.D'Annunzio" of Chieti-Pescara, 66013 Chieti, Italy
| | - David Hardisson
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz, 28029 Madrid, Spain
- Faculty of Medicine, Autonomous University of Madrid, 28029 Madrid, Spain
- Pathology Department, University Hospital La Paz, 28046 Madrid, Spain
| | - Begoña Vieites
- Pathology Department, University Hospital Virgen del Rocío, 41013 Sevilla, Spain
| | - Xavier Matías-Guiu
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Pathology and Medical Oncology Departments, Hospital Universitari Arnau de Vilanova, IRBLLEIDA, University of Lleida, 25003 Lleida, Spain
- Pathology Department, Hospital Universitari de Bellvitge, IDIBELL, University of Barcelona, 08007 Barcelona, Spain
| | - Purificación Estévez
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Oncology Department, University Hospital Virgen del Rocío, 41013 Sevilla, Spain
- Seville Biomedical Research Institute (IBIS), 41013 Sevilla, Spain
| | - Eva Guerra
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Oncology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
| | - Jaime Prat
- Pathology Department, Emeritus Faculty, Autonomous University of Barcelona, 08193 Barcelona, Spain
| | - Andrés Poveda
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Initia Oncología, Hospital Quironsalud Valencia, 46010 Valencia, Spain
| | - José Antonio López-Guerrero
- Instituto Valenciano de Oncología, 46009 Valencia, Spain
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
| | - José Palacios
- Pathology Department, University Hospital Ramón y Cajal, IRYCIS, 28034 Madrid, Spain
- Spanish Group for Investigation on Ovarian Cancer (GEICO), 28003 Madrid, Spain
- Biomedical Research Network in Oncology (CIBERONC), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá, 28801 Alcalá de Henares, Spain
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Ruiz-Cáceres I, Hermida Romero T, Guerra Merino I, Portu Zapirain J, Pérez-Mies B, Sánchez-Conde M, Riaño MA, Rubio R, Fortés Alen J, Vidal González Á, Salas Antón C, Múñez E, Sánchez Sánchez R, Corona-Mata D, Aldecoa Ansorregui I, Miró JM, Beloqui Pérez de Obanos R, Ibero C, Gómez-Román J, Fariñas MC, Tabuyo Bello T, de Alava E, Cisneros JM, Matías-Guiu X, Rivero A. Post-mortem findings in Spanish patients with COVID-19; a special focus on superinfections. Front Med (Lausanne) 2023; 10:1151843. [PMID: 37484846 PMCID: PMC10359908 DOI: 10.3389/fmed.2023.1151843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/15/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Whole-body autopsies may be crucial to understand coronavirus disease 2019 (COVID-19) pathophysiology. We aimed to analyze pathological findings in a large series of full-body autopsies, with a special focus on superinfections. Methods This was a prospective multicenter study that included 70 COVID-19 autopsies performed between April 2020 and February 2021. Epidemiological, clinical and pathological information was collected using a standardized case report form. Results Median (IQR) age was 70 (range 63.75-74.25) years and 76% of cases were males. Most patients (90%,) had at least one comorbidity prior to COVID-19 diagnosis, with vascular risk factors being the most frequent. Infectious complications were developed by 65.71% of the patients during their follow-up. Mechanical ventilation was required in most patients (75.71%) and was mainly invasive. In multivariate analyses, length of hospital stay and invasive mechanical ventilation were significantly associated with infections (p = 0.036 and p = 0.013, respectively). Necropsy findings revealed diffuse alveolar damage in the lungs, left ventricular hypertrophy in the heart, liver steatosis and pre-infection arteriosclerosis in the heart and kidneys. Conclusion Our study confirms the main necropsy histopathological findings attributed to COVID-19 in a large patient series, while underlining the importance of both comorbid conditions and superinfections in the pathology.
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Affiliation(s)
- Inmaculada Ruiz-Cáceres
- Department of Infectious Diseases, Reina Sofía University Hospital, The Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba University (UCO), Córdoba, Spain
- CIBERINFEC, ISCIII – CIBER de Enfermedades Infecciosas Instituto de Salud Carlos III, Madrid, Spain
| | - Teresa Hermida Romero
- Department of Pathological Anatomy, A Coruña University Hospital Complex, A Coruña, Spain
| | - Isabel Guerra Merino
- Department of Pathological Anatomy, University Hospital of Álava, Vitoria-Gasteiz, Spain
| | - Joseba Portu Zapirain
- Bioaraba, Microbiology, Infectious Diseases, Antimicrobials and Gene Therapy Research Group, Vitoria-Gasteiz, Spain
- Osakidetza Basque Health Service, Álava University Hospital, Vitoria-Gasteiz, Spain
| | - Belén Pérez-Mies
- Department of Pathological Anatomy, Ramón y Cajal University Hospital, Madrid, Spain
| | - Matilde Sánchez-Conde
- Department of Infectious Diseases, Ramón y Cajal University Hospital-IRYCIS, CIBERINFEC, Madrid, Spain
| | - Marina Alonso Riaño
- Department of Pathological Anatomy, 12 de Octubre University Hospital, Madrid, Spain
| | - Rafael Rubio
- Section of Internal Medicine, 12 de Octubre University Hospital, Department of Medicine, School of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Jose Fortés Alen
- Department of Pathological Anatomy, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Ánxela Vidal González
- Department of Intensive Care Medicine, Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Clara Salas Antón
- Department of Pathological Anatomy, Puerta de Hierro University Hospital, Majadahonda, Spain
| | - Elena Múñez
- Infectious Diseases Unit, Puerta de Hierro University Hospital, Majadahonda, Spain
| | | | - Diana Corona-Mata
- Department of Infectious Diseases, Reina Sofía University Hospital, The Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba University (UCO), Córdoba, Spain
| | | | - José M. Miró
- Infectious Diseases Service, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBERINFEC, Instituto Carlos III, Madrid, Spain
| | | | - Carlos Ibero
- Infectious Diseases, COVID Coordination at University Hospital of Navarra, Pamplona, Spain
| | - Javier Gómez-Román
- Department of Pathological Anatomy, Marqués de Valdecilla University Hospital, Santander, Spain
| | - M. Carmen Fariñas
- Department of Infectious Diseases, Marqués de Valdecilla University Hospital, IDIVAL, CIBERINFEC, University of Cantabria, Santander, Cantabria, Spain
| | - Teresa Tabuyo Bello
- Department of Intensive Care, A Coruña University Hospital Complex, A Coruña, Spain
| | - Enrique de Alava
- Department of Pathological Anatomy, Virgen del Rocío University Hospital, Seville, Spain
| | - José Miguel Cisneros
- Clinical Unit of Infectious Diseases, Microbiology and Preventive Medicine, Virgen del Rocío University Hospital, Seville, Spain
| | - Xavier Matías-Guiu
- Department of Pathological Anatomy, Bellvitge University Hospital, Barcelona, Spain
| | - Antonio Rivero
- Department of Infectious Diseases, Reina Sofía University Hospital, The Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Córdoba University (UCO), Córdoba, Spain
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4
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Jimeno R, Mouron S, Salgado R, Loi S, Pérez-Mies B, Sánchez-Bayona R, Manso L, Martínez M, Garrido-García A, Serrano-Pardo R, Colomer R, Quintela-Fandino M. Tumor P70S6K hyperactivation is inversely associated with tumor-infiltrating lymphocytes in triple-negative breast cancer. Clin Transl Oncol 2023; 25:1124-1131. [PMID: 36508123 PMCID: PMC10025236 DOI: 10.1007/s12094-022-03006-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
PURPOSE Triple-negative breast cancer (TNBC) is characterized by large heterogeneity and relative lack of available targeted therapies. To find therapeutic strategies for distinct patients with TNBC, several approaches have been used for TNBC clustering, including recently immune and phosphoproteomic patterns. Based on 70-kDa ribosomal protein S6 kinase (P70S6K)-TNBC clustering, the current study explores the immune profiling in TNBC tumors. METHODS Stromal tumor-infiltrating lymphocytes (sTILs) were evaluated in human TNBC tumor samples. Furthermore, immunohistochemistry staining for CD8, CD4, Foxp3, and CD20 was performed in tissue microarrays (TMA) sections. RESULTS Histological analysis showed decreased sTILs, CD20+ cells, and CD8+/CD4+ ratio in high phosphorylated P70S6K (p-P70S6K) tumors. Moreover, p-P70S6K score was directly correlated with CD4+ and Foxp3+ T cells, while it was inversely correlated with CD8+/CD4+ and CD8+/Foxp3+ ratios. CONCLUSION sTIL infiltration and lymphocyte profiling vary in the context of hyperactivation of P70S6K in TNBC tumors.
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Affiliation(s)
- Rebeca Jimeno
- Breast Cancer Clinical Research Unit, Clinical Research Program, CNIO, Madrid, Spain
| | - Silvana Mouron
- Breast Cancer Clinical Research Unit, Clinical Research Program, CNIO, Madrid, Spain
| | - Roberto Salgado
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Department of Pathology, GZA-ZNA, Antwerp, Belgium
| | - Sherene Loi
- Peter MacCallum Cancer Centre, Melbourne, VIC, Australia
- Sir Peter MacCallum Cancer Department of Oncology, University of Melbourne, Melbourne, VIC, Australia
| | - Belén Pérez-Mies
- Department of Pathology, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRyCIS), Madrid, Spain
- Faculty of Medicine, Universidad de Alcalá, Alcalá de Henares, Spain
- CIBERONC, Madrid, Spain
| | | | - Luis Manso
- Department of Medical Oncology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Mario Martínez
- Department of Pathology, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Ana Garrido-García
- Department of Medical Oncology, Hospital Universitario La Princesa, Madrid, Spain
| | | | - Ramón Colomer
- Department of Medical Oncology, Hospital Universitario La Princesa, Madrid, Spain
- Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - Miguel Quintela-Fandino
- Breast Cancer Clinical Research Unit, Clinical Research Program, CNIO, Madrid, Spain.
- Medical Oncology, Hospital Universitario de Fuenlabrada, Madrid, Spain.
- Endowed Chair of Personalised Precision Medicine, Department of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
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5
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Carretero-Barrio I, Caniego-Casas T, Rosas M, Sánchez MC, Martínez-Jáñez N, Chiva M, Sarrió D, Moreno-Bueno G, Palacios J, Pérez-Mies B. Evaluation of ERBB2 mRNA Expression in HER2-Equivocal (2+) Immunohistochemistry Cases. Cancers (Basel) 2023; 15:cancers15061688. [PMID: 36980575 PMCID: PMC10046044 DOI: 10.3390/cancers15061688] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/23/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
Xpert Breast Cancer STRAT4 is a RT-qPCR platform that studies the mRNA expression of ESR1, PGR, MKI67 and ERBB2, providing a positive or negative result for each of these breast cancer biomarkers. Its concordance with immunohistochemistry (IHC) and in situ hybridization (ISH) has been previously demonstrated, but none of the previous works was focused on HER2-equivocal (2+) cases identified by IHC. Thus, we studied the concordance between IHC/ISH and STRAT4 results for 112 HER2 2+ IBC samples, using 148 HER2 0+, 1+ and 3+ (no-HER2 2+) samples for comparison. We found 91.3% accuracy for the determination of HER2 status globally, 99.3% for no-HER2 2+ samples and 80.7% for HER2 2+ samples. Regarding the other biomarkers, we obtained 96.4% accuracy for estrogen receptor, 84.1% for progesterone receptor and 58.2% for Ki67. Our results suggest that the use of ERBB2 mRNA for the evaluation of HER2 2+ cases is not a reliable reflex method to assess the ERBB2 amplification status.
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Affiliation(s)
- Irene Carretero-Barrio
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
- Faculty of Medicine, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
| | - Tamara Caniego-Casas
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
| | - Marta Rosas
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
| | - María Concepción Sánchez
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Servicio de Ginecología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Noelia Martínez-Jáñez
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Servicio de Oncología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - Miguel Chiva
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Servicio de Radiología, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
| | - David Sarrió
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Departamento de Bioquímica, Universidad Autónoma de Madrid (UAM), Instituto de Investigaciones Biomédicas ‘Alberto Sols’, Conexión Cáncer (UAM-CSIC), 28029 Madrid, Spain
| | - Gema Moreno-Bueno
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Departamento de Bioquímica, Universidad Autónoma de Madrid (UAM), Instituto de Investigaciones Biomédicas ‘Alberto Sols’, Conexión Cáncer (UAM-CSIC), 28029 Madrid, Spain
- Fundación MD Anderson Internacional, 28033 Madrid, Spain
| | - José Palacios
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
- Faculty of Medicine, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Correspondence: (J.P.); (B.P.-M.); Tel.: +34-91-336-8337 (J.P. & B.P.-M.)
| | - Belén Pérez-Mies
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain; (I.C.-B.); (T.C.-C.); (M.R.)
- Faculty of Medicine, Universidad de Alcalá, 28801 Alcalá de Henares, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), 28029 Madrid, Spain; (D.S.); (G.M.-B.)
- Unidad de Patología Mamaria, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (M.C.S.); (N.M.-J.); (M.C.)
- Correspondence: (J.P.); (B.P.-M.); Tel.: +34-91-336-8337 (J.P. & B.P.-M.)
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Pérez-Mies B, Caniego-Casas T, Bardi T, Carretero-Barrio I, Benito A, García-Cosío M, González-García I, Pizarro D, Rosas M, Cristóbal E, Ruano Y, Garrido MC, Rigual-Bobillo J, de Pablo R, Galán JC, Pestaña D, Palacios J. Progression to lung fibrosis in severe COVID-19 patients: A morphological and transcriptomic study in postmortem samples. Front Med (Lausanne) 2022; 9:976759. [PMID: 36405615 PMCID: PMC9669577 DOI: 10.3389/fmed.2022.976759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/17/2022] [Indexed: 09/02/2023] Open
Abstract
The development of lung fibrosis is a major concern in patients recovered from severe COVID-19 pneumonia. This study aimed to document the evolution of diffuse alveolar damage (DAD) to the fibrosing pattern and define the transcriptional programs involved. Morphological, immunohistochemical and transcriptional analysis were performed in lung samples obtained from autopsy of 33 severe COVID-19 patients (median illness duration: 36 days). Normal lung and idiopathic pulmonary fibrosis (IPF) were used for comparison. Twenty-seven patients with DAD and disease evolution of more than 2 weeks had fibrosis. Pathways and genes related with collagen biosynthesis and extracellular matrix (ECM) biosynthesis and degradation, myofibroblastic differentiation and epithelial to mesenchymal transition (EMT) were overexpressed in COVID-19. This pattern had similarities with that observed in IPF. By immunohistochemistry, pathological fibroblasts (pFBs), with CTHRC1 and SPARC expression, increased in areas of proliferative DAD and decreased in areas of mature fibrosis. Immunohistochemical analysis demonstrated constitutive expression of cadherin-11 in normal epithelial cells and a similar pattern of cadherin and catenin expression in epithelial cells from both normal and COVID-19 samples. Transcriptomic analysis revealed downregulation of the Hippo pathway, concordant with the observation of YAP overexpression in hyperplastic alveolar epithelial cells. Progression to fibrosis in severe COVID-19 is associated with overexpression of fibrogenic pathways and increased in CTHRC1- and SPARC-positive pFBs. Whereas the Hippo pathway seemed to be implicated in the response to epithelial cell damage, EMT was not a major process implicated in COVID-19 mediated lung fibrosis.
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Affiliation(s)
- Belén Pérez-Mies
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Tamara Caniego-Casas
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Tommaso Bardi
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Department of Anesthesiology and Surgical Critical Care, Hospital Ramón y Cajal, Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Amparo Benito
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Mónica García-Cosío
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Irene González-García
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
| | - David Pizarro
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Rosas
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Eva Cristóbal
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Yolanda Ruano
- Department of Pathology, Medical School, Universidad Complutense, Instituto i + 12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - María Concepción Garrido
- Department of Pathology, Medical School, Universidad Complutense, Instituto i + 12, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Juan Rigual-Bobillo
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Department of Respiratory, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Raúl de Pablo
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
- Medical Intensive Care Unit, Hospital Ramón y Cajal, Madrid, Spain
| | - Juan Carlos Galán
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Clinical Microbiology Unit, Hospital Ramón y Cajal, Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - David Pestaña
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
- Department of Anesthesiology and Surgical Critical Care, Hospital Ramón y Cajal, Madrid, Spain
| | - José Palacios
- Pathology, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramon y Cajal de Investigación Sanitaria, Madrid, Spain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
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7
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Pérez-Mies B, Caniego-Casas T, Carretero-Barrio I, Biscuola M, López-García MA, Hardisson D, Rosas M, López Rodríguez MJ, Cristóbal E, Pizarro D, Rosa-Rosa JM, Palacios J. The Clonal Relationship Between the Ductal and Lobular Components of Mixed Ductal-Lobular Carcinomas Suggested a Ductal Origin in Most Tumors. Am J Surg Pathol 2022; 46:1545-1553. [PMID: 35877198 PMCID: PMC9561241 DOI: 10.1097/pas.0000000000001936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The relationship between the ductal and lobular components of invasive ductolobular carcinomas (IDLC) has not been fully elucidated. In this study, the molecular alterations of both components were analyzed in a series of 20 IDLC that were selected, not only by morphologic criteria, but also by the loss of E-cadherin expression in the lobular component. We found that 80% of tumors shared alterations of driver genes in both components, being PIK3CA the most common alteration. In addition, 45% of IDLC carried CDH1 mutations in their lobular component that were absent in the ductal component. Fluorescent in situ hybridization analysis of the CDH1 gene excluded homozygous CDH1 loss as a frequent cause of E-cadherin loss in tumors without CDH1 mutations. In addition, no pathogenic mutations of catenin genes were detected in this series of tumors. In 25% of tumors, actionable mutations in PIK3CA , AKT1 , and ERBB2 were found in only 1 component. Altogether, our results confirm that most IDLC derive from invasive carcinoma of no special type, in which a population of cells lose E-cadherin and acquire a lobular phenotype. The frequency of CDH1 mutations in IDLC appears to be lower than in conventional invasive lobular carcinomas, suggesting the implication of alternative mechanisms of E-cadherin loss. Moreover, molecular heterogeneity between ductal and lobular areas suggests the need for molecular characterization of both components to guide targeted therapies.
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Affiliation(s)
- Belén Pérez-Mies
- Department of Pathology, Hospital Ramón y Cajal
- Instituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)
- CIBERONC
- Faculty of Medicine, Universidad de Alcalá
| | - Tamara Caniego-Casas
- Department of Pathology, Hospital Ramón y Cajal
- Instituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)
- CIBERONC
| | - Irene Carretero-Barrio
- Department of Pathology, Hospital Ramón y Cajal
- Instituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)
- Faculty of Medicine, Universidad de Alcalá
| | - Michele Biscuola
- CIBERONC
- Department of Pathology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - María A. López-García
- CIBERONC
- Department of Pathology, Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - David Hardisson
- CIBERONC
- Department of Pathology, Hospital Universitario La Paz
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdidPAZ)
- Faculty of Medicine, Universidad Autónoma de Madrid
| | - Marta Rosas
- Department of Pathology, Hospital Ramón y Cajal
- Instituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)
| | - María J. López Rodríguez
- Instituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)
- Department of Gynecology, Hospital Universitario Ramón y Cajal, Madrid
| | - Eva Cristóbal
- Department of Pathology, Hospital Ramón y Cajal
- Instituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)
| | - David Pizarro
- Department of Pathology, Hospital Ramón y Cajal
- Instituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)
| | - Juan M. Rosa-Rosa
- Department of Pathology, Hospital Ramón y Cajal
- Instituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)
| | - José Palacios
- Department of Pathology, Hospital Ramón y Cajal
- Instituto Ramon y Cajal de Investigación Sanitaria (IRyCIS)
- CIBERONC
- Faculty of Medicine, Universidad de Alcalá
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8
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Ruz-Caracuel I, Pian-Arias H, Corral Í, Carretero-Barrio I, Bueno-Sacristán D, Pérez-Mies B, García-Cosío M, Caniego-Casas T, Pizarro D, García-Narros MI, Piris-Villaespesa M, Pestaña D, de Pablo R, Galán JC, Masjuan J, Palacios J. Neuropathological findings in fatal COVID-19 and their associated neurological clinical manifestations. Pathology 2022; 54:738-745. [PMID: 35691726 PMCID: PMC9182090 DOI: 10.1016/j.pathol.2022.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/27/2022] [Accepted: 03/07/2022] [Indexed: 12/19/2022]
Abstract
Severe cases of Coronavirus Disease 2019 (COVID-19) can present with multiple neurological symptoms. The available neuropathological studies have described different lesions; the most frequent was the presence of neuroinflammation and vascular-related lesions. The objective of this study was to report the neuropathological studies performed in a medical institution, with abundant long intensive care unit stays, and their associated clinical manifestations. This is a retrospective monocentric case series study based on the neuropathological reports of 13 autopsies with a wide range of illness duration (13–108 days). A neuroinflammatory score was calculated based on the quantification of CD8- and CD68-positive cells in representative areas of the central nervous system. This score was correlated afterwards with illness duration and parameters related to systemic inflammation. Widespread microglial and cytotoxic T-cell activation was found in all patients. There was no correlation between the neuroinflammatory score and the duration of the illness; nor with parameters of systemic inflammation such as the peak of IL-6 or the HScore (a parameter of systemic macrophage activation syndrome). Two patients had global hypoxic ischaemic damage and five patients had subacute infarcts. One patient had many more brain vascular microthrombi compared to the others and multiple subacute pituitary infarcts. SARS-CoV-2 RNA was not detected with qRT-PCR. The proportion of brain lesions in severe COVID-19 patients could be related to illness duration. In our series, with abundant long hospitalisation stays, neuroinflammation was present in all patients and was more prominent between day 34 and day 45 after onset of symptoms. Clinical correlation showed that two patients with the highest neuroinflammatory scores had severe encephalopathies that were not attributable to any other cause. The second most frequent lesions were related to vascular pathology.
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Affiliation(s)
| | - Héctor Pian-Arias
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Íñigo Corral
- Neurology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain
| | | | - Belén Pérez-Mies
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain; CIBERONC, Madrid, Spain
| | - Mónica García-Cosío
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain; CIBERONC, Madrid, Spain
| | - Tamara Caniego-Casas
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; CIBERONC, Madrid, Spain
| | - David Pizarro
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | | | | | - David Pestaña
- Universidad de Alcalá de Henares, Madrid, Spain; Anesthesiology and Surgical Critical Care Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Raúl de Pablo
- Universidad de Alcalá de Henares, Madrid, Spain; Department of Intensive Care Medicine, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Juan Carlos Galán
- Clinical Microbiology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; CIBERESP, Madrid, Spain
| | - Jaime Masjuan
- Neurology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain.
| | - José Palacios
- Pathology, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain; Universidad de Alcalá de Henares, Madrid, Spain; CIBERONC, Madrid, Spain.
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9
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Carretero-Barrio I, Lop-Gros J, Iglesias M, Martínez C, Matias-Guiu X, Pérez-Mies B, Palacios J. Impact of the COVID-19 pandemic on pathology training: a survey among Spanish residents. Virchows Arch 2022; 481:505-509. [PMID: 35352148 PMCID: PMC8964236 DOI: 10.1007/s00428-022-03303-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/17/2022] [Accepted: 02/11/2022] [Indexed: 11/23/2022]
Abstract
This study aimed to assess the impact of the COVID-19 pandemic on the training of Spanish pathology residents by conducting an online survey. It was distributed among the pathologists who had been residents during the pandemic and consisted of 31 questions about the demographics and the impact of the pandemic on their pathology training. In total, 114 residents completed the survey; they reported a decrease in the number of biopsies, cytology samples, autopsies, research activities, sessions, case corrections, and courses, as well as the detrimental effect this had on their training. Half of the residents had to cancel rotations and 32% were redeployed to other departments. The COVID-19 pandemic has affected pathology training, and our results can be used to understand the challenges residents have faced and mitigate their impact.
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10
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González-Martínez S, Pizarro D, Pérez-Mies B, Caniego-Casas T, Rodríguez-Peralto JL, Curigliano G, Cortés A, Gión M, Cortés J, Palacios J. Differences in the Molecular Profile between Primary Breast Carcinomas and Their Cutaneous Metastases. Cancers (Basel) 2022; 14:cancers14051151. [PMID: 35267459 PMCID: PMC8909188 DOI: 10.3390/cancers14051151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 01/01/2023] Open
Abstract
Simple Summary The development of new strategies for the management of cutaneous metastases is a major clinical challenge because of the poor prognosis. To advance in this field, a better understanding of the molecular alterations involved in the metastatic process is needed. In the present study, the clinicopathological characteristics of breast cancer that develop cutaneous metastases were analyzed and the molecular differences between primary breast tumors and their corresponding cutaneous metastases were compared. We observed that the surrogate molecular type of breast cancer with an increased risk to metastasize to the skin was triple negative. In total, 48.5% of the cutaneous metastases presented some additional molecular alteration with respect to the primary tumor. However, no characteristic mutational pattern related to skin metastasis development was observed. Identifying the genes involved in the development of cutaneous metastases is important to gain insights into the biology of the disease and to identify possible diagnostic and therapeutic biomarkers. Abstract Background: The characterization of molecular alterations of primary breast carcinomas (BC) and their cutaneous metastases (CM) to identify genes involved in the metastatic process have not yet been completely accomplished. Methods: To investigate the molecular alterations of BC and their CM, a total of 66 samples (33 BC and 33 CM) from 33 patients were analyzed by immunohistochemical and massive parallel sequencing analyses. In addition, the clinicopathological characteristics of patients and tumors were analyzed. Results: Triple negative (TN) BCs were overrepresented (36.4%) among tumors that developed CM. A change of tumor surrogate molecular type in metastases was found in 15% of patients and 48.5% of the CM presented some additional molecular alteration with respect to the primary tumor, the most frequent were amplification of MYC and MDM4, and mutations in TP53 and PIK3CA. Survival was related to histological grade, tumor surrogate molecular type and TP53 mutations in the univariate analysis but only the tumor surrogate molecular type remained as a prognostic factor in the multivariate analysis. Conclusions: The TN molecular type has a greater risk of developing skin metastases. There are phenotypic changes and additional molecular alterations in skin metastases compared to the corresponding primary breast tumors in nearly half of the patients. Although these changes do not follow a specific pattern and varied from patient to patient, they could impact on the treatment. More studies with larger patient and sample cohorts are needed.
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Affiliation(s)
- Silvia González-Martínez
- Clinical Research, Ramón y Cajal Hospital, 28034 Madrid, Spain;
- “Contigo Contra el Cáncer de la Mujer” Foundation, 28010 Madrid, Spain
| | - David Pizarro
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
| | - Belén Pérez-Mies
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
- Department of Pathology, Ramón y Cajal University Hospital, 28034 Madrid, Spain
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- Faculty of Medicine, University of Alcalá, 28801 Madrid, Spain
| | - Tamara Caniego-Casas
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
| | - José Luis Rodríguez-Peralto
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- I+D Institute, 12 de Octubre University Hospital, 28041 Madrid, Spain
- Department of Pathology, Medical School, Complutense University, 28040 Madrid, Spain
| | - Giuseppe Curigliano
- European Institute of Oncology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), 20141 Milan, Italy;
- Department of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Alfonso Cortés
- Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain; (A.C.); (M.G.)
| | - María Gión
- Department of Medical Oncology, Ramón y Cajal University Hospital, 28034 Madrid, Spain; (A.C.); (M.G.)
| | - Javier Cortés
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- Department of Medicine, Faculty of Biomedical and Health Sciences, European University of Madrid, 28670 Madrid, Spain
- International Breast Cancer Center (IBCC), Quironsalud Group, 08017 Barcelona, Spain
- Medica Scientia Innovation Research, 08007 Barcelona, Spain
- Medica Scientia Innovation Research, Ridgewood, NJ 07450, USA
- Correspondence: (J.C.); (J.P.)
| | - José Palacios
- Molecular Pathology of Cancer Group, Ramón y Cajal Health Research Institute (IRYCIS), 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
- Department of Pathology, Ramón y Cajal University Hospital, 28034 Madrid, Spain
- Centre for Biomedical Research in Cancer Networks (CIBERONC), Carlos III Health Institute, 28029 Madrid, Spain;
- Faculty of Medicine, University of Alcalá, 28801 Madrid, Spain
- Correspondence: (J.C.); (J.P.)
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11
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Carretero-Barrio I, Santón A, Caniego Casas T, López Miranda E, Reguero-Callejas ME, Pérez-Mies B, Benito A, Palacios J. Cytological and molecular characterization of secretory breast carcinoma. Diagn Cytopathol 2022; 50:E174-E180. [PMID: 35156343 PMCID: PMC9303577 DOI: 10.1002/dc.24945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 01/27/2022] [Accepted: 02/01/2022] [Indexed: 11/09/2022]
Abstract
Secretory breast carcinoma is a rare neoplasm, histologically well-characterized, and secondary to ETV6-NTRK3 gene fusion, whose cytological features are scarcely described in the literature. We report the case of a woman with a history of secretory breast carcinoma 8 years before, who presented a periareolar nodule. A recurrence was diagnosed by fine-needle aspiration based on the cytomorphological features and pan-TRK immunocytochemistry on the cell block, and the patient underwent a mastectomy. The histology and molecular studies performed on the surgical specimen (immunohistochemistry, FISH and NGS) confirmed the diagnosis. Cytological smears showed abundant epithelial cellularity, in groups and single cells. These cells showed moderate atypia, with abundant cytoplasm. We observed intracytoplasmic inclusions and extracellular metachromatic globules. Immunocytochemical and immunohistochemical studies showed a triple negative breast tumour. NTRK overexpression was demonstrated with immunocytochemistry against pan-TRK on the cell block, as well as with immunohistochemistry in the surgical specimen. NTRK3 rearrangement was proved by FISH. In the primary tumour and in the recurrence, we demonstrated ETV6-NTRK3 fusion by NGS. After conducting a literature review, we have found 26 articles describing the cytological features of secretory breast carcinoma in 33 patients. The smears were described as groups of epithelial cells with vacuolated cytoplasm, single signet ring cells and a globular extracellular secretion. In only two cases molecular confirmation of the diagnosis with ETV6-NTRK3 fusion was proven, although not in the cytological specimen, but in the subsequent biopsy. The distinct cytological features of secretory breast carcinoma can help in its diagnosis, thus guiding the molecular studies. This is the first reported case that proves TRK overexpression, as a fusion surrogate, in the cytological sample.
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Affiliation(s)
- Irene Carretero-Barrio
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.,Faculty of Medicine, University of Alcalá, Madrid, Spain
| | - Almudena Santón
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Tamara Caniego Casas
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Elena López Miranda
- Oncology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - Maria Eugenia Reguero-Callejas
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.,Faculty of Medicine, University of Alcalá, Madrid, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Belén Pérez-Mies
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.,Faculty of Medicine, University of Alcalá, Madrid, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Amparo Benito
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.,Faculty of Medicine, University of Alcalá, Madrid, Spain
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.,Faculty of Medicine, University of Alcalá, Madrid, Spain.,CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
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12
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Caniego-Casas T, Martínez-García L, Alonso-Riaño M, Pizarro D, Carretero-Barrio I, Martínez-de-Castro N, Ruz-Caracuel I, de Pablo R, Saiz A, Royo RN, Santiago A, Rosas M, Rodríguez-Peralto JL, Pérez-Mies B, Galán JC, Palacios J. RNA SARS-CoV-2 Persistence in the Lung of Severe COVID-19 Patients: A Case Series of Autopsies. Front Microbiol 2022; 13:824967. [PMID: 35173701 PMCID: PMC8841799 DOI: 10.3389/fmicb.2022.824967] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/03/2022] [Indexed: 12/21/2022] Open
Abstract
The exact role of viral replication in patients with severe COVID-19 has not been extensively studied, and it has only been possible to demonstrate the presence of replicative virus for more than 3 months in a few cases using different techniques. Our objective was to study the presence of RNA SARS-CoV-2 in autopsy samples of patients who died from COVID-19 long after the onset of symptoms. Secondary superimposed pulmonary infections present in these patients were also studied. We present an autopsy series of 27 COVID-19 patients with long disease duration, where pulmonary and extrapulmonary samples were obtained. In addition to histopathological analysis, viral genomic RNA (gRNA) and viral subgenomic RNA (sgRNA) were detected using RT-PCR and in situ hybridization, and viral protein was detected using immunohistochemistry. This series includes 26 adults with a median duration of 39 days from onset of symptoms to death (ranging 9–108 days), 92% of them subjected to immunomodulatory therapy, and an infant patient. We detected gRNA in the lung of all but one patient, including those with longer disease duration. SgRNA was detected in 11 out of 17 patients (64.7%) with illness duration up to 6 weeks and in 3 out of 9 patients (33.3%) with more than 6 weeks of disease progression. Viral protein was detected using immunohistochemistry and viral mRNA was detected using in situ hybridization in 3 out of 4 adult patients with illness duration of <2 weeks, but in none of the 23 adult patients with an illness duration of >2 weeks. A remarkable result was the detection of viral protein, gRNA and sgRNA in the lung cells of the pediatric patient after 95 days of illness. Additional pulmonary infections included: 9 acute bronchopneumonia, 2 aspergillosis, 2 cytomegalovirus, and 1 BK virus infection. These results suggest that in severe COVID-19, SARS-CoV-2 could persist for longer periods than expected, especially in immunocompromised populations, contributing to the persistence of chronic lung lesions. Additional infections contribute to the fatal course of the disease.
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Affiliation(s)
- Tamara Caniego-Casas
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Laura Martínez-García
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain
| | - Marina Alonso-Riaño
- Pathology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto 12 de Octubre for Health Research, Madrid, Spain
- Faculty of Medicine, Complutense University, Madrid, Spain
| | - David Pizarro
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
| | - Nilda Martínez-de-Castro
- Anaesthesiology and Surgical Critical Care Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Raúl de Pablo
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
- Medical Intensive Care Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Ana Saiz
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
| | - Rosa Nieto Royo
- Respiratory Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Ana Santiago
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Marta Rosas
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
| | - José L. Rodríguez-Peralto
- Pathology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
- Instituto 12 de Octubre for Health Research, Madrid, Spain
- Faculty of Medicine, Complutense University, Madrid, Spain
| | - Belén Pérez-Mies
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
| | - Juan C. Galán
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública, Madrid, Spain
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
- CIBERONC, Instituto de Salud Carlos III, Madrid, Spain
- Faculty of Medicine, University of Alcalá, Alcalá de Henares, Spain
- *Correspondence: José Palacios,
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13
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Pérez-Mies B, Carretero-Barrio I, Palacios J. Immune-related gene expression signatures: A step forward in the stratification of patients with ovarian clear cell carcinoma. J Pathol 2021; 256:366-368. [PMID: 34908168 DOI: 10.1002/path.5850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/13/2021] [Indexed: 11/10/2022]
Abstract
Clear cell carcinoma of the ovary (CCC) is one of the five major histological types of ovarian cancer and presents specific clinicopathological features, such as a higher prevalence in Asian population and a poor response to conventional chemotherapy. In a recent publication in The Journal of Pathology, Heong and coworkers demonstrated the heterogeneity of the immune landscape of CCC. They reported the immune signatures observed in a large cohort of CCC, including tumours from both Asian and Caucasian women. The authors analysed three cohorts from Europe, Japan and Singapore with a total of 246 tumours, and evaluated 730 immune related genes using NanoString technology. The study revealed four main transcriptional subtypes characterised by the expression of specific sets of genes: PD1-high (11%), CTLA4-high (29%), antigen-presentation (42%), and a pro-angiogenic subtype (18%). The two main conclusions of the study are: 1) CCC in women of Asian and Caucasian descent share significant molecular similarities, since all four molecular signatures are present in all the cohorts analysed, without any evident differences in frequency; and 2) the PD1-high and CTLA4-high subtypes were associated with worse clinical outcomes and may be useful when stratifying treatment in early-stage tumours. The immune signature could represent a promising biomarker of immunotherapy response if future prospective studies confirm it. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Belén Pérez-Mies
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.,Faculty of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.,CIBERONC, Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.,Faculty of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain.,Faculty of Medicine, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain.,CIBERONC, Madrid, Spain
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14
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Ferrer-Gómez A, Pian-Arias H, Carretero-Barrio I, Navarro-Cantero A, Pestaña D, de Pablo R, Zamorano JL, Galán JC, Pérez-Mies B, Ruz-Caracuel I, Palacios J. Late Cardiac Pathology in Severe Covid-19. A Postmortem Series of 30 Patients. Front Cardiovasc Med 2021; 8:748396. [PMID: 34722679 PMCID: PMC8555828 DOI: 10.3389/fcvm.2021.748396] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/22/2021] [Indexed: 01/08/2023] Open
Abstract
The role of SARS-CoV-2 as a direct cause in the cardiac lesions in patients with severe COVID-19 remains to be established. Our objective is to report the pathological findings in cardiac samples of 30 patients who died after a prolonged hospital stay due to Sars-Cov-2 infection. We performed macroscopic, histological and immunohistochemical analysis of the hearts of 30 patients; and detected Sars-Cov-2 RNA by RT-PCR in the cardiac tissue samples. The median age of our cohort was 69.5 years and 76.6% were male. The median time between symptoms onset and death was 36.5 days. The main comorbidities were arterial hypertension (13 patients, 43.3%), dyslipidemia (11 patients, 36.7%), cardiovascular conditions (8 patients, 26.7%), and obesity (8 patients, 26.7%). Cardiovascular conditions included ischemic cardiopathy in 4 patients (13.3%), hypertrophic cardiomyopathy in 2 patients (6.7%) and valve replacement and chronic heart failure in one patient each (3.3%). At autopsy, the most frequent histopathological findings were coronary artery atherosclerosis (8 patients, 26.7%), left ventricular hypertrophy (4 patients, 13.3%), chronic epicardial inflammation (3 patients, 10%) and adipose metaplasia (2 patients, 6.7%). Two patients showed focal myocarditis, one due to invasive aspergillosis. One additional patient showed senile amyloidosis. Sars-Cov-2 RNA was detected in the heart of only one out of 30 patients, who had the shortest disease evolution of the series (9 days). However, no relevant cardiac histological alterations were identified. In present series, cardiac pathology was only modest in most patients with severe COVID-19. At present, the contribution of a direct effect of SARS-CoV-2 on cardiac lesions remains to be established.
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Affiliation(s)
- Ana Ferrer-Gómez
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Héctor Pian-Arias
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - Antonia Navarro-Cantero
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain
| | - David Pestaña
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Anaesthesiology and Surgical Critical Care Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Raúl de Pablo
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Medical Intensive Care Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - José Luis Zamorano
- Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Cardiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan Carlos Galán
- Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Microbiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.,Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Belén Pérez-Mies
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - Ignacio Ruz-Caracuel
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain
| | - José Palacios
- Pathology Department, University Hospital Ramón y Cajal, Madrid, Spain.,Faculty of Medicine, Alcalá University, Alcalá de Henares, Spain.,Instituto Ramón y Cajal for Health Research (IRYCIS), Madrid, Spain.,Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
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15
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González-Martínez S, Pizarro D, Pérez-Mies B, Caniego-Casas T, Curigliano G, Cortés J, Palacios J. Clinical, Pathological, and Molecular Features of Breast Carcinoma Cutaneous Metastasis. Cancers (Basel) 2021; 13:5416. [PMID: 34771579 PMCID: PMC8582578 DOI: 10.3390/cancers13215416] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/25/2021] [Accepted: 10/26/2021] [Indexed: 12/20/2022] Open
Abstract
Cutaneous metastases (CMs) account for 2% of all skin malignancies, and nearly 70% of CMs in women originate from breast cancer (BC). CMs are usually associated with poor prognosis, are difficult to treat, and can pose diagnostic problems, such as in histopathological diagnosis when occurring long after development of the primary tumor. In addition, the molecular differences between the primary tumors and their CMs, and between CMs and metastases in other organs, are not well defined. Here, we review the main clinical, pathological, and molecular characteristics of breast cancer CMs. Identifying molecular markers in primary BC that predict CM and can be used to determine the molecular differences between primary tumors and their metastases is of great interest for the design of new therapeutic approaches.
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Affiliation(s)
- Silvia González-Martínez
- Clinical Researcher, Hospital Ramón y Cajal, 28034 Madrid, Spain;
- Fundación Contigo contra el Cáncer de la Mujer, 28010 Madrid, Spain
| | - David Pizarro
- Department of Pathology, Hospital Ramón y Cajal, 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
| | - Belén Pérez-Mies
- Department of Pathology, Hospital Ramón y Cajal, 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
- Institute Ramón y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá de Henares, Alcalá de Henares, 28801 Madrid, Spain
| | - Tamara Caniego-Casas
- Department of Pathology, Hospital Ramón y Cajal, 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
| | - Giuseppe Curigliano
- European Institute of Oncology, IRCCS, 20141 Milan, Italy;
- Departament of Oncology and Hematology, University of Milan, 20122 Milan, Italy
| | - Javier Cortés
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Department of Medicine, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
- International Breast Cancer Center (IBCC), Quironsalud Group, 08017 Barcelona, Spain
- Medica Scientia Innovation Research, 08007 Barcelona, Spain
- Medica Scientia Innovation Research, Ridgewood, NJ 07450, USA
- Vall d’Hebron Institute of Oncology, 08035 Barcelona, Spain
| | - José Palacios
- Department of Pathology, Hospital Ramón y Cajal, 28034 Madrid, Spain; (D.P.); (B.P.-M.); (T.C.-C.)
- Institute Ramón y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá de Henares, Alcalá de Henares, 28801 Madrid, Spain
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16
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Bueno D, Caniego-Casas T, Sánchez-Martínez MC, Saavedra-Serrano C, Palacios J, Pérez-Mies B. Vulvar Pilomatrix Carcinoma: Morphologic and Molecular Features. Int J Gynecol Pathol 2021; 40:482-486. [PMID: 33252403 DOI: 10.1097/pgp.0000000000000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Pilomatrix carcinoma (PC) is a rare malignant variant of pilomatrixoma, a skin adnexal tumor originating from hair matrix cells. It is most often located in the head, neck region, upper back and upper extremities. PC has a locally aggressive behavior but metastasis only occur in 10% of cases. Mutations in CTNNB1, the encoding gene of beta-catenin, have been found in both pilomatrixoma and PC, but other molecular alterations are unknown. The authors present a case of PC in the clitoris, the third known reported case located on the external genitalia. The tumor followed an unusual clinical course with the development of multiple metastases. Next-generation sequencing analysis of the tumor identified, in addition to a characteristic CTNNB1 mutation, pathogenic mutations in PTEN, PIK3CA, and ARID1A, which could explain the aggressive course of the disease. The diagnostic criteria of PC and the differential diagnoses of this unusual tumor in the genital area are discussed.
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17
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González-Martínez S, Pérez-Mies B, Pizarro D, Caniego-Casas T, Cortés J, Palacios J. Epithelial Mesenchymal Transition and Immune Response in Metaplastic Breast Carcinoma. Int J Mol Sci 2021; 22:ijms22147398. [PMID: 34299016 PMCID: PMC8306902 DOI: 10.3390/ijms22147398] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/04/2021] [Accepted: 07/07/2021] [Indexed: 01/08/2023] Open
Abstract
Metaplastic breast carcinoma (MBC) is a heterogeneous group of infrequent triple negative (TN) invasive carcinomas with poor prognosis. MBCs have a different clinical behavior from other types of triple negative breast cancer (TNBC), being more resistant to standard chemotherapy. MBCs are an example of tumors with activation of epithelial–mesenchymal transition (EMT). The mechanisms involved in EMT could be responsible for the increase in the infiltrative and metastatic capacity of MBCs and resistance to treatments. In addition, a relationship between EMT and the immune response has been seen in these tumors. In this sense, MBC differ from other TN tumors showing a lower number of tumor-infiltrating lymphocytes (TILS) and a higher percentage of tumor cells expressing programmed death-ligand 1 (PD-L1). A better understanding of the relationship between the immune system and EMT could provide new therapeutic approaches in MBC.
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Affiliation(s)
| | - Belén Pérez-Mies
- Department of Pathology, Hospital Ramón y Cajal, 28034 Madrid, Spain;
- Institute Ramón y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain; (D.P.); (T.C.-C.)
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá de Henares, Alcalá de Henares, 28801 Madrid, Spain
| | - David Pizarro
- Institute Ramón y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain; (D.P.); (T.C.-C.)
| | - Tamara Caniego-Casas
- Institute Ramón y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain; (D.P.); (T.C.-C.)
| | - Javier Cortés
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Biomedical and Health Sciences, Department of Medicine, Universidad Europea de Madrid, 28670 Madrid, Spain
- International Breast Cancer Center (IBCC), Quironsalud Group, 08017 Barcelona, Spain
- Medica Scientia Innovation Research, 08007 Barcelona, Spain
- Medica Scientia Innovation Research, Ridgewood, NJ 07450, USA
- Vall d’Hebron Institute of Oncology, 08035 Barcelona, Spain
- Correspondence: (J.C.); (J.P.)
| | - José Palacios
- Department of Pathology, Hospital Ramón y Cajal, 28034 Madrid, Spain;
- Institute Ramón y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain; (D.P.); (T.C.-C.)
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá de Henares, Alcalá de Henares, 28801 Madrid, Spain
- Correspondence: (J.C.); (J.P.)
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18
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Pérez-Mies B, Gómez-Rojo M, Carretero-Barrio I, Bardi T, Benito A, García-Cosío M, Caballero Á, de Pablo R, Galán JC, Pestaña D, Palacios J. Pulmonary vascular proliferation in patients with severe COVID-19: an autopsy study. Thorax 2021; 76:1044-1046. [PMID: 33758071 PMCID: PMC7992389 DOI: 10.1136/thoraxjnl-2020-216714] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/02/2021] [Accepted: 03/04/2021] [Indexed: 11/30/2022]
Abstract
Diffuse alveolar damage and thrombi are the most common lung histopathological lesions reported in patients with severe COVID-19. Although some studies have suggested increased pulmonary angiogenesis, the presence of vascular proliferation in COVID-19 lungs has not been well characterised. Glomeruloid-like microscopic foci and/or coalescent vascular proliferations measuring up to 2 cm were present in the lung of 14 out of 16 autopsied patients. These lesions expressed CD31, CD34 and vascular endothelial cadherin. Platelet-derived growth factor receptor-β immunohistochemistry and dual immunostaining for CD34/smooth muscle actin demonstrated the presence of pericytes. These vascular alterations may contribute to the severe and refractory hypoxaemia that is common in patients with severe COVID-19.
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Affiliation(s)
- Belén Pérez-Mies
- Pathology, Hospital Ramón y Cajal, Madrid, Spain.,Instituto Ramon y Cajal de Investigacion Sanitaria, Madrid, Spain.,CIBERONC, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain
| | - María Gómez-Rojo
- Anesthesiology and Surgical Critical Care Department, Hospital Ramón y Cajal, Madrid, Spain
| | | | - Tommaso Bardi
- Anesthesiology and Surgical Critical Care Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Amparo Benito
- Pathology, Hospital Ramón y Cajal, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain
| | - Mónica García-Cosío
- Pathology, Hospital Ramón y Cajal, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain
| | - Álvaro Caballero
- Medical Intensive Care Unit, Hospital Ramón y Cajal, Madrid, Spain
| | - Raul de Pablo
- Instituto Ramon y Cajal de Investigacion Sanitaria, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain.,Medical Intensive Care Unit, Hospital Ramón y Cajal, Madrid, Spain
| | - Juan Carlos Galán
- Instituto Ramon y Cajal de Investigacion Sanitaria, Madrid, Spain.,Clinical Microbiology Unit, Hospital Ramón y Cajal, Madrid, Spain.,CIBERESP, Madrid, Spain
| | - David Pestaña
- Universidad de Alcala de Henares, Madrid, Spain.,Anesthesiology and Surgical Critical Care Department, Hospital Ramón y Cajal, Madrid, Spain
| | - Jose Palacios
- Pathology, Hospital Ramón y Cajal, Madrid, Spain .,Instituto Ramon y Cajal de Investigacion Sanitaria, Madrid, Spain.,CIBERONC, Madrid, Spain.,Universidad de Alcala de Henares, Madrid, Spain
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19
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González-Martínez S, Pérez-Mies B, Carretero-Barrio I, Palacios-Berraquero ML, Perez-García J, Cortés J, Palacios J. Molecular Features of Metaplastic Breast Carcinoma: An Infrequent Subtype of Triple Negative Breast Carcinoma. Cancers (Basel) 2020; 12:cancers12071832. [PMID: 32650408 PMCID: PMC7408634 DOI: 10.3390/cancers12071832] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/01/2020] [Accepted: 07/04/2020] [Indexed: 12/12/2022] Open
Abstract
Metaplastic breast carcinoma (MBC) is a heterogeneous group of infrequent invasive carcinomas that display differentiation of the neoplastic epithelium towards squamous cells and/or mesenchymal-type elements. Most MBC have a triple negative phenotype and poor prognosis. Thus, MBC have worse survival rates than other invasive breast carcinomas, including other triple negative breast carcinomas (TNBC). In this study, we reviewed the molecular features of MBC, pointing out the differences among subtypes. The most frequently mutated genes in MBC were TP53 and PIK3CA. Additionally, mutations in the other genes of the PI3K/AKT pathway indicated its importance in the pathogenesis of MBC. Regarding copy number variations (CNVs), MYC was the most frequently amplified gene, and the most frequent gene loss affected the CDKN2A/CDKN2B locus. Furthermore, the pattern of mutations and CNVs of MBC differed from those reported in other TNBC. However, the molecular profile of MBC was not homogeneous among histological subtypes, being the alterations in the PI3K pathway most frequent in spindle cell carcinomas. Transcriptomic studies have demonstrated an epithelial to mesenchymal program activation and the enrichment of stemness genes in most MBC. In addition, current studies are attempting to define the immune microenvironment of these tumors. In conclusion, due to specific molecular features, MBC have a different clinical behavior from other types of TNBC, being more resistant to standard chemotherapy. For this reason, new therapeutic approaches based on tumor molecular characteristics are needed to treat MBC.
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Affiliation(s)
| | - Belén Pérez-Mies
- Pathology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (B.P.-M.); (I.C.-B.)
- Instituto Ramón y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá de Henares, Alcalá de Henares, 28801 Madrid, Spain
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, 28801 Madrid, Spain
| | - Irene Carretero-Barrio
- Pathology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (B.P.-M.); (I.C.-B.)
| | | | - José Perez-García
- IOB Institute of Oncology, Quironsalud Group, Hospital Quiron, 08023 Barcelona, Spain;
| | - Javier Cortés
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- IOB Institute of Oncology, Quironsalud Group, Hospital Quiron, 08023 Barcelona, Spain;
- IOB Institute of Oncology, Quironsalud Group, 28006 Madrid, Spain
- Medica Scientia Innovation Research, 08018 Barcelona, Spain
- Medica Scientia Innovation Research, Ridgewood, NJ 07450, USA
- Vall d’Hebron Institute of Oncology, 08035 Barcelona, Spain
- Correspondence: (J.C.); (J.P.)
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal, 28034 Madrid, Spain; (B.P.-M.); (I.C.-B.)
- Instituto Ramón y Cajal for Health Research (IRYCIS), 28034 Madrid, Spain
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Faculty of Medicine, University of Alcalá de Henares, Alcalá de Henares, 28801 Madrid, Spain
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, 28801 Madrid, Spain
- Correspondence: (J.C.); (J.P.)
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20
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Rosa-Rosa JM, Caniego-Casas T, Leskela S, Cristobal E, González-Martínez S, Moreno-Moreno E, López-Miranda E, Holgado E, Pérez-Mies B, Garrido P, Palacios J. High Frequency of ERBB2 Activating Mutations in Invasive Lobular Breast Carcinoma with Pleomorphic Features. Cancers (Basel) 2019; 11:cancers11010074. [PMID: 30641862 PMCID: PMC6356653 DOI: 10.3390/cancers11010074] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 12/30/2018] [Accepted: 01/07/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Characterisation of molecular alterations of pleomorphic lobular carcinoma (PLC), an aggressive subtype of invasive lobular carcinoma (ILC), have not been yet completely accomplished. Methods: To investigate the molecular alterations of invasive lobular carcinoma with pleomorphic features, a total of 39 tumour samples (in situ and invasive lesions and lymph node metastases) from 27 patients with nuclear grade 3 invasive lobular carcinomas were subjected to morphological, immunohistochemical and massive parallel sequencing analyses. Results: Our observations indicated that invasive lobular carcinomas with pleomorphic features were morphologically and molecularly heterogeneous. All cases showed absence or aberrant expression of E-cadherin and abnormal expression of β-catenin and p120. CDH1 (89%), PIK3CA (33%) and ERRB2 (26%) were the most common mutated genes. ERBB2 mutations preferentially affected the tyrosine-kinase activity domain, being the most frequent the targetable mutation p.L755S (57%). We also observed higher frequency of mutations in ARID1B, KMT2C, MAP3K1, TP53 and ARID1A in PLC than previously reported in classic ILC. Alterations related to progression from in situ to invasive carcinoma and/or to lymph node metastases included TP53 mutation, amplification of PIK3CA and CCND1 and loss of ARID1A expression. Conclusions: The high frequency of ERBB2 mutations observed suggests that ERBB2 mutation testing should be considered in all invasive lobular carcinomas with nuclear grade 3.
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Affiliation(s)
| | | | - Susanna Leskela
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain.
| | - Eva Cristobal
- Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain.
| | | | | | - Elena López-Miranda
- Department of Medical Oncology, Hospital Ramón y Cajal, 28034 Madrid, Spain.
| | - Esther Holgado
- Department of Medical Oncology, Hospital Ramón y Cajal, 28034 Madrid, Spain.
| | - Belén Pérez-Mies
- Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain.
- Department of Pathology, Hospital Ramón y Cajal, 28034 Madrid, Spain.
- Facultad de Medicina, Universidad de Alcalá de Henares, 28029 Madrid, Spain.
| | - Pilar Garrido
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain.
- Department of Medical Oncology, Hospital Ramón y Cajal, 28034 Madrid, Spain.
- Facultad de Medicina, Universidad de Alcalá de Henares, 28029 Madrid, Spain.
| | - José Palacios
- CIBER-ONC, Instituto de Salud Carlos III, 28029 Madrid, Spain.
- Instituto Ramón y Cajal de Investigación Sanitaria, 28034 Madrid, Spain.
- Department of Pathology, Hospital Ramón y Cajal, 28034 Madrid, Spain.
- Facultad de Medicina, Universidad de Alcalá de Henares, 28029 Madrid, Spain.
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21
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Peña-Jaimes L, González-García I, Reguero-Callejas ME, Pinilla-Pagnon I, Pérez-Mies B, Albarrán-Artahona V, Martínez-Jañez N, Rosa-Rosa JM, Palacios J. Pleomorphic lobular carcinoma of the breast with osteoclast-like giant cells: a case report and review of the literature. Diagn Pathol 2018; 13:62. [PMID: 30153845 PMCID: PMC6114493 DOI: 10.1186/s13000-018-0744-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/20/2018] [Indexed: 12/03/2022] Open
Abstract
Background Breast carcinoma with osteoclast-like giant cells (OGCs) is infrequent, being most reported cased described as ductal invasive carcinomas. Invasive pleomorphic lobular carcinoma (PLC) is a distinct morphological variant of invasive lobular carcinoma characterized by higher nuclear atypia and pleomorphism than the classical type. In the best of our knowledge, a PLC with OGCs has not been previously reported. Case presentation We report the case of a 72-year-old woman presenting with a pleomorphic tumor of the left breast with a dense infiltration by OGCs and T lymphocytes with a 10:1 predominance of CD8+ over CD4+ cells. The diagnosis of a lymphoid or mesenchymal neoplasia was excluded after demonstrating keratin expression by the neoplastic cells. The absence of E-cadherin expression and the morphological features were consistent with the diagnosis PLC with OGCs. In addition, we demonstrated the deleterious mutation C.del866C in CDH1gene, but no mutations in any of the other 33 genes analyzed by next generation sequencing. Conclusions Breast carcinoma with stromal osteoclast-like giant cells is a very rare tumor, for that reason, the use of the cytologic features and growth patterns in combination with immunohistochemically studies is mandatory for a correct diagnosis of lobular carcinoma. In addition, further studies are necessary to clarify the influence of OGCs in the prognosis of these patients. Electronic supplementary material The online version of this article (10.1186/s13000-018-0744-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
| | | | - María Eugenia Reguero-Callejas
- Department of Pathology, Hospital Ramón y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | | | - Belén Pérez-Mies
- Department of Pathology, Hospital Ramón y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain.,Universidad de Alcalá de Henares, Madrid, Spain
| | | | - Noelia Martínez-Jañez
- Department of Oncology, Hospital Ramón y Cajal, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - Juan Manuel Rosa-Rosa
- CIBER-ONC, Insituto de Salud Carlos III, Madrid, Spain.,Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | - José Palacios
- Department of Pathology, Hospital Ramón y Cajal, Madrid, Spain. .,CIBER-ONC, Insituto de Salud Carlos III, Madrid, Spain. .,Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain. .,Universidad de Alcalá de Henares, Madrid, Spain.
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22
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Pinilla-Pagnon I, Pérez-Mies B, Reguero ME, Martinez MT, Chiva M, Pérez-Rodrigo S, Illarramendi OA, Martin MER, Collado MV, Sanchez MC, Rosa-Rosa JM, Palacios J. Histological changes secondary to wire coil placement in breast tissue and lymph nodes. Virchows Arch 2018; 473:285-291. [PMID: 29984379 DOI: 10.1007/s00428-018-2399-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 06/04/2018] [Accepted: 06/18/2018] [Indexed: 11/25/2022]
Abstract
We describe the histological and immunohistochemical features of the changes produced by spiral coil localization wires in the breast parenchyma and lymph nodes of a total of 100 patients undergoing surgery for different breast lesions. Coil wires produced cystic lesions containing a hyaline, mucous-like, PAS-negative fluid. Cavities were lined by cells of variable morphology ranging from synovial-like cells (with a conspicuous epithelial appearance) to mononuclear or multinucleate histiocytic cells that expressed CD68, but were negative for keratins. CD3-positive/CD8-positive T lymphocytes predominated in the inflammatory reaction. Pathologists should be aware of these changes in order to differentiate coil-related lesions from other granulomatous or epithelial lesions, including mucocele-like and ductal carcinoma in situ lesions.
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Affiliation(s)
| | - Belén Pérez-Mies
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - María Eugenia Reguero
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Miguel Chiva
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Radiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Silvia Pérez-Rodrigo
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Radiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | | | - Maria Eugenia Rioja Martin
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Nuclear Medicine Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Maria Vicenta Collado
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
- General Surgery Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Maria Concepción Sanchez
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain
- Obstetrics and Gynecology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - Juan Manuel Rosa-Rosa
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain
| | - José Palacios
- Pathology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
- Breast Pathology Unit, Hospital Universitario Ramón y Cajal, Madrid, Spain.
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC), Instituto de Salud Carlos III, Madrid, Spain.
- IRyCIS, Instituto Ramón y Cajal de Investigación Sanitaria, Hospital Universitario Ramón y Cajal, Madrid, Spain.
- Universidad de Alcalá de Henares, Madrid, Spain.
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23
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Pinto-Díez C, García-Recio EM, Pérez-Morgado MI, García-Hernández M, Sanz-Criado L, Sacristán S, Toledo-Lobo MV, Pérez-Mies B, Esteban-Rodríguez I, Pascual A, Garcia-Villanueva M, Martínez-Jañez N, González VM, Martín ME. Increased expression of MNK1b, the spliced isoform of MNK1, predicts poor prognosis and is associated with triple-negative breast cancer. Oncotarget 2018; 9:13501-13516. [PMID: 29568373 PMCID: PMC5862594 DOI: 10.18632/oncotarget.24417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 01/31/2018] [Indexed: 02/05/2023] Open
Abstract
MAP kinase interacting kinases (MNKs) modulate the function of oncogene eukaryotic initiation factor 4E (eIF4E) through phosphorylation, which is necessary for oncogenic transformation. MNK1 gives rise to two mRNAs and thus two MNK1 isoforms, named MNK1a and MNK1b. MNK1b, the splice variant of human MNK1a, is constitutively active and independent of upstream MAP kinases. In this study, we have analyzed the expression of both MNK1 isoforms in 69 breast tumor samples and its association with clinicopathologic/prognostic characteristics of breast cancer. MNK1a and MNK1b expression was significantly increased in tumors relative to the corresponding adjacent normal tissue (p < 0.001). In addition, MNK1b overexpression was found in most of the triple-negative tumors and was associated with a shorter overall and disease-free survival time. Overexpression of MNK1b in MDA-MB-231 cells induced an increase in the expression of the MCL1 antiapoptotic protein and promoted proliferation, invasion and colony formation. In conclusion, a high expression level of MNK1b protein could be used as a marker of poor prognosis in breast cancer patients and it could be a therapeutic target in triple-negative tumors.
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Affiliation(s)
- Celia Pinto-Díez
- 1 Servicio de Bioquímica-Investigación, IRYCIS-Hospital Ramón y Cajal, Madrid, Spain
| | - Eva M. García-Recio
- 1 Servicio de Bioquímica-Investigación, IRYCIS-Hospital Ramón y Cajal, Madrid, Spain
| | | | | | - Lara Sanz-Criado
- 1 Servicio de Bioquímica-Investigación, IRYCIS-Hospital Ramón y Cajal, Madrid, Spain
| | - Silvia Sacristán
- 1 Servicio de Bioquímica-Investigación, IRYCIS-Hospital Ramón y Cajal, Madrid, Spain
| | - M. Val Toledo-Lobo
- 2 Departamento de Biomedicina y Biotecnología, Universidad de Alcalá, Alcalá de Henares, Madrid, Spain
| | - Belén Pérez-Mies
- 3 Servicio de Anatomía Patológica, IRYCIS-Hospital Ramón y Cajal, Madrid, Spain
| | | | - Alejandro Pascual
- 3 Servicio de Anatomía Patológica, IRYCIS-Hospital Ramón y Cajal, Madrid, Spain
| | | | | | - Víctor M. González
- 1 Servicio de Bioquímica-Investigación, IRYCIS-Hospital Ramón y Cajal, Madrid, Spain
| | - M. Elena Martín
- 1 Servicio de Bioquímica-Investigación, IRYCIS-Hospital Ramón y Cajal, Madrid, Spain
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24
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Rosa-Rosa J, Leskelä S, Cristóbal-Lana E, Santón A, López-García M, Muñoz G, Pérez-Mies B, Biscuola M, Prat J, Oliva E, Soslow R, Matias-Guiu X, Palacios J. Molecular genetic heterogeneity in undifferentiated endometrial carcinomas. Mod Pathol 2016; 29:1390-1398. [PMID: 27491810 PMCID: PMC5708881 DOI: 10.1038/modpathol.2016.132] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 06/13/2016] [Accepted: 06/13/2016] [Indexed: 01/02/2023]
Abstract
Undifferentiated and dedifferentiated endometrial carcinomas are rare and highly aggressive subtypes of uterine cancer, not well characterized at a molecular level. To investigate whether dedifferentiated carcinomas carry molecular genetic alterations similar to those of pure undifferentiated carcinomas, and to gain insight into the pathogenesis of these tumors, we selected a cohort of 18 undifferentiated endometrial carcinomas, 8 of them with a well-differentiated endometrioid carcinoma component (dedifferentiated endometrioid carcinomas), and studied them by immunohistochemistry and massive parallel and Sanger sequencing. Whole-exome sequencing of the endometrioid and undifferentiated components, as well as normal myometrium, was also carried out in one case. According to The Cancer Genome Atlas classification, we distributed 95% of the undifferentiated carcinomas in this series as follows: (a) hypermutated tumors with loss of any mismatch repair protein expression and microsatellite instability (eight cases, 45%); (b) ultramutated carcinomas carrying mutations in the exonuclease domain of POLE (two cases, 11%); (c) high copy number alterations (copy-number high) tumors group exhibiting only TP53 mutations and high number of alterations detected by FISH (two cases, 11%); and (d) low copy number alterations (copy-number low) tumors with molecular alterations typical of endometrioid endometrial carcinomas (five cases, 28%). Two of the latter cases, however, also had TP53 mutations and higher number of alterations detected by FISH and could have progressed to a copy-number high phenotype. Most dedifferentiated carcinomas belonged to the hypermutated group, whereas pure undifferentiated carcinomas shared molecular genetic alterations with copy-number low or copy-number high tumors. These results indicate that undifferentiated and dedifferentiated endometrial carcinomas are molecularly heterogeneous tumors, which may have prognostic value.
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Affiliation(s)
- J.M. Rosa-Rosa
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain,Corresponding authors: Juan Manuel Rosa Rosa, Servicio de Anatomía Patológica, Hospital Ramón y Cajal, Ctra. Colmenar Viejo km 9,100, 28034 Madrid (Spain), ,
| | - S. Leskelä
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - E. Cristóbal-Lana
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - A. Santón
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - M.A. López-García
- Department of Pathology, Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - G. Muñoz
- UCA en Genómica Traslacional, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - B. Pérez-Mies
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain
| | - M Biscuola
- Department of Pathology, Hospital Universitario Virgen del Rocío and Instituto de Biomedicina de Sevilla (IBIS), Sevilla, Spain
| | - J. Prat
- Department of Pathology, Hospital de la Santa Creu i Sant Pau, Autonomous University of Barcelona, Spain
| | - E. Oliva
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
| | - R.A. Soslow
- Department of Pathology, Gynecology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - X. Matias-Guiu
- Department of Pathology and Molecular Genetics HUAV, Dept de Ciències Mèdiques Bàsiques, Institut de Recerca Biomedica de Lleida, Univeristy of Lleida, IRB Lleida, Lleida, Spain,Department of Pathology, Hospital Universitari de Bellvitge, Idibell, Barcelona, Spain
| | - J. Palacios
- Servicio de Anatomía Patológica, Hospital Universitario Ramón y Cajal, IRYCIS, Universidad de Alcalá, Madrid, Spain,Corresponding authors: Juan Manuel Rosa Rosa, Servicio de Anatomía Patológica, Hospital Ramón y Cajal, Ctra. Colmenar Viejo km 9,100, 28034 Madrid (Spain), ,
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25
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Herranz-Antolín S, Mimica-Haasz N, Marcuello-Foncillas C, Álvarez-de Frutos V, Pérez-Mies B, del Cerro-González J. Hiperandrogenismo por tumor ovárico de células de Leydig. Rev Clin Esp 2015; 215:340-2. [DOI: 10.1016/j.rce.2015.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 01/01/2015] [Indexed: 10/24/2022]
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26
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Ramia-Ángel JM, de-la-Plaza-Llamas R, Sánchez-Tembleque MD, Pérez-Mies B, García-Parreño-Jofré J. Intraductal papillary mucinous neoplasm. Rev Esp Enferm Dig 2011; 103:480-1. [PMID: 21951117 DOI: 10.4321/s1130-01082011000900007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- José Manuel Ramia-Ángel
- Unit of Hepato-bilio-pancreatic Surgery, Department of General and Digestive Surgery, Hospital Universitario de Guadalajara, Guadalajara, Spain
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27
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Abstract
Cutaneous mucinoses, also called lichen myxoedematosus, are a group of diseases characterized by mucin deposit on the skin. They may be associated to systemic diseases (scleromyxedema) or be primary ones (papular mucinosis, localized lichen myxoedematous), although they share common findings (intermediate or atypical forms) in some cases. Acral persistent papular mucinosis (APPM) is a type of papular mucinosis that is located exclusively on the back of the hands and in the distal zone of the forearms and is not associated to any systemic disease. We present the case of a 52-year-old healthy woman who had skin lesions on the back of her hands and whose histological study confirmed an APPM.
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Affiliation(s)
- Belén Pérez-Mies
- Servicio de Anatomía Patológica, Hospital General Yagüe, Burgos, España
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28
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Delgado-López P, Martín-Velasco V, Castilla-Díez J, Fernández-Arconada O, Corrales-García E, Galacho-Harnero A, Rodríguez-Salazar A, Pérez-Mies B. Metastatic meningioma to the eleventh dorsal vertebral body: total en bloc spondylectomy. Case report and review of the literature. Neurocirugia (Astur) 2006. [DOI: 10.4321/s1130-14732006000300004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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29
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Delgado-López PD, Martín-Velasco V, Castilla-Díez JM, Fernández-Arconada O, Corrales-García EM, Galacho-Harnero A, Rodríguez-Salazar A, Pérez-Mies B. Metastatic meningioma to the eleventh dorsal vertebral body: total en bloc spondylectomy. Case report and review of the literature. Neurocirugia (Astur) 2006; 17:240-9. [PMID: 16855782 DOI: 10.1016/s1130-1473(06)70346-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION One in every thousand intracranial meningiomas metastatize extracranially. Lung and intraabdominal organs are most frequently affected. Only 7% involve vertebrae and just a dozen cases have been reported in the literature. To our knowledge, this is the first description of a total en bloc spondylectomy through a posterior approach for the treatment of an intraosseous metastatic meningioma to the eleventh dorsal vertebra. CASE REPORT In March 1996, a 37 year-old male underwent surgical resection for a left occipital intraventricular benign meningioma (WHO I). He was reoperated in February 2002 due to local recurrence. By the end on 2003 he developed progressively invalidating dorsolumbar pain. MRI studies revealed a T11 intraosseous mass. In March 2004, a percutaneous biopsy and vertebroplasty were performed. The pathological specimen was identified as adenocarcinoma and he initiated chemotherapy. Advice from a second pathologist was seeked, who suggested the diagnosis of intraosseous meningioma. Workup studies failed to reveal any primary tumor. In May 2004 the patient was admitted to our department and a new transpedicular biopsy confirmed the diagnosis. In June 2004 he underwent T11 total en bloc spondylectomy (Tomita's procedure), fusion with bone and calcium substitute-filled stackable carbon-fiber cages, and T9 to L1 transpedicular screw fixation. No postoperative complications ocurred and he is, so far, free from primary and secondary disease. Definite pathology: benign meningioma (WHO I). DISCUSSION Distant metastases from intracranial meningiomas are rare entities, arising from benign lesions in, at least, 60% of cases. Enam et al proposed a specific pathological score to differentiate benign, atypic and malignant meningiomas. Such score correlates with the chance of metastatizing: more than 40% in malignant meningiomas compared to 3.8% of brain tumors overall. The ability to metastatize seems to be linked to vascular or lifatic invasiveness. Metastases ocurr more frequently in angioblastic, papillary and meningothelial variants. Hematogenous (especially venous; Batson's perivertebral plexus), linfatic and cerebrospinal fluid are the main routes involved in the spreading of the tumor. Craniotomy itself may also play a role, for the majority of patients have been previously operated on repeatedly. The interval between the onset of the intracranial disease and the appearance of the metastasis varies from months to many years. The value of transpedicular biopsy is widely recognized (efficacy over 80%) and the suitability of the specimen for pathological examination improves when wide inner caliber trephines are used. In the case presented we applied the oncologic concept of vertebral en bloc resection. We believe this case represents a paradigmatic indication of this technique because it respects the concepts of radical resection and spinal stability, and offers an opportunity for the curation of the disease.
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30
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Sarrió D, Pérez-Mies B, Hardisson D, Moreno-Bueno G, Suárez A, Cano A, Martín-Pérez J, Gamallo C, Palacios J. Cytoplasmic localization of p120ctn and E-cadherin loss characterize lobular breast carcinoma from preinvasive to metastatic lesions. Oncogene 2004; 23:3272-83. [PMID: 15077190 DOI: 10.1038/sj.onc.1207439] [Citation(s) in RCA: 157] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Accumulating evidences indicate that p120 catenin, a member of the E-cadherin (E-CD)/catenin adhesion complex, plays a role in tumor invasion. To establish the expression pattern of p120 in breast cancer, we analysed 326 breast tissue biopsies by tissue microarray. Most of the lobular tumors (88%) showed exclusive cytoplasmic localization, and 6% of them also had p120 nuclear staining. Cytoplasmic p120 strongly associated with complete loss of E-CD and beta-catenin not only in lobular carcinoma and its metastases but also in atypical lobular hyperplasias. In the latter, loss of heterozygosity of E-CD gene was also observed. Complete loss of E-CD and cytoplasmic and nuclear p120 staining was also observed in primary lobular cancer cell cultures generated by us. In ductal tumors, by contrast, reduction of p120 and E-CD in membrane was very common (57 and 53%, respectively), whereas cytoplasmic p120 staining was rarely seen. This simultaneous reduction of membranous E-CD and p120 was not associated with increased Src kinase activity. To demonstrate that cytoplasmic p120 localization was a consequence of the absence of E-CD, the endogenous E-CD was re-expressed in MDA-231 cells by 5-Aza-2'-deoxycytidine (5Aza) treatment. After treatment, p120 shifted from the cytoplasm to the membrane, where it colocalized with endogenous E-CD. Additionally, suppressing E-CD expression in Madin-Darby canine kidney cells by stable transfection of the transcriptional repressors Snail, E47 or Slug, provokes p120 cytoplasmic localization and p120 isoform switching. In conclusion, abnormal cytoplasmic and nuclear localization of p120, which are mediated by the absence of E-CD, characteristically occur in the early stages of lobular breast cancer and are maintained during tumor progression to metastasis. Consequently, p120 may be an important mediator of the oncogenic effects derived from E-CD inactivation, including enhanced motility and invasion, in lobular breast cancer.
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Affiliation(s)
- David Sarrió
- Molecular Pathology Program, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
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31
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Picazo ML, Martínez Ara J, Díaz C, Pérez-Mies B. [Nephropathy with occlusive intracapillary IgA thrombi and necrotizing vasculitis, manifesting as rapidly progressive renal insufficiency]. Nefrologia 2003; 23:27-36. [PMID: 12708374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Affiliation(s)
- M L Picazo
- Departamento de Anatomía Patológica, Hospital Universitario La Paz, Po. de la Castellana, 216 28046 Madrid
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32
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Martínez-Bermejo A, López-Martín V, Serratosa JM, Gutiérrez-Molina M, Gómez-Garre P, Arcas J, Tendero A, Roche C, Pérez-Mies B. [Lafora disease. A new case of confirmation of diagnosis on molecular genetic studies]. Rev Neurol 2002; 34:117-20. [PMID: 11988905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
INTRODUCTION Lafora s disease is a type of progressive myoclonic epilepsy with bad prognosis. Until now diagnosis was based on finding characteristic intracytoplasmatic polyglucosan bodies in biopsies of sweat secreting cells in the skin. Recently the gene responsible has been discovered. This permits firm diagnosis and screening of carriers. We present the case of a child diagnosed on molecular genetic studies. CLINICAL CASE A 12 year old boy with a clinical history of three febrile seizures at the age of one year but no other abnormalities, presented a seizure of visual disorder with secondary generalization. There was no family history of seizures. Following a period of normality he had further seizures (clonic, visual and generalized myoclonic). The EEG showed generalized spike and wave activity, which was more marked after stimulation by light and became progressively worse. Neuroimaging studies were normal. In spite of treatment there was a progressive increase in visual and generalized myoclonic seizures together with deterioration of cognitive function and ataxia. Histological studies of the sweat glands showed homogeneous nodular deposits of intracytoplasmatic PAS+. Molecular studies of the EPM2A gene linked to chromosome 6q24 showed the presence of two mutations on the 1 and 4 exons. CONCLUSIONS We describe a 12 year old patient with all the clinical features of Lafora type progressive myoclonic epilepsy in whom characteristic cytoplasmic bodies were found in the sweat gland biopsy. Molecular genetic studies of the EPM2A gene confirmed diagnosis of the disorder.
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Affiliation(s)
- A Martínez-Bermejo
- Servicio de Neurología Pediátrica, Hospital Universitario La Paz, Madrid, España.
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33
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Abstract
We describe the anatomy and function of the gastroesophageal barrier in the piglet. Male piglets underwent dissection (N = 6) and gastroesophageal muscle layer histometry (N = 6). Sedated, nonintubated animals (N = 13) underwent four-probe perfusion esophageal manometry and the pressure profiles were related to the muscular thickness in the four quadrants. Hiatal and gastroesophageal anatomy are similar to our own. The muscle is thicker at the point where the clasp (on the right side) and sling fibers (on the left) concentrate. The pressure profiles were axially and radially asymmetric in coincidence with the thickness variations of the corresponding muscle layers. Sphincteric pressure was recorded as a plateau, whereas diaphragmatic crural pressure appeared as phasic oscillations in synchrony with respiration. The sphincter relaxed upon deglutition. In conclusion, the gastroesophageal structure and physiology are so similar in men and piglets that piglets are excellent models for research in this area.
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Affiliation(s)
- Y Vicente
- Department of Pediatric Surgery, Hospital Universitario La Paz, Madrid, Spain
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