HMGA2 阳性唾液腺肿瘤具有突出的小梁/针状形态:重点研究这种表型中出现的癌。

IF 3.9 2区 医学 Q2 CELL BIOLOGY Histopathology Pub Date : 2024-10-03 DOI:10.1111/his.15334
Melad N Dababneh, Elizabeth M Azzato, Joy Nakitandwe, Vincent Cracolici, Akeesha A Shah
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引用次数: 0

摘要

目的:具有突出小梁/针状形态的多形性腺瘤(PA)具有一致的HMGA2蛋白表达,并与HMGA2融合相关。我们报告了我们在这一亚型方面的经验,重点是在这种情况下可能出现的癌:我们对具有突出小梁/针状形态的主要唾液腺肿瘤进行了回顾性和前瞻性研究(2013-2024 年)。21例腮腺肿瘤符合标准:其中 14 例良性(66.7%),6 例癌(28.6%),1 例行为不确定(4.7%)。所有病例均进行了HMGA2免疫组化(IHC)。对 18 例病例成功进行了新一代测序。7例良性病例具有传统的PA成分。在所有病例中,这些小梁/针孔区的肿瘤细胞都表现出不同的甲状腺乳头状癌样核改变,包括染色质变清、过度拥挤、膜不规则和核内假包涵体。良性肿瘤分界清楚,而癌肿则表现为多结节性浸润或细微浸润。两个癌瘤的细胞学不典型性和结构复杂性增加,一个癌瘤有神经周围浸润。通过 IHC 检测,所有癌细胞的 HMGA2 均呈阳性。在小梁/颅骨区域,CAM5.2、S-100和SOX-10持续强表达,p63表达不一,但p40呈阴性。18 个病例中有 16 个(89%)检测到 HMGA2 改变。对两例癌症进行了随访,其中一例为局部复发:结论:虽然大多数 HMGA2 阳性唾液腺肿瘤具有突出的小梁/针状生长模式,属于良性肿瘤,但它们与传统的 PA 一样,可能会引发局部复发的癌变。这些癌肿可能是平淡无奇的,也可能是轻微浸润性的,或具有多结节浸润模式。
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HMGA2-positive salivary gland neoplasms with prominent trabecular/canalicular morphology: a focus on carcinomas arising within this phenotype.

Aims: Pleomorphic adenoma (PA) with a prominent trabecular/canalicular morphology has consistent HMGA2 protein expression, and association with HMGA2 fusions. We report our experience with this subtype, with emphasis on the carcinomas that can arise in this context.

Methods and results: A retro- and prospective review (2013-2024) of major salivary gland tumours with prominent trabecular/canalicular morphology was performed. Twenty-one parotid tumours met the criteria: 14 benign (66.7%), six carcinomas (28.6%), and one of uncertain behaviour (4.7%). HMGA2 immunohistochemistry (IHC) was performed on all cases. Next-generation sequencing was successfully performed on 18. Seven benign cases had a conventional PA component. In all cases, the tumour cells in these trabecular/canalicular areas demonstrated variable papillary thyroid carcinoma-like nuclear changes, including chromatin clearing, overcrowding, membrane irregularities, and intranuclear pseudoinclusions. Benign tumours were well-demarcated, whereas carcinomas demonstrated either a multinodular pattern of invasion or subtle infiltration. Two carcinomas showed increased cytologic atypia and architectural complexity and one had perineural invasion. By IHC, all were positive for HMGA2. In the trabecular/canalicular areas, there was consistent strong expression of CAM5.2, S-100, and SOX-10 and variable expression of p63 but negative p40. HMGA2 alterations were detected in 16 of 18 cases (89%). Follow-up was available on two carcinomas, with one being locally recurrent.

Conclusion: While most HMGA2-positive salivary gland neoplasms with a prominent trabecular/canalicular growth pattern are benign, they, like traditional PAs, may give rise to carcinomas that can locally recur. These carcinomas can be deceptively bland, subtly infiltrative, or have a multinodular pattern of invasion.

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来源期刊
Histopathology
Histopathology 医学-病理学
CiteScore
10.20
自引率
4.70%
发文量
239
审稿时长
1 months
期刊介绍: Histopathology is an international journal intended to be of practical value to surgical and diagnostic histopathologists, and to investigators of human disease who employ histopathological methods. Our primary purpose is to publish advances in pathology, in particular those applicable to clinical practice and contributing to the better understanding of human disease.
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