1
|
Klubíčková N, Dermawan JK, Mosaieby E, Martínek P, Vaněček T, Hájková V, Ptáková N, Grossmann P, Šteiner P, Švajdler M, Kinkor Z, Michalová K, Szepe P, Plank L, Hederová S, Kolenová A, Spasov NJ, Kosemehmetoglu K, Pažanin L, Špůrková Z, Baník M, Baumruk L, Meyer A, Kalmykova A, Koshyk O, Michal M, Michal M. Comprehensive clinicopathological, molecular, and methylation analysis of mesenchymal tumors with NTRK and other kinase gene aberrations. J Pathol 2024; 263:61-73. [PMID: 38332737 DOI: 10.1002/path.6260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 12/13/2023] [Accepted: 01/04/2024] [Indexed: 02/10/2024]
Abstract
Alterations in kinase genes such as NTRK1/2/3, RET, and BRAF underlie infantile fibrosarcoma (IFS), the emerging entity 'NTRK-rearranged spindle cell neoplasms' included in the latest WHO classification, and a growing set of tumors with overlapping clinical and pathological features. In this study, we conducted a comprehensive clinicopathological and molecular analysis of 22 cases of IFS and other kinase gene-altered spindle cell neoplasms affecting both pediatric and adult patients. Follow-up periods for 16 patients ranged in length from 10 to 130 months (mean 38 months). Six patients were treated with targeted therapy, achieving a partial or complete response in five cases. Overall, three cases recurred and one metastasized. Eight patients were free of disease, five were alive with disease, and two patients died. All cases showed previously reported morphological patterns. Based on the cellularity and level of atypia, cases were divided into three morphological grade groups. S100 protein and CD34 were at least focally positive in 12/22 and 14/22 cases, respectively. Novel PWWP2A::RET, NUMA1::RET, ITSN1::RAF1, and CAPZA2::MET fusions, which we report herein in mesenchymal tumors for the first time, were detected by RNA sequencing. Additionally, the first uterine case with BRAF and EGFR mutations and CD34 and S100 co-expression is described. DNA sequencing performed in 13 cases uncovered very rare additional genetic aberrations. The CNV profiles showed that high-grade tumors demonstrate a significantly higher percentage of copy number gains and losses across the genome compared with low- and intermediate-grade tumors. Unsupervised clustering of the tumors' methylation profiles revealed that in 8/9 cases, the methylation profiles clustered with the IFS methylation class, irrespective of their clinicopathological or molecular features. © 2024 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
Collapse
Affiliation(s)
- Natálie Klubíčková
- Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
- Bioptical Laboratory Ltd, Pilsen, Czech Republic
| | - Josephine K Dermawan
- Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Elaheh Mosaieby
- Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
- Bioptical Laboratory Ltd, Pilsen, Czech Republic
| | | | | | | | - Nikola Ptáková
- Bioptical Laboratory Ltd, Pilsen, Czech Republic
- Department of Biology and Medical Genetics, Second Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | | | - Petr Šteiner
- Bioptical Laboratory Ltd, Pilsen, Czech Republic
| | - Marián Švajdler
- Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
- Bioptical Laboratory Ltd, Pilsen, Czech Republic
| | | | - Květoslava Michalová
- Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
- Bioptical Laboratory Ltd, Pilsen, Czech Republic
| | - Peter Szepe
- Institute of Pathological Anatomy, Jessenius Faculty of Medicine in Martin, Comenius University, Martin, Slovakia
| | - Lukáš Plank
- Institute of Pathological Anatomy, Jessenius Faculty of Medicine in Martin, Comenius University, Martin, Slovakia
| | - Stanislava Hederová
- Department of Pediatric Hematology and Oncology, National Institute of Children's Diseases and Medical Faculty, Comenius University, Bratislava, Slovakia
| | - Alexandra Kolenová
- Department of Pediatric Hematology and Oncology, National Institute of Children's Diseases and Medical Faculty, Comenius University, Bratislava, Slovakia
| | - Neofit Juriev Spasov
- Department of Pediatrics and Medical Genetics, Oncohematology Unit, Medical University Plovdiv, University Hospital Sveti Georgi, Plovdiv, Bulgaria
| | | | - Leo Pažanin
- Department of Pathology, Sestre Milosrdnice University Hospital Center, Zagreb, Croatia
| | - Zuzana Špůrková
- Department of Pathology, Na Bulovce Hospital, Prague, Czech Republic
| | - Martin Baník
- Department of Pathology, Regional Hospital Karlovy Vary, Karlovy Vary, Czech Republic
| | - Luděk Baumruk
- Department of Pathology, Regional Hospital Příbram, Příbram, Czech Republic
| | - Anders Meyer
- Department of Pathology, University of Kansas, Kansas City, KS, USA
| | | | - Olena Koshyk
- Medical Laboratory CSD Health Care Ltd, Kyiv, Ukraine
| | - Michal Michal
- Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
- Bioptical Laboratory Ltd, Pilsen, Czech Republic
| | - Michael Michal
- Department of Pathology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
- Bioptical Laboratory Ltd, Pilsen, Czech Republic
| |
Collapse
|