1
|
Doytcheva K, Storozuk T, Tjota M, Antic T. Oncocytoma-Like Angiomyolipoma of the Kidney: A Closer Look into the Clinicopathologic, Immunohistochemical, and Molecular Characteristics of a Rare Entity with Review of the Literature. Int J Surg Pathol 2024; 32:625-631. [PMID: 37487196 DOI: 10.1177/10668969231186925] [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: 07/26/2023]
Abstract
Introduction. Angiomyolipoma (AML) is a mesenchymal neoplasm that belongs to the perivascular epithelioid cell tumor family (PEComa). AMLs can be subtyped into several patterns dependent on cell type, morphology, and tissue composition. One of the patterns, oncocytoma-like AML is a rare entity with only three cases published in the literature. Case presentation. We present a case of a previously healthy 29-year-old woman who underwent a left partial nephrectomy secondary to a 4.6 cm heterogeneous renal neoplasm. Gross examination demonstrated a well-circumscribed renal mass. Modified Giemsa stain preparation showed oncocytic cells in syncytial pattern with ample granular cytoplasm and round nuclei with prominent nucleoli. Histology assessment showed an oncocytic neoplasm with interspersed adipose tissue. The tumor exhibited tubular architecture with the tubules lined by eosinophilic epithelioid cells with nuclear atypia and prominent nucleoli. Thick blood vessels with emanating epithelioid cells were present. High-grade histology features were not identified. The tumor cells were positive for HMB-45 and SMA and negative for PAX8, keratins, KIT, and vimentin. A diagnosis of oncocytoma-like AML was rendered. Next-generation sequencing (NGS) and RNA fusion were performed. NGS revealed no pathogenic variants and RNA fusion identified no rearrangements. Chromosomal copy number alterations were present in the long arm of chromosome 1 (1p) and chromosome 22. Conclusions. We describe and discuss the clinical, cytomorphologic, histologic, and molecular findings of oncocytoma-like AML, a rare renal neoplasm, and provide a review of the literature.
Collapse
Affiliation(s)
| | - Tanner Storozuk
- Department of Pathology, The University of Chicago, Chicago, IL, USA
| | - Melissa Tjota
- Department of Pathology, The University of Chicago, Chicago, IL, USA
| | - Tatjana Antic
- Department of Pathology, The University of Chicago, Chicago, IL, USA
| |
Collapse
|
2
|
Mendoza RP, Doytcheva K, Ud Dean M, Jorgenson KM, Choi D, Segal J, Wang P, Lastra RR. Whole exome sequencing of placental chorangioma. Placenta 2024; 149:13-17. [PMID: 38484495 DOI: 10.1016/j.placenta.2024.03.003] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/06/2024] [Accepted: 03/07/2024] [Indexed: 04/07/2024]
Abstract
INTRODUCTION Placental chorangioma is a benign non-trophoblastic vascular proliferation of the placental chorion favored to represent hamartoma-like or hyperplastic capillary lesions. As the exact pathophysiology has not been established, we investigated the molecular characteristics of placental chorangiomas using exploratory whole exome sequencing. METHODS Three cases were retrospectively selected and whole exome sequencing was performed on macrodissected lesions. DNA extraction, DNA quantification, library preparation and sequencing were performed with IDT xGen™ Exome Hybridization Panel v2 for library capture. Sequencing data was analyzed with an in-house bioinformatics pipeline for single-nucleotide variants and insertions/deletions. RESULTS All neonates were delivered at term and had birth weights ranging from 11th-35th percentile for gestational age. All mothers presented with hypertensive disorder during pregnancy. Chorangiomas ranged from 0.7 cm to 5.1 cm and were well-circumscribed near the fetal surface. Case 1 showed a background of chorangiosis and acute subchorionitis, while case 2 had foci of chronic lymphocytic villitis. Whole exome sequencing did not reveal any significant pathologic variants. DISCUSSIONS The absence of molecular alteration in placental chorangioma is likely indicative of the reactive/non-neoplastic nature of this lesion. The presence of compromised blood flow in the form of hypertensive disorders in our cases may be one of its underlying pathophysiologic mechanisms.
Collapse
Affiliation(s)
- Rachelle P Mendoza
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Kristina Doytcheva
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA
| | - Minhaz Ud Dean
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA
| | - Kyla M Jorgenson
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Donghyuk Choi
- Department of Pathology, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Jeremy Segal
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA
| | - Peng Wang
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA
| | - Ricardo R Lastra
- Department of Pathology, University of Chicago Medical Center, Chicago, IL, 60637, USA.
| |
Collapse
|
3
|
Doytcheva K, Gallan AJ, Wang P, Wanjari P, Segal J, Antic T. Cystic MED15::TFE3 translocation renal cell carcinoma: histologic mimicker of multilocular cystic renal neoplasm of low malignant potential with review of the literature☆, ☆ ☆. Hum Pathol 2023; 136:25-33. [PMID: 36997032 DOI: 10.1016/j.humpath.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/15/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023]
Abstract
Presented are four cystic renal masses which harbored a MED15::TFE3 gene fusion detected by RNAseq, mimicking multilocular cystic neoplasm of low malignant potential. Clinicopathologic and outcomes data were collected for all cases. Radiologically, three cases were diagnosed as complex cystic masses and one case as a renal cyst, three years prior to surgery. The tumors ranged in size from 1.8 to 14.5 cm. Grossly, all masses were extensively cystic. Microscopically, cells with a clear or minimally granular cytoplasm and nuclei with inconspicuous nucleoli lined the cysts' septa. Focally, small mass-forming aggregates of malignant cells were present between septae and were associated with psammomatous calcifications. In case one, apparent prior cyst wall rupture was associated with reactive changes and cystic spaces filled with fibrin clots. Two of the tumors were staged as T1a, one as T1b, and the other as T2b. By immunohistochemistry, the tumors were positive for TFE3, MelanA, and P504S, with apical CD10 while CAIX and CK7 were negative. RNA sequencing was performed on all cases revealing a MED15::TFE3 gene fusion. The patients were alive and without evidence of disease 11-49 months (mean 29.5) after partial nephrectomy. To date, 12 of the 15 MED15::TFE3 fusion renal cell carcinomas published in the literature are cystic, with three being extensively cystic. Thus, if a multilocular cystic renal neoplasm is encountered in a kidney specimen, translocation renal cell carcinoma should be included in the differential diagnosis as cystic MED15::TFE3 tRCCs carry an uncertain prognosis making recognition for future characterization necessary.
Collapse
|
5
|
Howells L, Thomas KS, Sears AV, Nasr I, Wollenberg A, Schuttelaar MLA, Romeijn GLE, Paller AS, Mueller K, Doytcheva K, Kataoka Y, Daguze J, Barbarot S, von Kobyletzki LB, Beckman L, Ratib S, Cowdell F, Santer M, Chalmers JR. Defining and measuring 'eczema control': an international qualitative study to explore the views of those living with and treating atopic eczema. J Eur Acad Dermatol Venereol 2019; 33:1124-1132. [PMID: 30720903 PMCID: PMC6594222 DOI: 10.1111/jdv.15475] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 12/19/2018] [Indexed: 11/30/2022]
Abstract
Background Atopic eczema (also known as eczema) is a chronic, inflammatory skin condition that often afflicts patients’ health and well‐being. The Harmonising Outcome Measures for Eczema (HOME) initiative recommends that ‘long‐term control of eczema’ is measured in all clinical trials 3 months or longer in duration. However, little has been published on what eczema control means to those living with or treating atopic eczema. Objectives To (i) develop understanding of what eczema control means to patients, carers and clinicians and (ii) explore the feasibility and acceptability of different ways of measuring eczema control in the long term. Methods Online focus groups explored patients/carers experiences in the UK, the United States, the Netherlands, France, Sweden and Japan, and an international online survey gathered views of clinicians. The framework method was used to analyse the focus groups, and thematic analysis was used to analyse survey data. All findings were integrated into a theoretical framework to create overarching themes that cut across these diverse groups. Results Eight focus groups with patients (16 years+) and eight groups with carers of children took place (N = 97). Sixty‐two people took part in the survey. Eczema control was described as a multifaceted construct involving changes in disease activity, the treatment and management of the condition and psychological, social and physical functioning. Patient/carer measurement allows personal accounts and frequent measurement, whilst clinician measurement was deemed less subjective. The burden on patients/carers and issues for analysing and interpreting data should be considered. Conclusions This study formed the basis of judging the content validity and feasibility of measurement instruments/methods to assess control of eczema in clinical trials. This online approach to an international qualitative study is an example of how core outcome set developers with limited resources can engage with multiple stakeholder groups on an international basis to inform consensus meeting discussions.
Collapse
Affiliation(s)
- L Howells
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - K S Thomas
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - A V Sears
- St John's Institute of Dermatology, Guy's and St Thomas' NHS Foundation Trust, London, UK.,School of Immunology and Microbial Sciences, King's College London, London, UK
| | | | - A Wollenberg
- Department of Dermatology and Allergy, Ludwig Maximilian University, Munich, Germany.,Klinik Thalkirchner Straße, Munich, Germany
| | - M L A Schuttelaar
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - G L E Romeijn
- Department of Dermatology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - A S Paller
- Department of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - K Mueller
- Department of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - K Doytcheva
- Department of Dermatology and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Y Kataoka
- Department of Dermatology, Osaka Habikino Medical Center, Osaka, Japan
| | - J Daguze
- Department of Dermatology, CHU Nantes, Nantes, France
| | - S Barbarot
- Department of Dermatology, CHU Nantes, Nantes, France
| | | | - L Beckman
- Department of Public Health Science, Karlstad University, Karlstad, Sweden
| | - S Ratib
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | - F Cowdell
- Faculty of Health, Education and Life Sciences, Birmingham City University, Birmingham, UK
| | - M Santer
- Primary Care and Population Sciences, University of Southampton, Southampton, UK
| | - J R Chalmers
- Centre of Evidence Based Dermatology, University of Nottingham, Nottingham, UK
| | | |
Collapse
|
6
|
Brunner P, He H, Czarnowicki T, Huynh T, Mueller K, Doytcheva K, Suarez-Farinas M, Krueger J, Paller A, Guttman-Yassky E. 642 The serum proteomic signature of pediatric AD suggests early Th2/Th17 skewing and an inverse correlation of disease severity with Th1 markers. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.664] [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: 10/19/2022]
|