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Horio Y, Kuroda H, Masago K, Matsushita H, Sasaki E, Fujiwara Y. Current diagnosis and treatment of salivary gland-type tumors of the lung. Jpn J Clin Oncol 2024; 54:229-247. [PMID: 38018262 DOI: 10.1093/jjco/hyad160] [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: 09/13/2023] [Accepted: 11/02/2023] [Indexed: 11/30/2023] Open
Abstract
Salivary gland-type tumors of the lung are thought to originate from the submucosal exocrine glands of the large airways. Due to their rare occurrence, reports of their study are limited to small-scale or case reports. Therefore, daily clinical practices often require a search for previous reports. In the last 20 years, several genetic rearrangements have been identified, such as MYB::NF1B rearrangements in adenoid cystic carcinoma, CRTC1::MAML2 rearrangements in mucoepidermoid carcinoma, EWSR1::ATF1 rearrangements in hyalinizing clear cell carcinoma and rearrangements of the EWSR1 locus or FUS (TLS) locus in myoepithelioma and myoepithelial carcinoma. These molecular alterations have been useful in diagnosing these tumors, although they have not yet been linked to molecularly targeted therapies. The morphologic, immunophenotypic, and molecular characteristics of these tumors are similar to those of their counterparts of extrapulmonary origin, so clinical and radiologic differential diagnosis is required to distinguish between primary and metastatic disease of other primary sites. However, these molecular alterations can be useful in differentiating them from other primary lung cancer histologic types. The management of these tumors requires broad knowledge of the latest diagnostics, surgery, radiotherapy, bronchoscopic interventions, chemotherapy, immunotherapy as well as therapeutic agents in development, including molecularly targeted agents. This review provides a comprehensive overview of the current diagnosis and treatment of pulmonary salivary gland tumors, with a focus on adenoid cystic carcinoma and mucoepidermoid carcinoma, which are the two most common subtypes.
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Affiliation(s)
- Yoshitsugu Horio
- Department of Outpatient Services, Aichi Cancer Center Hospital, Nagoya, Japan
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, Nagoya, Japan
- Department of Thoracic Surgery, Teikyo University Hospital, Mizonokuchi, Kanagawa-prefecture, Japan
| | - Katsuhiro Masago
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Hirokazu Matsushita
- Division of Translational Oncoimmunology, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Eiichi Sasaki
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center Hospital, Nagoya, Japan
| | - Yutaka Fujiwara
- Department of Thoracic Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
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Hu C, Lin L, Ye M, Liu Y, Huang Q, Yuan C, Sun J, Sun H. Re-evaluating a historic cohort of sinonasal and skull base mucoepidermoid carcinoma: an institutional experience. Diagn Pathol 2024; 19:46. [PMID: 38429827 PMCID: PMC10905897 DOI: 10.1186/s13000-024-01466-5] [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: 11/18/2023] [Accepted: 02/10/2024] [Indexed: 03/03/2024] Open
Abstract
AIMS Primary mucoepidermoid carcinomas (MECs) of the sinonasal tract and nasopharynx are rare entities that represent a diagnostic challenge, especially in biopsy samples. Herein, we present a case series of MECs of the sinonasal and skull base and its mimics to evaluate the clinicopathological and molecular characteristics in order to avoid misdiagnosis. METHODS We reviewed the pathology records of patients diagnosed from 2014 to 2022. Thirty MECs were consecutively diagnosed during that period. RESULTS Based on morphological and fluorescence in situ hybridization (FISH) analyses, 30 tumors originally diagnosed as MECs were separated into MAML2 fusion-positive (7 cases) and MAML2 fusion-negative groups (23 cases), in which 14 tumors were positive for the EWSR1::ATF1 fusion; these tumors were reclassified to have hyalinizing clear cell carcinoma (HCCC). The remaining nine MAML2 FISH negative cases were reconfirmed as squamous cell carcinoma (SCC, 3 cases) which showed keratinization and high Ki-67 expression; DEK::AFF2 carcinomas (2 cases), in which DEK gene rearrangement was detected by FISH; and MECs as previously described (4 cases) with typical morphological features. Including 7 MAML2 rearrangements tumors, 11 MEC cases had a male-to-female ratio of 4.5:1, and 6 tumors arose from the nasopharyngeal region, while 5 tumors arose from the sinonasal region. The prognosis of this series of salivary gland-type MECs was favorable. CONCLUSIONS Our study confirmed that HCCC runs the risk of being misdiagnosed as MEC in the sinonasal tract and nasopharynx, particularly with biopsy specimens. Careful histological evaluation with supporting molecular testing can facilitate pathological diagnoses.
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Affiliation(s)
- Chunyan Hu
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
- Department of Radiotherapy, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, China
| | - Lan Lin
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
| | - Ming Ye
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
| | - Yifeng Liu
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
| | - Qiang Huang
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Cuncun Yuan
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
| | - Ji Sun
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China.
| | - Hui Sun
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
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Wang L, Cheng D, Wang H, Cheng L, Zhang X. A high-grade breast mucoepidermoid carcinoma without MAML2 rearrangement: A case report and literature review. Medicine (Baltimore) 2024; 103:e37163. [PMID: 38394503 DOI: 10.1097/md.0000000000037163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
INTRODUCTION Mucoepidermoid carcinoma (MEC) of the breast is an extremely rare primary breast tumor. Between 1979 and June 2022, only 50 cases were reported. The pathological morphology and biological behavior of breast MEC remain poorly understood. PATIENT CONCERNS A 47-year-old female was presented with a 10-day-old left breast mass detected by physical examination. DIAGNOSES Ultrasonography could not distinguish whether the breast tumor was benign or malignant. After a biopsy of a breast tumor excision specimen, combined with immunohistochemical results, the patient was diagnosed with high-grade mucoepidermoid breast carcinoma. INTERVENTIONS The patient underwent a modified radical mastectomy for her left breast. OUTCOMES The patient was still free from local recurrence or metastases at 1-year follow-up. CONCLUSION A high-grade MEC case without MAML2 rearrangement shows good recovery without complications. The diagnosis was confirmed by histomorphology and immunohistochemical markers. It is sometimes necessary to distinguish it from adenosquamous, adenoid cystic, or mucinous carcinoma. The primary treatment is surgical resection, and the prognosis is closely related to the pathological grade.
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Affiliation(s)
- Liangliang Wang
- Department of Pathology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332000, China
| | - Dan Cheng
- Department of Pathology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332000, China
| | - Huaying Wang
- Department of Pathology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332000, China
| | - Lin Cheng
- Department of Neurology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332000, China
| | - Xiaorong Zhang
- Department of Pathology, Affiliated Hospital of Jiujiang University, Jiujiang, Jiangxi 332000, China
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Ge Y, Lin X, He J, Chen W, Lin D, Zheng Y, Yang L, Xu F, Li Z. Genomics and tumor microenvironment of breast mucoepidermoid carcinoma based on whole-exome and RNA sequencing. Diagn Pathol 2024; 19:15. [PMID: 38243319 PMCID: PMC10797953 DOI: 10.1186/s13000-024-01439-8] [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: 11/24/2023] [Accepted: 01/04/2024] [Indexed: 01/21/2024] Open
Abstract
Mammary mucoepidermoid carcinoma (MEC) is a rare entity. The molecular characteristics of breast MEC have not been fully investigated due to its rarity. We performed a retrospective study among 1000 patients with breast carcinomas and identified four cases of breast MEC. Clinical and demographic data were collected. Immunohistochemistry panels which were used to diagnose salivary gland MEC and breast carcinomas were also performed. MAML2 rearrangements were detected by FISH and fusion partners were identified by RNA sequencing. Whole-exome sequencing (WES) was used to reveal the genomes of these four breast MEC. Then, the biological functions and features of breast MEC were further compared with those of invasive breast carcinomas and salivary gland MEC.According to Ellis and Auclair's methods, these four breast MEC could be classified as low-grade breast MEC. All the patients were alive, and disease-free survival (PFS) ranged from 20 months to 67 months. Among these four breast MEC, two cases were triple-negative, and the other two cases were found to be ER positive, with one also showing HER2 equivocal by immunohistochemical staining, but no amplification in FISH. FISH analysis confirmed the presence of the MAML2 translocation in three of four tumors, and CRTC1-MAML2 fusion was confirmed in two of them by RNA-sequencing. The average coverage size of WES for the tumor mutation burden estimation was 32 Mb. MUC4, RP1L1 and QRICH2 mutations were identified in at least three tumors, and these mutation also existed in breast invasive carcinoma databases (TCGA, Cell 2015; TCGA, Nature 2012). The results showed that there were many genes in breast MEC overlapping with the breast invasive carcinoma databases mentioned above, range from 5 to 63 genes (median:21 genes). Next, we assessed immune cell infiltration levels in these tumors. In all these tumors, M2 macrophages and plasma cell were in the high infiltration group. Our breast MEC showed different results from the salivary gland MEC, whose plasma cells were in the low infiltration group. Overall, we first analyzed the genomics and tumor microenvironment of breast mucoepidermoid carcinoma and proposed our hypothesis that although MECs arising in the breast resemble their salivary gland counterparts phenotypically, our findings indicate that breast MECs probably resemble invasive breast carcinomas at the genetic level and immune cell infiltration levels. More cases and in deep research need to be done to further understand this rare carcinoma.
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Affiliation(s)
- Yan Ge
- Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
- Department of Pathology, Guangdong Provincial People' s Hospital Ganzhou Hospital (Ganzhou Municipal Hospital), 49 Dagong Road, Zhanggong District, Ganzhou, China.
| | - Xingtao Lin
- Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Jiao He
- Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Wendan Chen
- Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Danyi Lin
- Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China
| | - Yihong Zheng
- Department of Pathology, Guangdong Provincial People' s Hospital Ganzhou Hospital (Ganzhou Municipal Hospital), 49 Dagong Road, Zhanggong District, Ganzhou, China
| | - Lingling Yang
- Geneseeq Research Institute, Geneseeq Technology Inc., Nanjing, China
| | - Fangping Xu
- Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
| | - Zhi Li
- Department of Pathology, Guangdong Provincial People's Hospital/Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.
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Abdullah B, Al Qeshty OAM, El-Nagdy SY, Ismail LE. Heterogeneity in PD-L1 expression in MAML2-rearranged mucoepidermoid carcinoma. Pathol Res Pract 2024; 253:155005. [PMID: 38091884 DOI: 10.1016/j.prp.2023.155005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 01/24/2024]
Abstract
OBJECTIVE Mucoepidermoid carcinoma (MEC) is a malignant tumor with diverse morphologies, some of which have poor prognostic indicators and others that challenge the grading system. This study investigated the expression of PD-L1 in different grades and phenotypes of MEC. METHODS The present study was carried out on twenty-four archival formalin-fixed, paraffin-embedded blocks of salivary MEC. Fluorescence in situ hybridization was used to detect MAML2 rearrangement in MEC cases to be included. The studied cases were then subcategorized based on their grading and phenotype and immunohistochemically stained for PD-L1. RESULTS PD-L1 expression in MEC varied, with some variants showing moderate to strong immunoexpression, while others did not express it at all. In the Warthin-like MEC, some tumors show high expression of PD-L1, while in the same pattern, a few cases showed low or no expression. Intraosseous MEC exhibited moderate PD-L1 expression. Sclerosing MEC featured lower PD-L1 expression, from weak to moderate. Oncocytic MEC displayed relatively low PD-L1 expression levels (weak to moderate). CONCLUSION The histomorphologic features of MEC may predict clinicopathologic behavior, and subtyping MEC may pose a significant therapeutic value, particularly for intraosseous MECs and clear-cell MECs. PD-L1 expression is a good predictor of survival outcomes in MECs.
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Affiliation(s)
- Bacem Abdullah
- Department of Oral Pathology, Faculty of Dentistry, Mansoura University, Egypt.
| | - Osama A M Al Qeshty
- Department of Oral Pathology, Faculty of Dentistry, Mansoura University, Egypt
| | - Sherif Y El-Nagdy
- Department of Oral Pathology, Faculty of Dentistry, Mansoura University, Egypt; Department of Oral Pathology, Faculty of Dentistry, Horus University in Egypt, Egypt
| | - Lawahez El Ismail
- Department of Oral Pathology, Faculty of Dentistry, Mansoura University, Egypt
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Mura MD, Clement C, Foschini MP, Vander Borght S, Waumans L, Van Eyken P, Hauben E, Keupers M, Weltens C, Smeets A, Nevelsteen I, Floris G. High-grade HER2-positive mucoepidermoid carcinoma of the breast: a case report and review of the literature. J Med Case Rep 2023; 17:527. [PMID: 38062474 PMCID: PMC10704702 DOI: 10.1186/s13256-023-04233-0] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 10/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Mucoepidermoid carcinoma of the breast is a rare special type of salivary gland-like tumor of the breast, usually displaying triple-negative phenotype. To date, only 64 cases have been reported in the English literature. Herein, we report the first case of mucoepidermoid carcinoma of the breast with human epidermal growth factor receptor 2 gene amplification. CASE PRESENTATION A 58-year-old Caucasian woman treated with breast-conserving surgery, radiotherapy, and chemotherapy for an invasive breast carcinoma of no special type, relapsed 20 years later in the ipsilateral left breast. Histological examination of the core needle biopsy of the relapse deferred to the surgical specimen for the definitive diagnosis, because of the broad differential diagnosis. On the resected specimen we observed the presence of a poorly differentiated carcinoma with mucoepidermoid carcinoma of the breast typical features consisting of epidermoid, intermediate and mucinous cells lacking true keratinization, in keeping with the latest World Health Organization diagnostic criteria. The mucoepidermoid carcinoma of the breast was weakly estrogen receptor and androgen receptor positive and progesterone receptor negative, but exceptionally showed human epidermal growth factor receptor 2 gene amplification. Mastermind-like transcriptional coactivator 2 gene translocations were not detected by fluorescent in situ hybridization. The patient received adjuvant chemotherapy with anti-human epidermal growth factor receptor 2 therapy but no endocrine therapy. After 61 months of follow-up, no signs of local or distant recurrence were observed. CONCLUSIONS Mucoepidermoid carcinoma of the breast is a very rare entity. Despite being most frequently triple negative, the standard evaluation of receptor status is mandatory, as well as strict application of World Health Organization diagnostic criteria for correct patient management.
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Affiliation(s)
- Mario Della Mura
- Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research, KU Leuven-University of Leuven, 3000, Louvain, Belgium
- Department of Pathology, KU Leuven-University of Leuven, University Hospitals Leuven, Herestraat 49, Campus Gasthuisberg, 3000, Louvain, Belgium
- School of Medicine and Surgery, Magna Græcia University of Catanzaro, Viale Europa, Germaneto University Campus, 88100, Catanzaro, Italy
| | - Céline Clement
- Department of Oncology, KU Leuven-University of Leuven, 3000, Louvain, Belgium
- Department of Surgical Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, 3000, Louvain, Belgium
| | - Maria P Foschini
- Department of Biomedical and Neuromotor Sciences, Unit of Anatomic Pathology, University of Bologna, Bellaria Hospital, 40139, Bologna, Italy
| | - Sara Vander Borght
- Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research, KU Leuven-University of Leuven, 3000, Louvain, Belgium
- Department of Pathology, KU Leuven-University of Leuven, University Hospitals Leuven, Herestraat 49, Campus Gasthuisberg, 3000, Louvain, Belgium
| | - Lise Waumans
- Department of Pathology, Regional Hospital East Limburg (ZOL), 3600, Genk, Belgium
| | - Peter Van Eyken
- Department of Pathology, Regional Hospital East Limburg (ZOL), 3600, Genk, Belgium
| | - Esther Hauben
- Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research, KU Leuven-University of Leuven, 3000, Louvain, Belgium
- Department of Pathology, KU Leuven-University of Leuven, University Hospitals Leuven, Herestraat 49, Campus Gasthuisberg, 3000, Louvain, Belgium
| | - Machteld Keupers
- Department of Radiology, KU Leuven-University of Leuven, University Hospitals Leuven, 3000, Louvain, Belgium
| | - Caroline Weltens
- Department of Oncology, KU Leuven-University of Leuven, 3000, Louvain, Belgium
- Department of Radiotherapy Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, 3000, Louvain, Belgium
| | - Ann Smeets
- Department of Oncology, KU Leuven-University of Leuven, 3000, Louvain, Belgium
- Department of Surgical Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, 3000, Louvain, Belgium
| | - Ines Nevelsteen
- Department of Oncology, KU Leuven-University of Leuven, 3000, Louvain, Belgium
- Department of Surgical Oncology, KU Leuven-University of Leuven, University Hospitals Leuven, 3000, Louvain, Belgium
| | - Giuseppe Floris
- Department of Imaging and Pathology, Laboratory of Translational Cell & Tissue Research, KU Leuven-University of Leuven, 3000, Louvain, Belgium.
- Department of Pathology, KU Leuven-University of Leuven, University Hospitals Leuven, Herestraat 49, Campus Gasthuisberg, 3000, Louvain, Belgium.
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Nocini R, Sanna G, Trotolo A, Fior A, Brunelli M, Manfrin E, Favero V. Secretory carcinoma of salivary glands with NTRK3 break-apart molecular rearrangement: Potential misdiagnosis with mucoepidermoid carcinoma. J Stomatol Oral Maxillofac Surg 2023; 124:101635. [PMID: 37709146 DOI: 10.1016/j.jormas.2023.101635] [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] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 09/16/2023]
Abstract
A woman presented a right submandibular gland lesion with cytologic diagnosis of mucoepidermoid carcinoma. Patient underwent sialoadenectomy en bloc with supraomohyoid neck dissection. Positivity for ETV6-NTRK3 genes fusion on surgical sample led to final diagnosis of secretory carcinoma (SC). Secretory carcinoma has been renamed by WHO in 2017 from mammary-analogue-secretory carcinoma (MASC). Only 649 have been reported until 2019. While cytologic alteration are shared with other neoplasms as the acinic cell and mucoepidermoid carcinomas, ETV6-NTRK3 rearrangement is pathognomonic of SC. Although usually indolent and with low-stage presentation, SC has higher rate of local recurrences and nodal involvement than ACC. Surgical treatment represent the gold standard. Real prevalence of SC is probably underestimated due to the recent WHO 2017 reclassification. While cytologic analysis does not allow to discriminate SC from other malignancies, chromosomal examination is recommended. When low-grade SC is diagnosed, complete surgical resection assures good prognosis.
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Affiliation(s)
- Riccardo Nocini
- Head and Neck Department, Division of Otolaringology, AOUI Verona, P.le L.A. Scuro.10, Verona 37134, Italy
| | - Giangiacomo Sanna
- Head and Neck Department, Division of Maxillo-Facial Surgery, AOUI Verona, P.le L.A. Scuro. 10, Verona 37134, Italy
| | - Alessandro Trotolo
- Head and Neck Department, Division of Maxillo-Facial Surgery, AOUI Verona, P.le L.A. Scuro. 10, Verona 37134, Italy
| | - Andrea Fior
- Head and Neck Department, Division of Maxillo-Facial Surgery, AOUI Verona, P.le L.A. Scuro. 10, Verona 37134, Italy
| | - Matteo Brunelli
- Department of Diagnostics and Public Health, Section of Pathology, AOUI Verona, P.le L.A. Scuro. 10, Verona 37134, Italy
| | - Erminia Manfrin
- Department of Diagnostics and Public Health, Section of Pathology, AOUI Verona, P.le L.A. Scuro. 10, Verona 37134, Italy
| | - Vittorio Favero
- Head and Neck Department, Division of Maxillo-Facial Surgery, AOUI Verona, P.le L.A. Scuro. 10, Verona 37134, Italy.
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De la Sancha C, Kuhar M, Kraft A, Alomari AK. Primary mucoepidermoid carcinoma of the external auditory canal with a CRTC1::MAML2 fusion: A case report and a review of literature. J Cutan Pathol 2023; 50:947-950. [PMID: 37394842 DOI: 10.1111/cup.14491] [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: 04/04/2023] [Revised: 06/08/2023] [Accepted: 06/13/2023] [Indexed: 07/04/2023]
Abstract
Mucoepidermoid carcinoma is a malignant neoplasm of exocrine glands that arises predominantly in salivary glands. It is seldom encountered as a primary cutaneous neoplasm, and in those patients, it often involves the external auditory canal. Given their rarity, they can pose a diagnostic challenge and prompt extensive workup. In salivary glands, mucoepidermoid carcinomas commonly harbor CRTC1/3::MAML2 fusions; however, genetic alterations of primary cutaneous neoplasms are less characterized, with previous studies reporting CRTC1 rearrangements in the absence of MAML2 aberrations. Herein, we report a case of a primary cutaneous mucoepidermoid carcinoma of the external auditory canal with a CRTC1::MAML2 rearrangement. We also review the clinical, morphologic, and molecular features of this neoplasm and compare them to those reported in the literature and to histopathologic mimics.
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Affiliation(s)
- Carlo De la Sancha
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Matthew Kuhar
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Adele Kraft
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ahmed K Alomari
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
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9
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Othman BK, Steiner P, Leivo I, Skálová A. Rearrangement of KMT2A Characterizes a Subset of Pediatric Parotid Mucoepidermoid Carcinomas Arising Metachronous to Acute Lymphoblastic Leukemia. Fetal Pediatr Pathol 2023; 42:796-807. [PMID: 37517063 DOI: 10.1080/15513815.2023.2241903] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/29/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
Introduction: Metachronous mucoepidermoid carcinomas (MMEC) may occur in association with childhood leukemias and lymphomas. We compared molecular abnormalities of MMEC in patients with ALL with the abnormalities found in primary mucoepidermoid carcinomas (MECs) in pediatric cases and young adults. Materials and methods: Immunohistochemical stains for p63 and SOX10, molecular alterations in MAML2 and KMT2A genes detected by FISH and/or next-generation sequencing were studied in 12 pediatric MMECs secondary to ALL and six primary MECs in pediatric patients and young adults. Follow-up information of patients in both groups was obtained. Results: KMT2A rearrangements were detected in pediatric MMECs, and they were associated with remarkable histomorphological changes, including deposits of abundant stromal collagen and intratumoral lymphoid proliferations. No KMT2A rearrangements were found in primary MECs. The prognosis of MMEC in patients with ALL, especially in KMT2A-rearranged cases, was worse than in primary MECs. Kruskal-Wallis test showed a statistically significant difference in overall survival between KMT2A-rearranged MMECs and KMT2A-intact MMECs in cases with ALL (p = 0.027). Conclusion: KMT2A-rearranged MMECs in ALL patients may have inherently more aggressive behavior, even when the histomorphology of MMEC suggests a low-grade malignancy.
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Affiliation(s)
- Bacem K Othman
- Department of Pathology, Charles University, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Petr Steiner
- Molecular Genetic Laboratory, Bioptic Laboratory, Pilsen, Czech Republic
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, and Turku University Hospital, Turku, Finland
| | - Alena Skálová
- Department of Pathology, Charles University, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
- Department of Pathology, Bioptic Laboratory, Ltd, Pilsen, Czech Republic
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10
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Ahn B, Choi SH, Kim D, Kim D, Cho KJ. Salivary Gland Neoplasms With a Unique Trabecular Histology and MAML2 Translocation : A Trabecular Variant of a Mucoepidermoid Carcinoma. Am J Surg Pathol 2023; 47:1085-1095. [PMID: 37589282 DOI: 10.1097/pas.0000000000002110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
Mucoepidermoid carcinomas (MECs) are the most common salivary gland malignancy and have a diverse histology. Many histologic variants of MEC have now been confirmed with characteristic molecular alterations involving CRTC1::MAML2 or CRTC1::MAML3 translocations. We here report a series of 7 trabecular variants of MEC which showed a predominant trabecular or nested pattern with either focal glandular differentiation or clear cell change and keloid-like fibrosis in the background. In addition, these tumors were either negative or showed only focal positivity for p63. Such features are not characteristic of known disease entities and resulted in an initial misdiagnosis of adenocarcinoma, not otherwise specified, or low-grade to intermediate-grade MEC with uncertainty. The patients' ages in our cohort ranged from 26 to 55 years with a female predominance (5/7). The tumors were located in the parotid gland (n=3), base of tongue (n=2), hard palate (n=1), and parapharyngeal space (n=1), with a median size of 1.5 cm. All 7 cases showed an MAML2 split pattern on fluorescence in situ hybridization analysis, and both RNA and whole-genome sequencing presented CRTC1::MAML2 translocation. All 7 cases showed a solid-predominant histology, and 3 cases displayed extracapsular extension. There were no other signs of high-grade histology and no recurrences or deaths occurred over a follow-up period of up to 79 months. We thus propose a unique trabecular variant of MEC that has atypical histologic and immunohistochemical features.
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Affiliation(s)
| | - Seung-Ho Choi
- Otolaryngology, Asan Medical Center, University of Ulsan College of Medicine
| | - Doeun Kim
- Department of Medical Science, Biomedical Science, University of Ulsan College of Medicine, Seoul, Republic of Korea
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Kumagai E, Matsumura M, Kato I, Arai H, Suzuki T, Sugiyama M, Sekiya M, Mitsui H, Kataoka T, Iwashita H, Okudela K. A case of lung carcinoma with a unique biphasic feature: Implications for histogenesis of "fake mucoepidermoid carcinoma" developing in the peripheral lung. Pathol Int 2023; 73:463-468. [PMID: 37606200 DOI: 10.1111/pin.13368] [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: 02/22/2023] [Accepted: 07/31/2023] [Indexed: 08/23/2023]
Abstract
We present a case of lung carcinoma with a unique biphasic feature. The patient was a 67-year-old male smoker with idiopathic pulmonary fibrosis (IPF). A subpleural tumor in the left lower lobe, embedded in fibrotic tissue, was resected. Histologically, the tumor consisted of major and minor components of mucoepidermoid carcinoma (MEC) and surrounding conventional lepidic adenocarcinoma, respectively. Both components had the same TP53 somatic mutation (p.V157F) but not Mastermind-like 2 (MAML2) gene rearrangement. The two components may have developed from an identical origin. The tumor could be trans-differentiating from lepidic adenocarcinoma to MEC, possibly promoted by IPF-induced tissue damage. The final diagnosis was "adenosquamous carcinoma with mucoepidermoid-like features (that may originate from lepidic adenocarcinoma)." This case has implications for the potential histogenesis of peripheral lung MEC. Over time, the MEC would expand and outgrow the lepidic adenocarcinoma, making it impossible to distinguish between fake and true MEC. The present case suggests that peripheral MEC could differ from proximal MEC in its histogenesis and molecular genetics. Thus, careful examination is necessary to diagnose peripheral lung MEC, particularly in patients with interstitial lung diseases.
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Affiliation(s)
- Eita Kumagai
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Mai Matsumura
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Ikuma Kato
- Department of Molecular Pathology, Yokohama City University, School of Medicine, Yokohama-shi, Japan
| | - Hiromasa Arai
- Division of Surgery, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Yokohama-shi, Japan
| | - Takehisa Suzuki
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Misaki Sugiyama
- Division of Pathology, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Yokohama-shi, Japan
| | - Motoki Sekiya
- Division of Pathology, Kanagawa Prefectural Cardiovascular and Respiratory Center Hospital, Yokohama-shi, Japan
| | - Hideaki Mitsui
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Toshiaki Kataoka
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Hiromichi Iwashita
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
| | - Koji Okudela
- Department of Pathology, Yokohama City University Medical Center, Kanazawa-ku, Yokohama-shi, Kanagawa, Japan
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Yan L, Xu J, Liu L, Li X. Warthin-like mucoepidermoid carcinoma of the parotid gland: Clinicopathological observation and literature review. Sci Prog 2023; 106:368504231179816. [PMID: 37335119 PMCID: PMC10358514 DOI: 10.1177/00368504231179816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
Warthin tumor (WT)-like mucoepidermoid carcinoma resembles the histologic pattern of WT and pathologists unaware of this possibility may misdiagnose it as WT with squamous and mucous epithelium metaplasia or WT malignant transfer into mucoepidermoid carcinoma. The present study reported a case of a 41-year-old Chinese female with a solitary mass in the left parotid gland. In this case, microscopic observation revealed prominent lymph node stroma and multiple cystic structures similar to those seen in WT. However, it lacked the two layers of oncocytic epithelial tissue characteristic of WT. Furthermore, fluorescence in situ hybridization detected MAML2 rearrangement in the case. Considering the histological findings, this case was diagnosed as WT-like mucoepidermoid carcinoma. The present case report provides pathological and clinical features to differentiate it from WT malignant transition into mucoepidermoid carcinoma, WT with squamous and mucous epithelium metaplasia and non-sebaceous lymphadenoma-like mucoepidermoid carcinoma. In conclusion, WT-like mucoepidermoid carcinoma as a special subtype of mucoepidermoid carcinoma has special histological characteristics, which required further observations and more case reports to clearly define this variant.
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Affiliation(s)
- Limin Yan
- Department of Pathology, Tangshan Gongren Hospital, Tangshan,
Hebei, China
| | - Jinheng Xu
- Department of Pathology, Tangshan Zhongxin Hospital, Tangshan, Hebei, China
| | - Liyun Liu
- Department of Pathology, Tangshan Gongren Hospital, Tangshan,
Hebei, China
| | - Xin Li
- Department of Neurology, Tangshan Gongren Hospital,
Tangshan, Hebei, China
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Keerthika R, Devi A, Kamboj M, Sivakumar N, Vijayakumar G, Narwal A, Girdhar A. Diagnostic Reliability of CRTC1/3::MAML2 Gene Fusion Transcripts in Discriminating Histologically Similar Intraosseous Mucoepidermoid Carcinoma from Glandular Odontogenic Cyst: A Systematic Review and Meta-analysis. Head Neck Pathol 2023; 17:233-245. [PMID: 36357765 PMCID: PMC10063707 DOI: 10.1007/s12105-022-01494-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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 09/09/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Intraosseous mucoepidermoid carcinoma (IMEC) and Glandular odontogenic cyst (GOC) are those two pathological entities causing diagnostic dilemma due to the histopathological similarity. An accurate distinction between the two entities is difficult as both presents with a common radiological and histological similarities. The aim of our systematic review was to establish the diagnostic reliability of CRTC1/3::MAML2 gene fusion for the distinction between IMEC and GOC. METHODS A complete electronic literature search was made in MEDLINE by PubMed, Google Scholar, and EMBASE databases. Articles with keywords using molecular genetic findings of CRTC1/3::MAML2 gene fusion transcripts, IMEC and GOC were assessed and included for the systematic review. RESULTS Twelve subgroups having both qualitative and quantitative analysis revealed CRTC1/3::MAML2 sensitivity of 100% and specificity of 70.59% in differentiating GOC and IMEC. Fixed-effects model confirmed translocation-negative cases to have a decreased risk of association with IMEC (combined odds ratio 8.770, 95% confidence interval - 2.45 to 31.45, p < 0.002). CONCLUSIONS The current evidence supports that in all cases with positive gene fusion transcript of the CRTC1/3::MAML2 was specific for IMEC and was significantly differentiating it from GOC. Whereas cases of IMEC with negative gene fusion transcript pose diagnostic difficulty in differentiating from a GOC which is negative for CRTC1/3::MAML2 expression.
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Affiliation(s)
- R. Keerthika
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - Anju Devi
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - Mala Kamboj
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - N. Sivakumar
- Department of Oral and Maxillofacial Pathology & Microbiology, King George’s Medical University, Lucknow, Uttar Pradesh 226003 India
| | - Gopikrishnan Vijayakumar
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - Anjali Narwal
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
| | - Akhil Girdhar
- Department of Oral Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana 124001 India
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Le HT, Nguyen TPX, Hirokawa M, Katoh R, Mitsutake N, Matsuse M, Sako A, Kondo T, Vasan N, Kim YM, Liu Y, Hassell L, Kakudo K, Vuong HG. Primary Thyroid Mucoepidermoid Carcinoma (MEC) Is Clinically, Prognostically, and Molecularly Different from Sclerosing MEC with Eosinophilia: A Multicenter and Integrated Study. Endocr Pathol 2023; 34:100-111. [PMID: 36394696 DOI: 10.1007/s12022-022-09741-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2022] [Indexed: 11/19/2022]
Abstract
Mucoepidermoid carcinoma (MEC) and sclerosing MEC with eosinophilia (SMECE) are rare primary thyroid carcinomas. In this study, we aimed to present our multicenter series of MEC and SMECE and integrated our data with published literature to further investigate the clinicopathological characteristics and prognoses of these tumors. We found 2 MECs and 4 SMECEs in our multicenter archives. We performed fluorescence in situ hybridization (FISH) to determine the MAML2 gene rearrangement. We screened for mutations in BRAF, TERT promoter, and RAS mutations using Sanger sequencing and digital polymerase chain reaction. Histopathologically, MECs and SMECEs were composed of two main cell types including epidermoid and mucin-secreting cells, arranged in cords, nests, and tubules. SMECEs were characterized by a densely sclerotic stroma with abundant eosinophils. We did not detect any MAML2 fusion in any of our cases. Two MEC cases harbored concomitant BRAF p.V600E and TERT C228T mutations. RAS mutations were absent in all cases. Concurrent foci of another thyroid malignancy were more commonly seen in MECs (p < 0.001), whereas SMECEs were associated with chronic lymphocytic thyroiditis (p < 0.001). MECs and SMECEs had equivalent recurrence-free survival (RFS) but MECs conferred significantly dismal disease-specific survival (DSS) as compared to SMECEs (p = 0.007). In conclusion, MECs and SMECEs not only shared some similarities but also demonstrated differences in clinicopathological characteristics, prognoses, and molecular profiles. SMECEs had a superior DSS in comparison to MECs, suggesting that they are low-grade cancers. This could help clinicians better evaluate patient outcomes and decide appropriate treatment plans.
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Affiliation(s)
- Hieu Trong Le
- Department of Pathology, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, 700-000, Vietnam
| | - Truong P X Nguyen
- Department of Pathology, Chulalongkorn University, Krung Thep Maha Nakhon , Bangkok, 10300, Thailand
| | - Mitsuyoshi Hirokawa
- Department of Diagnostic Pathology and Cytology, Kuma Hospital, Kobe, Hyogo, 650-0011, Japan
| | - Ryohei Katoh
- Department of Pathology, Ito Hospital, Shibuya, Tokyo, 150-8308, Japan
| | - Norisato Mitsutake
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Michiko Matsuse
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Ayaka Sako
- Department of Radiation Medical Sciences, Atomic Bomb Disease Institute, Nagasaki University, Nagasaki, 852-8523, Japan
| | - Tetsuo Kondo
- Department of Pathology, University of Yamanashi, Yamanashi, 409-3821, Japan
| | - Nilesh Vasan
- Department of Otolaryngology, Oklahoma University Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Young Mi Kim
- Genetics Laboratory, Oklahoma University Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Ying Liu
- Genetics Laboratory, Oklahoma University Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Lewis Hassell
- Department of Pathology, Oklahoma University Health Sciences Center, Oklahoma City, OK, 73104, USA
| | - Kennichi Kakudo
- Department of Pathology, Cancer Genome Center and Thyroid Disease Center, Izumi City General Hospital, Izumi, Japan
| | - Huy Gia Vuong
- Department of Pathology, University of Iowa Hospitals and Clinics, Iowa City, IA, 52242, USA.
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Wang X, Li W, Yan J, Li BB. [Salivary papillary cystic low-grade mucoepidermoid carcinoma and cystadenoma: a comparison of clinicopathological and genetic features]. Zhonghua Kou Qiang Yi Xue Za Zhi 2022; 57:1134-1140. [PMID: 36379892 DOI: 10.3760/cma.j.cn112144-20220615-00327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Objective: To study the clinicopathologic and genetic features of papillary cystic low-grade mucoepidermoid carcinoma (LG-MEC) and cystadenoma. Methods: A retrospective review was performed on salivary gland tumor patients with papillary cystic architecture who presented to department of oral pathology, Peking University School and Hospital of Stomatology between January 2010 and June 2022. Among this cohort, there were 17 males and 17 females with a range age of 23-82 years [(55.6±14.6) years]. Diagnosis was confirmed by histological, immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) analysis. Finally, 15 papillary cystic LG-MEC and 19 cystadenoma patients were included in the present study. All patients were followed clinically and radiologically, and the duration of follow-up ranged from 1 to 141 months. Results: All neoplasms showed papillary proliferation with multilocular or giant cystic tumors. Papillary cystic LG-MEC was characterized by epidermoid cells, intermediate cell and mucous cells with multiple lining-layers. Papillary cystic LG-MEC had mild cellular atypia and a pushing infiltration. Cystadenoma was characterized by cuboidal, columnar and ciliated pseudostratified columnar lining epithelium. Squamous metaplasia, mucinous metaplasia and acidophilic degeneration could also be observed focally in cystadenoma. For IHC staining, papillary cystic LG-MEC showed diffusely and strongly positive for mucin 4 (MUC4) (15/15) and mucin 5 Subtype AC (MUC5AC) (4/15) in the epidermoid cells, intermediate cell and mucous cells. The epidermoid cells and intermediate cells were diffusely positive for p40 and p63. The Ki-67 index was about 10%-15% in LG-MEC. As a contrast, p40 (17/19) and p63 (14/15) were only detected in the basal cells of cystadenoma. Cystadenoma showed focal MUC5AC (4/19)expression and MUC4 (19/19)diffuse expression. In addition, the Ki-67 index was 5%-10% in cystadenoma. The MAML2 gene translocation was detected in 11 LG-MEC patients, but none in cystadenoma. Conclusions: The differential diagnosis points between papillary cystic LG-MEC and cystadenoma included the specific epidermoid cells, intermediate cells and mucus cells in LG-MEC, cell atypia, the pushing-infiltration pattern, diffuse expression of p40 and p63 in the lining epithelium, and a MAML2 gene rearrangement. The molecular test of MAML2 should be recommended to reduce missed LG-MEC diagnoses.
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Affiliation(s)
- X Wang
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences, Beijing 100081, China
| | - W Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences, Beijing 100081, China
| | - J Yan
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences, Beijing 100081, China
| | - B B Li
- Department of Oral Pathology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & Research Unit of Precision Pathologic Diagnosis in Tumors of the Oral and Maxillofacial Regions, Chinese Academy of Medical Sciences, Beijing 100081, China
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16
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White VA, Hyrcza MD, Lennerz JK, Thierauf J, Lokuhetty D, Cree IA, Indave BI. Mucoepidermoid carcinoma (MEC) and adenosquamous carcinoma (ASC), the same or different entities? Mod Pathol 2022; 35:1484-1493. [PMID: 35871081 PMCID: PMC9514988 DOI: 10.1038/s41379-022-01100-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 03/10/2022] [Accepted: 05/03/2022] [Indexed: 02/07/2023]
Abstract
Mucoepidermoid carcinoma (MEC) and adenosquamous carcinoma (ASC) have overlapping histopathological appearances and sites of occurrence, which may cause diagnostic difficulty impacting subsequent treatment. We conducted a systematic review of the scientific literature to determine whether molecular alterations were sufficiently different in MEC and ASC to aid in classifying the two entities. We searched Medline, Embase and Web of Science for studies reporting molecular determinations of ASC and/or MEC and screened retrieved records for eligibility. Two independent researchers reviewed included studies, assessed methodological quality and extracted data. Of 8623 identified records, 128 articles were included for analysis: 5 which compared the two tumors in the same investigation using the same methods and 123 which examined the tumors separately. All articles, except one were case series of moderate to poor methodological quality. The 5 publications examining both tumors showed that 52/88 (59%) MEC and 0% of 110 ASC had rearrangement of the MAML2 gene as detected by FISH and/or RT-PCR, but did not investigate other genes. In the entire series MEC had MAML2 gene rearrangement in 1337/2009 (66.6%) of tumors studied. The articles examining tumors separately found that MEC had mutations in EGFR (11/329 cases, 3.3%), KRAS (11/266, 4.1%) and ERBB2 (9/126, 7.1%) compared with ASC that had mutations in EGFR (660/1705, 38.7%), KRAS (143/625, 22.9%) and ERBB2 (6/196, 3.1%). The highest level of recurrent mutations was in pancreatic ASC where (108/126, 85.7%) reported mutations in KRAS. The EGFR mutations in ASC were similar in number and kind to those in lung adenocarcinoma. By standards of systematic review methodology and despite the large number of retrieved studies, we did not find adequate evidence for a distinctive molecular profile of either MEC or ASC that could definitively aid in its classification, especially in histologically difficult cases that are negative for MAML2 rearrangement. The case series included in this review indicate the relevance of MAML2 rearrangement to support the diagnosis of MEC, findings that should be confirmed by additional research with adequate study design.
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Affiliation(s)
| | - Martin D Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Arnie Charbonneau Cancer Institute, Calgary, AB, Canada
| | - Jochen K Lennerz
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Julia Thierauf
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital/Harvard Medical School, Boston, MA, USA
| | - Dilani Lokuhetty
- International Agency for Research on Cancer, Lyon, France
- Department of Pathology, University of Colombo, Colombo, Sri Lanka
| | - Ian A Cree
- International Agency for Research on Cancer, Lyon, France
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Skalova A, Leivo I, Hellquist H, Simpson RHW, Vander Poorten V, Willems SM, Mosaieby E, Slouka D, Ferlito A. Clear Cell Neoplasms of Salivary Glands: A Diagnostic Challenge. Adv Anat Pathol 2022; 29:217-226. [PMID: 35249992 DOI: 10.1097/pap.0000000000000339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This review focuses on the heterogenous group of clear cell neoplasms of salivary glands and attempts to identify major differential diagnostic features. Within the head and neck region, clear cells are found most commonly in salivary gland tumors, but may also be seen in tumors of squamous or odontogenic epithelial origin, primary or metastatic carcinomas, benign or malignant melanocytic lesions, or benign or malignant mesenchymal tumors. Clear cells occur fairly commonly among a wide variety of salivary gland neoplasms, but mostly they constitute only a minor component of the tumor cell population. Clear cells represent a major diagnostic feature in two salivary gland neoplasms, epithelial-myoepithelial carcinoma and hyalinizing clear cell carcinoma. In addition, salivary gland neoplasms composed predominantly of clear cells could also include clear cell variants of other salivary neoplasms, such as mucoepidermoid carcinoma and myoepithelial carcinoma, but their tumor type-specific histologic features may only be available in limited nonclear cell areas of the tumor. Diagnosing predominantly clear cell salivary gland tumors is difficult because the immunoprofiles and morphologic features may overlap and the same tumor entity may also have a wide range of other histologic presentations. Many salivary gland tumors are characterized by tumor type-specific genomic alterations, particularly gene fusions of the ETV6 gene in secretory carcinoma, the MYB and MYBL1 genes in adenoid cystic carcinoma, the MAML2 gene in mucoepidermoid carcinoma, the EWSR1 gene in hyalinizing clear cell carcinoma, and others. Thus, along with conventional histopathologic examination and immunoprofiling, molecular and genetic tests may be important in the diagnosis of salivary gland clear cell tumors by demonstrating genetic alterations specific to them.
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Affiliation(s)
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku and Department of Pathology, Turku University Hospital, Turku, Finland
| | - Henrik Hellquist
- Epigenetics and Human Disease Laboratory, Department of Biomedical Sciences and Medicine, Algarve Biomedical Center (ABC), University of Algarve, Faro, Portugal
| | - Roderick H W Simpson
- Department of Anatomical Pathology, University of Calgary, Calgary, Alberta, Canada
| | - Vincent Vander Poorten
- Department of Oncology, Section Head and Neck Oncology, University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Stefan M Willems
- Department of Pathology and Medical Biology, University of Groningen, Groningen, The Netherlands
| | - Elaheh Mosaieby
- Departments of Pathology
- Molecular and Genetic Laboratory, Bioptic Laboratory Ltd, Plzen, Czech Republic
| | - David Slouka
- Otorhinolaryngology, Faculty of Medicine in Plzen, Charles University
| | - Alfio Ferlito
- International Head and Neck Scientific Group, Padua, Italy
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18
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Sun H, Cai R, Zhai C, Song W, Sun J, Bi Y. Primary Mucoepidermoid Carcinoma of the Lacrimal Apparatus. Am J Ophthalmol 2022; 239:170-179. [PMID: 35288069 DOI: 10.1016/j.ajo.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/21/2022] [Accepted: 03/01/2022] [Indexed: 11/20/2022]
Abstract
PURPOSE In this study, we evaluated the clinicopathologic and molecular characteristics of lacrimal apparatus mucoepidermoid carcinoma (MEC) to define its typical diagnostic features. DESIGN Retrospective observational case series. METHODS Institutional pathology records between 2011 and 2021 were searched for all cases of lacrimal apparatus MEC. RESULTS A total of 2 male and 6 female patients ranging in age from 18 to 83 years (median 56, mean 54) were included. Six lacrimal apparatus MECs were found in the lacrimal gland, and 2 cases occurred in the lacrimal sac and nasolacrimal duct. Histologically, there were 6 cases of conventional MEC, 1 clear-cell variant of MEC, and 1 oncocytic variant of MEC for a total of 8 cases. There were 3 low-grade cases and 5 high-grade cases. All 8 cases were evaluated via immunohistochemistry, and the results were positive (scores 1-4) for pankeratin, 34betaE12, p63, p40, CK7, CK8, and CK19, with a relatively higher expression of p63 observed in high-grade MEC. The presence of human papillomavirus (HPV) type 6 DNA was found in 4 patients. MAML2 fluorescence in situ hybridization was positive for MAML2 rearrangement in 3 lacrimal gland tumors (2 low-grade and 1 high-grade). Six tumors were managed with radical resection, and 2 patients underwent orbital exenteration. Postoperative radiation therapy was delivered to 6 patients, and chemotherapy was administered to 1 patient. CONCLUSIONS MECs of the lacrimal apparatus are rare tumors, and the rate of MAML2 translocations is lower than that in salivary MECs. Lacrimal gland and lacrimal sac MECs may not be of the same subtypes intrinsically because of the difference in MAML2 translocation, anatomy, and clinical course. The etiologic function of HPV type 6 infection should be explored in lacrimal apparatus MECs. Radical surgery is the treatment of choice. The description of these unique findings may assist in the definitive diagnosis of and improve our understanding of lacrimal apparatus MEC.
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Affiliation(s)
- Hui Sun
- From the Department of Pathology, Eye and ENT Hospital, Fudan University (H.S., R.C., C.Z., W.S., J.S., Y.B.); Department of Pathology, Fudan University Shanghai Cancer Center (H.S.), Shanghai, China
| | - Rongrong Cai
- From the Department of Pathology, Eye and ENT Hospital, Fudan University (H.S., R.C., C.Z., W.S., J.S., Y.B.)
| | - Changwen Zhai
- From the Department of Pathology, Eye and ENT Hospital, Fudan University (H.S., R.C., C.Z., W.S., J.S., Y.B.)
| | - Wanjing Song
- From the Department of Pathology, Eye and ENT Hospital, Fudan University (H.S., R.C., C.Z., W.S., J.S., Y.B.)
| | - Ji Sun
- From the Department of Pathology, Eye and ENT Hospital, Fudan University (H.S., R.C., C.Z., W.S., J.S., Y.B.)
| | - Yingwen Bi
- From the Department of Pathology, Eye and ENT Hospital, Fudan University (H.S., R.C., C.Z., W.S., J.S., Y.B.).
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19
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Thierauf JC, Farahani AA, Indave BI, Bard AZ, White VA, Smith CR, Marble H, Hyrcza MD, Chan JKC, Bishop J, Shi Q, Ely K, Agaimy A, Martinez-Lage M, Nose V, Rivera M, Nardi V, Dias-Santagata D, Garg S, Sadow P, Le LP, Faquin W, Ritterhouse LL, Cree IA, Iafrate AJ, Lennerz JK. Diagnostic Value of MAML2 Rearrangements in Mucoepidermoid Carcinoma. Int J Mol Sci 2022; 23:4322. [PMID: 35457138 PMCID: PMC9026998 DOI: 10.3390/ijms23084322] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023] Open
Abstract
Mucoepidermoid carcinoma (MEC) is often seen in salivary glands and can harbor MAML2 translocations (MAML2+). The translocation status has diagnostic utility as an objective confirmation of the MEC diagnosis, for example, when distinction from the more aggressive adenosquamous carcinoma (ASC) is not straightforward. To assess the diagnostic relevance of MAML2, we examined our 5-year experience in prospective testing of 8106 solid tumors using RNA-seq panel testing in combinations with a two-round Delphi-based scenario survey. The prevalence of MAML2+ across all tumors was 0.28% (n = 23/8106) and the majority of MAML2+ cases were found in head and neck tumors (78.3%), where the overall prevalence was 5.9% (n = 18/307). The sensitivity of MAML2 for MEC was 60% and most cases (80%) were submitted for diagnostic confirmation; in 24% of cases, the MAML2 results changed the working diagnosis. An independent survey of 15 experts showed relative importance indexes of 0.8 and 0.65 for "confirmatory MAML2 testing" in suspected MEC and ASC, respectively. Real-world evidence confirmed that the added value of MAML2 is a composite of an imperfect confirmation test for MEC and a highly specific exclusion tool for the diagnosis of ASC. Real-world evidence can help move a rare molecular-genetic biomarker from an emerging tool to the clinic.
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Affiliation(s)
- Julia C. Thierauf
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Otorhinolaryngology, Head and Neck Surgery, Heidelberg University Hospital and Research Group Molecular Mechanisms of Head and Neck Tumors, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Alex A. Farahani
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - B. Iciar Indave
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Adam Z. Bard
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Valerie A. White
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - Cameron R. Smith
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Hetal Marble
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Martin D. Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary, AB 2500, Canada;
| | - John K. C. Chan
- Department of Pathology, Queen Elizabeth Hospital, Kowloon, Hong Kong, China;
| | - Justin Bishop
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA;
| | - Qiuying Shi
- Department of Pathology, Emory University Hospital, Atlanta, GA 30322, USA;
| | - Kim Ely
- Department of Pathology, Vanderbilt University Medical Center, Nashville, TN 37232, USA;
| | - Abbas Agaimy
- Institute of Pathology, Friedrich Alexander University Erlangen-Nürnberg, University Hospital, 91054 Erlangen, Germany;
| | - Maria Martinez-Lage
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Vania Nose
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Miguel Rivera
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Valentina Nardi
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Dora Dias-Santagata
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Salil Garg
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Peter Sadow
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Long P. Le
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - William Faquin
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Lauren L. Ritterhouse
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
| | - Ian A. Cree
- International Agency for Research on Cancer (IARC), World Health Organization, 69372 Lyon, France; (B.I.I.); (V.A.W.); (I.A.C.)
| | - A. John Iafrate
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (C.R.S.); (M.M.-L.); (V.N.); (P.S.); (W.F.)
| | - Jochen K. Lennerz
- Department of Pathology, Center for Integrated Diagnostics, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA; (J.C.T.); (A.A.F.); (A.Z.B.); (H.M.); (M.R.); (V.N.); (D.D.-S.); (S.G.); (L.P.L.); (L.L.R.); (A.J.I.)
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20
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Basak K, Mericoz CA, Firat P. Warthin-Like Mucoepidermoid Carcinoma: A Morphological Spectrum - A Report of 3 Cases with Histological and Cytological Findings and Review of the Literature. Acta Cytol 2022; 66:244-252. [PMID: 35124667 DOI: 10.1159/000521134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/19/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mucoepidermoid carcinoma (MEC) showing Warthin's tumor (WT)-like features is a low-grade malignancy which should be differentiated from WT. Morphological features may be distinctly different in each case, causing diagnostic difficulties. CASE PRESENTATION Three cases were presented and discussed with their morphologies. All cases that presented with a mass in the parotid gland went to parotidectomy, and all had preoperative fine-needle aspirations (FNAs). Case 1 was a 16-year-old female; FNA was suggestive of WT and initially interpreted as WT histologically. Case 2 was a 27-year-old male; FNA was interpreted as noninformative due to the presence of cyst fluid only. Case 3 was a 53-year-old male and cytologically was found to be suspicious for MEC which contained squamous and goblet cells on a mucoid background. On histopathological examination, case 2 and case 3 were morphologically consistent with low-grade MEC with WT-like features. Prominent lymphoid stroma and the cystic pattern were the characters of these tumors. Case 1 had the classical WT appearance with some mucinous and squamous metaplasia which could only be interpreted as MEC after the detection of MAML2 rearrangement by FISH. The other 2 showed either focal or relatively diffuse usual low-grade MEC findings, and case 3 was also confirmed by MAML2 rearrangement. CONCLUSION Cytological and histopathological features revealed a spectrum. Differentiating WT-like MECs from ordinary WTs may be challenging. On the one end of the spectrum, they may look very much like WT, and on the other end, even though usual MEC features are present, still, WT-like appearance may pose diagnostic difficulty. Showing MAML2 rearrangement in these cases is very helpful. The presence of mucinous and squamous cells in an otherwise WT-like looking tumor should be alarming for MEC, and if possible, each case should be analyzed for MAML2 rearrangement.
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Affiliation(s)
- Kayhan Basak
- Department of Pathology, Kartal Dr. Lütfi Kirdar City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Cisel Aydin Mericoz
- Department of Pathology, Koc University, School of Medicine, Istanbul, Turkey
| | - Pinar Firat
- Department of Pathology, Koc University, School of Medicine, Istanbul, Turkey
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21
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Bundele M, Weinreb I, Xu B, Chiosea S, Faquin W, Dias-Santagata D, Leon M, Hyrcza M, Seethala RR. Mucoacinar Carcinoma: A Rare Variant of Mucoepidermoid Carcinoma. Am J Surg Pathol 2021; 45:1028-1037. [PMID: 34091485 DOI: 10.1097/pas.0000000000001752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mucoepidermoid carcinoma (MEC) is generally characterized by an admixture of mucous, epidermoid and intermediate type cells. Numerous variants morphologies are described and defined by stromal and/or cytoplasmic tinctorial characteristics. We now report 11 cases of MEC with serous acinar differentiation, reflecting a distal intercalated duct/acinar phenotype, which we designate as mucoacinar carcinomas. Seven patients were female while 4 were male with a mean age of 55 years (range: 21 to 72 y). Ten cases were from the parotid while 1 was from the submandibular gland. Mean size of the tumors was 1.8 cm (range: 0.7 to 4.5 cm). Three cases were low grade, 7 were intermediate grade, and 1 was high grade. Low to intermediate grade cases demonstrated prominent clear to vacuolated cells with focal serous acinar differentiation. The high-grade case showed a distinctive scattering of acinar cells interspersed between epidermoid cells. Periodic acid Schiff after diastase (9/9), SOX-10 (9/9), and DOG-1 (9/10) highlighted the acinar component. Six of 7 cases showed a focal acinar predominant NR4A3 expression. MAML2 fluorescence in situ hybridization was positive in all cases, in both acinar and mucoepidermoid components. Two cases tested by next generation sequencing showed standard CRTC1-MAML2 fusions. MSANTD3 and NR4A3 fluorescence in situ hybridization on the other hand were negative. Evidence thus suggests that mucoacinar carcinoma represents an acinar variant morphology in MEC, rather than a true MEC-acinic cell carcinoma hybrid, or collision tumor. The acinar differentiation, SOX-10, DOG-1, and even focal NR4A3 reactivity may thus be diagnostic pitfalls.
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Affiliation(s)
| | - Ilan Weinreb
- Department of Laboratory Medicine & Pathobiology, University Health Network, Toronto, ON
| | - Bin Xu
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Simion Chiosea
- Department of Pathology and Laboratory Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | | | - Marino Leon
- Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | - Martin Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Arnie Charbonneau Cancer Institute, Calgary, AB, Canada
| | - Raja R Seethala
- Department of Pathology and Laboratory Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA
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22
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Pesi R, Allegrini S, Garcia-Gil M, Piazza L, Moschini R, Jordheim LP, Camici M, Tozzi MG. Cytosolic 5'-Nucleotidase II Silencing in Lung Tumor Cells Regulates Metabolism through Activation of the p53/AMPK Signaling Pathway. Int J Mol Sci 2021; 22:ijms22137004. [PMID: 34209768 PMCID: PMC8268954 DOI: 10.3390/ijms22137004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 12/25/2022] Open
Abstract
Cytosolic 5′-nucleotidase II (cN-II) is an allosteric catabolic enzyme that hydrolyzes IMP, GMP, and AMP. The enzyme can assume at least two different structures, being the more active conformation stabilized by ATP and the less active by inorganic phosphate. Therefore, the variation in ATP concentration can control both structure and activity of cN-II. In this paper, using a capillary electrophoresis technique, we demonstrated that a partial silencing of cN-II in a pulmonary carcinoma cell line (NCI-H292) is accompanied by a decrease in adenylate pool, without affecting the energy charge. We also found that cN-II silencing decreased proliferation and increased oxidative metabolism, as indicated by the decreased production of lactate. These effects, as demonstrated by Western blotting, appear to be mediated by both p53 and AMP-activated protein kinase, as most of them are prevented by pifithrin-α, a known p53 inhibitor. These results are in line with our previous observations of a shift towards a more oxidative and less proliferative phenotype of tumoral cells with a low expression of cN-II, thus supporting the search for specific inhibitors of this enzyme as a therapeutic tool for the treatment of tumors.
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Affiliation(s)
- Rossana Pesi
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy; (R.P.); (L.P.); (R.M.); (M.C.); (M.G.T.)
| | - Simone Allegrini
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy; (R.P.); (L.P.); (R.M.); (M.C.); (M.G.T.)
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health”, Università di Pisa, 56126 Pisa, Italy;
- CISUP, Centro per l’Integrazione della Strumentazione dell’Università di Pisa, 56127 Pisa, Italy
- Correspondence: ; Tel.: +39-050-221-1459
| | - Mercedes Garcia-Gil
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health”, Università di Pisa, 56126 Pisa, Italy;
- CISUP, Centro per l’Integrazione della Strumentazione dell’Università di Pisa, 56127 Pisa, Italy
- Unità di Fisiologia Generale, Dipartimento di Biologia, Università di Pisa, Via San Zeno 31, 56127 Pisa, Italy
| | - Lucia Piazza
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy; (R.P.); (L.P.); (R.M.); (M.C.); (M.G.T.)
| | - Roberta Moschini
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy; (R.P.); (L.P.); (R.M.); (M.C.); (M.G.T.)
- Interdepartmental Research Center Nutrafood “Nutraceuticals and Food for Health”, Università di Pisa, 56126 Pisa, Italy;
- CISUP, Centro per l’Integrazione della Strumentazione dell’Università di Pisa, 56127 Pisa, Italy
| | - Lars Petter Jordheim
- Université de Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Centre de Recherche en Cancérologie de Lyon, 69008 Lyon, France;
| | - Marcella Camici
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy; (R.P.); (L.P.); (R.M.); (M.C.); (M.G.T.)
| | - Maria Grazia Tozzi
- Unità di Biochimica, Dipartimento di Biologia, Università di Pisa, Via San Zeno 51, 56127 Pisa, Italy; (R.P.); (L.P.); (R.M.); (M.C.); (M.G.T.)
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23
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Musicant AM, Parag-Sharma K, Gong W, Sengupta M, Chatterjee A, Henry EC, Tsai YH, Hayward MC, Sheth S, Betancourt R, Hackman TG, Padilla RJ, Parker JS, Giudice J, Flaveny CA, Hayes DN, Amelio AL. CRTC1/MAML2 directs a PGC-1α-IGF-1 circuit that confers vulnerability to PPARγ inhibition. Cell Rep 2021; 34:108768. [PMID: 33626346 PMCID: PMC7955229 DOI: 10.1016/j.celrep.2021.108768] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 11/22/2020] [Accepted: 01/27/2021] [Indexed: 01/03/2023] Open
Abstract
Mucoepidermoid carcinoma (MEC) is a life-threatening salivary gland cancer that is driven primarily by a transcriptional coactivator fusion composed of cyclic AMP-regulated transcriptional coactivator 1 (CRTC1) and mastermind-like 2 (MAML2). The mechanisms by which the chimeric CRTC1/MAML2 (C1/M2) oncoprotein rewires gene expression programs that promote tumorigenesis remain poorly understood. Here, we show that C1/M2 induces transcriptional activation of the non-canonical peroxisome proliferator-activated receptor gamma coactivator-1 alpha (PGC-1α) splice variant PGC-1α4, which regulates peroxisome proliferator-activated receptor gamma (PPARγ)-mediated insulin-like growth factor 1 (IGF-1) expression. This mitogenic transcriptional circuitry is consistent across cell lines and primary tumors. C1/M2-positive tumors exhibit IGF-1 pathway activation, and small-molecule drug screens reveal that tumor cells harboring the fusion gene are selectively sensitive to IGF-1 receptor (IGF-1R) inhibition. Furthermore, this dependence on autocrine regulation of IGF-1 transcription renders MEC cells susceptible to PPARγ inhibition with inverse agonists. These results yield insights into the aberrant coregulatory functions of C1/M2 and identify a specific vulnerability that can be exploited for precision therapy.
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Affiliation(s)
- Adele M Musicant
- Graduate Curriculum in Genetics and Molecular Biology, Biological and Biomedical Sciences Program, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kshitij Parag-Sharma
- Graduate Curriculum in Cell Biology and Physiology, Biological and Biomedical Sciences Program, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Weida Gong
- Bioinformatics Core, Lineberger Comprehensive Cancer Center, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Monideepa Sengupta
- Graduate Curriculum in Pharmacological and Physiological Sciences, School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Arindam Chatterjee
- Department of Pharmacology and Physiology, School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - Erin C Henry
- Division of Oral and Craniofacial Health Sciences, UNC Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yi-Hsuan Tsai
- Bioinformatics Core, Lineberger Comprehensive Cancer Center, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michele C Hayward
- Lineberger Comprehensive Cancer Center, Cancer Genetics Program, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Siddharth Sheth
- Division of Hematology/Oncology, Department of Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Renee Betancourt
- Department of Pathology and Laboratory Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Trevor G Hackman
- Department of Otolaryngology/Head and Neck Surgery, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ricardo J Padilla
- Division of Diagnostic Sciences, UNC Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Joel S Parker
- Lineberger Comprehensive Cancer Center, Cancer Genetics Program, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Genetics, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jimena Giudice
- Department of Cell Biology and Physiology, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; McAllister Heart Institute, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Colin A Flaveny
- Department of Pharmacology and Physiology, School of Medicine, Saint Louis University, Saint Louis, MO, USA
| | - David N Hayes
- Lineberger Comprehensive Cancer Center, Cancer Genetics Program, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Medical Oncology, University of Tennessee Health Sciences West Cancer Center, Memphis, TN, USA
| | - Antonio L Amelio
- Division of Oral and Craniofacial Health Sciences, UNC Adams School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Cell Biology and Physiology, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Biomedical Research Imaging Center, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Lineberger Comprehensive Cancer Center, Cancer Cell Biology Program, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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24
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Okumura Y, Nakano S, Murase T, Ueda K, Kawakita D, Nagao T, Kusafuka K, Urano M, Yamamoto H, Kano S, Tsukahara K, Okami K, Nagao T, Hanai N, Iwai H, Kawata R, Tada Y, Nibu K, Inagaki H. Prognostic impact of CRTC1/3-MAML2 fusions in salivary gland mucoepidermoid carcinoma: A multiinstitutional retrospective study. Cancer Sci 2020; 111:4195-4204. [PMID: 32860299 PMCID: PMC7648036 DOI: 10.1111/cas.14632] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/13/2020] [Accepted: 08/19/2020] [Indexed: 12/12/2022] Open
Abstract
Mucoepidermoid carcinoma (MEC) is rare, but the most common primary malignancy of the salivary gland and not infrequent in young individuals. CRTC1/3-MAML2 fusions are frequently detected in MEC and are useful as a diagnostic biomarker. However, there has been debate as to whether the fusions have prognostic significance. In this study, we retrospectively collected 153 salivary gland MEC cases from 11 tertiary hospitals in Japan. As inclusion criteria, the MEC patients in this study had curative surgery as the initial treatment, received no preoperative treatment, and had no distant metastasis at the time of the initial surgery. The MEC diagnosis was validated by a central pathology review by five expert salivary gland pathologists. The CRTC1/3-MAML2 fusions were detected using FISH and RT-PCR. In 153 MEC cases, 90 (58.8%) were positive for CRTC1/3-MAML2 fusions. During the follow-up period, 28 (18.3%) patients showed tumor recurrence and 12 (7.8%) patients died. The presence of the fusions was associated with favorable tumor features. Of note, none of the fusion-positive patients died during the follow-up period. Statistical analysis showed that the presence of the fusions was a prognostic indicator of a better overall survival in the total and advanced-stage MEC cohorts, but not in the early-stage MEC cohort. In conclusion, CRTC1/3-MAML2 fusions are an excellent biomarker for favorable overall survival of patients with salivary gland MEC.
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Affiliation(s)
- Yoshihide Okumura
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
- Department of Maxillofacial SurgerySchool of DentistryAichi‐Gakuin UniversityNagoyaJapan
| | - Satsuki Nakano
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
| | - Takayuki Murase
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
| | - Kaori Ueda
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
- Department of Maxillofacial SurgerySchool of DentistryAichi‐Gakuin UniversityNagoyaJapan
| | - Daisuke Kawakita
- Department of Otolaryngology, Head and Neck SurgeryGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
| | - Toshitaka Nagao
- Department of Anatomic PathologyTokyo Medical UniversityTokyoJapan
| | | | - Makoto Urano
- Department of Diagnostic PathologySchool of MedicineFujita Health UniversityToyoakeJapan
| | - Hidetaka Yamamoto
- Department of Anatomic PathologyGraduate of School of Medical ScienceKyushu UniversityFukuokaJapan
| | - Satoshi Kano
- Department of Otolaryngology‐Head and Neck SurgeryFaculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
| | - Kiyoaki Tsukahara
- Department of Otorhinolaryngology, Head and Neck SurgeryTokyo Medical UniversityTokyoJapan
| | - Kenji Okami
- Department of Otolaryngology‐Head and Neck SurgeryTokai University School of MedicineIseharaJapan
| | - Toru Nagao
- Department of Maxillofacial SurgerySchool of DentistryAichi‐Gakuin UniversityNagoyaJapan
| | - Nobuhiro Hanai
- Department of Head and Neck SurgeryAichi Cancer Center HospitalNagoyaJapan
| | - Hiroshi Iwai
- Department of Otolaryngology, Head and Neck SurgeryKansai Medical UniversityHirakataJapan
| | - Ryo Kawata
- Department of Otorhinolaryngology‐Head and Neck SurgeryOsaka Medical CollegeTakatsukiJapan
| | - Yuichiro Tada
- Department of Head and Neck Oncology and SurgeryInternational University of Health and WelfareMita HospitalTokyoJapan
| | - Ken‐Ichi Nibu
- Department of Otolaryngology‐Head and Neck SurgeryKobe University Graduate School of MedicineKobeJapan
| | - Hiroshi Inagaki
- Department of Pathology and Molecular DiagnosticsGraduate School of Medical SciencesNagoya City UniversityNagoyaJapan
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Szymanski LJ, Molas-Torreblanca K, Bawab R, Kim E, Don D, Mascarenhas L, Stanley P, Zhou S, Shillingford N. Bronchial Mucoepidermoid Carcinoma With the Classic MAML2 Gene Rearrangement in a 2-year-old Boy. Pediatr Dev Pathol 2018; 21:480-485. [PMID: 28492094 DOI: 10.1177/1093526617707855] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pulmonary mucoepidermoid carcinoma (PMEC) is rare. To date, primary PMEC has not been reported in a child younger than 3 years of age. We report a case of a 2-year-old boy who presented with 3 episodes of wheezing, cough, and fever over a period of 1 month. Radiologic findings were consistent with foreign body aspiration with consequent bronchial obstruction. Bronchoscopy was performed and attempts to retrieve the foreign body resulted in a biopsy of a fleshy lesion. By histology, the lesion was an epithelial neoplasm comprising cells arranged in a nested pattern. The neoplastic cells were round with round nuclei and amphophilic, vacuolated cytoplasm. Our diagnosis was low-grade salivary gland-type carcinoma of the bronchus. The pneumonectomy specimen showed a well-circumscribed, polypoid intrabronchial mass measuring 2.1 cm in greatest dimension. Histologic examination of the tumor showed an admixture of intermediate cells which were predominant, a small number of mucus cells and rare foci of squamous cells. The final diagnosis rendered was a low-grade mucoepidermoid carcinoma of the bronchus. Accurate diagnosis of PMEC can be challenging on limited biopsy material as seen in the case reported here. The use of molecular studies such as MAML2 gene rearrangement may facilitate diagnosis in difficult cases. Increased awareness of this entity and further molecular studies are needed for a better understanding of the pathogenesis of PMEC. To date, the reported age range for primary bronchial mucoepidermoid carcinoma is between 3 years and 78 years. This case represents the youngest patient reported in the English literature.
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Affiliation(s)
- Linda J Szymanski
- 1 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Kira Molas-Torreblanca
- 2 Keck School of Medicine, University of Southern California, Los Angeles, California
- 3 Department of Hospital Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Ramzi Bawab
- 1 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
| | - Eugene Kim
- 2 Keck School of Medicine, University of Southern California, Los Angeles, California
- 4 General Pediatric Surgery, Children's Hospital Los Angeles, Los Angeles, California
| | - Debra Don
- 2 Keck School of Medicine, University of Southern California, Los Angeles, California
- 5 Division of Otolaryngology, Department of Surgery, Children's Hospital Los Angeles, Los Angeles, California
| | - Leo Mascarenhas
- 2 Keck School of Medicine, University of Southern California, Los Angeles, California
- 6 Division of Hematology-Oncology, Department of Pediatrics, Children's Hospital Los Angeles, Los Angeles, California
| | - Phillip Stanley
- 2 Keck School of Medicine, University of Southern California, Los Angeles, California
- 7 Department of Radiology, Children's Hospital Los Angeles, Los Angeles, California
| | - Shengmei Zhou
- 1 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
- 2 Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Nick Shillingford
- 1 Department of Pathology and Laboratory Medicine, Children's Hospital Los Angeles, Los Angeles, California
- 2 Keck School of Medicine, University of Southern California, Los Angeles, California
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26
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Bazarsad S, Kim JY, Zhang X, Kim KY, Lee DY, Ryu MH, Kim J. Ataxia-Telangiectasia-Mutated Protein Expression as a Prognostic Marker in Adenoid Cystic Carcinoma of the Salivary Glands. Yonsei Med J 2018; 59:717-726. [PMID: 29978608 PMCID: PMC6037598 DOI: 10.3349/ymj.2018.59.6.717] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 01/24/2023] Open
Abstract
PURPOSE Adenoid cystic carcinoma (ACC) is a high-grade malignant tumor of the salivary glands, clinically characterized by multiple recurrences and late distant metastasis. Biological markers for assessing the prognosis of ACC have remained elusive. The purpose of this study was to investigate whether the protein expressions of ataxia telangiectasia mutated (ATM), p53, and ATM-mediated phosphorylated p53 are related to patient survival in ACC. MATERIALS AND METHODS In this study, 48 surgical samples were used to assess the expressions of ATM and its downstream target p53. Fisher's exact test and Kaplan-Meier analysis were conducted to evaluate the role of ATM, p53, and phospho-p53 (S15) protein expressions in predicting patient survival and distant metastasis. RESULTS Myb expression was positive in 85.4% of ACCs, but did not reflect patient survival rate. In contrast, low expression of ATM in cancer cells was significantly correlated with poor survival rate (p=0.037). Moreover, under positive p53 expression, low expression of ATM was highly predictive of poor survival in ACC (p=0.017). CONCLUSION These data indicate that combined assessment of ATM and p53 expression can serve as a useful prognostic marker for assessing survival rate in patients with ACC of the salivary glands.
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Affiliation(s)
- Shadavlonjid Bazarsad
- Oral Cancer Research Institute, Department of Oral Pathology, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
- Dental School of Mongolian National University of Medical Science, Ulaanbaatar, Mongolia
| | - Jue Young Kim
- Oral Cancer Research Institute, Department of Oral Pathology, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Xianglan Zhang
- Oral Cancer Research Institute, Department of Oral Pathology, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
- Department of Pathology, Yanbian University Hospital, Yanji City, Jilin Province, China
| | - Ki Yeol Kim
- Brain Korea 21 Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Doo Young Lee
- Oral Cancer Research Institute, Department of Oral Pathology, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea
| | - Mi Heon Ryu
- Department of Oral Pathology, BK21 Plus Project, School of Dentistry, Pusan National University, Yangsan, Korea.
| | - Jin Kim
- Oral Cancer Research Institute, Department of Oral Pathology, Brain Korea 21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea.
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27
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Alamri AM, Liu X, Blancato JK, Haddad BR, Wang W, Zhong X, Choudhary S, Krawczyk E, Kallakury BV, Davidson BJ, Furth PA. Expanding primary cells from mucoepidermoid and other salivary gland neoplasms for genetic and chemosensitivity testing. Dis Model Mech 2018; 11:dmm031716. [PMID: 29419396 PMCID: PMC5818080 DOI: 10.1242/dmm.031716] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/01/2017] [Indexed: 12/15/2022] Open
Abstract
Restricted availability of cell and animal models is a rate-limiting step for investigation of salivary gland neoplasm pathophysiology and therapeutic response. Conditionally reprogrammed cell (CRC) technology enables establishment of primary epithelial cell cultures from patient material. This study tested a translational workflow for acquisition, expansion and testing of CRC-derived primary cultures of salivary gland neoplasms from patients presenting to an academic surgical practice. Results showed that cultured cells were sufficient for epithelial cell-specific transcriptome characterization to detect candidate therapeutic pathways and fusion genes, and for screening for cancer risk-associated single nucleotide polymorphisms (SNPs) and driver gene mutations through exome sequencing. Focused study of primary cultures of a low-grade mucoepidermoid carcinoma demonstrated amphiregulin-mechanistic target of rapamycin-protein kinase B (AKT; AKT1) pathway activation, identified through bioinformatics and subsequently confirmed as present in primary tissue and preserved through different secondary 2D and 3D culture media and xenografts. Candidate therapeutic testing showed that the allosteric AKT inhibitor MK2206 reproducibly inhibited cell survival across different culture formats. By contrast, the cells appeared resistant to the adenosine triphosphate competitive AKT inhibitor GSK690693. Procedures employed here illustrate an approach for reproducibly obtaining material for pathophysiological studies of salivary gland neoplasms, and other less common epithelial cancer types, that can be executed without compromising pathological examination of patient specimens. The approach permits combined genetic and cell-based physiological and therapeutic investigations in addition to more traditional pathologic studies, and can be used to build sustainable bio-banks for future inquiries.This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Ahmad M Alamri
- Oncology, Georgetown University, Washington, DC 20057, USA
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61413, Saudi Arabia
| | - Xuefeng Liu
- Pathology, Center for Cell Reprogramming, Georgetown University, Washington, DC 20057, USA
| | - Jan K Blancato
- Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA
| | - Bassem R Haddad
- Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA
| | - Weisheng Wang
- Oncology, Georgetown University, Washington, DC 20057, USA
| | - Xiaogang Zhong
- Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC 20057, USA
| | | | - Ewa Krawczyk
- Pathology, Center for Cell Reprogramming, Georgetown University, Washington, DC 20057, USA
| | - Bhaskar V Kallakury
- Pathology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA
| | - Bruce J Davidson
- Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC 20007, USA
| | - Priscilla A Furth
- Oncology and Medicine, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA
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28
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Wang K, McDermott JD, Schrock AB, Elvin JA, Gay L, Karam SD, Raben D, Somerset H, Ali SM, Ross JS, Bowles DW. Comprehensive genomic profiling of salivary mucoepidermoid carcinomas reveals frequent BAP1, PIK3CA, and other actionable genomic alterations. Ann Oncol 2017; 28:748-753. [PMID: 28327999 DOI: 10.1093/annonc/mdw689] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [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: 09/02/2016] [Indexed: 12/15/2022] Open
Abstract
Background We sought to identify genomic alterations (GAs) in salivary mucoepidermoid carcinomas. Patients and methods DNA was extracted from 48 mucoepidermoid carcinomas. Comprehensive genomic profiling (CGP) including the calculation to tumor mutational burden (TMB) was performed on hybridization-captured adaptor ligation-based libraries of 315 cancer-related genes plus introns from 28 genes frequently rearranged for cancer and evaluated for all classes of GAs. Results A total of 183 GAs were found in 80 unique genes. High-grade tumors had more GAs (mean 5 ± 3.8) compared with low (2.3 ± 1.4) or intermediate (2.6 ± 1.5) (P = 0.019). TP53 GAs were seen in all tumor grades (41.7%) but were most common in high-grade malignancies (56%) (P = 0.047). CDKN2A GAs were seen in 41.6% of tumors. PI3K/mTOR pathway activation, including PI3KCA mutations, were more common in high grade (52%) than in low- and intermediate-grade tumors (4.3%) (P = 0.007). BAP1 GAs were observed in 20.8% of tumors and BRCA1/2 GAs present in 10.5% of specimens. ERBB2 amplifications were seen in only 8.3% of tumors. The TMB for this patient group was relatively low with only 5 (10%) of cases having greater than 10 mutations/megabase of sequenced DNA. Conclusion CGP of salivary mucoepidermoid carcinomas revealed diverse GAs that may lead to customized treatment options for patients with these rare tumors.
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Affiliation(s)
- K Wang
- Foundation Medicine, Inc., Cambridge, USA
- Center for Precision Medicine, Zhejiang University International Hospital, Hangzhou, Zhejiang, China
| | - J D McDermott
- Division of Medical Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - J A Elvin
- Foundation Medicine, Inc., Cambridge, USA
| | - L Gay
- Foundation Medicine, Inc., Cambridge, USA
| | - S D Karam
- Departments of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - D Raben
- Departments of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO, USA
| | - H Somerset
- Department of Pathology, University of Colorado School of Medicine, Aurora, CO, USA
| | - S M Ali
- Foundation Medicine, Inc., Cambridge, USA
| | - J S Ross
- Foundation Medicine, Inc., Cambridge, USA
- Department of Pathology and Laboratory Medicine, Albany Medical College, Albany, USA
| | - D W Bowles
- Division of Medical Oncology, University of Colorado School of Medicine, Aurora, CO, USA
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29
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Birkeland AC, Foltin SK, Michmerhuizen NL, Hoesli RC, Rosko AJ, Byrd S, Yanik M, Nor JE, Bradford CR, Prince ME, Carey TE, McHugh JB, Spector ME, Brenner JC. Correlation of Crtc1/3-Maml2 fusion status, grade and survival in mucoepidermoid carcinoma. Oral Oncol 2017; 68:5-8. [PMID: 28438292 DOI: 10.1016/j.oraloncology.2017.02.025] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [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: 11/10/2016] [Revised: 02/15/2017] [Accepted: 02/22/2017] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Mucoepidermoid carcinoma (MEC) is the most common malignant tumor of the salivary glands. Tumor stage and grade have historically been important predictors of survival. An oncogenic CRTC1- or CRTC3-MAML2 gene fusion has been identified in a number of MECs. Historically, these gene fusions have been associated with lower grade tumors and better survival. However, reported gene fusion rates and prognosis varies widely across studies, and have not controlled for tumor grade. We sought to identify gene fusion rates and outcomes in our cohort of MEC patients. MATERIALS AND METHODS An IRB-approved retrospective cohort of patients with MEC was identified at the University of Michigan. Clinical, histologic, and outcome data was collected from medical records. RNA was isolated from formalin fixed paraffin-embedded tumor sections, and qRT-PCR was performed to identify CRTC1/3-MAML2 gene fusions. Sanger sequencing of qRT-PCR products was used to confirm gene fusions. RESULTS Overall, 90 patient MEC tumors were collected (58 low-grade, 25 intermediate-grade, and 7 high-grade). Gene fusions were identified in 59% (53/90) of tumors. On univariate and bivariate analysis, fusion status did not significantly associate with grade or survival. CONCLUSION We have identified a high rate of CRTC1/3-MAML2 gene fusions in a large cohort of MEC. We do not identify any correlation between fusion status with tumor grade or survival. These findings suggest further characterization of MECs is needed before considering the CRTC1/3-MAML2 gene fusion as a prognostic biomarker. Additional genetic drivers may account for survival and grade in MECs.
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Affiliation(s)
- Andrew C Birkeland
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Susan K Foltin
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Nicole L Michmerhuizen
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States; Department of Pharmacology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Rebecca C Hoesli
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Andrew J Rosko
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Serena Byrd
- Department of Otolaryngology - Head and Neck Surgery, St. Louis University, 3635 Vista Ave, St. Louis, MO 63110, United States
| | - Megan Yanik
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Jacques E Nor
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Carol R Bradford
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States; Comprehensive Cancer Center, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Mark E Prince
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States; Comprehensive Cancer Center, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Thomas E Carey
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States; Comprehensive Cancer Center, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Jonathan B McHugh
- Department of Pathology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - Matthew E Spector
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States; Comprehensive Cancer Center, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States
| | - J Chad Brenner
- Department of Otolaryngology - Head and Neck Surgery, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States; Comprehensive Cancer Center, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, United States.
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30
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Skálová A, Šteiner P, Vaneček T. [New developments in molecular diagnostics of carcinomas of the salivary glands: "translocation carcinomas"]. Cesk Patol 2016; 52:139-145. [PMID: 27526014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In recent years the discovery of translocations and the fusion oncogenes that they result in has changed the way diagnoses are made in salivary gland pathology. These genetic aberrations are recurrent; and at the very least serve as powerful diagnostic tools in salivary gland tumors diagnosis and classification. They also show promise as prognostic markers and hopefully as targets of therapy. In this review the 4 carcinomas currently known to harbor translocations will be discussed, namely mucoepidermoid carcinoma, adenoid cystic carcinoma, mammary analogue secretory carcinoma, and hyalinizing clear cell carcinoma. The discovery and implications of each fusion will be highlighted and how they have helped to reshape the current classification of salivary gland tumors.
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MESH Headings
- Carcinoma/diagnosis
- Carcinoma/genetics
- Carcinoma/metabolism
- Carcinoma/pathology
- Carcinoma, Adenoid Cystic/diagnosis
- Carcinoma, Adenoid Cystic/genetics
- Carcinoma, Adenoid Cystic/metabolism
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/diagnosis
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/metabolism
- Carcinoma, Mucoepidermoid/pathology
- Humans
- Oncogene Proteins, Fusion/genetics
- Pathology, Molecular
- Salivary Gland Neoplasms/diagnosis
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/pathology
- Salivary Glands/metabolism
- Salivary Glands/pathology
- Translocation, Genetic
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31
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Huo Z, Wu H, Li J, Li S, Wu S, Liu Y, Luo Y, Cao J, Zeng X, Liang Z. Primary Pulmonary Mucoepidermoid Carcinoma: Histopathological and Moleculargenetic Studies of 26 Cases. PLoS One 2015; 10:e0143169. [PMID: 26575266 PMCID: PMC4648574 DOI: 10.1371/journal.pone.0143169] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Accepted: 11/02/2015] [Indexed: 01/03/2023] Open
Abstract
Introduction Pulmonary mucoepidermoid carcinoma (PMEC) is an uncommon neoplasm of the lung and the main salivary gland-type lung carcinoma. The aims of this study were to review the clinicopathological and immunohistochemical features of PMEC and characterize the genetic events in PMEC. Methods We reviewed the pathology cases in our hospital and found 34 initially diagnosed PMEC cases, 26 of which were confirmed as PMEC after excluding 8 cases of MEC-like pulmonary carcinoma. The clinicopathological characteristics of the 26 PMEC cases and the 8 cases of MEC-like pulmonary carcinoma were retrospectively reviewed. MAML2 rearrangement was detected by fluorescence In Situ Hybridization (FISH). Immunostains of ALK, calponin, collagen IV, CK7, EGFR, HER2, Ki-67, Muc5Ac, p63, p40, and TTF-1 were performed. DNA was extracted from 23 cases of PMEC. Mutation profiling of the EGFR, KRAS, BRAF, ALK, PIK3CA, PDGFRA, and DDR2 genes were carried out using next-generation sequencing (NGS), Sanger sequencing, and quantitative polymerase chain reaction (QPCR) in 9 successfully amplified cases. Results Twenty-six cases of PMEC (18 low-grade, 8 high-grade) included 13 men and 13 women aged 12–79 years. Twenty-two cases had a central/endobronchial growth pattern, and 4 cases had a peribronchial growth pattern. Immunohistochemically, CK7, Muc5Ac, p40, and p63 were positive in all cases (26/26);EGFR was positive in 11 cases (11/26); TTF-1, Calponin, HER2 and ALK were negative in all cases (0/26). MAML2 rearrangement was identified in 12 of 18 PMEC cases. No mutations were detected in any of the 7 genes in the 9 cases that qualified for mutation analysis. Twenty-three PMEC patients had follow-up information with a median interval of 32.6 months. Both the 5- and 10-year overall survival rates (OS) were 72.1%, and a high-grade tumor was an adverse prognostic factor in PMEC. There were 8 cases of MEC-like pulmonary carcinoma aged 36–78 years: 2 cases were located in the bronchus, and 6 cases were located in the lung. p63 and TTF-1 were positive in all cases (8/8), p40 was positive in 5 cases (5/8), and ALK was positive in 5 cases (5/8). No cases of MAML2 rearrangement were detected, but there were 5 cases of ALK rearrangement. Conclusions PMEC is a primary malignant pulmonary tumor with a relatively good prognosis that is historically characterized by the presence of mucous cells and a lack of keratinization. There are distinct differences between PMEC and MEC-like pulmonary carcinoma in tumor location preference, immunophenotype, and molecular genetics, and the differential diagnosis is critical due to the therapeutic and prognostic considerations.
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Affiliation(s)
- Zhen Huo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Huanwen Wu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Ji Li
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Shanqing Li
- Department of Thoracic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Shafei Wu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yuanyuan Liu
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Yufeng Luo
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Jinling Cao
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
| | - Xuan Zeng
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- * E-mail: (ZL); (XZ)
| | - Zhiyong Liang
- Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- * E-mail: (ZL); (XZ)
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32
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Wang Z, Ling S, Rettig E, Sobel R, Tan M, Fertig EJ, Considine M, El-Naggar AK, Brait M, Fakhry C, Ha PK. Epigenetic screening of salivary gland mucoepidermoid carcinoma identifies hypomethylation of CLIC3 as a common alteration. Oral Oncol 2015; 51:1120-5. [PMID: 26490796 DOI: 10.1016/j.oraloncology.2015.09.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 04/16/2015] [Revised: 09/16/2015] [Accepted: 09/23/2015] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The role of promoter methylation in the development of mucoepidermoid carcinoma (MEC) has not been fully explored. In this study, we investigated the epigenetic landscape of MEC. METHODS The Illumina HumanMethylation27 BeadChip array and differential methylation analysis were utilized to screen for epigenetic alterations in 14 primary MEC tumors and 14 matched normal samples. Bisulfite sequencing was used to validate these results, with subsequent quantitative Methylation-Specific PCR (qMSP) to validate chloride intracellular channel protein 3 (CLIC3) in a separate cohort. Furthermore, CLIC3 immunohistochemical (IHC) staining was performed in another separate cohort of MEC. Finally, clinical and pathological characteristics were statistically analyzed for correlation with methylation status of CLIC3 and CLIC3 IHC H-scores by Wilcoxon rank sum, Kruskall-Wallis, and X(2) test tests. RESULTS We obtained 6 significantly differentially methylated gene candidates demonstrating significant promoter hyper- or hypo-methylation from the array data. Using bisulfite sequencing, we found one gene, CLIC3, which showed differential methylation between MEC tumor and normal samples in a small validation cohort. qMSP analysis of the CLIC3 promoter in a separate validation set showed significantly lower methylation level in tumor than in normal. The level of CLIC3 methylation in MECs was not statistically correlated with clinical or pathological characteristics. However, IHC staining intensity and distribution of CLIC3 were significantly increased in MECs, compared with those of normal salivary gland tissues. CONCLUSIONS Hypomethylation of CLIC3 promoter and its overexpression are significant events in MEC. Its functional role and potential therapeutic utility in MEC are worthy of further exploration.
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Affiliation(s)
- Zhiming Wang
- Department of Oral and Maxillofacial Surgery, Shengjing Hospital of China Medical University, Shenyang, Liaoning, China; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA.
| | - Shizhang Ling
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Eleni Rettig
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Ryan Sobel
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Marietta Tan
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Elana J Fertig
- Department of Oncology Biostatistics, Johns Hopkins University, Baltimore, MD, USA
| | - Michael Considine
- Department of Oncology Biostatistics, Johns Hopkins University, Baltimore, MD, USA
| | - Adel K El-Naggar
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Mariana Brait
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA
| | - Carole Fakhry
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA; Milton J. Dance Jr. Head and Neck Center at the Greater Baltimore Medical Center, Baltimore, MD, USA
| | - Patrick K Ha
- Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, Baltimore, MD, USA; Milton J. Dance Jr. Head and Neck Center at the Greater Baltimore Medical Center, Baltimore, MD, USA.
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Zhu F, Wang W, Hou Y, Shi J, Liu Z, He D, Bai C, Li S, Jiang L. MAML2 rearrangement in primary pulmonary mucoepidermoid carcinoma and the correlation with FLT1 expression. PLoS One 2014; 9:e94399. [PMID: 24714697 PMCID: PMC3979848 DOI: 10.1371/journal.pone.0094399] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 03/13/2014] [Indexed: 12/20/2022] Open
Abstract
Introduction Primary pulmonary mucoepidermoid carcinoma (PMEC) is an uncommon neoplasm with remarkable resemblance to mucoepidermoid carcinoma of the salivary glands. The latter has been shown to harbor t(11,19) resulting in MECT1-MAML2 fusion, which may be of diagnostic and prognostic values. However, the importance of such feature in PMEC has not been well studied. Methods We detected MAML2 rearrangement using fluorescence in situ hybridization (FISH) in tissue samples from 42 cases of PMEC and 40 of adenosquamous carcinoma (ASC), and the expression of potential downstream targets of MECT1-MAML2, including HES1, FLT1 and NR4A2 with immunohistochemistry (IHC). The findings were then examined regarding the clinicopathological parameters and patient outcomes. Results FISH analysis revealed MAML2 rearrangement in 50% of the PMEC cases, and such property was prominent in considerable younger patients (33 versus 60 years; p = 0.001) and restricted to cases of low and intermediate grades. IHC analysis showed that FLT1 and HES1 were expressed at lower level in MAML2 rearranged group than MAML2 non-rearranged group (p<0.001 and p = 0.023, respectively). Survival analysis showed significant correlation between MAML2 rearrangement and overall survival (p = 0.023) or disease-free survival (p = 0.027) as well as correlation between FLT1 and overall survival (p = 0.009). Conclusions MAML2 rearrangement appears frequent in PMEC and specific with this tumor. Both the presence of MAML2 rearrangement and absence of FLT1 tend to confer a favorable clinical outcome. These findings suggest that molecular detection of MAML2 rearrangement combined with FLT1 may be of important clinical value for PMEC.
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Affiliation(s)
- Fen Zhu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Weige Wang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yingyong Hou
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jindong Shi
- The Fifth People's Hospital of Shanghai, Fudan University, Shanghai, China
| | - Zilong Liu
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Deming He
- Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Chunxue Bai
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Shanqun Li
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
- * E-mail: (LJ); (SL)
| | - Liyan Jiang
- Department of Pulmonary Medicine, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China
- * E-mail: (LJ); (SL)
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Bishop JA, Yonescu R, Batista D, Warnock GR, Westra WH. Glandular odontogenic cysts (GOCs) lack MAML2 rearrangements: a finding to discredit the putative nature of GOC as a precursor to central mucoepidermoid carcinoma. Head Neck Pathol 2014; 8:287-90. [PMID: 24647913 PMCID: PMC4126918 DOI: 10.1007/s12105-014-0534-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 03/11/2014] [Indexed: 12/14/2022]
Abstract
Glandular odontogenic cyst (GOC) is a cyst of the gnathic bones that is characterized by squamous and glandular differentiation. The histopathologic features of GOC overlap considerably with central mucoepidermoid carcinoma (MEC), suggesting that GOC could be a precursor lesion to, or even a low-grade form of, central MEC. Differentiating the two lesions may be difficult or impossible on a limited biopsy. MAML2 rearrangements have been recently found to be specific for MEC, even those arising in the jaws. An analysis of MAML2 in GOCs could help clarify its relationship with central MEC. Tissue blocks from 21 GOCs and 5 central MECs were retrieved from the surgical pathology archives of The Johns Hopkins Hospital. Each MEC exhibited solid areas and clear-cut stromal invasion. In addition, 4 of the MECs demonstrated cystic areas that were histologically similar to GOC. Break-apart fluorescence in situ hybridization for MAML2 was performed. For the MECs, analysis was performed on both the solid components and the cystic areas that resembled GOC. MAML2 rearrangements were identified in all 5 of the MECs, but in none of the 21 GOCs (100 vs. 0 %; p < 0.0001, Fisher's Exact). In the MECs, the rearrangement was present in both the solid and GOC-like cystic areas. While central MECs consistently harbor the MAML2 rearrangement, even in low-grade cystic areas that resemble a pre-existing GOC, true GOCs do not. Accordingly, GOC does not appear to represent an early or low-grade form of central MEC, but rather an unrelated lesion. The high sensitivity and specificity of MAML2 rearrangement for MECs points to its utility as a diagnostic adjunct in separating mucinous cystic lesions of the gnathic bones.
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Affiliation(s)
- Justin A Bishop
- Department of Pathology, The Johns Hopkins Medical Institutions, Baltimore, MD, USA,
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35
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Abstract
In recent years the discovery of translocations and the fusion oncogenes that they result in has changed the way diagnoses are made in the salivary gland. These genetic aberrations are recurrent and reproducible and at the very least serve as powerful diagnostic tools in salivary gland diagnosis and salivary gland classification. They also show promise as prognostic markers and hopefully as targets of therapy. Many of these fusions have been found in other tumor types that show little to no overlap with their salivary gland counterparts, but effectively they are specific within the salivary gland. In this review the 5 tumors currently known to harbor translocations will be discussed, namely pleomorphic adenoma, mucoepidermoid carcinoma, adenoid cystic carcinoma, mammary analog secretory carcinoma, and hyalinizing clear cell carcinoma. The discovery and implications of each fusion will be highlighted and how they have helped reshape the current classification of salivary gland tumors.
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MESH Headings
- Activating Transcription Factor 1/genetics
- Adenocarcinoma, Clear Cell/genetics
- Adenocarcinoma, Clear Cell/pathology
- Adenoma, Pleomorphic/genetics
- Adenoma, Pleomorphic/pathology
- Breast Neoplasms/genetics
- Breast Neoplasms/pathology
- Calmodulin-Binding Proteins/genetics
- Carcinoma/genetics
- Carcinoma/pathology
- Carcinoma, Adenoid Cystic/genetics
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/pathology
- DNA-Binding Proteins/genetics
- Humans
- NFI Transcription Factors/genetics
- Nuclear Proteins/genetics
- Oncogene Proteins v-myb/genetics
- Oncogene Proteins, Fusion/genetics
- Proto-Oncogene Proteins c-ets/genetics
- RNA-Binding Protein EWS
- RNA-Binding Proteins/genetics
- Receptor, trkC/genetics
- Repressor Proteins/genetics
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/pathology
- Trans-Activators
- Transcription Factors/genetics
- Translocation, Genetic
- ETS Translocation Variant 6 Protein
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Affiliation(s)
- Ilan Weinreb
- *Department of Pathology, University Health Network †Department of Pathobiology and Laboratory medicine, University of Toronto, ON, Canada
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Zhang L, Mitani Y, Caulin C, Rao PH, Kies MS, Saintigny P, Zhang N, Weber RS, Lippman SM, El-Naggar AK. Detailed genome-wide SNP analysis of major salivary carcinomas localizes subtype-specific chromosome sites and oncogenes of potential clinical significance. Am J Pathol 2013; 182:2048-57. [PMID: 23583282 DOI: 10.1016/j.ajpath.2013.02.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 02/04/2013] [Accepted: 02/11/2013] [Indexed: 01/31/2023]
Abstract
The molecular genetic alterations underlying the development and diversity of salivary gland carcinomas are largely unknown. To characterize these events, comparative genomic hybridization analysis was performed, using a single-nucleotide polymorphism microarray platform, of 60 fresh-frozen specimens that represent the main salivary carcinoma types: mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ACC), and salivary duct carcinoma (SDC). The results were correlated with the clinicopathologic features and translocation statuses to characterize the genetic alterations. The most commonly shared copy number abnormalities (CNAs) in all types were losses at chromosomes 6q23-26 and the 9p21 region. Subtype-specific CNAs included a loss at 12q11-12 in ACC and a gain at 17q11-12 in SDC. Focal copy number losses included 1p36.33-p36-22 in ACC, 9p13.2 in MEC, and 3p12.3-q11-2, 6q21-22.1, 12q14.1, and 12q15 in SDC. Tumor-specific amplicons were identified at 11q23.3 (PVRL1) in ACC, 11q13.3 (NUMA1) in MEC, and 6p21.1 (CCND3), 9p13.2 (PAX5), 12q15 (CNOT2/RAB3IP), 12q21.1 (GLIPR1L1), and 17q12 (ERBB2/CCL4) in SDC. A comparative CNA analysis of fusion-positive and fusion-negative ACCs and MECs revealed relatively lower CNAs in fusion-positive tumors than in fusion-negative tumors in both tumor types. An association between CNAs and high grade and advanced stage was observed in MECs only. These findings support the pathogenetic segregation of these entities and define novel chromosomal sites for future identification of biomarkers and therapeutic targets.
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Affiliation(s)
- Li Zhang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77030, USA.
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Abstract
Mucoepidermoid carcinoma (MEC), the most common salivary gland malignancy of the upper aerodigestive tract and tracheobronchial tree, is also known for its considerable cellular heterogeneity including epidermoid, intermediate and mucin producing cells. Despite this structural and cellular heterogeneity, MEC is uniquely characterized by a specific translocation t(11; 19) (q12; p13), resulting in a fusion between the MECT1 and the MAML2 genes. Although the incidence of this fusion in MEC varies, it is generally accepted that more than 50 % of this entity manifest the MECT1-MAML2. Fusion-positive cases showed significantly better survival than fusion-negative cases, suggesting that MECT1-MAML2 represents a specific prognostic molecular marker in MEC. We contend that fusion in MEC represents a distinct mechanism in the development of this entity. In that context, fusion positive MEC, regardless of grade, manifest a more stable genome and better clinical behaviour, while fusion negative MEC represent a distinctly different pathway characterized by marked genomic instability and relatively aggressive tumors.
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Affiliation(s)
- Diana Bell
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030 USA
| | - Adel K. El-Naggar
- Department of Pathology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030 USA
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Abstract
Malignant salivary gland tumors make up a small proportion of malignancies worldwide, yet vary widely in terms of histology, patterns of spread, and recurrence. A better understanding of this variability will guide appropriate treatment recommendations and lead to improved outcomes. Recent molecular genetic studies have uncovered a translocation-generated gene fusion network in salivary gland carcinomas that can be used for diagnosis, treatment decisions, and development of specific targeted therapies. The gene fusions encode novel fusion oncoproteins that function as transcriptional coactivators, tyrosine kinase receptors, and transcription factors involved in growth-factor signaling and cell-cycle regulation. While surgery currently is the primary therapy for operable tumors, radiation plays an important role in the postoperative setting, as well as in the definitive setting for inoperable lesions. An awareness of the risk factors for tumor recurrence and spread is important for both adjuvant therapy referrals and for radiation treatment planning purposes. Additionally, chemotherapy is being used increasingly in both the concurrent setting as a radiosensitizer, as well as in the palliative setting for metastatic tumors. Future trials investigating concurrent chemotherapy and radiation, as well as the use of targeted agents based on evolving molecular discoveries, will elucidate optimal personalized approaches for this challenging disease.
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Affiliation(s)
- Julie Carlson
- From the Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, CO; Head and Neck Unit, Medical Oncology Department, Fondazione, IRCCS Istituto Tumori, Milan, Italy; Departments of Pathology and Oncology, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden
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Abstract
CONCLUSION The data suggest that histamine up-regulates MUC2 gene regulation and mucin production in airway epithelial cells through histamine 1 receptor (H1R). Histamine appears to play an important role in the early phase of mucin regulation, which might be effectively blocked by an H1R antagonist. OBJECTIVE Histamine is an important inflammatory mediator during the early phase of allergic response and antihistamine is known to have an ability to reduce mucus secretion in inflamed airways. The goal of the present study was to determine the effects of histamine on MUC2 gene expression and mucin secretion and to investigate the response to histamine 1 receptor (H1R) blocker in NCI-H292 cells and HM3-MUC2 cells. METHODS NCI-H292 cells, a human pulmonary mucoepidermoid carcinoma cell line, and HM3-MUC2 cells transfected with MUC2 promoter (-2,864/+19) pGL2 luciferase construct were used in the study. MUC2 mRNA expression was analyzed by RT-PCR for NCI-H292 cells and by luciferase assays for HM3-MUC2 cells. MUC2 protein production was determined by immunoassay and immunofluorescent stain in NCI-H292 cells. RESULTS Histamine increased MUC2 gene expression in a dose- and time-dependent manner. Peak response was reached at 12 h after histamine administration. MUC2 protein production was also dose-dependently increased, while it decreased with time in NCI-H292 cells. Pretreatment with histamine at a concentration of 1 mM induced MUC2 mRNAand protein production, which was equivalent to that caused by 10 µg/ml LPS, but less than that of 0.5 µM PMA. Histamine-induced MUC2 mRNA expression and mucin secretion were significantly suppressed by pretreatment with H1R antagonist.
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MESH Headings
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/metabolism
- Carcinoma, Mucoepidermoid/pathology
- Cell Line, Tumor
- Gene Expression Regulation, Neoplastic/drug effects
- Goblet Cells/drug effects
- Goblet Cells/metabolism
- Goblet Cells/pathology
- Histamine/pharmacology
- Histamine Agonists/pharmacology
- Histamine H1 Antagonists, Non-Sedating/pharmacology
- Humans
- Immunohistochemistry
- Lung Neoplasms/genetics
- Lung Neoplasms/metabolism
- Lung Neoplasms/pathology
- Mucin-2/biosynthesis
- Mucin-2/drug effects
- Mucin-2/genetics
- Mucins/biosynthesis
- Mucins/drug effects
- Mucins/genetics
- RNA, Messenger/biosynthesis
- RNA, Messenger/genetics
- Receptors, Histamine H1/genetics
- Receptors, Histamine H1/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Transcriptional Activation
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Affiliation(s)
- Hyoung-Mi Kim
- Department of Otolaryngology, CHA Bundang Medical Center, CHA University, Seongnam, Korea
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40
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MESH Headings
- Carcinoma, Adenoid Cystic/genetics
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/classification
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/pathology
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 11/ultrastructure
- Chromosomes, Human, Pair 19/genetics
- Chromosomes, Human, Pair 19/ultrastructure
- DNA-Binding Proteins/genetics
- Humans
- In Situ Hybridization, Fluorescence
- Neoplasm Grading
- Oncogene Proteins, Fusion/genetics
- Prognosis
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/pathology
- Translocation, Genetic
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Guo Z, Zhao J, Xue TM, Ma JX, Wang CJ, Huang SS. [Gossypol acetic acid induces DNA double-strand breaks in human mucoepidermoid carcinoma cell MEC-1]. Sheng Li Xue Bao 2011; 63:164-170. [PMID: 21505732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The present study was conducted to investigate the effects of gossypol acetic acid (GAA) on the proliferation of human mucoepidermoid carcinoma cell line MEC-1 in vitro and its possible molecular mechanisms of DNA double-strand breaks (DSB). MTT assay was performed to test the inhibition of proliferation of MEC-1 cells by GAA. DSB and γH2AX foci formation induced by GAA were detected by neutral comet assay and immunostaining. GAA (5-40 μmol/L) inhibited the growth of MEC-1 cells in a dose- and time-dependent manner. One of the indexes of comet assay, percentage of head DNA was decreased, however other indexes, including tail length, percentage of tail DNA, tail moment (TM) and Olive tail moment (OTM) were increased when treated with 2.5- 40 μmol/L GAA for 24 h or 20 μmol/L GAA for 3-48 h, compared with those in control. The percentage of γH2AX-positive cells was also increased when MEC-1 was treated with 2.5-20 μmol/L GAA for 24 h or 20 μmol/L GAA for 3-48 h, compared with that in control. All these results show that GAA inhibits the proliferation of MEC-1, and DSB maybe one of the mechanisms of inhibitory effect of GAA on the growth of tumor cells.
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Affiliation(s)
- Zhong Guo
- Medical College of Northwest University for Nationalities, Lanzhou 730030, China
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42
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Abstract
The MECT1/MAML2 translocation is identified in a large proportion of mucoepidermoid carcinomas (MEC) of the salivary gland and is an emerging favorable prognosticator. However, there are conflicting data on this translocation's specificity, restriction to low/intermediate MEC, and strength as a prognosticator. We present our experience with the MECT1/MAML2 translocation in a large cohort of MECs to address these issues. We analyzed 55 salivary MEC and 36 potential MEC mimics (24 Warthin tumors, 5 oncocytomas, 3 squamous cell carcinomas, 2 squamoid salivary duct carcinomas, 1 lymphoepithelial cyst, 1 Schneiderian carcinoma ex papilloma) for presence of the MECT1/MAML2 translocation by fluorescent in-situ hybridization (FISH) and real-time RT-PCR. Overall, MECT1/MAML2 translocation was present in 36/55 (66%) of MEC whereas all 36 non-MEC were negative for translocation. Low or intermediate-grade MEC had a higher frequency of translocation (75%) than high-grade MEC (46%) (P=0.039). Translocation positive cases had a better disease-specific survival (log rank P=0.026) although 2 patients still died of disease. Within high-grade MEC, MECT1/MAML2 positive tumors had lower rates of anaplasia (P=0.001), and mitotic counts (P=0.012). Thus, MECT1/MAML2 translocation is highly specific for MEC and imparts a better prognosis. However, it is frequent even within high-grade MEC and can be seen in lethal cases suggesting that translocation status should not supersede conventional parameters. There are 2 distinct subgroups within high-grade MEC, and the translocation negative tumors may actually be more appropriately categorized as another tumor type (such as adenosquamous carcinoma).
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Affiliation(s)
- Raja R Seethala
- Pathology and Laboratory Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
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Schwarz S, Stiegler C, Zenk J, Iro H, Agaimy A. [Salivary gland mucoepidermoid carcinoma: unusual variants with detection of the t(11,19)(q21;p13) translocation]. Pathologe 2009; 30:472-7. [PMID: 19820938 DOI: 10.1007/s00292-009-1205-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mucoepidermoid carcinoma (MEC) represents the most common malignant salivary gland tumour. Based on the proportion of their constituent cell types, MECs may display a wide morphological spectrum, thereby mimicking diverse types of other primary salivary gland carcinomas. The correct diagnosis relies on demonstration of classical MEC features, assisted by histochemical and immunohistochemical stains in equivocal cases. The current article aims to demonstrate, on the basis of own observations, how the detection of the MEC-typical t(11, 19) translocation may be of great value in difficult-to-classify cases. The differential diagnosis includes squamous cell carcinoma, clear cell carcinoma and oncocytic neoplasms, as well as highly malignant adenocarcinomas which cannot be further classified.
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MESH Headings
- Adult
- Aged
- Aged, 80 and over
- Carcinoma, Mucoepidermoid/diagnosis
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/pathology
- Cell Transformation, Neoplastic/genetics
- Cell Transformation, Neoplastic/pathology
- Chromosomes, Human, Pair 11/genetics
- Chromosomes, Human, Pair 19/genetics
- Diagnosis, Differential
- Female
- Humans
- Male
- Neoplasm Staging
- Parotid Gland/pathology
- Parotid Neoplasms/diagnosis
- Parotid Neoplasms/genetics
- Parotid Neoplasms/pathology
- Submandibular Gland/pathology
- Submandibular Gland Neoplasms/diagnosis
- Submandibular Gland Neoplasms/genetics
- Submandibular Gland Neoplasms/pathology
- Translocation, Genetic/genetics
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Affiliation(s)
- S Schwarz
- Pathologisches Institut, Universitätsklinikum Erlangen, Krankenhausstr 12, 91054 Erlangen.
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Verdorfer I, Fehr A, Bullerdiek J, Scholz N, Brunner A, Krugmann J, Hager M, Haufe H, Mikuz G, Scholtz A. Chromosomal imbalances, 11q21 rearrangement and MECT1-MAML2 fusion transcript in mucoepidermoid carcinomas of the salivary gland. Oncol Rep 2009; 22:305-311. [PMID: 19578770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
The aim of this study was to determine genetic alterations in mucoepidermoid carcinomas of the salivary gland in association with clinical and histopathological parameters. Nineteen formalin-fixed, paraffin-embedded tumors were analysed by using comparative genomic hybridization (CGH), fluorescence in situ hybridization (FISH) on interphase nuclei and reverse transcriptase-polymerase chain reaction (RT-PCR) for detection of MECT1-MAML2 fusion transcript. The CGH analysis showed an overrepresentation of chromosome X and losses of entire chromosomes or regions on chromosome 1, 2, and 15 as the most frequent copy number changes. In 37% of the analysed tumors a MAML2-rearrangement by interphase FISH was detected, whereas 58% of the samples showed expression of MECT1-MAML2 fusion transcript. We conclude that the presence of MAML2-rearrangement as well as of MECT1-MAML2 fusion transcript may reflect a more favourable prognosis and may be a useful marker for clinical prediction of the biological behavior of these tumors as previously reported.
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Affiliation(s)
- Irmgard Verdorfer
- Institute of Pathology, Medical University of Innsbruck, 6020 Innsbruck, Austria.
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Achcar RDOD, Nikiforova MN, Dacic S, Nicholson AG, Yousem SA. Mammalian mastermind like 2 11q21 gene rearrangement in bronchopulmonary mucoepidermoid carcinoma. Hum Pathol 2009; 40:854-60. [PMID: 19269006 DOI: 10.1016/j.humpath.2008.11.007] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2008] [Revised: 11/21/2008] [Accepted: 11/21/2008] [Indexed: 01/09/2023]
Abstract
The translocation t(11;19)(q21;p13) results in the gene fusion of mucoepidermoid carcinoma translocated 1-mammalian mastermind like 2 genes that is the major chromosomal abnormality observed in mucoepidermoid carcinomas of salivary glands but has not been studied in bronchopulmonary mucoepidermoid carcinoma. To investigate the importance of the mammalian mastermind like 2 gene rearrangement and mucoepidermoid carcinoma translocated 1-mammalian mastermind like 2 fusion gene in bronchopulmonary mucoepidermoid carcinoma tumorigenesis and its differential diagnosis with primary pulmonary non-small-cell carcinomas, we evaluated the presence of the mammalian mastermind like 2 gene rearrangement and the mucoepidermoid carcinoma translocated 1-mammalian mastermind like 2 fusion in formalin-fixed, paraffin-embedded tissue sections from 17 adult bronchopulmonary mucoepidermoid carcinoma, 16 adenosquamous carcinomas, 24 squamous cell carcinomas, and 41 primary adenocarcinomas by fluorescence in situ hybridization and reverse transcriptase polymerase chain reaction. We detected mammalian mastermind like 2 gene rearrangement by fluorescence in situ hybridization analysis in 13 (77%) of 17 bronchopulmonary mucoepidermoid carcinoma cases (10 of 10 being low grade and 3 of 7 being high grade). Reverse transcriptase polymerase chain reaction analysis confirmed positive fluorescence in situ hybridization results in 6 (43%) of 14 mucoepidermoid carcinoma cases. None of the squamous, adenosquamous, or adenocarcinoma cases revealed the mammalian mastermind like 2 gene rearrangement by fluorescence in situ hybridization, and the mucoepidermoid carcinoma translocated 1-mammalian mastermind like 2 fusion product by reverse transcriptase polymerase chain reaction was not identified specifically in our adenosquamous carcinoma cases. In conclusion, our study demonstrates that mammalian mastermind like 2 gene rearrangement and mucoepidermoid carcinoma translocated 1-mammalian mastermind like 2 fusion product can be detected by fluorescence in situ hybridization and reverse transcriptase polymerase chain reaction analysis performed on low- and high-grade primary bronchopulmonary mucoepidermoid carcinoma and can be used to help discriminate low- and high-grade mucoepidermoid carcinoma from adenocarcinoma, adenosquamous carcinoma, and squamous cell carcinoma mimics in histologically challenging cases.
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MESH Headings
- Adenosarcoma/genetics
- Adenosarcoma/pathology
- Adult
- Aged
- Aged, 80 and over
- Bronchial Neoplasms/genetics
- Bronchial Neoplasms/pathology
- Carcinoma, Adenosquamous/genetics
- Carcinoma, Adenosquamous/pathology
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/pathology
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/pathology
- DNA-Binding Proteins/genetics
- Female
- Gene Fusion
- Gene Rearrangement
- Humans
- In Situ Hybridization, Fluorescence
- Lung Neoplasms/genetics
- Lung Neoplasms/pathology
- Male
- Middle Aged
- Nuclear Proteins/genetics
- Oncogene Proteins, Fusion/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Trans-Activators
- Transcription Factors/genetics
- Translocation, Genetic
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Kaye FJ. Emerging biology of malignant salivary gland tumors offers new insights into the classification and treatment of mucoepidermoid cancer. Clin Cancer Res 2007; 12:3878-81. [PMID: 16818681 DOI: 10.1158/1078-0432.ccr-06-0791] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Frederic J Kaye
- Genetics Branch, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, USA.
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Okabe M, Miyabe S, Nagatsuka H, Terada A, Hanai N, Yokoi M, Shimozato K, Eimoto T, Nakamura S, Nagai N, Hasegawa Y, Inagaki H. MECT1-MAML2 fusion transcript defines a favorable subset of mucoepidermoid carcinoma. Clin Cancer Res 2007; 12:3902-7. [PMID: 16818685 DOI: 10.1158/1078-0432.ccr-05-2376] [Citation(s) in RCA: 179] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Mucoepidermoid carcinoma is the most common primary malignancy of the salivary gland. Mucoepidermoid carcinoma translocated gene 1-mastermind-like gene family (MECT1-MAML2) gene fusion was identified from a recurring t(11;19)(q21;p13) translocation, which is often the sole cytogenetic alteration in this disease. This fusion transcript has been frequently detected in mucoepidermoid carcinoma and shown to be involved in the transformation of epithelial cells. However, its clinicopathologic significance remains unclear. EXPERIMENTAL DESIGN Seventy-one cases of mucoepidermoid carcinoma and 51 cases of nonmucoepidermoid carcinoma salivary gland tumors (including 26 Warthin tumor cases) were retrospectively analyzed. RNA was extracted from archival materials: histologic paraffin specimens in all cases and cytologic specimens in 10 mucoepidermoid carcinoma cases. The MECT1-MAML2 fusion transcript was detected by a reverse transcription-PCR assay, which can be applied to both histologic and cytologic specimens. The presence of the fusion transcript was correlated with relevant clinicopathologic and survival data of the mucoepidermoid carcinoma patients. RESULTS The MECT1-MAML2 fusion transcript was detected in 27 of the 71 (38%) mucoepidermoid carcinoma cases but not in any case of nonmucoepidermoid carcinoma tumors. The reverse transcription-PCR results showed no difference between histologic and cytologic specimens. Detection of the MECT1-MAML2 fusion transcript was associated with a less advanced clinical stage and a low-grade tumor histology. The presence of the transcript was associated with longer disease-free and overall survivals on univariate analysis and emerged as an independent prognostic factor for longer overall survival on multivariate analysis. CONCLUSIONS The MECT1-MAML2 fusion transcript may be specific to mucoepidermoid carcinoma and associated with a distinct mucoepidermoid carcinoma subset that exhibits favorable clinicopathologic features and an indolent clinical course.
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Affiliation(s)
- Mitsukuni Okabe
- Department of Pathology, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan
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Maiorano E, Favia G, Pece S, Resta L, Maisonneuve P, Di Fiore PP, Capodiferro S, Urbani U, Viale G. Prognostic implications of NUMB immunoreactivity in salivary gland carcinomas. Int J Immunopathol Pharmacol 2007; 20:779-89. [PMID: 18179751 DOI: 10.1177/039463200702000414] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2023] Open
Abstract
The gene numb encodes for a protein (Numb) involved in cell fate decisions in Drosophila, with proposed endocytic and developmental functions in mammalians. The distribution pattern of Numb in human tissues however, has not been fully characterized. We set out to explore the immunohistochemical expression of Numb in normal and neoplastic (28 adenoid cystic and 34 mucoepidermoid carcinomas) salivary glands, and correlated the results with the clinico-pathologic features of the neoplasms. Intense Numb immunoreactivity was detected in normal ductal cells and in a subset of acinar cells. In salivary carcinomas, we detected diffuse and intense Numb immunostaining in 5 adenoid cystic and 8 mucoepidermoid carcinomas. By contrast, the majority of adenoid cystic and mucoepidermoid cancers showed only moderate (14 and 5 cases) or focal staining (9 and 21 cases), respectively. The corresponding expression of Numb mRNA was documented in normal parotid gland and adenoid cystic carcinoma. Numb immunoreactivity was inversely correlated with the histological grade and Ki-67 immunoreactivity of both adenoid cystic and mucoepidermoid carcinomas. In addition, while tumor grade, stage, Ki-67 and Numb immunoreactivity were associated with disease-free survival in univariate analysis, only Numb and Ki-67 immunoreactivities retained independent prognostic significance in multivariate analysis. These data suggest that loss of Numb is implicated in aberrant differentiation programs of salivary gland carcinomas and may serve as a prognostic indicator in patients treated for these neoplasms.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Biomarkers, Tumor
- Carcinoma, Adenoid Cystic/epidemiology
- Carcinoma, Adenoid Cystic/genetics
- Carcinoma, Adenoid Cystic/pathology
- Carcinoma, Mucoepidermoid/epidemiology
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/pathology
- DNA, Neoplasm/biosynthesis
- DNA, Neoplasm/genetics
- Female
- Humans
- Immunohistochemistry
- Ki-67 Antigen/genetics
- Male
- Membrane Proteins/genetics
- Membrane Proteins/immunology
- Middle Aged
- Nerve Tissue Proteins/genetics
- Nerve Tissue Proteins/immunology
- Parotid Gland/metabolism
- Prognosis
- Proportional Hazards Models
- RNA, Neoplasm/biosynthesis
- RNA, Neoplasm/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Salivary Gland Neoplasms/epidemiology
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/pathology
- Submandibular Gland/metabolism
- Survival Analysis
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Affiliation(s)
- E Maiorano
- Department of Pathological Anatomy, University of Bari, Italy.
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Abstract
Abstract
Although mucoepidermoid carcinoma of the salivary gland is relatively common, mucoepidermoid carcinoma arising from the mucous glands of the bronchus is rare. Bronchial mucoepidermoid carcinoma usually presents as an intraluminal mass producing luminal occlusion. Symptoms are airway obstruction and recurrent pneumonia. Macroscopically, mucoepidermoid carcinoma appears as an exophytic intrabronchial mass with intact or ulcerated bronchial mucosa. Microscopically, the tumors are located in the submucosa of the large bronchi. The tumors are usually well differentiated and contain a combination of mucus-secreting, squamous, and intermediate cells. The increased frequency of this tumor in the pediatric population suggests a genetic abnormality. Recent genetic studies have demonstrated reciprocal chromosomal translocations including t(1;11)(p22;q13), t(11;19)(q14-21;p12), and t(11; 19)(q21;p13). Chromosome 11 in the first translocation appears to have been altered resulting in up-regulation of the cyclin D1 gene and overexpression of cyclin D1. The t(11;19)(q21;p13) encodes a novel fusion product capable of disrupting the Notch signaling pathway.
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Affiliation(s)
- Xiuli Liu
- Department of Pathology, University of Alabama at Birmingham, USA
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Falvella FS, Spinola M, Pignatiello C, Noci S, Conti B, Pastorino U, Carbone A, Dragani TA. AZGP1 mRNA levels in normal human lung tissue correlate with lung cancer disease status. Oncogene 2007; 27:1650-6. [PMID: 17724461 DOI: 10.1038/sj.onc.1210775] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Evidence in animal models has suggested an association between susceptibility to lung tumorigenesis and gene-expression profiles in normal lung. Here, we compared RNA pools from normal lung tissue of lung adenocarcinoma patients (cases) or non-lung cancer patients (controls) by hybridization of whole-human genome expression arrays. Principal component analysis identified a gene-expression signature of 85 genes that distinguishes cases from controls as well as smokers from nonsmokers. Elevated mRNA levels of one of these genes, AZGP1, were significantly associated with disease status. These results support the hypothesis that differences in the gene-expression levels of the normal tissue may be predictive of genetic predisposition to lung cancer in humans.
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MESH Headings
- Adenocarcinoma/genetics
- Adenocarcinoma/metabolism
- Adenocarcinoma/pathology
- Adipokines
- Aged
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/metabolism
- Blotting, Western
- Carcinoma, Mucoepidermoid/genetics
- Carcinoma, Mucoepidermoid/metabolism
- Carcinoma, Mucoepidermoid/pathology
- Carcinoma, Squamous Cell/genetics
- Carcinoma, Squamous Cell/metabolism
- Carcinoma, Squamous Cell/pathology
- Carrier Proteins/genetics
- Carrier Proteins/metabolism
- Case-Control Studies
- Female
- Gene Expression Profiling
- Glycoproteins/genetics
- Glycoproteins/metabolism
- Humans
- Lung/metabolism
- Lung/pathology
- Male
- Middle Aged
- Oligonucleotide Array Sequence Analysis
- RNA, Messenger/genetics
- RNA, Messenger/metabolism
- Reverse Transcriptase Polymerase Chain Reaction
- Tissue Array Analysis
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Affiliation(s)
- F S Falvella
- Department of Experimental Oncology and Laboratories, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy
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