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Arcovito G, Crucitta S, Del Re M, Caporalini C, Palomba A, Nozzoli F, Franchi A. Recurrent USP6 rearrangement in a subset of atypical myofibroblastic tumours of the soft tissues: low-grade myofibroblastic sarcoma or atypical/malignant nodular fasciitis? Histopathology 2024. [PMID: 38651320 DOI: 10.1111/his.15196] [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: 02/11/2024] [Revised: 03/24/2024] [Accepted: 04/06/2024] [Indexed: 04/25/2024]
Abstract
AIMS Low-grade myofibroblastic sarcoma (LGMS) is a rarely metastasizing myofibroblastic tumour mostly affecting extremities and the head and neck of adults. Histologically, it shows long infiltrative fascicles of spindle cells with moderate nuclear atypia. By immunohistochemistry, it stains positive for smooth muscle actin (SMA) and sometimes for desmin. To date, no recurrent genetic abnormalities have been described. Ubiquitin-specific peptidase 6 (USP6) gene rearrangement is typically found in some benign bone and soft-tissue tumours including nodular fasciitis (NF), among others. Nevertheless, rare cases of USP6-rearranged tumours resembling NF with atypical features have been reported. METHODS AND RESULTS One index case of LGMS of the deltoid in a 56-year-old man presented the THBS2::USP6 translocation by RNA sequencing (Archer FusionPlex Sarcoma v2 panel). Further screening of 11 cases of LGMS using fluorescent in situ hybridization (FISH) analysis with a USP6 break-apart probe identified two additional cases. These cases were investigated with RNA-sequencing, and a RRBP1::USP6 translocation was detected in one. The other case was not assessable because of low-quality RNA. Noteworthy, rearranged LGMSs presented distinctive features including variable multinodular/plexiform architecture, prominent vasculature with occasional wall thickening, scattered osteoclast-like multinucleated giant cells, and peripheral lymphoid aggregates. CONCLUSION Our findings support the notion that among soft-tissue neoplasms with fibroblastic/myofibroblastic phenotype, USP6 rearrangement is not limited to benign tumours, and warrants further investigation of genetic changes in myofibroblastic sarcomas.
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Affiliation(s)
- Giorgia Arcovito
- Section of Pathology, Department of Translational Research, University of Pisa, Pisa, Italy
| | - Stefania Crucitta
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marzia Del Re
- Unit of Clinical Pharmacology and Pharmacogenetics, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Annarita Palomba
- Unit of Histopathology and Molecular Diagnostic, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Filippo Nozzoli
- Department of Health Sciences, University of Florence, Florence, Italy
| | - Alessandro Franchi
- Section of Pathology, Department of Translational Research, University of Pisa, Pisa, Italy
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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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3
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Zhang Q, Guo C, Liu L, Li Y. miR-148b-3p suppresses the proliferation and migration of Schwann cells by targeting USP6 following sciatic nerve injury. Neurol Res 2023; 45:1035-1043. [PMID: 37702221 DOI: 10.1080/01616412.2023.2257413] [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: 07/25/2022] [Accepted: 06/05/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND Peripheral nerve injury is a common disorder associated with damaged axons and distal myelin sheath degeneration, and Schwann cells play a paramount role in peripheral nerve regeneration. This study aims to explore the role of microRNA miR-148b-3p on Schwann cells after peripheral nerve injury. METHODS Sciatic nerve transection was conducted in rat as the model of peripheral nerve injury. The expression level of miR-148b-3p and Ubiquitin Specific Peptidase 6 (USP6) was detected by qRT-PCR and Western blot at diverse time points after nerve transection. Cell migration and proliferation were determined in primary Schwann cells isolated from rat. The functional interaction of miR-148b-3p and USP6 mRNA was validated by dual-luciferase reporter assay. RESULTS In the animal model of sciatic nerve injury, miR-148b-3p expression level in the proximal nerve stump showed downregulation after nerve transection procedure, while USP6 expression level was elevated. The overexpression of miR-148b-3p inhibited the proliferation and migration of primary Schwann cells, while suppressing miR-148b-3p showed the opposite effect. USP6 mRNA was identified as a target of miR-148b-3p, which was found to mediate the effect of miR-148b-3p. USP6 silencing suppressed the migration and proliferation in primary Schwann cells. CONCLUSION Our data demonstrated the functional role of miR-148b-3p/USP6 axis in regulating the migration and proliferation of Schwann cells following peripheral nerve injury. miR-148b-3p showed downregulation and its target USP6 was upregulated after nerve transection procedure. Targeting miR-148b-3p/USP6 axis may provide a novel opportunity for peripheral nerve repair.
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Affiliation(s)
- Qin Zhang
- Department of Rehabilitation, The First People's Hospital of Jingmen, Jingmen, Hubei, China
| | - Chengkun Guo
- Department of Rehabilitation, The First People's Hospital of Jingmen, Jingmen, Hubei, China
| | - Lijuan Liu
- Department of Rehabilitation, The First People's Hospital of Jingmen, Jingmen, Hubei, China
| | - Yang Li
- Department of Rehabilitation, The First People's Hospital of Jingmen, Jingmen, Hubei, China
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Broski SM, Wenger DE. Multimodality imaging features of USP6-associated neoplasms. Skeletal Radiol 2023; 52:297-313. [PMID: 35962835 DOI: 10.1007/s00256-022-04146-x] [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] [Received: 02/15/2022] [Revised: 06/16/2022] [Accepted: 06/27/2022] [Indexed: 02/02/2023]
Abstract
Since the discovery of USP6 gene rearrangements in aneurysmal bone cysts nearly 20 years ago, we have come to recognize that there is a family of USP6-driven mesenchymal neoplasms with overlapping clinical, morphologic, and imaging features. This family of neoplasms now includes myositis ossificans, aneurysmal bone cyst, nodular fasciitis, fibroma of tendon sheath, fibro-osseous pseudotumor of digits, and their associated variants. While generally benign and in many cases self-limiting, these lesions may undergo rapid growth, and be confused with malignant bone and soft tissue lesions, both clinically and on imaging. The purpose of this article is to review the imaging characteristics of the spectrum of USP6-driven neoplasms, highlight key features that allow distinction from malignant bone or soft tissue lesions, and discuss the role of imaging and molecular analysis in diagnosis.
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Affiliation(s)
- Stephen M Broski
- Department of Radiology, Mayo Clinic, Charlton Building North, 1st Floor, 200 First Street SW , Rochester, MN, 55905, USA.
| | - Doris E Wenger
- Department of Radiology, Mayo Clinic, Charlton Building North, 1st Floor, 200 First Street SW , Rochester, MN, 55905, USA
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Wang C, Wang W, Xu R, Xiang J. Case report: Large-size intramuscular nodular fasciitis, a challenging histopathologic diagnosis confirmed by molecular detection of USP6 gene rearrangement: Case report and literature review. Pathol Oncol Res 2023; 29:1610785. [PMID: 36741963 PMCID: PMC9894875 DOI: 10.3389/pore.2023.1610785] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/11/2023] [Indexed: 01/21/2023]
Abstract
The intramuscular subtype of nodular fasciitis (NF) is rare with lesions normally not more than 2 cm in size and characterized by pseudosarcomatous morphology. We report a case of a 27-year-old man with a large-size intramuscular NF. The patient came for treatment complaining of an increasingly enlarged mass in the left upper arm for 4 months. Magnetic resonance imaging (MRI) confirmed the presence of a well-defined tumor measuring 5 cm within the outer edge of the middle humerus. Microscopically, the neoplasm was rich in fibroblasts and myofibroblasts in an interlaced pattern with high mitotic index and evident multinuclear giant cells. Erythrocyte extravasation was easily seen in the stroma. The tumor border was infiltrative. Immunohistochemically, the tumor cells were positive for smooth muscle actin (SMA) and negative for cytokeratin, desmin, H-Caldesmon, CD34, S100, ALK, and β-catenin. Fibrosarcoma was highly suspected by histopathological and immunohistochemical examination. Molecular detection demonstrated evidence of ubiquitin-specific peptidase 6 (USP6) gene rearrangement in this tumor. Based on the findings, the tumor was diagnosed as intramuscular NF. At 56 months after the initial surgery, the patient had recovered with no evidence of recurrence or metastasis. Large-size intramuscular NF is very rare and easily overdiagnosed as malignant tumor due to its obvious pseudosarcomatoid pathological features. USP6 gene rearrangement detection can effectively avoid this major misdiagnosis.
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Imada H, Torigoe T, Yazawa Y, Kanno S, Ichikawa J, Yamaguchi T, Kawasaki T. Case Report: Extraskeletal osteosarcoma with preceding myositis ossificans. Front Oncol 2023; 13:1024768. [PMID: 36910624 PMCID: PMC9999043 DOI: 10.3389/fonc.2023.1024768] [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: 08/24/2022] [Accepted: 02/13/2023] [Indexed: 02/26/2023] Open
Abstract
Extraskeletal osteosarcoma (EO) is a soft tissue sarcoma characterized by the production of bone matrix by neoplastic cells. Benign osteoid in EO, leading to a diagnostic dilemma, is rarely encountered. Herein, for the first time, we present a case with cytogenetically confirmed EO combined with or preceding myositis ossificans (MO). A 21-year-old man had a mildly painful swelling in his left knee. Imaging studies demonstrated a 39-mm mass with peripheral mineralization and cystic change on the posterolateral side of the left fibular head. He was clinically suspected of having either MO or a malignancy, such that wide resection was performed. Macroscopically, the mass was grayish to brown. In the cut section, multiple cystic lesions in addition to solid components were noted. Histopathologically, the solid components demonstrated diffuse proliferation of pleomorphic tumor cells with osteoclast-like giant cells. The malignant tumor cells formed osteoid. In the periphery, the mass was benign, showing mature bone tissue and focally non-malignant woven bone with fibroblasts, compatible with zonation. Fluorescence in situ hybridization (FISH) demonstrated split signals of the USP6 gene. These findings suggested EO with preceding MO. Although the pathogenesis remains to be elucidated, the observed USP6 rearrangement might contribute to both the diagnosis of EO with preceding MO and an understanding of the underlying histopathology.
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Affiliation(s)
- Hiroki Imada
- Department of Pathology, Saitama Medical University Saitama Medical Center, Kawagoe, Japan
| | - Tomoaki Torigoe
- Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Yasuo Yazawa
- Department of Orthopaedic Oncology and Surgery, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Satoshi Kanno
- Department of Pathology, Saitama Medical University International Medical Center, Hidaka, Japan
| | - Jiro Ichikawa
- Department of Orthopedic Surgery, Graduate School of Medical Science, University of Yamanashi, Chuo, Japan
| | - Takehiko Yamaguchi
- Department of Pathology, Dokkyo Medical University Nikko Medical Center, Nikko, Japan
| | - Tomonori Kawasaki
- Department of Pathology, Saitama Medical University International Medical Center, Hidaka, Japan
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Lambert WA, Angelo S, Bookland MJ, Tessema B, Balarezo F, Hersh DS. Solid-variant aneurysmal bone cysts in the craniofacial skeleton: the role of genomic analysis. Childs Nerv Syst 2022; 38:1615-9. [PMID: 35102523 DOI: 10.1007/s00381-022-05447-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 01/06/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Solid variant aneurysmal bone cysts (SVABCs) are a rare but well-described subtype of ABCs. While classic ABCs are readily identified radiographically, SVABCs lack these characteristic radiographic features and thus have a wide differential diagnosis on presentation (including Ewing sarcoma, Langerhans cell histiocytosis, osteosarcoma, metastasis, and giant cell tumor). Genomic/molecular analyses are often necessary for the diagnosis of SVABCs, with USP6 rearrangements being a characteristic finding. We present two cases in which genomic analysis was critical in the diagnosis of SVABCs and revealed unique gene fusions that may provide insight into SVABC pathogenesis. CASE DESCRIPTIONS Two 13-year old male children presented to our institution with new mass lesions involving the craniofacial skeleton. Magnetic resonance imaging (MRI) in both cases revealed predominantly solid, avidly enhancing masses, one of the squamous portion of the temporal bone, and the other arising from the sphenopalatine foramen with extension into the ipsilateral maxillary and ethmoid sinuses. Histopathology displayed predominantly solid morphology, and next generation sequencing (NGS) revealed a FAT1-USP6 gene fusion in the temporal lesion, and a MIR22HG-USP6 gene fusion in the maxillofacial lesion, the latter of which was not identified on fluorescence in situ hybridization (FISH). These findings were most consistent with a diagnosis of SVABC in each case. CONCLUSIONS These two cases highlight novel gene fusions in atypically located SVABCs and emphasize the ability of NGS to more accurately and consistently identify USP6 gene fusions, particularly in SVABCs that may otherwise be indistinguishable from alternative pathologies.
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Khoshnoodi P, John I, Naous R. Synchronous polyostotic solid variant of aneurysmal bone cyst involving thoracic vertebrae and harboring a novel AHNAK::USP6 gene fusion. A case report and review. Virchows Arch 2022; 481:805-809. [PMID: 35717456 DOI: 10.1007/s00428-022-03362-z] [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: 02/11/2022] [Revised: 06/10/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
Aneurysmal bone cyst (ABC) is a benign bone neoplasm that usually affects the metaphysis of long bones and the posterior elements of vertebral bodies. The rearrangement of USP6 gene is present in most of primary ABC cases. Synchronous polyostotic presentation is extremely rare. All of the eight reported cases in literature have a classic ABC histomorphology, including dilated-blood filled cystic spaces separated by fibrous septa and composed of variably cellular bland fibroblasts with scattered osteoclast-like giant cells and reactive new bone formation. Herein, we report a case of a 29-year-old female with a synchronous polyostotic solid variant of ABC involving her T7-T11 posterior elements of her thoracic vertebrae with a novel AHNAK::USP6 fusion, detected by next-generation sequencing (NGS). This case is distinguished by its synchronous polyostotic presentation, solid rather than classic ABC morphology and novel AHNAK::USP6 fusion, which has not been previously reported in ABC or in any mesenchymal bone tumor.
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Affiliation(s)
- Pooria Khoshnoodi
- Department of Pathology, University of Pittsburgh Medical Center, UPMC Presbyterian Shadyside, Pittsburgh, PA, USA.
| | - Ivy John
- Department of Pathology, University of Pittsburgh Medical Center, UPMC Presbyterian Shadyside, Pittsburgh, PA, USA
| | - Rana Naous
- Department of Pathology, University of Pittsburgh Medical Center, UPMC Presbyterian Shadyside, Pittsburgh, PA, USA
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Malik F, Bernieh A, El Jamal SM, Saad AG. Cranial Fasciitis in Children: Expanding the Spectrum of USP6-Associated Clonal Transient Neoplasms. Pediatr Dev Pathol 2022; 25:304-315. [PMID: 35686345 DOI: 10.1177/10935266211063989] [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: 11/15/2022]
Abstract
Background: Cranial fasciitis (CF) is a benign (myo)fibroblastic proliferation of children. Typical presentation consists of a rapidly growing solitary mass on the temporal or parietal cranium in the first 2 years of age. CF is characterized by a rapid growth followed by a relative slowdown and even growth arrest. The finding of somatic USP6 gene rearrangements demonstrating clonality in CF together with its clinical behavior places it in the category of diseases recently termed "transient neoplasia."Methods: Histological, immunohistochemical, and molecular findings of 18 patients with CF were retrospectively studied.Results: The tumor typically presented as a painless rapidly enlarging mass in the temporal region. Sixty-six percent of the cases harbored USP6 gene rearrangement. Nine patients were treated with gross total resection (GTR) and 9 with subtotal tumor resection (STR). Two patients treated with GTR had recurrence. Five patients treated with STR had progression-free disease for at least 10 months after surgery and in four patients the tumor regressed spontaneously a median 16 months after surgery.Conclusions: In this largest series to date, we reported the clinicopathological, immunohistochemical, and molecular findings of 18 pediatric cases of CF with emphasis on the clinical growth pattern of these tumors.
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Affiliation(s)
- Faizan Malik
- Department of Pathology and Laboratory Medicine, 12326University of Tennessee Health Science Center, Memphis, TN, USA
| | - Anas Bernieh
- Division of Pathology, 2518Cincinnati Children's Hospital, Cincinnati, OH, USA
| | - Siraj M El Jamal
- Department of Pathology, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ali G Saad
- Department of Pathology, 12235University of Miami Miller School of Medicine, Miami, FL, USA
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10
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Han Y, Yang X, Tang L, Wang P, Zhang J, Ge W, Ni X. Primary Aneurysmal Bone Cyst of Nasal Cavity and Sinuses in a Child: Case Report and Literature Review. Ear Nose Throat J 2022; 102:231-238. [PMID: 35428416 DOI: 10.1177/01455613221081569] [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: 11/16/2022] Open
Abstract
INTRODUCTION Aneurysmal bone cysts (ABCs) are a rare benign bone lesion, which are divided into primary and secondary categories, and occur mainly in the vertebra and the long tubular bones. Primary ABCs in the nasal cavity and the sinuses are rare. CASE PRESENTATION We reported on a one-year-old boy who suffered from progressive nasal obstruction and intermittent nosebleeds over a period of approximately 1 month. The patient had no history of trauma or surgery. Physical examination showed a red tumor in his right nasal cavity. A magnetic resonance imaging scan showed a multicystic lesion arising from the ethmoid sinus. The lesion was resected under a nasal endoscope without any complications. Histological evaluation confirmed that the lesion was an aneurysmal bone cyst. Because an osteoma was found during the surgery on the cyst, the lesion was considered secondary clinically. However, fluorescence in situ hybridization testing showed a rearrangement of the USP6 (ubiquitin-specific protease 6) oncogene on chromosome 17. No recurrence was observed after 1 year. CONCLUSION An ABC of the nasal cavity and sinuses in such a young child is very rare and needs to be further analyzed according to postoperative pathology and combined with a genetic examination to make a diagnosis. Endoscopic sinus surgery is an effective method of treatment for this kind of disease.
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Affiliation(s)
- Yang Han
- Department of Otolaryngology, Head and Neck Surgery, 117984Beijing Children's Hospital, Capital Medical University, China
| | - Xiaojian Yang
- Department of Otolaryngology, Head and Neck Surgery, 117984Beijing Children's Hospital, Capital Medical University, China
| | - Lixing Tang
- Department of Otolaryngology, Head and Neck Surgery, 117984Beijing Children's Hospital, Capital Medical University, China
| | - Pengpeng Wang
- Department of Otolaryngology, Head and Neck Surgery, 117984Beijing Children's Hospital, Capital Medical University, China
| | - Jie Zhang
- Department of Otolaryngology, Head and Neck Surgery, 117984Beijing Children's Hospital, Capital Medical University, China
| | - Wentong Ge
- Department of Otolaryngology, Head and Neck Surgery, 117984Beijing Children's Hospital, Capital Medical University, China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, 117984Beijing Children's Hospital, Capital Medical University, China
| | - Xin Ni
- Department of Otolaryngology, Head and Neck Surgery, 117984Beijing Children's Hospital, Capital Medical University, China.,Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, 117984Beijing Children's Hospital, Capital Medical University, China
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11
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Sennett R, Friedlander S, Tucker S, Hinds B, Hightower G. USP6 rearrangement in pediatric nodular fasciitis. J Cutan Pathol 2022; 49:743-746. [PMID: 35362105 DOI: 10.1111/cup.14237] [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: 09/06/2021] [Revised: 02/24/2022] [Accepted: 03/27/2022] [Indexed: 11/30/2022]
Abstract
Nodular fasciitis (NF) is a myofibroblastic proliferation that uncommonly presents in pediatric patients. These benign neoplasms can masquerade as more insidious sarcomatous proliferations on both clinical exam and initial histopathologic review, often prompting undue concern in patients, parents and providers. While immunohistochemical analysis of NF can be variable, adding to the diagnostic uncertainty, molecular analysis documenting ubiquitin-specific protease 6 (USP6) gene rearrangement can help confirm the diagnosis as an association between NF and USP6 overexpression was first identified 10 years ago in an analysis that found rearrangements of the involved locus in over 90% of studied samples.1 In this report, we review one case of nodular fasciitis located on the chin of a 9-year-old in which molecular testing was essential to secure the correct diagnosis, and provide a summary of documented cases of USP6 overexpression in transient pediatric neoplasms. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Rachel Sennett
- Department of Dermatology, University of California San Diego, La Jolla, CA
| | - Sheila Friedlander
- Departments of Pediatrics and Dermatology, Rady Children's Hospital, San Diego, CA
| | - Suzanne Tucker
- Department of Pathology, Rady Children's Hospital, San Diego, CA
| | - Brian Hinds
- Department of Dermatology, University of California San Diego, La Jolla, CA
| | - George Hightower
- Departments of Pediatrics and Dermatology, Rady Children's Hospital, San Diego, CA
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Eisenberg JM, Buckwalter V JA, Snow AN, Davick J. Cellular Fibroma of Tendon Sheath With Novel TNC-USP6 Gene Fusion Clinically Mimicking Arthritis in a 7-Year-Old Boy. Pediatr Dev Pathol 2022; 25:192-196. [PMID: 34520696 DOI: 10.1177/10935266211043869] [Citation(s) in RCA: 2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cellular fibroma of tendon sheath (CFTS) is a rare, benign myofibroblastic neoplasm of tenosynovial soft tissues closely resembling nodular fasciitis (NF), but is histomorphologically distinct from classic fibroma of tendon sheath (FTS). We report a case of a pediatric patient with thumb swelling clinically concerning for arthritis with a biopsy demonstrating myofibroblastic proliferation with features consistent with NF/CFTS, and molecular studies confirming the presence of a USP6 gene fusion (TNC-USP6). This case highlights a unique clinical presentation of CFTS in a pediatric patient mimicking an inflammatory or reactive/non-neoplastic musculoskeletal disorder and the increasingly crucial role of molecular testing to differentiate a reactive myofibroblastic process from a neoplasm. Moreover, this report identifies TNC as a new fusion partner to USP6 fusion partner adding to our growing understanding of the USP6-rearranged family of tumors.
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Affiliation(s)
- Joshua M Eisenberg
- Department of Orthopedics and Rehabilitation, University of Iowa, Iowa City, Iowa
| | | | - Anthony N Snow
- Department of Pathology, University of Iowa, Iowa City, Iowa
| | - Jonathan Davick
- Department of Pathology, University of Iowa, Iowa City, Iowa
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13
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Papke DJ, Bredella MA, Lozano-Calderon S, Oliveira AM, Lennerz J, Nielsen GP. Aneurysmal bone cyst with an unusual clinical presentation and a novel VDR- USP6 fusion. Genes Chromosomes Cancer 2021; 60:833-836. [PMID: 34369017 DOI: 10.1002/gcc.22989] [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: 05/07/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/06/2022] Open
Abstract
Aneurysmal bone cyst is a benign bone neoplasm that most commonly arises from the metaphyses of long bones in the first and second decades of life. Here, we describe a case of an aneurysmal bone cyst that occurred in the distal tibial diaphysis of a 72-year-old female that was concerning for malignancy on imaging, demonstrating cortical breakthrough and soft tissue extension. Histologically, the tumor showed the characteristic morphologic features of aneurysmal bone cyst. Fluorescence in situ hybridization was positive for USP6 rearrangement, and RNA sequencing revealed a USP6 gene fusion with VDR, a novel partner that encodes the vitamin D receptor and that has not been implicated previously in human neoplasia. This case highlights the diagnostic challenges presented by aneurysmal bone cyst in elderly adults, and it expands the genetic spectrum of USP6 rearrangements.
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Affiliation(s)
- David J Papke
- Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Miriam A Bredella
- Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | | | - Andre M Oliveira
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jochen Lennerz
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - G Petur Nielsen
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
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14
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Papke DJ Jr, Oliveira AM, Chou MM, Fletcher CDM. Morphologically malignant nodular fasciitis with CALD1- USP6 fusion. Virchows Arch 2021. [PMID: 34213575 DOI: 10.1007/s00428-021-03149-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/23/2021] [Accepted: 06/25/2021] [Indexed: 10/20/2022]
Abstract
Nodular fasciitis is a benign myofibroblastic neoplasm that characteristically enlarges rapidly and then usually regresses spontaneously. While the vast majority of tumors are benign, there are rare reports of morphologically benign nodular fasciitis giving rise to metastases, not predictable on histologic grounds. Here, we report what we believe is an example of morphologically malignant nodular fasciitis, which occurred in the upper extremity of a 7-year-old male. The tumor was composed of short, intersecting fascicles of myofibroblastic cells in a loose myxoid matrix, with keloidal hyalinization and admixed osteoclastic giant cells, all characteristic of nodular fasciitis. However, it additionally exhibited striking nuclear pleomorphism, a feature not compatible with conventional nodular fasciitis. Fluorescence in situ hybridization demonstrated a USP6 translocation, confirmed by next-generation sequencing to be the novel CALD1-USP6 fusion. No other somatic or germline mutations were detected. This case adds to the expanding morphologic and molecular genetic spectrum of nodular fasciitis.
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15
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Pižem J, Šekoranja D, Matjašič A, Zupan A, Boštjančič E, Limpel Novak KA, Salapura V, Mavčič B, Gazič B, Dimnik K. The role of molecular diagnostics in aneurysmal and simple bone cysts - a prospective analysis of 19 lesions. Virchows Arch 2021. [PMID: 34089379 DOI: 10.1007/s00428-021-03130-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 05/23/2021] [Accepted: 05/28/2021] [Indexed: 10/21/2022]
Abstract
Aneurysmal (ABC) and simple bone cysts (SBC) have been traditionally distinguished by radiological and histopathological features. However, there is some radiological and histopathological overlap between ABC and SBC. ABC is characterised by USP6 fusions while, recently, NFATC2 fusions have been found in a large proportion of SBC. Identifying these fusions may assist in confirming the diagnosis of either ABC or SBC. To elaborate the potential benefit of molecular testing, we report a prospective series of 19 consecutive bone cysts with comprehensive radiological, histopathological and molecular diagnostics. Integrating radiological, histopathological and molecular findings, 11 cysts were diagnosed as SBC and 8 as ABC. Radiologically, 6 of 11 SBC and 6 of 8 ABC were diagnosed as ABC. Fibrin-like collagen deposits were identified in 8 of 11 (73%) SBC and 3 of 8 (38%) ABC. Nodular fasciitis-like areas were identified in 6 of 8 (75%) ABC and in 7 of 11 (64%) SBC. A USP6 fusion was identified in all 8 ABC, including a novel RBM5-USP6 fusion. An NFATC2 fusion was found in 7 of 11 SBC (FUS-NFATC2 fusion in 5 and EWSR1-NFATC2 in 2 cases). There is radiological and histopathological overlap between SBC and ABC in a significant proportion of cases. A diagnosis of ABC is frequently suggested radiologically in SBC, and fibrin-like deposits, thought to be specific for SBC, may be found in some ABC. Molecular testing may significantly improve diagnostic accuracy in bone cysts.
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16
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Panagopoulos I, Gorunova L, Andersen K, Lobmaier I, Lund-Iversen M, Micci F, Heim S. Fusion of the Lumican ( LUM) Gene With the Ubiquitin Specific Peptidase 6 ( USP6) Gene in an Aneurysmal Bone Cyst Carrying a t(12;17)(q21;p13) Chromosome Translocation. Cancer Genomics Proteomics 2021; 17:555-561. [PMID: 32859633 DOI: 10.21873/cgp.20211] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 04/23/2020] [Revised: 05/25/2020] [Accepted: 06/01/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/AIM Aneurysmal bone cyst is a benign bone lesion with a strong tendency to recur. The rearrangement of chromosome band 17p13/USP6 gene is now considered a characteristic genetic feature of aneurysmal bone cyst, with t(16;17)(q22;p13)/CDH11-USP6 as the most frequent chromosomal aberration/fusion gene. We report a novel variant translocation leading to a new fusion gene in an aneurysmal bone cyst. MATERIALS AND METHODS Genetic analyses were performed on an aneurysmal bone cyst found in the tibia of a child. RESULTS G-banding chromosome analysis yielded the karyotype 46,XX,t(12;17)(q21;p13)[5]/46,XX[2]. FISH analysis with a USP6 break-apart probe showed rearrangement of USP6. RNA sequencing detected LUM-USP6 and USP6-LUM fusion transcripts which were subsequently verified by RT-PCR/Sanger sequencing. The two genes exchanged 5'- non-coding exons. Thus, promoter swapping between USP6 and LUM had taken place. CONCLUSION We report a novel t(12;17)(q21;p13) chromosome translocation which gave rise to a LUM-USP6 fusion in an aneurysmal bone cyst.
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Affiliation(s)
- Ioannis Panagopoulos
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, the Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Ludmila Gorunova
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, the Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Kristin Andersen
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, the Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | | | | | - Francesca Micci
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, the Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - Sverre Heim
- Section for Cancer Cytogenetics, Institute for Cancer Genetics and Informatics, the Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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17
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Nakayama S, Nishio J, Aoki M, Koga K, Nabeshima K, Yamamoto T. Ubiquitin-specific Peptidase 6 ( USP6)-associated Fibroblastic/Myofibroblastic Tumors: Evolving Concepts. Cancer Genomics Proteomics 2021; 18:93-101. [PMID: 33608306 DOI: 10.21873/cgp.20244] [Citation(s) in RCA: 15] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 01/17/2021] [Accepted: 01/18/2021] [Indexed: 12/28/2022] Open
Abstract
Ubiquitin-specific peptidase 6 (USP6) is a hominoid-specific gene residing on chromosome 17p13 and serves as a deubiquitinating enzyme with a diverse set of functions including intracellular trafficking, inflammatory signaling, cell transformation and protein turnover. USP6 rearrangements were first identified in aneurysmal bone cysts, resulting in promoter swapping and over-expression of wild type USP6. Several morphologically overlapping fibroblastic/myofibroblastic tumors are known to harbor USP6 rearrangements, including nodular fasciitis, cellular fibroma of tendon sheath, myositis ossificans and fibro-osseous pseudotumor of digits. Over the past few years, fusions involving the USP6 gene and various partner genes have been described in these neoplasms. The current World Health Organization Classification of Tumors of Soft Tissue suggests that USP6-rearranged lesions are typically benign and usually self-limited in their growth. This review provides an updated overview of the clinical, histological and molecular genetic features of USP6-associated fibroblastic/myofibroblastic tumors and discusses how these lesions should be best classified.
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Affiliation(s)
- Shizuhide Nakayama
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Jun Nishio
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan;
| | - Mikiko Aoki
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kaori Koga
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Kazuki Nabeshima
- Department of Pathology, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
| | - Takuaki Yamamoto
- Department of Orthopaedic Surgery, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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18
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Legrand M, Jourdan ML, Tallet A, Collin C, Audard V, Larousserie F, Aubert S, Gomez-Brouchet A, Bouvier C, de Pinieux G. Novel partners of USP6 gene in a spectrum of bone and soft tissue lesions. Virchows Arch 2021; 479:147-156. [PMID: 33558945 DOI: 10.1007/s00428-021-03047-z] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 01/10/2021] [Accepted: 01/28/2021] [Indexed: 12/16/2022]
Abstract
Nodular fasciitis, primary aneurysmal bone cyst, myositis ossificans, and their related lesions are benign tumors that share common histological features and a chromosomal rearrangement involving the ubiquitin-specific peptidase 6 (USP6) gene. The identification of an increasing number of new partners implicated in USP6 rearrangements demonstrates a complex tumorogenesis of this tumor spectrum. In this study on a series of 77 tumors (28 nodular fasciitis, 42 aneurysmal bone cysts, and 7 myositis ossificans) from the database of the French Sarcoma Group, we describe 7 new partners of the USP6 gene. For this purpose, rearrangements were first researched by multiplexed RT-qPCRs in the entire population. A targeted RNA sequencing was then used on samples selected according to a high USP6-transcription level expression estimated by RT-qPCR. Thanks to this multistep approach, besides the common USP6 fusions observed, we detected novel USP6 partners: PDLIM7 and MYL12A in nodular fasciitis and TPM4, DDX17, GTF2I, KLF3, and MEF2A in aneurysmal bone cysts. In order to try to bring to light the role played by the recently identified USP6 partners in this lesional spectrum, their functions are discussed. Taking into account that a traumatic participation has long been mentioned in the histogenesis of most of these lesions and because of their morphological resemblance to organizing granulation reparative tissue or callus, a focus is placed on their relationship with tissue remodeling and, to a lesser extent, with bone metabolism.
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Affiliation(s)
- Mélanie Legrand
- Service d'anatomie et cytologie pathologiques, CHRU de Tours, Avenue de la République, 37044 Cedex 9, Tours, France
| | - Marie-Lise Jourdan
- Plateforme de Génétique moléculaire des cancers, CHRU de Tours, Tours, France
| | - Anne Tallet
- Plateforme de Génétique moléculaire des cancers, CHRU de Tours, Tours, France
| | - Christine Collin
- Plateforme de Génétique moléculaire des cancers, CHRU de Tours, Tours, France
| | - Virginie Audard
- Service d'anatomie et cytologie pathologiques, Hôpital Cochin, Paris, France
| | | | - Sébastien Aubert
- Service d'anatomie et cytologie pathologiques, CHU de Lille, Lille, France
| | | | - Corinne Bouvier
- Service d'anatomie et cytologie pathologiques, CHU de Marseille La Timone, Marseille, France
| | - Gonzague de Pinieux
- Service d'anatomie et cytologie pathologiques, CHRU de Tours, Avenue de la République, 37044 Cedex 9, Tours, France. .,PRES Centre-Val de Loire Université, Université François-Rabelais de Tours, Tours, France.
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19
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Wang JC, Li WS, Kao YC, Lee JC, Lee PH, Huang SC, Tsai JW, Chen CC, Chang CD, Yu SC, Huang HY. Clinicopathological and molecular characterisation of USP6-rearranged soft tissue neoplasms: the evidence of genetic relatedness indicates an expanding family with variable bone-forming capacity. Histopathology 2020; 78:676-689. [PMID: 33000481 DOI: 10.1111/his.14268] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 01/20/2023]
Abstract
AIMS USP6 rearrangement underpins self-limiting fibroblastic/myofibroblastic neoplasms, including nodular fasciitis (NF), myositis ossificans (MO), aneurysmal bone cyst (ABC), and related variants. The aim of this study was to characterise UPS6 and fusion partners in order to delineate the clinicopathological, genetic and bone-forming features in such lesions of soft tissue (ST). METHODS AND RESULTS Break-apart fluorescence in-situ hybridisation (FISH) validated USP6 rearrangement in 31 of 35 NF [comprising three of three fasciitis ossificans (FO) cases, seven of eight cellular variant of fibroma of tendon sheath (C-FTS), four of six MO, three of three ST-ABC, and two of two fibro-osseous pseudotumours of digits (FOPD)]. As determined with FISH and reverse transcription polymerase chain reaction, MYH9-USP6 was the commonest fusion in four C-FTS and 20 NF, including one intravascular case and two infantile (one retroperitoneal) cases. The presence of MYH9-USP6 confirmed the diagnosis of two NFs> 50 mm with prominent ischaemic necrosis. COL1A1-USP6 was predominant in ossifying lesions, including all FO, MO, ST-ABC and FOPD with identified partner genes, and was also present in non-ossifying head and neck NF (HN-NF) and C-FTS in two cases each. A cervical NF of a 14-month-old girl harboured the novel COL1A2-USP6. Ossifying lesions showed considerable genetic and morphological overlaps. Sharing COL1A1-USP6, FO and FOPD showed similar central or haphazard bone matrix deposition. Besides zonation of outward bone maturation, four COL1A1-USP6-positive MO had incipient to sieve-like pseudocysts reminiscent of ST-ABC. CONCLUSION MYH9-USP6 is present in some C-FTS and most NF, including rare variants, but is unrelated to bone formation. All bone-forming USP6-rearranged lesions adopt COL1A1 as the 5' partner, indicating close genetic kinships. However, COL1A1/COL1A2 also contributes to the pathogenesis of minor subsets of non-ossifying USP6-rearranged HN-NF and C-FTS.
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Affiliation(s)
- Jui-Chu Wang
- Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Department of Medical Laboratory Science and Biotechnology, School of Medical and Health Sciences, Fooyin University, Kaohsiung, Taiwan
| | - Wan-Shan Li
- Department of Pathology, Chi-Mei Medical Centre, Tainan, Taiwan.,Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Yu-Chien Kao
- Department of Pathology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Jen-Chieh Lee
- Department and Graduate Institute of Pathology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Pei-Hang Lee
- Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shih-Chiang Huang
- Department of Anatomical Pathology, Linkou Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jen-Wei Tsai
- Department of Pathology, E-DA Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation, Chia-Yi Christian Hospital, Chia-Yi, Taiwan.,Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
| | - Ching-Di Chang
- Department of Radiology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shih-Chen Yu
- Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hsuan-Ying Huang
- Department of Anatomical Pathology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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20
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Malik F, Wang L, Yu Z, Edelman MC, Miles L, Clay MR, Hedges D, Brennan RC, Nichols KE, Beth McCarville M, Bahrami A. Benign infiltrative myofibroblastic neoplasms of childhood with USP6 gene rearrangement. Histopathology 2020; 77:760-768. [PMID: 32583473 DOI: 10.1111/his.14182] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 06/10/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022]
Abstract
AIMS Several morphologically overlapping (myo)fibroblastic neoplasms harbour USP6 fusions, including aneurysmal bone cysts, nodular fasciitis, myositis ossificans, cranial fasciitis, fibro-osseous pseudotumour of the digits, and cellular fibroma of the tendon sheath. USP6-induced neoplasms are almost universally benign and cured by local excision. We aim to highlight the diagnostic value of USP6 fusion detection in a series of aggressive-appearing paediatric myofibroblastic tumours. METHODS AND RESULTS Three deep-seated, radiographically aggressive, and rapidly growing childhood myofibroblastic neoplasms were morphologically and molecularly characterised by USP6 break-apart fluorescence in-situ hybridisation (FISH), transcriptome sequencing, and targeted capture analysis. Each tumour occurred in the lower-extremity deep soft tissue of a child presenting with pain, limping, or a mass. In all three patients, imaging studies showed a solid mass that infiltrated into surrounding skeletal muscle or involved/eroded underlying bone. The biopsied tumours consisted of variably cellular myofibroblastic proliferations with variable mitotic activity that lacked overt malignant cytological features. FISH showed that all tumours had USP6 rearrangements. On the basis of these results, all three patients were treated with conservative excision with positive margins. The excised tumours had foci resembling nodular fasciitis, fibromatosis, and pseudosarcomatous proliferation. Next-generation sequencing revealed COL1A1-USP6 fusions in two tumours and a COL3A1-USP6 fusion in the third tumour. One tumour had a subclonal somatic APC in-frame deletion. No recurrence was observed during follow-up (8-40 months). CONCLUSION We present a series of benign, but aggressive-appearing, USP6-rearranged myofibroblastic tumours. These deep-seated tumours had concerning clinical and radiographic presentations and did not fit into one distinct histological category. These cases highlight the diagnostic value of USP6 fusion detection to identify benign nondescript tumours of this group, especially those with aggressive features, to avoid overtreatment.
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Affiliation(s)
- Faizan Malik
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Lu Wang
- Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Zhongxin Yu
- Department of Pathology, University of Oklahoma Health Science Center, Oklahoma City, OK, USA
| | - Morris C Edelman
- Department of Pathology, Northwell Health, New Hyde Park, NY, USA
| | - Lili Miles
- Department of Pathology and Laboratory Medicine, Nemours Children's Hospital, Orlando, FL, USA
| | - Michael R Clay
- Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Dale Hedges
- Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Rachel C Brennan
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Kim E Nichols
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - M Beth McCarville
- Department of Diagnostic Imaging, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Armita Bahrami
- Department of Pathology and Laboratory Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Pathology, St Jude Children's Research Hospital, Memphis, TN, USA.,Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
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21
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Hiemcke-Jiwa LS, van Gorp JM, Fisher C, Creytens D, van Diest PJ, Flucke U. USP6-Associated Neoplasms: A Rapidly Expanding Family of Lesions. Int J Surg Pathol 2020; 28:816-825. [PMID: 32635781 DOI: 10.1177/1066896920938878] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [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: 12/20/2022]
Abstract
Nearly 20 years ago, the first description of a translocation involving chromosome 17 on which USP6 resides was described. Since then, not only the culprit gene but also many fusion partners, leading to transcriptional activation of USP6, have been detected. The first neoplasm known to harbor USP6 rearrangements was aneurysmal bone cyst. Since then, other entities like nodular fasciitis, myositis ossificans, fibro-osseous pseudotumor of digits, and a subgroup of fibromas of tendon sheath, probably representing tenosynovial nodular fasciitis, have been added to the list of USP6-rearranged lesions. Remarkably, all of them share clinical as well as morphological characteristics, and authors have suggested that these entities actually belong to the same spectrum. This review summarizes the current knowledge regarding USP6-rearranged lesions and further elaborates on how these neoplasms relate to one another. We propose to call these lesions UAN (Usp6-associated neoplasm).
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Affiliation(s)
- Laura S Hiemcke-Jiwa
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Utrecht University Hospital, Utrecht, The Netherlands
| | | | - Cyril Fisher
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - David Creytens
- Ghent University and Ghent University Hospital, Ghent, Belgium
| | | | - Uta Flucke
- Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Radboud University Medical Center, Nijmegen, The Netherlands
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22
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Jebastin Thangaiah J, Vickery J, Selwanes W, Al-Haddad E, Perry KD, Palanisamy N, Poulik JM, Williamson SR, Chitale DA, Shehata BM. A Novel COL1A1-CAMTA1 Rearrangement in Cranial Fasciitis. Int J Surg Pathol 2020; 28:678-682. [PMID: 32192385 DOI: 10.1177/1066896920912485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/15/2022]
Abstract
Cranial fasciitis is an uncommon benign fibroblastic tumor, generally histologically identical to nodular fasciitis. It develops almost exclusively in children. Cranial fasciitis manifests clinically as a painless rapidly growing solitary nodule in the head and neck area, frequently eroding the underlying bone. Thus, this entity is often confused with aggressive lesions such as sarcomas, both clinically and radiologically. Histopathologic examination is essential to differentiate between cranial fasciitis and fibrohistiocytic or even sarcomatous lesions observed in children. In this article, we present a case of cranial fasciitis with intracranial extension in a 2-year-old boy. Although USP6 rearrangement has recently been recognized as a recurring alteration in nodular fasciitis, we present a novel COL1A1-CAMTA1 fusion in this lesion.
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Affiliation(s)
| | | | | | | | | | | | | | - Sean R Williamson
- Henry Ford Health System, Detroit, MI, USA.,Wayne State University, Detroit, MI, USA
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23
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Igrec J, Brčić I, Igrec R, Bergovec M, Kashofer K, Fuchsjäger M, Leithner A, Liegl-Atzwanger B. Intraarticular Nodular Fasciitis of the Knee With MHY9-USP6 Fusion: A Case Report. Int J Surg Pathol 2020; 28:672-677. [PMID: 32089028 DOI: 10.1177/1066896920908054] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 11/16/2022]
Abstract
Background. Nodular fasciitis (NF) is a self-limiting, benign mesenchymal neoplasm of fibroblastic/myofibroblastic origin. Due to the fast growth, cellularity, and frequently observed high mitotic count, it is commonly misdiagnosed as a sarcoma, often resulting in overtreatment. Intraarticular examples of NF are extremely rare. Radiologically, NF can mimic fibroma of the tendon sheath, tenosynovial giant cell tumor, and synovial chondromatosis. Histology can vary from hypercellular, mitotically active lesions to fibrotic, less cellular ones, and can, therefore, mimic other benign and low-grade malignant neoplasms. Recently, the MYH9-USP6 fusion has been found in up to 92% of NF. Case Presentation. In this article, we report a case of a 38-year-old patient with an intraarticular lesion, radiologically suspicious of tenosynovial giant cell tumor. Histology demonstrated a spindle cell lesion composed of fibroblasts/myofibroblasts embedded in a highly collagenous/hyalinized stroma, partly arranged in short fascicles. Extravasated erythrocytes and rare mitotic figures were present. Immunohistochemically, tumor cells expressed smooth muscle actin and were negative for desmin, β-catenin, CD34, and SOX10. These findings rendered the diagnosis of NF. Molecular analysis using next-generation sequencing (Archer FusionPlex Sarcoma Panel) revealed gene rearrangement involving USP6 and MYH9 supporting the diagnosis of NF in the knee joint. Conclusions. Radiological and histological features of NF can overlap with other benign and low-grade malignant lesion. Identification of the USP6 gene rearrangements or finding of the MYH9-USP6 fusion, especially in core needle biopsies and in the lesions occurring at unusual sites, can result in adequate therapeutic approach avoiding overtreatment.
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Affiliation(s)
- Jasminka Igrec
- Division of General Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Iva Brčić
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Renato Igrec
- Department of Orthopedics and Trauma, Medical University of Graz, Graz, Austria
| | - Marko Bergovec
- Department of Orthopedics and Trauma, Medical University of Graz, Graz, Austria
| | - Karl Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Michael Fuchsjäger
- Division of General Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
| | - Andreas Leithner
- Department of Orthopedics and Trauma, Medical University of Graz, Graz, Austria
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24
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Song W, Suurmeijer AJH, Bollen SM, Cleton-Jansen AM, Bovée JVMG, Kroon HM. Soft tissue aneurysmal bone cyst: six new cases with imaging details, molecular pathology, and review of the literature. Skeletal Radiol 2019; 48:1059-67. [PMID: 30603771 DOI: 10.1007/s00256-018-3135-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/28/2018] [Accepted: 12/10/2018] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Aneurysmal bone cysts (ABC) rarely present in soft tissue locations (STABC). The 30 cases of STABC reported in the English literature were reviewed. Six new cases retrieved from the files of the Netherlands Committee on Bone Tumors were compared to the six cases described in the radiological literature. MATERIALS AND METHODS Imaging studies and histopathology of six new STABC cases were reviewed. Follow-up was recorded with respect to local recurrence. FISH for USP6 rearrangement and/or anchored multiplex PCR-based targeted NGS using Archer FusionPlex Sarcoma Panel were attempted. RESULTS On imaging, the six STABC cases presented as a solid or multicystic intramuscular soft tissue mass, usually with thin peripheral mineralized bone shell. On MRI, perilesional edema was visualized in nearly all cases. Fluid-fluid levels were observed in one case. All lesions had the distinct histologic features of STABC. In three cases suitable for NGS, the diagnosis of STABC was confirmed by a COL1A1-USP6 fusion gene. In one additional case, USP6 gene rearrangement was detected by FISH. After marginal excision, none of the six STABC recurred after a mean follow-up period of 50 months (range, 39-187 months). CONCLUSIONS On imaging, it can be difficult to discriminate between STABC and myositis ossificans. The presence of a thin bony shell and fluid-fluid levels can be helpful in discriminating these two entities. STABC is readily diagnosed after histopathologic examination of the resection specimen. STABC belongs to the spectrum of tumors with USP6 rearrangements, which includes ABC, myositis ossificans, and nodular fasciitis.
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Salib C, Edelman M, Lilly J, Fantasia JE, Yancoskie AE. USP6 Gene Rearrangement by FISH Analysis in Cranial Fasciitis: A Report of Three Cases. Head Neck Pathol 2020; 14:257-61. [PMID: 30758758 DOI: 10.1007/s12105-019-01018-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/28/2019] [Indexed: 01/06/2023]
Abstract
Cranial fasciitis (CF) is an uncommon benign myofibroblastic proliferation involving the soft and hard tissues of the cranium. It typically occurs in the pediatric population with a male predilection (male-to-female ratio 1.5:1). The clinical presentation is usually a rapidly expanding, painless nodule. Bone erosion may be appreciated radiographically. Histopathologic sections of CF show plump, fibroblast-like cells with pale, oval shaped nuclei and prominent nucleoli in a fibrous or myxoid background. Growth is self-limited and surgical excision is considered curative. Due to these features, CF is thought to be a variant of nodular fasciitis (NF). As with NF, CF may mimic a sarcomatous process and pose a diagnostic challenge to clinicians and pathologists alike. Erickson-Johnson et al. identified rearrangements of the ubiquitin-specific protease 6 (USP6) gene in 44 of 48 cases of NF. MYH9 was the fusion partner in 12 of these cases. To date, the molecular profile of CF has not been studied. Here we present the molecular findings in three cases of CF identified at our institution. Each case was subjected to fluorescence in-situ hybridization with appropriate negative controls. Two of three cases were positive for the USP6 gene rearrangement. The third case failed to hybridize, likely related to nucleic acid damage secondary to decalcification. Negative controls did not demonstrate the genetic rearrangement. These findings warrant further investigation of the USP6 gene rearrangement in CF, as it may prove helpful as a diagnostic adjunct in challenging cases.
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Zeng H, Yuan F, Mi Y, Xian G, Qin C, Zhang D. As an independent prognostic factor, USP6 promotes the invasion and metastasis of colon cancer. Biochem Biophys Res Commun 2018; 505:816-822. [PMID: 30297112 DOI: 10.1016/j.bbrc.2018.08.168] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [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: 07/25/2018] [Revised: 08/16/2018] [Accepted: 08/27/2018] [Indexed: 11/29/2022]
Abstract
The lack of efficient tumor invasion and metastatic biomarkers led to high mortality rates in colon cancer patients. Aberrant expression of ubiquitin-specific protease 6 (USP6) was involved in several diseases including cancer, while its role in the progression of colon cancer was still unclear. In this study, USP6 was evaluated at both mRNA and protein levels by using RT-PCR, western blot and immunohistochemistry staining analyses. The results revealed that high USP6 expression predicted poor disease-specific survival and overall survival through Kaplan-Meier analyses with log-rank tests, univariate and multivariate Cox analyses. Furthermore, cell function assay demonstrated that USP6 could promote colon cancer cells' invasion in vitro and liver metastasis in vivo. These findings indicated that high USP6 expression contributed to the progression of colon cancer and USP6 may be a valuable prognostic factor in patients with colon cancer.
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Affiliation(s)
- Hong Zeng
- Department of Critical Care Medicine, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Fukang Yuan
- Department of Vascular Surgery of XuZhou Central Hospital, XuZhou Institute of Cardiovascular Disease, 199 Jiefang Road, Xuzhou, 221009, Jiangsu, China.
| | - Yushuai Mi
- Department of General Surgery, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
| | - Guozhe Xian
- Department of General Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China
| | - Chengyong Qin
- Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong, China.
| | - Dongyuan Zhang
- Department of General Surgery, Qianfoshan Hospital, Shandong University, Jinan 250014, Shandong, China.
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Abstract
The maintenance of cell surface proteins is critical to the ability of a cell to sense and respond to information in its environment. As such, modulation of cell surface composition and receptor trafficking is a potentially important target of control in virus infection. Sorting endosomes (SEs) are control stations regulating the recycling or degradation of internalized plasma membrane proteins. Here we report that human cytomegalovirus (HCMV), a ubiquitous betaherpesvirus, alters the fate of internalized clathrin-independent endocytosis (CIE) cargo proteins, retaining them in virally reprogrammed SEs. We show that the small G protein ARF6 (ADP ribosylation factor 6), a regulator of CIE trafficking, is highly associated with SE membranes relative to uninfected cells. Combined with the observation of accumulated CIE cargo at the SE, these results suggest that infection diminishes the egress of ARF6 and its cargo from the SE. Expression of ubiquitin-specific protease 6 (USP6), also known as TRE17, was sufficient to restore ARF6 and some ARF6 cargo trafficking to the cell surface in infected cells. The USP activity of TRE17 was required to rescue both ARF6 and associated cargo from SE retention in infection. The finding that TRE17 expression does not rescue the trafficking of all CIE cargos retained at SEs in infection suggests that HCMV hijacks the normal sorting machinery and selectively sorts specific cargos into endocytic microdomains that are subject to alternative sorting fates. Cells maintain their surface composition, take up nutrients, and respond to their environment through the internalization and recycling of cargo at the cell surface through endocytic trafficking pathways. During infection with human cytomegalovirus (HCMV), host endocytic membranes are reorganized into a juxtanuclear structure associated with viral assembly and egress. Less appreciated is the effect of this reorganization on the trafficking of host proteins through the endocytic pathway. We show that HCMV retains internalized cargo and the effector of clathrin-independent endocytosis at sorting endosomes. The retention of some cargo, but not all, was reversed by overexpression of a ubiquitin-specific protease, TRE17. Our results demonstrate that HCMV induces profound reprogramming of endocytic trafficking and influences cargo sorting decisions. Further, our work suggests the presence of a novel ubiquitin-regulated checkpoint for the recycling of cargo from sorting endosome. These findings have important implications for host signaling and immune pathways in the context of HCMV infection.
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Li L, Yang H, He Y, Li T, Feng J, Chen W, Ao L, Shi X, Lin Y, Liu H, Zheng E, Lin Q, Bu J, Zeng Y, Zheng M, Xu Y, Liao Z, Lin J, Lin D. Ubiquitin-Specific Protease USP6 Regulates the Stability of the c-Jun Protein. Mol Cell Biol 2018; 38:e00320-17. [PMID: 29061731 DOI: 10.1128/MCB.00320-17] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/12/2017] [Indexed: 01/22/2023] Open
Abstract
The c-Jun gene encodes a transcription factor that has been implicated in many physiological and pathological processes. c-Jun is a highly unstable protein that is degraded through a ubiquitination/proteasome-dependent mechanism. However, the deubiquitinating enzyme (DUB) that regulates the stability of the c-Jun protein requires further investigation. Here, by screening a DUB expression library, we identified ubiquitin-specific protease 6 (USP6) and showed that it regulates the stability of the c-Jun protein in a manner depending on its enzyme activity. USP6 interacts with c-Jun and antagonizes its ubiquitination. USP6 overexpression upregulates the activity of the downstream signaling pathway mediated by c-Jun/AP-1 and promotes cell invasion. Moreover, many aberrant genes that are upregulated in USP6 translocated nodular fasciitis are great potential targets regulated by c-Jun. Based on our data, USP6 is an enzyme that deubiquitinates c-Jun and regulates its downstream cellular functions.
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Madan B, Walker MP, Young R, Quick L, Orgel KA, Ryan M, Gupta P, Henrich IC, Ferrer M, Marine S, Roberts BS, Arthur WT, Berndt JD, Oliveira AM, Moon RT, Virshup DM, Chou MM, Major MB. USP6 oncogene promotes Wnt signaling by deubiquitylating Frizzleds. Proc Natl Acad Sci U S A 2016; 113:E2945-54. [PMID: 27162353 DOI: 10.1073/pnas.1605691113] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The Wnt signaling pathways play pivotal roles in carcinogenesis. Modulation of the cell-surface abundance of Wnt receptors is emerging as an important mechanism for regulating sensitivity to Wnt ligands. Endocytosis and degradation of the Wnt receptors Frizzled (Fzd) and lipoprotein-related protein 6 (LRP6) are regulated by the E3 ubiquitin ligases zinc and ring finger 3 (ZNRF3) and ring finger protein 43 (RNF43), which are disrupted in cancer. In a genome-wide small interfering RNA screen, we identified the deubiquitylase ubiquitin-specific protease 6 (USP6) as a potent activator of Wnt signaling. USP6 enhances Wnt signaling by deubiquitylating Fzds, thereby increasing their cell-surface abundance. Chromosomal translocations in nodular fasciitis result in USP6 overexpression, leading to transcriptional activation of the Wnt/β-catenin pathway. Inhibition of Wnt signaling using Dickkopf-1 (DKK1) or a Porcupine (PORCN) inhibitor significantly decreased the growth of USP6-driven xenograft tumors, indicating that Wnt signaling is a key target of USP6 during tumorigenesis. Our study defines an additional route to ectopic Wnt pathway activation in human disease, and identifies a potential approach to modulate Wnt signaling for therapeutic benefit.
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Pichler Sekulic S, Sekulic M. Nodular fasciitis of the vulva: a challenging histopathologic diagnosis supported by the detection of USP6 gene rearrangement. APMIS 2016; 124:534-537. [PMID: 26991143 DOI: 10.1111/apm.12532] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 02/03/2016] [Indexed: 11/29/2022]
Abstract
Nodular fasciitis involving the vulva on physical examination can mimic a Bartholin gland lesion, and histologically can have overlapping features with more ominous mesenchymal pathologies. We describe a case in which a 52-year-old perimenopausal woman presents with a vulvar mass. After an initial biopsy and later excision, the myofibroblastic lesion was noted to have areas of differing cellularity, with compact nodule formations at the periphery. Immunohistochemical staining showed lesional cells to be positive for desmin, estrogen receptor, progesterone receptor, and smooth muscle actin, and negative for CD34, ALK-1, myogenin, caldesmon, S100, and wide spectrum (Oscar) cytokeratin. Desmin is generally negative in this lesion type, but the positivity in this case was considered to be secondary to the origin of the myofibroblastic cells of the vulva. The morphologic pattern and immunophenotype favored a diagnosis of nodular fasciitis, however, the degree of hypercellularity and desmin positivity warranted further analysis. The diagnosis was supported with fluorescence in situ hybridization that demonstrated USP6 gene rearrangement. This highlights the necessity in certain challenging cases for ancillary molecular and/or cytogenetic analysis.
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Affiliation(s)
- Simona Pichler Sekulic
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
| | - Miroslav Sekulic
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA
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Jacquot C, Szymanska J, Nemana LJ, Steinbach LS, Horvai AE. Soft-tissue aneurysmal bone cyst with translocation t(17;17)(p13;q21) corresponding to COL1A1 and USP6 loci. Skeletal Radiol 2015; 44:1695-9. [PMID: 26142538 DOI: 10.1007/s00256-015-2205-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [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: 05/14/2015] [Revised: 06/10/2015] [Accepted: 06/15/2015] [Indexed: 02/02/2023]
Abstract
We present the case of a 46-year-old woman with no significant past medical history who developed left mid-thigh pain and fullness. Imaging demonstrated a mineralized soft-tissue mass, which increased in size during a year of monitoring, but retained a circumscribed appearance. The mass was located in the medial soft tissues of the thigh, separate from the bone on imaging studies, and this finding was confirmed during excision. The mass showed gross and microscopic features of an aneurysmal bone cyst. This diagnosis was supported by cytogenetic analysis revealing a t(17;17)(p13;q21) translocation corresponding to the USP6 and COL1A1 loci. Soft-tissue aneurysmal bone cyst is a rare entity, with fewer than 25 reports in the literature. Limited cytogenetic information about these tumors is available. To our knowledge, the USP6 and COL1A1 rearrangement has only previously been described in a pediatric soft-tissue aneurysmal bone cyst. We also discuss the differential diagnosis of ossifying soft-tissue lesions.
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Affiliation(s)
- Cyril Jacquot
- Department of Pathology, University of California, San Francisco, CA, USA
| | - Jadwiga Szymanska
- Integrated Oncology, Laboratory Corporation of America® Holdings, Phoenix, AZ, USA
| | - Lakshmi J Nemana
- Integrated Oncology, Laboratory Corporation of America® Holdings, Phoenix, AZ, USA
| | - Lynne S Steinbach
- Departments of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Andrew E Horvai
- Department of Pathology, University of California, San Francisco, CA, USA. .,UCSF Medical Center at Mission Bay, 1825 4th Street, Room M2354, San Francisco, CA, 94158, USA.
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32
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Presneau N, Baumhoer D, Behjati S, Pillay N, Tarpey P, Campbell PJ, Jundt G, Hamoudi R, Wedge DC, Loo PV, Hassan AB, Khatri B, Ye H, Tirabosco R, Amary MF, Flanagan AM. Diagnostic value of H3F3A mutations in giant cell tumour of bone compared to osteoclast-rich mimics. J Pathol Clin Res 2015; 1:113-23. [PMID: 27499898 PMCID: PMC4858131 DOI: 10.1002/cjp2.13] [Citation(s) in RCA: 114] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 12/24/2014] [Indexed: 12/11/2022]
Abstract
Driver mutations in the two histone 3.3 (H3.3) genes, H3F3A and H3F3B, were recently identified by whole genome sequencing in 95% of chondroblastoma (CB) and by targeted gene sequencing in 92% of giant cell tumour of bone (GCT). Given the high prevalence of these driver mutations, it may be possible to utilise these alterations as diagnostic adjuncts in clinical practice. Here, we explored the spectrum of H3.3 mutations in a wide range and large number of bone tumours (n = 412) to determine if these alterations could be used to distinguish GCT from other osteoclast-rich tumours such as aneurysmal bone cyst, nonossifying fibroma, giant cell granuloma, and osteoclast-rich malignant bone tumours and others. In addition, we explored the driver landscape of GCT through whole genome, exome and targeted sequencing (14 gene panel). We found that H3.3 mutations, namely mutations of glycine 34 in H3F3A, occur in 96% of GCT. We did not find additional driver mutations in GCT, including mutations in IDH1, IDH2, USP6, TP53. The genomes of GCT exhibited few somatic mutations, akin to the picture seen in CB. Overall our observations suggest that the presence of H3F3A p.Gly34 mutations does not entirely exclude malignancy in osteoclast-rich tumours. However, H3F3A p.Gly34 mutations appear to be an almost essential feature of GCT that will aid pathological evaluation of bone tumours, especially when confronted with small needle core biopsies. In the absence of H3F3A p.Gly34 mutations, a diagnosis of GCT should be made with caution.
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Affiliation(s)
- Nadège Presneau
- UCL Cancer Institute, University College LondonHuntley StreetLondonUK; Sarah Cannon-University College London Advanced Diagnostics Molecular Profiling Research LaboratoriesUCL Cancer Institute, UCLLondonUK; Present address: Department of Biomedical SciencesFaculty of Science and TechnologyUniversity of WestminsterW1W 6UWUK
| | - Daniel Baumhoer
- Bone Tumour Reference Centre at the Institute of Pathology University Hospital Basel Basel Switzerland
| | - Sam Behjati
- Cancer Genome Project Wellcome Trust Sanger Institute Wellcome Trust Genome Campus Cambridgeshire UK
| | - Nischalan Pillay
- Department of Histopathology Royal National Orthopaedic Hospital NHS Trust Middlesex UK
| | - Patrick Tarpey
- Cancer Genome Project Wellcome Trust Sanger Institute Wellcome Trust Genome Campus Cambridgeshire UK
| | - Peter J Campbell
- Cancer Genome Project Wellcome Trust Sanger Institute Wellcome Trust Genome Campus Cambridgeshire UK
| | - Gernot Jundt
- Bone Tumour Reference Centre at the Institute of Pathology University Hospital Basel Basel Switzerland
| | - Rifat Hamoudi
- UCL Cancer Institute, University College LondonHuntley StreetLondonUK; Sarah Cannon-University College London Advanced Diagnostics Molecular Profiling Research LaboratoriesUCL Cancer Institute, UCLLondonUK; Present address: Division of Surgery and Interventional ScienceUniversity College LondonW1W 7EJUK
| | - David C Wedge
- Cancer Genome Project Wellcome Trust Sanger Institute Wellcome Trust Genome Campus Cambridgeshire UK
| | - Peter Van Loo
- Cancer Genome ProjectWellcome Trust Sanger InstituteWellcome Trust Genome CampusCambridgeshireUK; Department of Human GeneticsUniversity of LeuvenLeuvenBelgium
| | - A Bassim Hassan
- CR-UK Tumour Growth Group Oxford Molecular Pathology Institute Sir William Dunn School of Pathology University of Oxford Oxford UK
| | - Bhavisha Khatri
- Department of Histopathology Royal National Orthopaedic Hospital NHS Trust Middlesex UK
| | - Hongtao Ye
- Department of Histopathology Royal National Orthopaedic Hospital NHS Trust Middlesex UK
| | - Roberto Tirabosco
- Department of Histopathology Royal National Orthopaedic Hospital NHS Trust Middlesex UK
| | - M Fernanda Amary
- Department of Histopathology Royal National Orthopaedic Hospital NHS Trust Middlesex UK
| | - Adrienne M Flanagan
- UCL Cancer Institute, University College LondonHuntley StreetLondonUK; Sarah Cannon-University College London Advanced Diagnostics Molecular Profiling Research LaboratoriesUCL Cancer Institute, UCLLondonUK; Department of HistopathologyRoyal National Orthopaedic Hospital NHS TrustMiddlesexUK
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Funakoshi Y, Chou MM, Kanaho Y, Donaldson JG. TRE17/ USP6 regulates ubiquitylation and trafficking of cargo proteins that enter cells by clathrin-independent endocytosis. J Cell Sci 2014; 127:4750-61. [PMID: 25179595 DOI: 10.1242/jcs.156786] [Citation(s) in RCA: 16] [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] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Plasma membrane proteins that enter cells by clathrin-independent endocytosis (CIE) are sorted either to lysosomes for degradation or recycled back to the plasma membrane. Expression of some MARCH E3 ubiquitin ligases promotes trafficking of CIE cargo proteins to lysosomes by ubiquitylating the proteins. Here, we show that co-expression of the ubiquitin-specific protease TRE17/USP6 counteracts the MARCH-dependent targeting of CIE cargo proteins, but not that of transferrin receptor, to lysosomes, leading to recovery of the stability and cell surface level of the proteins. The ubiquitylation of CIE cargo proteins by MARCH8 was reversed by TRE17, suggesting that TRE17 leads to deubiquitylation of CIE cargo proteins. The effects of TRE17 were dependent on its deubiquitylating activity and expression of TRE17 alone led to a stabilization of surface major histocompatibility complex class I (MHCI) molecules, a CIE cargo, suggesting that deubiquitylation of endogenous CIE cargo proteins promotes their stability. This study demonstrates that cycles of ubiquitylation and deubiquitylation can determine whether CIE cargo proteins are degraded or recycled.
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Affiliation(s)
- Yuji Funakoshi
- Cell Biology & Physiology Center, NHLBI, NIH, Bethesda, MD 20891, USA Department of Physiological Chemistry, Faculty of Medicine and Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Ten-nodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Margaret M Chou
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, 3615 Civic Center Boulevard, Philadelphia, PA19104, USA
| | - Yasunori Kanaho
- Department of Physiological Chemistry, Faculty of Medicine and Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Ten-nodai, Tsukuba, Ibaraki 305-8575, Japan
| | - Julie G Donaldson
- Cell Biology & Physiology Center, NHLBI, NIH, Bethesda, MD 20891, USA
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Agaram NP, LeLoarer FV, Zhang L, Hwang S, Athanasian EA, Hameed M, Antonescu CR. USP6 gene rearrangements occur preferentially in giant cell reparative granulomas of the hands and feet but not in gnathic location. Hum Pathol 2014; 45:1147-52. [PMID: 24742829 DOI: 10.1016/j.humpath.2014.01.020] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Revised: 01/15/2014] [Accepted: 01/24/2014] [Indexed: 11/24/2022]
Abstract
Giant cell reparative granulomas (GCRGs) are lytic lesions that occur predominantly in the gnathic bones and occasionally in the small bones of the hands and feet. They are morphologically indistinguishable from, and are regarded as synonymous with, solid variant of aneurysmal bone cysts (ABC) in extragnathic sites. Identification of USP6 gene rearrangements in primary ABC has made possible investigating potential pathogenetic relationships with other morphologic mimics. USP6 gene alterations in giant cell-rich lesions (GCRG/ABC) of small bones of the hands and feet have not been previously studied. We investigated USP6 gene alterations in a group of 9 giant cell-rich lesions of the hands and feet and compared the findings with morphologically similar lesions including 8 gnathic GCRGs, 22 primary ABCs, 8 giant cell tumors of bone, and 2 brown tumors of hyperparathyroidism. Overall, there were 49 samples from 48 patients including 26 females and 22 males. Of the 9 lesions of the hands and feet, 8 (89%) showed USP6 gene rearrangements, whereas no abnormalities were identified in the 8 gnathic GCRGs, 2 brown tumors, or 8 giant cell tumors of bone. Of the 22 primary ABCs, 13 (59%) showed USP6 gene rearrangements. In conclusion, most GCRGs of the hands and feet represent true ABCs and should be classified as such. The terminology of GCRG should be limited to lesions from gnathic location. Fluorescence in situ hybridization for USP6 break-apart is a useful ancillary tool in the diagnosis of primary ABCs and distinguishing them from GCRGs and other morphologically similar lesions.
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Affiliation(s)
- Narasimhan P Agaram
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065.
| | - Francois V LeLoarer
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065
| | - Lei Zhang
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065
| | - Sinchun Hwang
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065
| | - Edward A Athanasian
- Department of Orthopedic Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, 10065
| | - Meera Hameed
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065
| | - Cristina R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065.
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Roberts JL, Hovanes K, Dasouki M, Manzardo AM, Butler MG. Chromosomal microarray analysis of consecutive individuals with autism spectrum disorders or learning disability presenting for genetic services. Gene 2014; 535:70-8. [PMID: 24188901 PMCID: PMC4423794 DOI: 10.1016/j.gene.2013.10.020] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Revised: 09/26/2013] [Accepted: 10/10/2013] [Indexed: 01/15/2023]
Abstract
Chromosomal microarray analysis is now commonly used in clinical practice to identify copy number variants (CNVs) in the human genome. We report our experience with the use of the 105 K and 180K oligonucleotide microarrays in 215 consecutive patients referred with either autism or autism spectrum disorders (ASD) or developmental delay/learning disability for genetic services at the University of Kansas Medical Center during the past 4 years (2009-2012). Of the 215 patients [140 males and 75 females (male/female ratio=1.87); 65 with ASD and 150 with learning disability], abnormal microarray results were seen in 45 individuals (21%) with a total of 49 CNVs. Of these findings, 32 represented a known diagnostic CNV contributing to the clinical presentation and 17 represented non-diagnostic CNVs (variants of unknown significance). Thirteen patients with ASD had a total of 14 CNVs, 6 CNVs recognized as diagnostic and 8 as non-diagnostic. The most common chromosome involved in the ASD group was chromosome 15. For those with a learning disability, 32 patients had a total of 35 CNVs. Twenty-six of the 35 CNVs were classified as a known diagnostic CNV, usually a deletion (n=20). Nine CNVs were classified as an unknown non-diagnostic CNV, usually a duplication (n=8). For the learning disability subgroup, chromosomes 2 and 22 were most involved. Thirteen out of 65 patients (20%) with ASD had a CNV compared with 32 out of 150 patients (21%) with a learning disability. The frequency of chromosomal microarray abnormalities compared by subject group or gender was not statistically different. A higher percentage of individuals with a learning disability had clinical findings of seizures, dysmorphic features and microcephaly, but not statistically significant. While both groups contained more males than females, a significantly higher percentage of males were present in the ASD group.
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Key Words
- A2BP1
- ACADL
- ACOXL
- ADIPOQ
- ALS2 chromosome region gene 8
- ALS2CR8
- ANKRD11
- ANOVA
- ASD
- Autism spectrum disorders (ASD)
- BAC
- BCL2-like 11 gene
- BCL2L11
- CACNA1C
- CHRNA7
- CNV
- COBL
- CT
- Chromosomal microarray analysis
- Copy number variant (CNV)
- DLG1
- DLG4
- DNA
- Developmental delay
- EEF1B2
- EEG
- F-box only 45 gene
- FAM117B
- FAT tumor suppressor 1 gene
- FAT1
- FBXO45
- FISH
- FXR2
- FZD5
- GALR1
- GATA zinc finger domain-containing protein 2B gene
- GATAD2B
- GDNF-inducible zinc finger protein 1 gene
- GZF1
- HAX1
- HCLS1-associated protein X1 gene
- HDAC
- IDH1
- IL1RAPL1
- ITPR1
- KLF7
- KNG1
- LINS
- LMNA
- Learning disability
- MAP2
- MBP
- MRPL19
- MYL1
- NADH-ubiquinone oxidoreductase Fe-S protein 1 gene
- NDUFS1
- NLGN2
- NPHP1
- NRXN1
- PAK2
- PARK2
- PMP22
- POLG
- PRPF8
- PTEN
- PTH2R
- RPE
- SACS
- SD
- SH2B adaptor protein 1 gene
- SH2B1
- SH3 and multiple ankyrin repeat domains 3 gene
- SHANK3
- SHOX
- SMARCA4
- STAG2
- SUMF1
- SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member gene
- TRAPPC2
- UCSC
- USP6
- University of California, Santa Cruz
- X-linked inhibitor of apoptosis gene
- XIAP
- YWHAE
- ZNF407
- aCGH
- acyl-coA dehydrogenase, long chain gene
- acyl-coA oxidase-like gene
- adipocyte-, C1q-, and collagen domain containing gene
- analysis of variance
- ankyrin repeat domain-containing protein 11 gene
- array comparative genomic hybridization
- ataxin 2-binding protein 1 gene
- autism spectrum disorder
- bacterial artificial chromosome
- calcium channel, voltage dependent, L-type, alpha 1C subunit gene
- cholinergic receptor, neuronal nicotinic, alpha polypeptide 7 gene
- computed tomography
- copy number variant
- cordon-bleu gene
- deoxyribonucleic acid
- discs, large homolog 1 gene
- discs, large homolog 4 gene
- electroencephalogram
- eukaryotic translation elongation factor 1, beta-2 gene
- family with sequence similarity 117, member B gene
- fluorescence in situ hybridization
- fragile X mental retardation, autosomal homolog 2 gene
- frizzled 5 gene
- galanin receptor 1 gene
- histone deacetylase gene
- inositol 1,4,5-triphosphate receptor, type 1 gene
- interleukin 1 receptor accessory protein-like 1 gene
- isocitrate dehydrogenase 1 gene
- kininogen 1 gene
- kruppel-like factor 7 gene
- lamin A gene
- lines homolog gene
- microtubule-associated protein 2 gene
- mitochondrial ribosomal protein L19 gene
- myelin basic protein gene
- myosin, light peptide 1 gene
- nephrocystin 1 gene
- neurexin 1 gene
- neuroligin 2 gene
- parathyroid hormone receptor 2 gene
- parkin gene
- peripheral myelin protein 22 gene
- phosphatase and tensin homolog gene
- polymerase gamma gene
- precursor mRNA-processing factor 8 gene
- protein-activated kinase 2 gene
- ribulose 5-phosphate 3-epimerase gene
- sacsin gene
- short stature homeobox gene
- standard deviation
- stromal antigen 2 gene
- sulfatase-modifying factor 1 gene
- tracking protein particle complex, subunit 2 gene
- tyrosine 3-monooxygenase/tryptophan 5-monooxygenase activation protein, epsilon isoform gene
- ubiquitin-specific protease 6 gene
- zinc finger protein 407 gene
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Affiliation(s)
- Jennifer L Roberts
- Departments of Psychiatry, Behavioral Sciences and Pediatrics, The University of Kansas, Medical Center, Kansas City, KS, USA
| | | | - Majed Dasouki
- Department of Neurology, The University of Kansas Medical Center, Kansas City, KS, USA; King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ann M Manzardo
- Departments of Psychiatry, Behavioral Sciences and Pediatrics, The University of Kansas, Medical Center, Kansas City, KS, USA
| | - Merlin G Butler
- Departments of Psychiatry, Behavioral Sciences and Pediatrics, The University of Kansas, Medical Center, Kansas City, KS, USA.
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36
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Oliveira AM, Chou MM. USP6-induced neoplasms: the biologic spectrum of aneurysmal bone cyst and nodular fasciitis. Hum Pathol 2013; 45:1-11. [PMID: 23769422 DOI: 10.1016/j.humpath.2013.03.005] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Revised: 03/18/2013] [Accepted: 03/20/2013] [Indexed: 10/26/2022]
Abstract
USP6 (also known as TRE17) is a ubiquitin-specific protease that was identified as an oncogene in transfection experiments with Ewing sarcoma DNA 2 decades ago. Until recently, little was known about USP6 function and mechanisms of oncogenic activation. The identification of USP6 fusion genes in aneurysmal bone cyst (ABC) and, more recently, in nodular fasciitis led to a better understanding of the pathogenesis of these lesions. Furthermore, the detection of USP6 genomic rearrangements or USP6 fusion genes may be used as a diagnostic tool for these lesions. In this review, we discuss the clinicopathologic features, molecular pathology, and pathogenesis of ABC and nodular fasciitis. We also discuss the possible line of differentiation of ABC and its relationship to nodular fasciitis and other lesions.
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Affiliation(s)
- André M Oliveira
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA; Department of Orthopedics, Mayo Clinic, Rochester, MN, USA.
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