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Mejbel HA, Zein-Sabatto B, Wei S, Siegal GP. An Aneurysmal bone cyst harboring a novel ACSL4::USP6 fusion gene. J Orthop Sci 2024; 29:690-694. [PMID: 37349178 DOI: 10.1016/j.jos.2023.05.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/23/2023] [Accepted: 05/26/2023] [Indexed: 06/24/2023]
Affiliation(s)
- Haider A Mejbel
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Bassel Zein-Sabatto
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA; Department of Pathology & Laboratory Medicine, University of Kansas School of Medicine, Kansas City, KS 66160, USA.
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA; Department of Genetics, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
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Huang X, Anderson SA, Siegal GP, Wei S, Liu S, Yang J, Roisin P, Pickens JT, Huo L, Sahin AA, Granada CP, Chen S. Comparison of PD-L1 (22C3) Expression in Paired Primary and Metastatic Breast Carcinoma. Clin Breast Cancer 2024:S1526-8209(24)00046-6. [PMID: 38492995 DOI: 10.1016/j.clbc.2024.02.010] [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: 10/04/2023] [Revised: 01/18/2024] [Accepted: 02/12/2024] [Indexed: 03/18/2024]
Abstract
INTRODUCTION PD-L1 immunohistochemistry (IHC) is being used as a predictive marker of the benefit derived from immunotherapy in several cancer types, including breast cancer. However, the insight gleaned of the prognostic and predictive value of PD-L1 status and its correlation with molecular characteristics during breast cancer progression remains limited. METHODS We performed an PD-L1 (22C3) assay in pre-treatment primary and metastatic tumor sections from 33 patients with breast carcinoma, matched for post neoadjuvant chemotherapy (p-NACT). PD-L1 expression was evaluated using 3 scoring methods: immune cell (IC) and tumor cell (TC) with a 1% as the cutoff value, and combined positive scores (CPS) with a 1 as the cutoff value. Twenty-two samples from 11 patients had successful fluorescence in situ hybridization (FISH)-based molecular data available for analysis. RESULTS In the 33 pre-treatment primary tumors, PD-L1 IC, TC, and CPS showed positive correlation with stromal tumor infiltrate lymphocytes (sTIL), histological grade 3, and triple negative breast carcinoma (TNBC). In the matched metastatic tumors, only PD-L1 IC showed a positive correlation with sTIL. The primary tumors showed a higher PD-L1 expression than the matched metastatic tumors by IC and CPS. Negative to positive conversion by CPS was identified in the metastatic tumors from lung, pleura and liver. p-NACT tumors also showed a trend of lower PD-L1 expression compared to the pre-treatment tumors. Six patients had matched samples for molecular and PD-L1 comparison, and none of them showed consistent gene alterations or PD-L1 expression among the primary, p-NACT and metastatic tumors. CONCLUSION Our study showed a decrease in PD-L1 expression and disconnected molecular features during breast cancer progression. Repeating PD-L1 IHC testing could be considered in some specific metastatic sites if primary tumors were negative. Further studies are needed to identify other predictive factors for immune checkpoint inhibitor (ICI) therapy in patients with breast carcinoma.
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Affiliation(s)
- Xiao Huang
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL.
| | - Sarah A Anderson
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL
| | - Shi Wei
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS
| | - Shanrun Liu
- Department of Biochemistry and Molecular Genetics, The University of Alabama at Birmingham, Birmingham, AL
| | - Jingyun Yang
- Department of Neurological Sciences, RUSH University, Chicago, IL
| | | | - J Taylor Pickens
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL
| | - Lei Huo
- Department of Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Aysegul A Sahin
- Department of Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Carlos Prieto Granada
- Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center, Nashville, TN
| | - Shuojun Chen
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL
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Mejbel HA, Siegal GP, Wei S. Palmer Nodular Fasciitis Harboring a Novel SREBF1::USP6 Fusion Gene. Int J Surg Pathol 2024:10668969241229330. [PMID: 38304953 DOI: 10.1177/10668969241229330] [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] [Indexed: 02/03/2024]
Abstract
The diagnosis of low-grade fibroblastic/myofibroblastic tumors of acral sites can be challenging. These tumors encompass a diverse group of neoplasms with a spectrum of biologic potential ranges from benign to overtly malignant. They often demonstrate significant clinical, radiologic, and immunophenotypic overlap, in which the molecular phenotype may play an important diagnostic role to arrive at the final diagnosis. Herein, we report a case of soft tissue mass lesion presented on the palm of an adult patient for four months. Histologically, the tumor consisted of primarily low-grade spindle cells expressing smooth muscle actin. Molecular testing revealed a novel SREBF1::USP6 fusion gene, confirming the final diagnosis of nodular fasciitis and ultimately expanding its molecular profile. This case highlights the diagnostic value of single, cost-effective, targeted molecular panel to arrive at an accurate diagnosis and provide helpful therapeutic information.
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Affiliation(s)
- Haider A Mejbel
- Departments of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Gene P Siegal
- Departments of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shi Wei
- Departments of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Pathology & Laboratory Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
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4
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Aldrees R, Siegal GP, Wei S. The Peritumoral CD8 + /FOXP3 + Cell Ratio Has Prognostic Value in Triple-negative Breast Cancer. Appl Immunohistochem Mol Morphol 2023; 31:621-628. [PMID: 37615661 DOI: 10.1097/pai.0000000000001147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 07/19/2023] [Indexed: 08/25/2023]
Abstract
Compelling data has demonstrated the prognostic significance of tumor-infiltrating lymphocytes (TILs) in triple-negative breast cancer (TNBC), a subtype generally associated with a poor clinical outcome but highly heterogeneous in nature. There have been limited studies investigating the importance of subsets of T cells in TILs. Further, the significance of intratumoral versus peritumoral TILs remains controversial. We examined the prognostic value of tumor-associated CD8 + cytotoxic T cells and FOXP3 + regulatory T cells in 35 chemotherapy-naive TNBC cases with a tumor-host interface in the tissue sections. The CD8 + and FOXP3 + cell count was expressed by immunoreactive cells per high-power field in an average of 10 high-power fields. There was a wide range of CD8 + and FOXP3 + T cells within the peritumoral and intratumoral stroma. Both CD8 + and FOXP3 + TILs were significantly higher at the former location as compared with the latter ( P <0.0001 and 0.003, respectively). The numbers of CD8 + and FOXP3 + T cells, either within peritumoral or intratumoral stroma, were not significantly associated with distant relapse-free or disease-specific survival. However, the peritumoral CD8 + /FOXP3 + ratio of TILs was significantly associated with prolonged relapse-free survival ( P =0.04) and disease-specific survival ( P =0.02). This association was not observed with the CD8 + /FOXP3 + ratio of intratumoral TILs. These observations suggest that the immunologic balance in the tumor microenvironment might determine antitumor immunity. Further, the peritumoral TILs appear to play a more important role in the progression of TNBC when compared with the intratumoral TILs, thus reaffirming the necessity of revisiting the method for the assessment of TILs.
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Affiliation(s)
- Rana Aldrees
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
- Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
- Department of Pathology and Laboratory Medicine, University of Kansas School of Medicine, Kansas City, KS
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Mejbel HA, Siegal GP, Wei S. Periosteal Fasciitis With Unusual Radiologic Features Harboring a Novel STAG1::USP6 Fusion Gene. Int J Surg Pathol 2023; 31:1387-1392. [PMID: 36694417 DOI: 10.1177/10668969221150369] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Periosteal fasciitis is a subtype of nodular fasciitis originating from the periosteum. The diagnosis can be challenging and requires radiologic-pathologic correlation. Advances in molecular analysis confirmed that nodular fasciitis and its related lesions harbor a USP6 gene rearrangement with one of the several potential partners. Herein, we report a case of periosteal fasciitis with metaplastic bone formation detected incidentally during a radiologic survey for breast carcinoma. Radiologic examination revealed a 2.4 cm, heterogeneous, avidly enhancing lesion of the right femoral distal metaphysis concerning for low-grade periosteal chondrosarcoma. Histological examination of a core needle biopsy revealed a tumor composed of bland spindle cells with myofibroblastic and osteoblastic phenotypes admixed with immature bone and cartilaginous elements. Molecular analysis revealed a novel STAG1::USP6 fusion that helped arrive at the right diagnosis and further expands the molecular profile of USP6-associated neoplasms.
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Affiliation(s)
- Haider A Mejbel
- Departments of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gene P Siegal
- Departments of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- Departments of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shi Wei
- Departments of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Pathology & Laboratory Medicine, University of Kansas School of Medicine, Kansas City, KS, USA
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Anderson S, Bartow BB, Siegal GP, Huang X, Wei S. The dynamics of HER2-low expression during breast cancer progression. Breast Cancer Res Treat 2023; 201:437-446. [PMID: 37433993 DOI: 10.1007/s10549-023-07020-z] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 06/20/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE Low HER2 expression is emerging as an actionable target for the treatment of breast cancer (BC) with the antibody drug conjugate Trastuzumab deruxtecan. The aim of the study was to characterize the dynamics of HER2 expression during BC progression. METHODS We evaluated the evolution of HER2 expression in 171 paired primary and metastatic BCs (pBCs/mBCs) by including the HER2-low category. RESULTS The proportions of HER2-low cases were 25.7% in pBCs and 23.4% in mBCs, respectively, while those of HER2-0 cases were 35.1% and 42.7%, respectively. The overall conversion rate between HER2-0 and HER2-low was 31.7%. HER2-low switching to HER2-0 was more frequent than the reverse (43.2% vs. 23.3%; P = 0.03). Two (3.3%) and 9 (20.5%) cases of pBCs with a HER2-0 and a HER2-low status, respectively, were converted to HER2-positive mBCs. In contrast, 10 (14.9%) HER2-positive pBCs were converted to HER2-0 and an identical number to HER2-low mBCs, respectively, significantly higher than that when compared to the HER2-0 to HER2-positive (P = 0.03), but not HER2-low to HER2-positive conversion. No significant difference was found when comparing the conversion rates among the common organs of relapse. Of the 17 patients with multiorgan metastases, 41.2% had discordance among the different sites of relapse. CONCLUSIONS HER2-low BCs constitute a heterogeneous group of tumors. Low HER2 expression is dynamic, with significant discordance between primary tumors and advanced disease as well as the distant sites of relapse. Repeat biomarker studies from advanced disease are warranted in making appropriate treatment plans in the pursuit of precision medicine.
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Affiliation(s)
- Sarah Anderson
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Brooke Baxter Bartow
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xiao Huang
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shi Wei
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA.
- Department of Pathology and Laboratory Medicine, The University of Kansas Medical Center, 4000 Cambridge Street, Mail Stop 3067, Kansas City, KS, 66160, USA.
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Anderson SA, Harbi D, Oramas Mogrovejo D, Floyd AD, Eltoum IE, Fatima H, Rosenblum F, Lora Gonzalez M, Lin D, Mackinnon AC, Siegal GP, Winokur T, Yalniz C, Huo L, Harada S, Huang X. PD-L1 (22C3) Expression Correlates with Clinical and Molecular Features of Lung Adenocarcinomas in Cytological Samples. Acta Cytol 2023; 67:507-518. [PMID: 37494911 DOI: 10.1159/000532036] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/16/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION PD-L1 expression is the most widely used predictive marker for immune checkpoint inhibitor (ICI) therapy in patients with lung adenocarcinoma. However, the current understanding of the association between PD-L1 expression and treatment response is suboptimal. A significant percentage of patients have only a cytological specimen available for clinical management. Therefore, it is relevant to examine the impact of molecular features on PD-L1 expression in cytological samples and how it might correlate with a therapeutic response. METHODS We evaluated patients diagnosed with adenocarcinoma of the lung who had both in-house targeted next-generation sequencing analysis and paired PD-L1 (22C3) immunohistochemical staining performed on the same cell blocks. We explored the association between molecular features and PD-L1 expression. In patients who underwent ICIs therapy, we assessed how a specific gene mutation impacted a therapeutic response. RESULTS 145 patients with lung adenocarcinoma were included in this study. PD-L1-high expression was found to be more common in pleural fluid than in other sample sites. Regional lymph node samples showed a higher proportion of PD-L1-high expression (29%) compared with lung samples (6%). The predictive value of PD-L1 expression was retained in cytological samples. Mutations in KRAS were also associated with a PD-L1-high expression. However, tumors with TP53 or KRAS mutations showed a lower therapy response rate regardless of the PD-L1 expression. CONCLUSION Cytological samples maintain a predictive value for PD-L1 expression in patients with lung adenocarcinoma as regards the benefit of ICI treatment. Specific molecular alterations additionally impact PD-L1 expression and its predictive value.
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Affiliation(s)
- Sarah A Anderson
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Djamel Harbi
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Diana Oramas Mogrovejo
- Department of Laboratory Medicine and Pathology, The University of Minnesota, Minneapolis, Minnesota, USA
| | - Antoinette D Floyd
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Isam-Eldin Eltoum
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Huma Fatima
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Frida Rosenblum
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Manuel Lora Gonzalez
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Diana Lin
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Alexander C Mackinnon
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Thomas Winokur
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ceren Yalniz
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lei Huo
- Department of Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Shuko Harada
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Xiao Huang
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Bartow BB, Siegal GP, Yalniz C, Elkhanany AM, Huo L, Ding Q, Sahin AA, Guo H, Magi-Galluzzi C, Harada S, Huang X. Mutations in Homologous Recombination Genes and Loss of Heterozygosity Status in Advanced-Stage Breast Carcinoma. Cancers (Basel) 2023; 15:cancers15092524. [PMID: 37173992 PMCID: PMC10177458 DOI: 10.3390/cancers15092524] [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] [Received: 03/23/2023] [Revised: 04/21/2023] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
Poly (adenosine diphosphate-ribose) polymerase inhibitors (PARPis) have demonstrated antitumor activity in cancers with a homologous recombination deficiency (HRD) and have recently been approved by the FDA for the treatment of germline BRCA1/2-mutation-associated breast cancer. PARPis have also been found to be efficacious in BRCA wild-type (BRCAwt) lesions with high genomic loss of heterozygosity (LOH-high). The goal of this study was to retrospectively investigate the tumor mutations in homologous recombination (HRR) genes and the LOH score in advanced-stage breast carcinomas (BCs). Sixty-three patients were included in our study, 25% of whom had HRR gene mutations in their tumors, including 6% BRCA1/2 and 19% non-BRCA-containing gene mutations. An HRR gene mutation was associated with a triple-negative phenotype. Twenty-eight percent of the patients had an LOH-high score, which, in turn, was associated with a high histological grade, a triple-negative phenotype, and a high tumor mutational burden (TMB). Among the six patients who received PARPi therapy, one had a tumor with a PALB2 mutation other than BRCA and had a clinical partial response. Twenty-two percent of the LOH-low tumors had BRCAwt-HRR gene mutations, compared with 11% of the LOH-high tumors. Comprehensive genomic profiling revealed a subset of breast cancer patients with a BRCAwt-HRR gene mutation that would be missed by an LOH test. The necessity of next-generation sequencing coupled with HRR gene analysis for PARPi therapy requires further investigation in clinical trials.
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Affiliation(s)
- Brooke B Bartow
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ceren Yalniz
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ahmed M Elkhanany
- Department of Breast Medical Oncology, Division of Hematology & Oncology, The University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Lei Huo
- Department of Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Qingqing Ding
- Department of Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Aysegul A Sahin
- Department of Pathology, Division of Pathology/Lab Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hua Guo
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Cristina Magi-Galluzzi
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Shuko Harada
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Xiao Huang
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
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Zota V, Siegal GP, Kelly D, Bridge JA, Berglund A, Bui K, Khalil F, R Reed D, Altiok S, Magliocco A, Bui MM. Validation of PRKCB Immunohistochemistry as a Biomarker for the Diagnosis of Ewing Sarcoma. Fetal Pediatr Pathol 2023; 42:241-252. [PMID: 36062956 DOI: 10.1080/15513815.2022.2117579] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background: Ewing sarcoma (ES) can be confirmed by identifying the EWSR1-FLI1 fusion transcript. This study is to investigate whether immunostaining (IHC) of PRKCB-a protein directly regulated by EWSR1-FLI1 is a surrogate maker for diagnosing ES in routine practice. Methods: Microarray gene expression analyses were conducted. RKCB IHC was applied to 69 ES confirmed by morphology and molecular methods, and 41 non-Ewing small round cell tumors. EWSR1 rearrangement, EWSR1-FLI1 fusion or t(11;22)(q24;q12) were identified by fluorescence in situ hybridization, reverse transcriptase polymerase chain reaction, or cytogenetic analysis, respectively. Results: Gene array analyses showed significant overexpression of the PRKCB in ES. PRKCB IHC was positive in 19 cases of ES with EWSR1-FLI1 fusion, 3 cases with cytogenetic 11:22 translocation and 59 cases with EWSR1 rearrangement while negative in only one EWSR1 rearranged case. PRKCB IHC is sensitive (98%) and specific (96%) in detecting EWSR1 rearranged ES. Conclusions: PRKCB is a reliable antibody for diagnosing ES in routine practice.
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Affiliation(s)
- Victor Zota
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Genetics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David Kelly
- Department of Pathology and Laboratory, Children's of Alabama, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Julia A Bridge
- Molecular Pathology, ProPath, Dallas, TX, USA
- Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, USA
| | - Anders Berglund
- Biostatistics and Bioinformatics Core, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Katherine Bui
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Farah Khalil
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Damon R Reed
- Department of Individualized Cancer Management, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Soner Altiok
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Anthony Magliocco
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
| | - Marilyn M Bui
- Department of Pathology, H. Lee Moffitt Cancer Center and Research Center, Tampa, FL, USA
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Siegal GP. Gratitude and a Warning. J Transl Med 2023; 103:100065. [PMID: 36925199 DOI: 10.1016/j.labinv.2023.100065] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Affiliation(s)
- Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama.
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Fei F, Siegal GP, Wei S. Characterizing Clinicopathologic Features of Estrogen Receptor-Positive/Progesterone Receptor-Negative Breast Cancers. Clin Breast Cancer 2022; 22:e788-e797. [DOI: 10.1016/j.clbc.2022.07.001] [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: 04/05/2022] [Revised: 06/14/2022] [Accepted: 07/01/2022] [Indexed: 11/26/2022]
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12
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Fei F, Zhang K, Siegal GP, Wei S. A simplified breast cancer prognostic score: comparison with the AJCC clinical prognostic staging system. Mod Pathol 2021; 34:2141-2147. [PMID: 34365462 DOI: 10.1038/s41379-021-00890-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/21/2021] [Accepted: 07/21/2021] [Indexed: 12/23/2022]
Abstract
There have been many breast cancer prognostic models proposed in the last few decades, varying in their methods of development and validation, predictors, outcomes, and patients included. Most models were developed to assess prognostic outcomes for early breast cancers. In this study, we established a simplified prognostic score to predict survival outcomes in all breast cancer patients. A total of 36,152 breast cancer patients diagnosed between 2010 and 2015 in the Surveillance, Epidemiology, and End Results (SEER) database were used as the training dataset. Multivariate analyses were performed to identify independent factors for disease-specific survival (DSS). A prognostic score was calculated by summing the point values based on the magnitude of the hazard ratio for all independent factors. The authors institutional cohort (n = 4982) was used as the validation dataset. The prognostic score model consisting of histologic grade, ER, PR, HER2, and TNM status demonstrated a similar predictive power when compared to the revised 8th AJCC Clinical Prognostic Staging system in both training and validation datasets, whereas the addition of age and race did not facilitate stratification of prognostic groups. Pairwise comparison of hazard ratios showed a significant difference in all categories when compared to their proximate groups in both prognostic schemes in the SEER database, while the prognostic score model demonstrated a slightly better discriminating power in the validation dataset. Thus, the proposed prognostic score showed at least a comparable predicting power for survival outcomes in breast cancer patients receiving standard-of-care treatment when compared to the AJCC Clinical Prognostic Stage. This prognostic model provides a convenient and alternative modality in clinical practice thus warranting further validation using larger cohorts with longer follow-up.
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Affiliation(s)
- Fei Fei
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kui Zhang
- Department of Mathematical Sciences, Michigan Technological University, Houghton, MI, USA
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.,O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA. .,O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA.
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Abstract
Tenosynovial giant cell tumors typically arise in the synovium of joints, bursae, or tendon sheaths. They may occur in an intra- or extra-articular location and can be divided into localized and diffuse types. The neoplastic nature of the lesion has been supported by a recurrent CSF1 gene rearrangement in a small subset of lesional cells, of which the most common fusion partner is COL6A3. Herein, we report a case of intramuscular localized tenosynovial giant cell tumor harboring a novel CSF1-CD96 fusion transcript, thus expanding the molecular profile of this tumor.
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Affiliation(s)
- Haider Mejbel
- 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gene P Siegal
- 9968University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shi Wei
- 9968University of Alabama at Birmingham, Birmingham, AL, USA
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14
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Spurlock B, Parker D, Basu MK, Hjelmeland A, GC S, Liu S, Siegal GP, Gunter A, Moran A, Mitra K. Fine-tuned repression of Drp1-driven mitochondrial fission primes a 'stem/progenitor-like state' to support neoplastic transformation. eLife 2021; 10:e68394. [PMID: 34545812 PMCID: PMC8497058 DOI: 10.7554/elife.68394] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 09/08/2021] [Indexed: 12/13/2022] Open
Abstract
Gene knockout of the master regulator of mitochondrial fission, Drp1, prevents neoplastic transformation. Also, mitochondrial fission and its opposing process of mitochondrial fusion are emerging as crucial regulators of stemness. Intriguingly, stem/progenitor cells maintaining repressed mitochondrial fission are primed for self-renewal and proliferation. Using our newly derived carcinogen transformed human cell model, we demonstrate that fine-tuned Drp1 repression primes a slow cycling 'stem/progenitor-like state', which is characterized by small networks of fused mitochondria and a gene-expression profile with elevated functional stem/progenitor markers (Krt15, Sox2 etc) and their regulators (Cyclin E). Fine tuning Drp1 protein by reducing its activating phosphorylation sustains the neoplastic stem/progenitor cell markers. Whereas, fine-tuned reduction of Drp1 protein maintains the characteristic mitochondrial shape and gene-expression of the primed 'stem/progenitor-like state' to accelerate neoplastic transformation, and more complete reduction of Drp1 protein prevents it. Therefore, our data highlights a 'goldilocks' level of Drp1 repression supporting stem/progenitor state dependent neoplastic transformation.
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Affiliation(s)
- Brian Spurlock
- Department of Genetics, University of Alabama at BirminghamBirminghamUnited States
| | - Danitra Parker
- Department of Genetics, University of Alabama at BirminghamBirminghamUnited States
| | - Malay Kumar Basu
- Departments of Pathology, University of Alabama at BirminghamBirminghamUnited States
| | - Anita Hjelmeland
- Department of Cell Development and Integrative Biology, University of Alabama at BirminghamBirminghamUnited States
| | - Sajina GC
- Department of Cell Development and Integrative Biology, University of Alabama at BirminghamBirminghamUnited States
| | - Shanrun Liu
- Department of Genetics, University of Alabama at BirminghamBirminghamUnited States
| | - Gene P Siegal
- Departments of Pathology, Surgery, Genetics and Cell and Developmental Biology, University of Alabama at BirminghamBirminghamUnited States
| | - Alan Gunter
- Department of Genetics, University of Alabama at BirminghamBirminghamUnited States
| | - Aida Moran
- Department of Genetics, University of Alabama at BirminghamBirminghamUnited States
| | - Kasturi Mitra
- Department of Genetics, University of Alabama at BirminghamBirminghamUnited States
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15
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Fei F, Prieto Granada CN, Harada S, Siegal GP, Wei S. Round cell tumor with a myxoid matrix harboring a PHF1-TFE3 fusion: Myoepithelial neoplasm or ossifying fibromyxoid tumor? Pathol Res Pract 2021; 225:153578. [PMID: 34391181 DOI: 10.1016/j.prp.2021.153578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 11/16/2022]
Abstract
Myoepithelial tumors arising in soft tissue are uncommon and mostly manifest a benign clinical course, although a malignant form does exist. An EWSR1 gene rearrangement is a common event in these tumors. Ossifying fibromyxoid tumor, a rare soft tissue neoplasm of uncertain differentiation, may have overlapping histologic and immunophenotypic features with myoepithelial tumors, but frequently harbors a PHF1 gene rearrangement. Interestingly, a PHF1-TFE3 fusion has been recently reported in both entities. Here we report a case of a malignant soft tissue tumor demonstrating myoepithelial differentiation and harboring a PHF1-TFE3 fusion. Despite being slow-growing and lacking significant cytologic atypia at initial presentation, the patient deteriorated rapidly with local recurrence and distant metastases. A discussion of the potential clinicopathologic implications of a PHF1-TFE3 fusion in these entities is also developed.
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Affiliation(s)
- Fei Fei
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | | | - Shuko Harada
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35249, USA.
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16
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Herndon GG, Patel CR, Rose B, Wei S, Siegal GP, Al Diffalha S. Osteosarcoma with Telangiectatic Features Metastatic to the Small Bowel. Human Pathology: Case Reports 2021. [DOI: 10.1016/j.ehpc.2021.200499] [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] [Indexed: 11/15/2022] Open
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17
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Memon R, Prieto Granada CN, Harada S, Winokur T, Reddy V, Kahn AG, Siegal GP, Wei S. Discordance Between Immunohistochemistry and In Situ Hybridization to Detect HER2 Overexpression/Gene Amplification in Breast Cancer in the Modern Age: A Single Institution Experience and Pooled Literature Review Study. Clin Breast Cancer 2021; 22:e123-e133. [PMID: 34120846 DOI: 10.1016/j.clbc.2021.05.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 04/26/2021] [Accepted: 05/08/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Human epidermal growth factor 2 (HER2) amplification and/or overexpression occurs in 12% to 25% of breast cancers. Accurate detection of HER2 is critical in predicting response to HER2-targeted therapy. Both immunohistochemistry (IHC) and in situ hybridization (ISH) are FDA-approved methods for detecting HER2 status because its protein overexpression is largely attributable to gene amplification. However, variable discordant results between IHC and ISH have been reported. METHODS We determined the frequency of HER2 IHC/ISH discordance in these patients and also performed a pooled literature review analysis. RESULTS Of the 1125 consecutive primary or metastatic breast cancers with HER2 IHC and ISH performed simultaneously between 2015 and 2020, 84.6% had an unequivocal HER2 status. Discordance was found in 30 cases from 26 patients, including 13 IHC-/ISH+ and 17 IHC+/ISH-, representing 1.6% and 11.9% of IHC- and IHC+ cases, respectively. Review of the literature between 2001 and 2020 identified 46 relevant studies, with a total of 43,468 cases with IHC and ISH performed. The IHC-/ISH+ and IHC+/ISH- discordances were seen in all antibody clones and ISH methods used. The IHC+/ISH- discordance was significantly higher than IHC-/ISH+ (13.8% vs. 3%, P < .0001). The overall discordance constituted 4% of all cases and 5.4% of those with an unequivocal IHC status. Significantly lower incongruities for both IHC-/ISH+ and IHC+/ISH- were found in those published after 2018. The discordances probably reflect altered biology of HER2 oncogene/oncoprotein. Routinely performing both IHC and ISH may uncover such cases to prevent denial of potentially beneficial targeted therapy.
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Affiliation(s)
| | | | - Shuko Harada
- Department of Pathology; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | | | | | | | - Gene P Siegal
- Department of Pathology; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL
| | - Shi Wei
- Department of Pathology; O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL.
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18
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Abstract
CONTEXT.— A number of fibro-osseous and osteocartilaginous lesions, especially common in the small bones of hand and feet, pose a diagnostic challenge and have historically been thought to be reactive lesions. However, modern molecular techniques when supplementing clinical, radiographic, and histologic evaluation suggest they may, in fact, be neoplasms. OBJECTIVE.— To review the clinical presentation and histopathologic, molecular, and radiologic features of selective bone lesions, focusing most specifically on subungual exostosis, florid reactive periostitis, and bizarre periosteal osteochondromatous proliferation. DATA SOURCES.— Literature review and personal experience are the source of this review. CONCLUSIONS.— Some lesions previously thought to be reactive are locally aggressive and demonstrate reproducible molecular abnormalities, and thus may be neoplasms. Although most common in the bones of the fingers and toes, these lesions also occur in long and other bones. The clinical presentations, radiologic appearances, and histopathologic features often overlap, making the diagnosis challenging, and these lesions may require molecular evaluation to maximize accurate prognostication.
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Affiliation(s)
- Raima A Memon
- From the Departments of Pathology & Genetics, University of Alabama at Birmingham
| | - Shi Wei
- From the Departments of Pathology & Genetics, University of Alabama at Birmingham
| | - Gene P Siegal
- From the Departments of Pathology & Genetics, University of Alabama at Birmingham
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19
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Fei F, Siegal GP, Wei S. Characterization of estrogen receptor-low-positive breast cancer. Breast Cancer Res Treat 2021; 188:225-235. [PMID: 33694051 DOI: 10.1007/s10549-021-06148-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [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: 01/05/2021] [Accepted: 02/12/2021] [Indexed: 01/09/2023]
Abstract
PURPOSE The biology of breast cancer with a low expression level (1-10%) of estrogen receptor (ER) remains a matter of confusion. The recent American Society of Oncology/College of American Pathologist Guidelines have recommended reporting such tumors as a new "ER-low-positive" category with a recommended comment to emphasize the possible overall benefit of endocrine therapies in these patients. The aim of the study was to analyze the clinicopathologic features and clinical outcomes of ER-low-positive breast cancers. METHODS We characterized the clinicopathologic features and survival outcomes of ER-low-positive breast cancers in our 4179 patients diagnosed from 1998 to 2018. RESULTS The ER-positive, ER-low-positive, and ER-negative cases in our cohort were 2982 (71.4%), 97 (2.3%), and 1100 (26.3%), respectively. ER-low-positive tumors showed similar clinicopathologic characteristics yet significantly superior prognosis when compared to ER-negative tumors, while demonstrated largely overlapping survival outcomes with ER-positive tumors in the entire cohort. In the subcohort of tumors with a PR-positive phenotype, the prognosis of ER-low-positive tumors was intermediate between that of the ER-positive and ER-negative groups. ER-low-positive/PR-positive tumors had a significantly worse prognosis than ER-positive tumors, and a trend toward favorable survival outcomes when compared to ER-negative tumors, although no significant difference was identified for the latter. In contrast, the ER-positive and ER-low-positive groups showed similar survival outcomes in the subset of tumors with a PR-negative status, both being significantly better than ER-negative tumors. CONCLUSIONS PR status as a surrogate marker of functional ER signaling provides critical information in this regard. These findings suggest that while ER-low-positive tumors are themselves heterogeneous, they often respond to endocrine treatment. Analysis of molecular signatures and standardization of therapeutic strategies are important to understand the biology of ER-low-positive tumors and to enable optimal treatment in the pursuit of individualized medicine.
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Affiliation(s)
- Fei Fei
- Department of Pathology, University of Alabama at Birmingham, NP 3545, 619 19th St. South, Birmingham, AL, 35249-7331, USA
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, NP 3545, 619 19th St. South, Birmingham, AL, 35249-7331, USA.,O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, 35249, USA
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, NP 3545, 619 19th St. South, Birmingham, AL, 35249-7331, USA. .,O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, 35249, USA.
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20
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Abstract
CONTEXT.— Small round cell tumors of soft tissue and bone constitute a divergent group of neoplasms. These lesions often demonstrate overlapping clinical and radiologic characteristics and share histomorphologic and sometimes immunophenotypic similarities, but they typically have diverse prognostic outcomes, thus warranting different clinical management. Recent advances in molecular and cytogenetic techniques have identified a number of novel molecular alterations contributing to the diversity of these lesions. This state-of-the-art knowledge has enhanced our understanding of these diseases. OBJECTIVE.— To provide an overview of the current concepts in the classification and diagnosis of small round cell tumors of soft tissue and bone, focusing on salient histologic features, key immunophenotypic characteristics, and recent molecular genetic advancements. DATA SOURCES.— Data were obtained from pertinent peer-reviewed English-language literature and firsthand experience from the authors as practicing bone and soft tissue pathologists. CONCLUSIONS.— Immunohistochemistry plays a vital role in rendering a specific diagnosis or narrowing the differential diagnosis in small round cell tumors of soft tissue and bone. Molecular genetic studies are often needed, especially for those lesions with unusual histologic features, an uncommon immunoprofile, and/or unusual clinical presentation. Accurate diagnosis of these tumors necessitates recognition of salient histologic features, judicious and astute use of ancillary studies, and correlation with the clinical and radiologic characteristics to guide clinical decision-making.
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Affiliation(s)
- Shi Wei
- From the Department of Pathology (Wei, Siegal), University of Alabama, Birmingham
| | - Gene P Siegal
- From the Department of Pathology (Wei, Siegal), University of Alabama, Birmingham.,Department of Genetics (Siegal), O'Neal Comprehensive Cancer Center, University of Alabama, Birmingham
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21
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Aldrees R, Gao X, Zhang K, Siegal GP, Wei S. Validation of the revised 8th AJCC breast cancer clinical prognostic staging system: analysis of 5321 cases from a single institution. Mod Pathol 2021; 34:291-299. [PMID: 32778677 DOI: 10.1038/s41379-020-00650-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 07/28/2020] [Accepted: 07/29/2020] [Indexed: 11/09/2022]
Abstract
The anatomic stage groups (ASG) have been arguably the most powerful in predicting breast cancer (BC) outcomes. Recognizing the prognostic influence of histologic grade and receptor status, the 8th AJCC mandates their incorporation into the newly established prognostic stage groups (PSG). This staging scheme was subsequently revised to provide pathological and clinical prognostic stage tables (PPSG/CPSG) due to its incapability to categorize a significant subset of BCs, with the former only used for patients having surgical resection as the initial treatment, and the latter for all patients. Given the increasingly used neoadjuvant therapy, PPSG cannot be assigned in a significant proportion of higher staged BCs. In this study, we validated the CPSG in a cohort of 5321 BCs. Compared to ASG, the application of CPSG resulted in assigning 16.1% and 27.2% of cases to a higher or a lower stage group in non-stage IV BCs, respectively. The changes were seen mostly frequently in ASG IB, followed by IIIC, IIB, IIA, IIIA, IIIB, and IA. In 7.9% of cases, the assigned CPSG changed more than one stage group from the ASG. CPSG provided an improved overall discriminating power in predicting BC-specific survival when compared to ASG. Pairwise comparison using the Cox proportional hazard model demonstrated further advantages for CPSG as the latter showed a significant difference in all categories when compared to their proximate groups, except IIA vs. IB and IIIA vs. IIIB. In contrast, a significantly different hazard was only seen when comparing IIB vs. IIA, IIIA vs. IIB, and IV vs. IIIC for ASG. Thus, the revised 8th AJCC CPSG provided a superior overall staging scheme for predicting prognostic outcomes in BC patients receiving standard of care treatment. Further validation using the available data with larger populations and longer follow-up may be needed to refine and improve this table.
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Affiliation(s)
- Rana Aldrees
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Xiaoqing Gao
- Department of Mathematical Sciences, Michigan Technological University, Houghton, MI, USA
| | - Kui Zhang
- Department of Mathematical Sciences, Michigan Technological University, Houghton, MI, USA
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.
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22
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Amm HM, DeVilliers P, Srivastava AR, Diniz MG, Siegal GP, MacDougall M. Mandibular undifferentiated pleomorphic sarcoma: Molecular analysis of a primary cell population. Clin Exp Dent Res 2020; 6:495-505. [PMID: 32652895 PMCID: PMC7545231 DOI: 10.1002/cre2.301] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 04/22/2020] [Accepted: 04/29/2020] [Indexed: 12/12/2022] Open
Abstract
Background Undifferentiated pleomorphic sarcomas are one of the most common subtypes of soft tissue sarcomas. These are aggressive mesenchymal tumors and are devoid of the major known biomarkers except vimentin. Our objective was to establish and characterize a primary cell population from a mandibular UPS specimen. Methods The tumor was surgically removed from the right mandible of a 24‐year‐old male with IRB approved signed consent. Tumor was dissected, cultured ex vivo, and a cell population, MUPS‐1, were isolated from outgrowths. Gene and protein expression profiles of both the primary tumor and the derived there from cells were obtained by quantitative RT‐PCR and immunohistochemistry and included markers of epithelial, endothelial, and mesenchymal differentiation. To better define potential biomarkers, MUPS‐1 cells were additionally characterized by RNA sequencing analysis. Results Pathological analysis of primary tumor tissue revealed a sarcoma demonstrating multiple pathways of differentiation simultaneously with myxoid, fibrous, and osseous tissue. The isolated cells had a spindle cell‐like morphology, were maintained in culture for greater than 20 passages, and formed colonies in soft agar indicating tumorigenicity. The cells, similar to the primary tumor, were strongly positive for vimentin and moderately expressed alkaline phosphatase. RNA‐seq analysis revealed the tumor over‐expressed several genes compared to normal tissue, including components of the Notch signaling pathway, NOTCH3 and JAG1. Conclusions We have successfully established an undifferentiated pleomorphic sarcoma cell population, which will provide a valuable resource for studying fundamental processes and potentially serving as a platform for exploring therapeutic strategies for sarcomas.
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Affiliation(s)
- Hope M Amm
- Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Patricia DeVilliers
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ambika R Srivastava
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Marina G Diniz
- Department of Pathology and Oral Surgery and Pathology, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mary MacDougall
- Oral and Maxillofacial Surgery, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Faculty of Dentistry, The University of British Columbia, Vancouver, British Columbia, Canada
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23
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Seghatol-Eslami F, Farris GR, Chapman GD, Lloyd SG, Siegal GP. A Rare Cause of Left Atrial Mass. ACTA ACUST UNITED AC 2020; 4:260-262. [PMID: 32875192 PMCID: PMC7451912 DOI: 10.1016/j.case.2020.04.004] [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] [Indexed: 11/18/2022]
Abstract
LAIH may be a complication of blunt chest trauma. Multimodality imaging with TEE and CMR can lead to the correct diagnosis. Conservative management may be considered in hemodynamically stable patients.
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Affiliation(s)
- Frank Seghatol-Eslami
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gary Ross Farris
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gregory D Chapman
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Steven G Lloyd
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, Alabama
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24
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Wang K, Hackney JR, Siegal GP, Wei S. RANKLed by the Complexity of Signaling in Breast Cancer Metastasis to the Brain. Clin Breast Cancer 2020; 20:e569-e575. [PMID: 32381383 DOI: 10.1016/j.clbc.2020.04.001] [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: 01/19/2020] [Revised: 03/17/2020] [Accepted: 04/01/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Receptor activator of nuclear factor κB (RANK) and its ligand, RANKL, are essential for mammary gland development and play a vital role in breast carcinogenesis. RANKL-RANK signaling also drives thermoregulation and modulates inflammatory activation in the brain. The expression of RANKL in primary breast cancer (BC) has been negatively associated with brain metastases, while significantly higher levels of RANK are seen in BC with brain metastases. We examined the expression of RANK and RANKL in BC metastasis to the brain. PATIENTS AND METHODS We examined the expression of RANK and RANKL in 40 cases of BC metastasis to the brain. RESULTS RANK was variably expressed in BC cells but minimally expressed in the adjacent brain parenchyma. In contrast, the expression of RANKL was minimal in metastatic BC but highly variable in tumoral stroma. RANKL expression in normal brain stroma obtained during autopsy was negligible. Histologic grade and BC subtypes were not significantly associated with RANK expression in metastatic BC. A significant negative correlation between RANK in metastatic BC and RANKL in tumoral stroma was identified (P < .001). CONCLUSION RANK expressed by primary BC and RANKL detected in the tumor microenvironment together participate in cancer development, while the same principle may operate at distant sites. Further investigation is necessary to provide additional insight into the role of the RANKL-RANK pathway in BC progression and to investigate the potential efficacy of therapeutic strategies targeting these molecules in BC metastasis to the brain.
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Affiliation(s)
- Kai Wang
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - James R Hackney
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL.
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25
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Sobel ME, Dreyfus JC, Dillehay McKillip K, Kolarcik C, Muller WA, Scott MJ, Siegal GP, Wadosky K, O'Leary TJ. Return of Individual Research Results: A Guide for Biomedical Researchers Utilizing Human Biospecimens. Am J Pathol 2020; 190:918-933. [PMID: 32201265 DOI: 10.1016/j.ajpath.2020.01.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/17/2020] [Accepted: 01/24/2020] [Indexed: 12/20/2022]
Abstract
The recent movement toward returning individual research results to study subjects/participants generates ethical and legal challenges for laboratories performing research on human biospecimens. The concept of an individual's interest in knowing the results of testing on their tissue is pitted against individual and systemic risks and an established legal framework regulating the performance of laboratory testing for medical care purposes. This article discusses the rationale for returning individual research results to subjects, the potential risks associated with returning these results, and the legal framework in the United States that governs testing of identifiable human biospecimens. On the basis of these considerations, this article provides recommendations for investigators to consider when planning and executing human biospecimen research, with the objective of appropriately balancing the interests of research subjects, the need for ensuring integrity of the research process, and compliance with US laws and regulations.
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Affiliation(s)
- Mark E Sobel
- American Society for Investigative Pathology, Rockville, Maryland.
| | | | | | | | - William A Muller
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Melanie J Scott
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Gene P Siegal
- University of Alabama at Birmingham, Birmingham, Alabama
| | | | - Timothy J O'Leary
- Veterans Health Administration, Washington, DC; University of Maryland School of Medicine, Baltimore, Maryland
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26
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Wilson JT, Pitts C, Hess M, Phillips SG, Siegal GP, Johnson MD. Extraskeletal Myxoid Chondrosarcoma of the Midfoot Presenting as Charcot Arthropathy: A Case Report. JBJS Case Connect 2019; 9:e0458. [PMID: 31589174 DOI: 10.2106/jbjs.cc.18.00458] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE Extraskeletal myxoid chondrosarcoma (EMC) is a rare soft tissue malignancy that very seldomly presents in the foot or ankle and as a result is not commonly in the differential of patients presenting with foot pain. We cite a case of EMC presenting in the atypical location of the midfoot. Because of its location and similarities, this tumor was initially misdiagnosed and mistreated by multiple medical providers as midfoot Charcot arthropathy. CONCLUSIONS Neoplastic etiologies, including EMC, should remain in the differential for atypical, refractory foot pain that presents in a manner similar to Charcot foot.
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Affiliation(s)
| | - Charles Pitts
- Orthopaedics Department, University of Alabama at Birmingham, Alabama
| | - Matthew Hess
- Orthopaedics Department, University of Alabama at Birmingham, Alabama
| | - Sierra G Phillips
- Orthopaedics Department, University of Alabama at Birmingham, Alabama
| | - Gene P Siegal
- Pathology Department, University of Alabama at Birmingham, Alabama
| | - Michael D Johnson
- Orthopaedics Department, University of Alabama at Birmingham, Alabama
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27
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Chinta KC, Rahman MA, Saini V, Glasgow JN, Reddy VP, Lever JM, Nhamoyebonde S, Leslie A, Wells RM, Traylor A, Madansein R, Siegal GP, Antony VB, Deshane J, Wells G, Nargan K, George JF, Ramdial PK, Agarwal A, Steyn AJC. Microanatomic Distribution of Myeloid Heme Oxygenase-1 Protects against Free Radical-Mediated Immunopathology in Human Tuberculosis. Cell Rep 2019; 28:3286. [PMID: 31533049 PMCID: PMC6859473 DOI: 10.1016/j.celrep.2019.08.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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28
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Abstract
Bone pathology can be challenging because the skeleton is a living tissue prone to developing a diverse array of inflammatory, metabolic, genetic, reactive, circulatory, and neoplastic abnormalities. Several areas of bone pathology are particularly difficult or problematic for hematopathologists given the close resemblance of some hematologic entities to primary/metastatic bone lesions; examples include plasmacytic disorders versus osteoblastic tumors and lymphoma/leukemia versus round cell tumors of bone. This article provides a conceptual and practical overview of selective bone disorders commonly encountered in the differential diagnosis of hematologic diseases.
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Affiliation(s)
- Deniz Peker
- Department of Pathology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA
| | - Shi Wei
- Department of Pathology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA
| | - Gene P Siegal
- Department of Pathology, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249, USA.
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29
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Wang K, Guo R, Siegal GP, Wei S. Inflammatory myofibroblastic tumor of bone harboring an ALK gene amplification. Pathol Res Pract 2019; 215:152535. [PMID: 31326196 DOI: 10.1016/j.prp.2019.152535] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2019] [Revised: 06/14/2019] [Accepted: 07/12/2019] [Indexed: 11/25/2022]
Abstract
Inflammatory myofibroblastic tumor (IMT) is a neoplastic proliferation of myofibroblastic/fibroblastic cells with a variable admixture of inflammatory cells. It primarily affects soft tissue and viscera of children and young adults. IMT occurring in bone is extremely rare. Approximately 50% of IMTs carry a clonal rearrangement of the anaplastic lymphoma kinase (ALK) gene, while other receptor tyrosine kinase gene rearrangements have been seen in a small subset of IMT. Herein, we report the first case of IMT which harbors an ALK gene amplification rather than a rearrangement thus resulting in overexpression of the protein, arising from the femur of a 24-year-old man. Our case provides a novel pathogenesis for IMT. An overview of cytogenetic abnormalities of IMT is also integrated into this report.
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Affiliation(s)
- Kai Wang
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - Rongjun Guo
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - Gene P Siegal
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249, United States; Department of Genetics, the University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - Shi Wei
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249, United States.
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30
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Siegal GP, Ketcham CM. Let's go swimming. J Transl Med 2019; 99:450-451. [PMID: 30723258 DOI: 10.1038/s41374-019-0194-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/17/2019] [Indexed: 11/09/2022] Open
Affiliation(s)
- Gene P Siegal
- Departments of Pathology & Genetics, University of Alabama at Birmingham, HSB 149K
- 619 19th St. South, Birmingham, AL, USA.
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31
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Chinta KC, Rahman MA, Saini V, Glasgow JN, Reddy VP, Lever JM, Nhamoyebonde S, Leslie A, Wells RM, Traylor A, Madansein R, Siegal GP, Antony VB, Deshane J, Wells G, Nargan K, George JF, Ramdial PK, Agarwal A, Steyn AJC. Microanatomic Distribution of Myeloid Heme Oxygenase-1 Protects against Free Radical-Mediated Immunopathology in Human Tuberculosis. Cell Rep 2018; 25:1938-1952.e5. [PMID: 30428359 PMCID: PMC6250977 DOI: 10.1016/j.celrep.2018.10.073] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 07/18/2018] [Accepted: 10/19/2018] [Indexed: 11/26/2022] Open
Abstract
Heme oxygenase-1 (HO-1) is a cytoprotective enzyme that controls inflammatory responses and redox homeostasis; however, its role during pulmonary tuberculosis (TB) remains unclear. Using freshly resected human TB lung tissue, we examined the role of HO-1 within the cellular and pathological spectrum of TB. Flow cytometry and histopathological analysis of human TB lung tissues showed that HO-1 is expressed primarily in myeloid cells and that HO-1 levels in these cells were directly proportional to cytoprotection. HO-1 mitigates TB pathophysiology by diminishing myeloid cell-mediated oxidative damage caused by reactive oxygen and/or nitrogen intermediates, which control granulocytic karyorrhexis to generate a zonal HO-1 response. Using whole-body or myeloid-specific HO-1-deficient mice, we demonstrate that HO-1 is required to control myeloid cell infiltration and inflammation to protect against TB progression. Overall, this study reveals that zonation of HO-1 in myeloid cells modulates free-radical-mediated stress, which regulates human TB immunopathology.
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Affiliation(s)
- Krishna C Chinta
- Department of Microbiology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | | | - Vikram Saini
- Department of Microbiology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Joel N Glasgow
- Department of Microbiology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Vineel P Reddy
- Department of Microbiology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jeremie M Lever
- Nephrology Research and Training Center, Division of Nephrology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | | | | | - Ryan M Wells
- Department of Microbiology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Amie Traylor
- Nephrology Research and Training Center, Division of Nephrology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | | | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Veena B Antony
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Jessy Deshane
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Gordon Wells
- Africa Health Research Institute, Durban 4001, South Africa
| | | | - James F George
- Division of Cardiothoracic Surgery, Department of Surgery, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Pratistadevi K Ramdial
- Department of Anatomical Pathology, NHLS, Inkosi Albert Luthuli Central Hospital, University of KwaZulu-Natal, Durban 4091, South Africa
| | - Anupam Agarwal
- Nephrology Research and Training Center, Division of Nephrology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; Department of Veterans Affairs, Birmingham, AL 35294, USA
| | - Adrie J C Steyn
- Department of Microbiology, School of Medicine, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; Africa Health Research Institute, Durban 4001, South Africa; UAB Center for AIDS Research, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; Center for Free Radical Biology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA.
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32
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Broadwater DR, Conant JL, Czuchlewski DR, Hall JM, Wei S, Siegal GP, Peker D. Clinicopathologic Features and Clinical Outcome Differences in De Novo Versus Secondary Histiocytic Sarcomas: A Multi-institutional Experience and Review of the Literature. Clinical Lymphoma Myeloma and Leukemia 2018; 18:e427-e435. [DOI: 10.1016/j.clml.2018.07.286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 06/26/2018] [Accepted: 07/09/2018] [Indexed: 10/28/2022]
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33
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Fasciano D, Wei S, Li R, Siegal GP. Chondroblastoma-like tumor of the skull in a patient with cardio-facio-cutaneous syndrome. Pathol Res Pract 2018; 214:1510-1513. [DOI: 10.1016/j.prp.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/25/2018] [Accepted: 08/06/2018] [Indexed: 01/09/2023]
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34
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Kouba E, Ford A, Brown CG, Yeh C, Siegal GP, Manne U, Eltoum IE. Detection of BRAF V600E Mutations With Next-Generation Sequencing in Infarcted Thyroid Carcinomas After Fine-Needle Aspiration. Am J Clin Pathol 2018; 150:177-185. [PMID: 29868707 DOI: 10.1093/ajcp/aqy045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Fine-needle aspiration (FNA) of thyroid lesions may result in infarction and diagnostic difficulties on subsequent thyroidectomy specimens. Next-generation sequencing (NGS) methods for detection of hallmark driver BRAF V600E mutations may help characterize such tumors in which histologic alterations preclude definitive tissue diagnosis. METHODS Thyroidectomy specimens with both malignant FNA diagnoses and resultant infarction were identified from our institutional database. NGS methods were used to detect BRAF V600E mutations in the infarcted thyroid carcinomas. RESULTS Nine thyroid carcinomas with infarction were characterized as BRAF-like papillary thyroid carcinoma based on molecular driver categorization and histologic diagnosis. BRAF V600E mutations were detected in the infarcted tissue in four (67%) of six lesions. CONCLUSIONS We demonstrate detection of hallmark BRAF V600E mutations by NGS within infarcted tissue of thyroid carcinomas after FNA. This suggests a potential ancillary method of characterizing infarcted thyroid carcinomas whose altered histology may be nondiagnostic.
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Affiliation(s)
- Erik Kouba
- Department of Pathology, University of Alabama–Birmingham, Birmingham, AL
| | | | | | | | - Gene P Siegal
- Department of Pathology, University of Alabama–Birmingham, Birmingham, AL
| | - Upender Manne
- Department of Pathology, University of Alabama–Birmingham, Birmingham, AL
| | - Isam-Eldin Eltoum
- Department of Pathology, University of Alabama–Birmingham, Birmingham, AL
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35
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Ping Z, Siegal GP, Harada S, Eltoum IE, Youssef M, Shen T, He J, Huang Y, Chen D, Li Y, Bland KI, Chang HR, Shen D. ERBB2 mutation is associated with a worse prognosis in patients with CDH1 altered invasive lobular cancer of the breast. Oncotarget 2018; 7:80655-80663. [PMID: 27811364 PMCID: PMC5340256 DOI: 10.18632/oncotarget.13019] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [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: 09/09/2016] [Accepted: 10/24/2016] [Indexed: 01/09/2023] Open
Abstract
E-cadherin (CDH1) is a glycoprotein that mediates adhesion between epithelial cells and also suppresses cancer invasion. Mutation or deletion of the CDH1 gene has been reported in 30-60% cases of invasive lobular carcinoma (ILC). However, little is known about genomic differences between ILC with and without a CDH1 alteration. Therefore, we analyzed whole genome sequencing data of 169 ILC cases from The Cancer Genome Atlas (TCGA) to address this deficiency. Our study shows that CDH1 gene was altered in 59.2% (100/169) of ILC. No significant difference was identified between CDH1-altered and -unaltered ILC cases for any of the examined demographic, clinical or pathologic characteristics, including histologic grade, tumor stage, lymph node metastases, or ER/PR/HER2 states. Seven recurrent mutations (PTEN, MUC16, ERBB2, FAT4, PCDHGA2, HERC1 and FLNC) and four chromosomal changes with recurrent copy number variation (CNV) (11q13, 17q12-21, 8p11 and 8q11) were found in ILC, which correlated with a positive or negative CDH1 alteration status, respectively. The prevalence of the most common breast cancer driver abnormalities including TP53 and PIK3CA mutations and MYC and ERBB2 amplifications showed no difference between the two groups. However, CDH1-altered ILC with an ERBB2 mutation shows a significantly worse prognosis compared to its counterparts without such a mutation. Our study suggests that CDH1-altered ILC patients with ERBB2 mutations may represent an actionable group of patients who could benefit from targeted breast cancer therapy.
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Affiliation(s)
- Zheng Ping
- Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gene P Siegal
- Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Shuko Harada
- Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Isam-Eldin Eltoum
- Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mariam Youssef
- Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tiansheng Shen
- Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jianbo He
- Division of Hematology/Oncology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yingjie Huang
- Ningbo Clinical and Pathological Diagnosis Center, Ningbo, Zhejiang, China
| | - Dongquan Chen
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yiping Li
- Division of Cell and Molecular Pathology, Departments of Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kirby I Bland
- Division of Surgical Oncology, Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Helena R Chang
- Revlon/UCLA Breast Center, Department of Surgery, University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA
| | - Dejun Shen
- Division of Anatomic Pathology, University of Alabama at Birmingham, Birmingham, AL, USA.,UAB Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
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36
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Stevens TM, Qarmali M, Morlote D, Mikhail FM, Swensen J, Gatalica Z, Siegal GP, Conry RM. Malignant Ewing-Like Neoplasm With an EWSR1-KLF15 Fusion: At the Crossroads of a Myoepithelial Carcinoma and a Ewing-Like Sarcoma. A Case Report With Treatment Options. Int J Surg Pathol 2018; 26:440-447. [PMID: 29390927 DOI: 10.1177/1066896918755009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We present a case of a malignant Ewing-like neoplasm of the parotid gland in a 20-year-old woman with an EWSR1-KLF15 gene fusion that presented with pulmonary metastasis. Despite the fact that the tumor was essentially immunohistochemically negative for keratins, p63, and p40, we interpret this neoplasm as an unusual form of a high-grade myoepithelial carcinoma based on its focal plasmacytoid cytology, chondromyxoid matrix, SOX10, S100 protein, and calponin expression, and the knowledge that the EWSR1-KLF15 gene fusion has, to date, only been identified in 2 tumors, both myoepithelial carcinomas of the kidney. We also present a cytogenetic analysis of this unusual tumor. This "Ewing-like myoepithelial carcinoma" initially did not respond to 2 cycles of ifosfamide and etoposide alternated with a cycle of cytoxan, adriamycin, and vincristine, a standard regimen for Ewing sarcoma. Subsequent oral pazopanib therapy did result in a reduction of the patient's pulmonary and nodal disease.
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37
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Shen T, Gao C, Zhang K, Siegal GP, Wei S. Prognostic outcomes in advanced breast cancer: the metastasis-free interval is important. Hum Pathol 2017; 70:70-76. [DOI: 10.1016/j.humpath.2017.10.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 09/24/2017] [Accepted: 10/04/2017] [Indexed: 12/29/2022]
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38
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Chen S, Fritchie K, Wei S, Ali N, Curless K, Shen T, Brini AT, Latif F, Sumathi V, Siegal GP, Cheng L. Corrigendum to "Diagnostic utility of IDH1/2 mutations to distinguish dedifferentiated chondrosarcoma from undifferentiated pleomorphic sarcoma of bone" [Hum Pathol 2017;65:239-46]. Hum Pathol 2017; 69:143. [PMID: 29146074 DOI: 10.1016/j.humpath.2017.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Shaoxiong Chen
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Karen Fritchie
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Shi Wei
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Naser Ali
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Kendra Curless
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tiansheng Shen
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anna T Brini
- IRCCS Galeazzi, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Farida Latif
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Vaiyapuri Sumathi
- Department of Musculoskeletal Pathology, The Royal Orthopaedic Hospital, Birmingham B15 2TT, United Kingdom
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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Abstract
Many cancers demonstrate a non-random distribution of sites for distant relapse while others have the propensity to metastasize to multiple organ systems. One of the notable recent findings is that the breast cancer subtypes differ not only in their biological characteristics as primary tumors but also in their capacity for metastatic progression. This information could potentially be utilized in treatment decision making and surveillance strategies.
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Affiliation(s)
- Shi Wei
- Department of Pathology, School of Medicine, the University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Gene P Siegal
- Department of Pathology, School of Medicine, the University of Alabama at Birmingham, Birmingham, AL, USA
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40
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Li R, Zhang K, Siegal GP, Wei S. Clinical and pathological factors related to brain relapse-free survival in breast cancer patients—reply. Hum Pathol 2017; 69:142. [DOI: 10.1016/j.humpath.2017.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 05/10/2017] [Indexed: 11/24/2022]
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41
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Wang K, Shen T, Siegal GP, Wei S. The CD4/CD8 ratio of tumor-infiltrating lymphocytes at the tumor-host interface has prognostic value in triple-negative breast cancer. Hum Pathol 2017; 69:110-117. [PMID: 28993275 DOI: 10.1016/j.humpath.2017.09.012] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Revised: 09/19/2017] [Accepted: 09/29/2017] [Indexed: 02/08/2023]
Abstract
Compelling evidence has demonstrated the prognostic value of tumor-infiltrating lymphocytes (TILs), especially in triple-negative breast cancer (TNBC). However, only a limited number of studies to investigate the importance of the subsets of T cells in TILs have been carried out, less so the significance of the location of these TILs. In this study, we explored in a cohort of 42 consecutive TNBC cases the prognostic significance of TIL subsets at the tumor-host interface (within 1 high-power field [0.5 mm] of the invasive front) and compared them with TILs within the intratumoral stroma. Given the reported importance of TILs in HER2-overexpressing breast cancer, a subset of such tumors was also included for comparison. The range was wide in both locations; nevertheless, the mean CD4+ and CD8+ T cell count was significantly higher at the tumor-host interface than that found within the intratumoral stroma (both P<.0001). The number of CD4+ or CD8+ T cells at either location was not significantly associated with distant relapse-free or overall survival. However, the CD4/CD8 ratio at the tumor-host interface was significantly associated with both relapse-free survival (hazard ratio 0.2, P=.002) and overall survival (hazard ratio 0.13, P=.002), whereas this association was not seen for the CD4/CD8 ratio within the intratumoral stroma. As expected, both tumor size and nodal status were significantly associated with survival outcomes. The findings further support the contention that TILs, as markers of regional immune escape, are of prognostic importance in TNBC progression and that the CD4/CD8 ratio of TILs at the tumor-host interface plays a distinctive role, thus appearing to be of clinical relevance.
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Affiliation(s)
- Kai Wang
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249-7331
| | - Tiansheng Shen
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249-7331
| | - Gene P Siegal
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249-7331
| | - Shi Wei
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249-7331.
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42
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Lopez LV, Rodriguez MG, Siegal GP, Wei S. Extraskeletal aneurysmal bone cyst: Report of a case and review of the literature. Pathol Res Pract 2017; 213:1445-1449. [PMID: 28756986 DOI: 10.1016/j.prp.2017.07.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 05/15/2017] [Accepted: 07/02/2017] [Indexed: 12/01/2022]
Abstract
Aneurysmal bone cyst (ABC) is an expansile cystic lesion that may affect any bone of the skeleton. Although exceedingly rare, lesions with histomorphologic characteristics of an ABC have reportedly originated within soft tissue. Extraskeletal ABC may mimic a variety of benign and malignant lesions and can be confused with other more common or rare giant cell-rich tumors of soft tissue, especially myositis ossificans. Clinical, radiological and histologic correlation is crucial in reaching the correct diagnosis. Cytogenetic and/or molecular genetic analysis is a useful adjunct in diagnosing these exquisitely rare lesions. Here we report a case of an ABC arising in an extraskeletal site and provide a comprehensive review of literature on this rare entity.
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Affiliation(s)
- Liurka V Lopez
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - Michael G Rodriguez
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35249, United States
| | - Shi Wei
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL 35249, United States.
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43
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Chen S, Fritchie K, Wei S, Ali N, Curless K, Shen T, Brini AT, Latif F, Sumathi V, Siegal GP, Cheng L. Diagnostic utility of IDH1/2 mutations to distinguish dedifferentiated chondrosarcoma from undifferentiated pleomorphic sarcoma of bone. Hum Pathol 2017; 65:239-246. [PMID: 28552826 DOI: 10.1016/j.humpath.2017.05.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/01/2017] [Accepted: 05/10/2017] [Indexed: 01/14/2023]
Abstract
Histologically, it is nearly impossible to distinguish the dedifferentiated component of dedifferentiated chondrosarcoma from undifferentiated pleomorphic sarcoma (UPS) of bone when the low-grade cartilaginous component is absent. Previous studies have revealed that isocitrate dehydrogenase 1 (IDH1) and IDH2 mutations are present in a significant number of cartilaginous tumors including most conventional chondrosarcomas and dedifferentiated chondrosarcomas. These mutations have not been studied in UPSs of bone. We sought to investigate whether an IDH1 or IDH2 mutation signature could be used as a clinically diagnostic marker for the distinction of dedifferentiated component of chondrosarcoma from UPS of bone. Sixty-eight bone tumor cases, including 31 conventional chondrosarcomas, 23 dedifferentiated chondrosarcomas, and 14 UPSs of bone, were collected for IDH1/2 mutation analysis either using the Qiagen IDH1/2 RGQ PCR Kit or using whole-exome sequencing. IDH1/2 mutations were detected in 87% (20/23) of dedifferentiated chondrosarcomas and 30% (6/20) of conventional chondrosarcomas. No mutations were detected in the IDH1/2 codon 132 or codon 172 among 14 UPSs of bone. Identification of IDH1 or IDH2 mutations supports the diagnosis of dedifferentiated chondrosarcoma rather than UPS of bone while also providing some insight into the pathogenesis of these 2 lesions.
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Affiliation(s)
- Shaoxiong Chen
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Karen Fritchie
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Shi Wei
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Naser Ali
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Kendra Curless
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tiansheng Shen
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anna T Brini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Farida Latif
- Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom
| | - Vaiyapuri Sumathi
- Department of Musculoskeletal Pathology, The Royal Orthopaedic Hospital, Birmingham B15 2TT, United Kingdom
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Liang Cheng
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
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44
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Li R, Zhang K, Siegal GP, Wei S. Clinicopathological factors associated with survival in patients with breast cancer brain metastasis. Hum Pathol 2017; 64:53-60. [PMID: 28428107 DOI: 10.1016/j.humpath.2017.03.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/17/2017] [Accepted: 03/30/2017] [Indexed: 11/29/2022]
Abstract
Brain metastasis from breast cancer generally represents a catastrophic event yet demonstrates substantial biological heterogeneity. There have been limited studies solely focusing on the prognosis of patients with such metastasis. In this study, we carried out a comprehensive analysis in 108 consecutive patients with breast cancer brain metastases between 1997 and 2012 to further define clinicopathological factors associated with early onset of brain metastasis and survival outcomes after development of them. We found that lobular carcinoma, higher clinical stages at diagnosis, and lack of coexisting bone metastasis were significantly associated with a worse brain relapse-free survival when compared with brain-only metastasis. High histologic grade, triple-negative breast cancer, and absence of visceral involvement were unfavorable prognostic factors after brain metastasis. Furthermore, high histologic grade, advanced tumor stages, and lack of coexisting bone involvement indicated a worse overall survival. Thus, the previously established prognostic factors in early stage or advanced breast cancers may not entirely apply to patients with brain metastases. Furthermore, the prognostic significance of the clinicopathological factors differed before and after a patient develops brain metastasis. This knowledge might help in establishing an algorithm to further stratify patients with breast cancer into prognostically significant categories for optimal prevention, screening, and treatment of their brain metastasis.
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Affiliation(s)
- Rong Li
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Kui Zhang
- Department of Mathematical Sciences, Michigan Technological University, Houghton, MI 49931, USA
| | - Gene P Siegal
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249, USA
| | - Shi Wei
- Department of Pathology, the University of Alabama at Birmingham, Birmingham, AL 35249, USA.
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Hensel JA, Khattar V, Ashton R, Lee C, Siegal GP, Ponnazhagan S. Location of tumor affects local and distant immune cell type and number. Immun Inflamm Dis 2017; 5:85-94. [PMID: 28250928 PMCID: PMC5322166 DOI: 10.1002/iid3.144] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 11/15/2016] [Accepted: 11/18/2016] [Indexed: 01/09/2023]
Abstract
Introduction Tumors comprise heterogeneous populations of cells, including immune infiltrates that polarize during growth and metastasis. Our preclinical studies on breast cancer (BCa) identified functional differences in myeloid‐derived suppressor cells based on tumor microenvironment (TME), prompting variations in host immune response to tumor growth, and dissemination based on tissue type. Methods In order to understand if such variations existed among other immune cells, and if such alteration occurs in response to tumor growth at the primary site or due to bone dissemination, we characterized immune cells, examining localized growth and in the tibia. In addition, immune cells from the spleen were examined from animals of both tumor locations by flow cytometry. Results The study demonstrates that location of tumor, and not simply the tumor itself, has a definitive role in regulating immune effectors. Among all immune cells characterized, macrophages were decreased and myeloid dendritic cell were increased in both tumor locations. This difference was more evident in subcutaneous tumors. Additionally, spleens from mice with subcutaneous tumors contained greater increases in both macrophages and myeloid dendritic cells than in mice with bone tumors. Furthermore, in subcutaneous tumors there was an increase in CD4+ and CD8+ T‐cell numbers, which was also observed in their spleens. Conclusions These data indicate that alterations in tumor‐reactive immune cells are more pronounced at the primary site, and exert a similar change at the major secondary lymphoid organ than in the bone TME. These findings could provide translational insight into designing therapeutic strategies that account for location of metastatic foci.
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Affiliation(s)
- Jonathan A Hensel
- Department of Pathology University of Alabama at Birmingham Birmingham Alabama USA
| | - Vinayak Khattar
- Department of Pathology University of Alabama at Birmingham Birmingham Alabama USA
| | - Reading Ashton
- Department of Pathology University of Alabama at Birmingham Birmingham Alabama USA
| | - Carnellia Lee
- Department of Pathology University of Alabama at Birmingham Birmingham Alabama USA
| | - Gene P Siegal
- Department of Pathology University of Alabama at Birmingham Birmingham Alabama USA
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Shen T, Siegal GP, Wei S. Clinicopathologic factors associated with de novo metastatic breast cancer. Pathol Res Pract 2016; 212:1167-1173. [DOI: 10.1016/j.prp.2016.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 08/26/2016] [Accepted: 09/12/2016] [Indexed: 10/21/2022]
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Ma YR, Siegal GP, Wei S. Reacquisition of E-cadherin expression in metastatic deposits of signet-ring cell carcinoma of the upper gastrointestinal system: a potential anchor for metastatic deposition. J Clin Pathol 2016; 70:528-532. [PMID: 27864451 DOI: 10.1136/jclinpath-2016-203959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 06/20/2016] [Revised: 10/18/2016] [Accepted: 10/27/2016] [Indexed: 01/06/2023]
Abstract
AIMS To examine the expression of E-cadherin in paired primary and metastatic signet-ring cell carcinomas (SRCC) of various organ systems in order to explore the potential role of the molecule in metastatic dissemination of this unique tumour type. METHODS Thirty-seven consecutive cases of SRCC from various organs with paired primary and metastatic tumorous tissue available were retrieved. The intensity of membranous E-cadherin expression was semiquantitatively scored on a scale of 0-3+. RESULTS Reduced E-cadherin expression was a distinct feature of primary SRCC and was observed in 78% of primary tumours. Interestingly, the E-cadherin reduction was less frequently seen in metastatic SRCC when compared with their primary counterparts, and was only found in 57% of tumours in lymph node metastases or at distant sites of relapse. Furthermore, the mean score of E-cadherin expression of primary SRCC was significantly lower than that of their metastatic counterparts (2.3 vs 1.8; p=0.008). When divided by organ systems, the reacquisition of E-cadherin expression in the metastatic deposits was most remarkable in the SRCC of upper gastrointestinal tract origin (2.3 vs 1.4; p=0.003), whereas no significant difference was observed in other organ systems. CONCLUSIONS While the reduction of E-cadherin in primary SRCC supports its pivotal role in epithelial-mesenchymal transition, a process crucial in tumour progression and metastatic dissemination, the re-expression of this molecule in metastatic SRCC cells implies a reversal to their epithelial phenotype (thus mesenchymal-epithelial transition) which, in turn, theoretically helps tumour cells to anchor and form cohesive metastatic deposits.
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Affiliation(s)
- Yihong R Ma
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Shi Wei
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Kropp L, Siegal GP, Frampton GM, Rodriguez MG, McKee S, Conry RM. Primary Intraosseous Smooth Muscle Tumor of Uncertain Malignant Potential: Original Report and Molecular Characterization. Rare Tumors 2016; 8:6507. [PMID: 27994831 PMCID: PMC5136771 DOI: 10.4081/rt.2016.6507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/21/2016] [Revised: 07/22/2016] [Accepted: 07/26/2016] [Indexed: 11/29/2022] Open
Abstract
We report the first case of primary intraosseous smooth muscle tumor of uncertain malignant potential (STUMP) which is analogous to borderline malignant uterine smooth muscle tumors so designated. The tumor presented in the femur of an otherwise healthy 30-year-old woman. Over a 3-year period, the patient underwent 11 biopsies or resections and 2 cytologic procedures. Multiple pathologists reviewed the histologic material including musculoskeletal pathologists but could not reach a definitive diagnosis. However, metastases eventually developed and were rapidly progressive and responsive to gemcitabine and docetaxel. Molecular characterization and ultrastructural analysis was consistent with smooth muscle origin, and amplification of unmutated chromosome 12p and 12q segments appears to be the major genomic driver of this tumor. Primary intraosseous STUMP is thought to be genetically related to leiomyosarcoma of bone, but likely representing an earlier stage of carcinogenesis. Wide excision and aggressive follow-up is warranted for this potentially life-threatening neoplasm.
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Affiliation(s)
- Lauren Kropp
- Department of Radiation Oncology and Anatomic Pathology, University of Alabama at Birmingham , AL
| | - Gene P Siegal
- Department of Anatomic Pathology, University of Alabama at Birmingham , AL
| | | | - Michael G Rodriguez
- Department of Radiology and Hematology Oncology, University of Alabama at Birmingham , AL, USA
| | - Svetlana McKee
- Division of Hematology Oncology, University of Alabama at Birmingham , AL, USA
| | - Robert M Conry
- Division of Hematology Oncology, University of Alabama at Birmingham , AL, USA
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Ketcham CM, Umezawa A, Zou H, Siegal GP. Laboratory Investigation web focus on China. J Transl Med 2016; 96:1144-1146. [PMID: 27777411 DOI: 10.1038/labinvest.2016.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The vast growth of China's publishing output is a reflection of the increasing strength of Chinese science. The editors of Laboratory Investigation (LI) present a collection of papers that showcases research by authors from institutions across China, highlighting the significant contributions of Chinese scientists to the journal.
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Affiliation(s)
| | - Akihiro Umezawa
- Department of Reproductive Biology, National Institute for Child Health and Development, Tokyo, Japan
| | - Hejian Zou
- Division of Rheumatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Gene P Siegal
- Department of Pathology, The University of Alabama at Birmingham, Birmingham, AL, USA
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Abstract
OBJECTIVES To analyze the expression of E-cadherin and β-catenin in triple-negative breast cancer (TNBC) to assess their prognostic significance. METHODS The expression of E-cadherin and β-catenin was examined semiquantitatively and correlated with other pathologic factors and survival outcomes. RESULTS Of 72 consecutive TNBCs, 56% showed reduced membranous expression of E-cadherin or β-catenin, with a strong correlation to each other. Of the clinicopathologic factors analyzed, tumor size and nodal status were significantly associated with overall survival and disease-specific survival, while the latter remained an independent factor by multivariate analysis. Reduced E-cadherin and β-catenin were both significantly associated with a poor overall survival and disease-specific survival by univariate and multivariate analyses. CONCLUSIONS E-cadherin and β-catenin expression provides discriminative prognostic power independent of conventional pathologic factors, thus further reinforcing the important role of cell adhesion molecules in the process of tumor metastasis, especially in TNBC.
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Affiliation(s)
- Tiansheng Shen
- From the Department of Pathology, the University of Alabama at Birmingham
| | - Kui Zhang
- Department of Mathematical Sciences, Michigan Technological University, Houghton
| | - Gene P Siegal
- From the Department of Pathology, the University of Alabama at Birmingham
| | - Shi Wei
- From the Department of Pathology, the University of Alabama at Birmingham
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