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  1. Article ; Online: Keratin-positive giant cell-rich tumors of soft tissue with HMGA2::NCOR2 fusions.

    Weigelt, Maximillian A / Azzato, Elizabeth M / Habermehl, Gabriel K / Billings, Steven D / Ko, Jennifer S / Fritchie, Karen J

    Journal of cutaneous pathology

    2023  Volume 50, Issue 11, Page(s) 977–982

    Abstract: Background: Giant cell tumor of soft tissue (GCT-ST) is a rare soft tissue neoplasm that is morphologically similar to but genetically distinct from giant cell tumor of bone. A novel keratin-positive GCT-ST (KPGCT-ST) harboring HMGA2::NCOR2 fusions was ... ...

    Abstract Background: Giant cell tumor of soft tissue (GCT-ST) is a rare soft tissue neoplasm that is morphologically similar to but genetically distinct from giant cell tumor of bone. A novel keratin-positive GCT-ST (KPGCT-ST) harboring HMGA2::NCOR2 fusions was recently discovered. Fewer than 30 cases have been described; herein is reported an additional seven.
    Methods: Cases diagnosed as GCT-ST were retrieved from institutional archives and consultation files. The histopathologic characteristics were assessed, and the electronic medical record was reviewed.
    Results: Seven tumors were identified in six women and one man with a median age of 23 years. All patients underwent excision; no recurrences or metastases were noted during a median follow-up period of 7 months. Histopathologically, the tumors were characterized by a multinodular proliferation of keratin-positive mononuclear cells with evenly admixed osteoclast-like giant cells and absent neoplastic bone. A fibrous capsule with lymphoid cuffing was frequently seen. Foamy macrophages, inflammation, hemorrhage, and hemosiderin were variably present. The HMGA2::NCOR2 fusion was detected in all cases.
    Conclusions: Our findings support previously reported hypotheses that KPGCT-ST is a spectrum of the same entity as the recently described xanthogranulomatous epithelial tumor. Although follow-up data are limited, to date, KPGCT-ST appears to follow an indolent course.
    MeSH term(s) Male ; Humans ; Female ; Young Adult ; Adult ; Keratins ; Giant Cell Tumors/pathology ; Soft Tissue Neoplasms/pathology ; Diagnosis, Differential ; Giant Cells/pathology ; Nuclear Receptor Co-Repressor 2
    Chemical Substances Keratins (68238-35-7) ; NCOR2 protein, human ; Nuclear Receptor Co-Repressor 2
    Language English
    Publishing date 2023-07-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 187078-6
    ISSN 1600-0560 ; 0303-6987
    ISSN (online) 1600-0560
    ISSN 0303-6987
    DOI 10.1111/cup.14497
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: YAP1-TFE3 gene fusion variant in clear cell stromal tumour of lung: report of two cases in support of a distinct entity.

    Dermawan, Josephine K / Azzato, Elizabeth M / McKenney, Jesse K / Liegl-Atzwanger, Bernadette / Rubin, Brian P

    Histopathology

    2021  Volume 79, Issue 6, Page(s) 940–946

    Abstract: Aims: Clear cell (haemangioblastoma-like) stromal tumour of the lung is a newly described, rare pulmonary neoplasm. Recurrent YAP1-TFE3 gene fusions have recently been reported in three cases. We describe two additional cases and confirm the ... ...

    Abstract Aims: Clear cell (haemangioblastoma-like) stromal tumour of the lung is a newly described, rare pulmonary neoplasm. Recurrent YAP1-TFE3 gene fusions have recently been reported in three cases. We describe two additional cases and confirm the characteristic YAP1-TFE3 gene fusion.
    Methods and results: Two mesenchymal tumours of lung were identified from our soft tissue pathology consultation services and RNA sequencing was performed. Both cases were in male patients, aged 35 and 77 years. Both presented as solitary lung nodules measuring 3.9 and 7.5 cm in greatest dimension. Histopathologically, the tumours were composed of epithelioid to plump spindle cells arranged in packets and solid sheets. The cells showed fusiform to ovoid nuclei with open chromatin, variably prominent nucleoli and scant to moderate, clear to eosinophilic cytoplasm. Cytological atypia and significant mitotic activity were minimal. None of the tumours expressed lineage-specific immunophenotypical markers. Both cases were diffusely positive for nuclear TFE3. Unlike YAP1-TFE3-fused epithelioid haemangioendothelioma, for which the fusion breakpoint occurs in YAP1 exon 1 and TFE3 exons 4 or 6, the fusion breakpoints of these tumours were located in YAP1 exon 4 and TFE3 exon 7. Following complete surgical resection, neither of the tumours has recurred or metastasised (follow-up period 6-7 months).
    Conclusions: We validate the presence of YAP1-TFE3 gene fusion in a unique primary mesenchymal tumour of lung, adding additional support for clear cell stromal tumour of the lung as a distinct entity.
    MeSH term(s) Adult ; Aged ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/genetics ; Humans ; Lung Neoplasms/genetics ; Lung Neoplasms/pathology ; Male ; Neoplasms, Connective and Soft Tissue/genetics ; Neoplasms, Connective and Soft Tissue/pathology ; Oncogene Proteins, Fusion/genetics ; YAP-Signaling Proteins/genetics
    Chemical Substances Basic Helix-Loop-Helix Leucine Zipper Transcription Factors ; Oncogene Proteins, Fusion ; TFE3 protein, human ; YAP-Signaling Proteins ; YAP1 protein, human
    Language English
    Publishing date 2021-08-22
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 131914-0
    ISSN 1365-2559 ; 0309-0167
    ISSN (online) 1365-2559
    ISSN 0309-0167
    DOI 10.1111/his.14437
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: Integration of Next-Generation Sequencing to Treat Acute Lymphoblastic Leukemia with Targetable Lesions: The St. Jude Children's Research Hospital Approach.

    Inaba, Hiroto / Azzato, Elizabeth M / Mullighan, Charles G

    Frontiers in pediatrics

    2017  Volume 5, Page(s) 258

    Abstract: Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children. In recent Total Therapy studies conducted at St. Jude Children's Research Hospital, children with ALL had a 5-year overall survival of around 94%. This is the result of a ... ...

    Abstract Acute lymphoblastic leukemia (ALL) is the most common type of cancer in children. In recent Total Therapy studies conducted at St. Jude Children's Research Hospital, children with ALL had a 5-year overall survival of around 94%. This is the result of a combination of risk stratification based on the biological features of the leukemic cells and the response to treatment (as assessed by the detection of minimal residual disease), treatment modification based on pharmacodynamic and pharmacogenomic data, and improved supportive care. However, innovative approaches are required to further improve survival to as close to 100% as possible and to reduce the adverse effects of treatment. Next-generation sequencing of leukemic cell DNA and RNA, as well as of germline DNA, can identify submicroscopic genetic structural changes and sequence alterations that contribute to leukemogenesis. Next-generation sequencing data can be used to define new ALL subtypes, to help improve treatment response and reduce adverse effects, and to identify novel prognostic markers and therapeutic targets to facilitate personalized precision medicine. In this article, we describe our approach to detecting targetable lesions in patients with ALL by next-generation sequencing and explain how we integrate the sequencing data into the treatment of these patients.
    Language English
    Publishing date 2017-12-04
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2017.00258
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Novel NONO::TFE3 fusion and ALK co-expression identified in a subset of cutaneous microcystic/reticular schwannoma.

    Fritchie, Karen J / Dermawan, Josephine K / Astbury, Caroline / Sharma, Anurag / Bakhshwin, Ahmed / Fuller, Lanisha / Agrawal, Shruti / Wieland, Carilyn N / Greipp, Patricia T / Azzato, Elizabeth M / Folpe, Andrew L / Billings, Steven D

    Virchows Archiv : an international journal of pathology

    2023  Volume 483, Issue 2, Page(s) 237–243

    Abstract: Microcystic/reticular schwannoma (MRS) is a benign variant of schwannoma with a predilection for the gastrointestinal tract and skin. To date, genetic characterization of this tumor is limited. Prompted by the identification of TFE3::NONO fusion and ALK ... ...

    Abstract Microcystic/reticular schwannoma (MRS) is a benign variant of schwannoma with a predilection for the gastrointestinal tract and skin. To date, genetic characterization of this tumor is limited. Prompted by the identification of TFE3::NONO fusion and ALK overexpression in an index case of MRS, a cohort of tumors was collected from institutional and consultation archives of two institutions. Next-generation sequencing (NGS), TFE3 fluorescence in situ hybridization (FISH), and TFE3 and ALK immunohistochemistry were performed, while clinicopathologic variables were documented. Eighteen MRS cases were identified (35 to 85 years) arising in the skin (n=8), gastrointestinal tract (n=5), adrenal gland (n=3), abdominal wall (n=1), and unknown site (n=1). Tumors showed a circumscribed to multinodular to plexiform low-power architecture with variable amounts of microcystic/reticular and solid schwannian components. Mitotic figures were scarce (0-1/10 HPFs), and atypia was absent. S100 protein and/or SOX10 immunoreactivity was noted in the microcystic/reticular and schwannian areas of all cases. NGS performed on two cutaneous tumors yielded NONO exon 12 fusion with TFE3 exon 4, and these lesions also showed HMB45 and ALK expression. Two additional cases showed ALK expression (1 weak), while a third was positive for TFE3, but these cases failed to show ALK or TFE3 rearrangement by FISH/NGS. There were no morphologic variables that correlated with the presence of NONO::TFE3. We identified a subset of microcystic/reticular schwannomas with NONO::TFE3 fusions and ALK co-expression, adding to the cohort of mesenchymal neoplasms that show ALK overexpression without rearrangement of the ALK gene.
    MeSH term(s) Humans ; In Situ Hybridization, Fluorescence ; Neurilemmoma/genetics ; Neurilemmoma/pathology ; Skin Neoplasms/genetics ; Cysts ; Basic Helix-Loop-Helix Leucine Zipper Transcription Factors/genetics ; Receptor Protein-Tyrosine Kinases/genetics ; DNA-Binding Proteins/genetics ; RNA-Binding Proteins/genetics
    Chemical Substances Basic Helix-Loop-Helix Leucine Zipper Transcription Factors ; Receptor Protein-Tyrosine Kinases (EC 2.7.10.1) ; TFE3 protein, human ; NONO protein, human ; DNA-Binding Proteins ; RNA-Binding Proteins
    Language English
    Publishing date 2023-07-19
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 1184867-4
    ISSN 1432-2307 ; 0945-6317
    ISSN (online) 1432-2307
    ISSN 0945-6317
    DOI 10.1007/s00428-023-03605-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Superficial ALK-rearranged myxoid spindle cell neoplasm: a cutaneous soft tissue tumor with distinctive morphology and immunophenotypic profile.

    Dermawan, Josephine K / Azzato, Elizabeth M / Goldblum, John R / Rubin, Brian P / Billings, Steven D / Ko, Jennifer S

    Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc

    2021  Volume 34, Issue 9, Page(s) 1710–1718

    Abstract: Gene rearrangements involving the anaplastic lymphoma kinase (ALK) receptor tyrosine kinase gene have been identified in various neoplasms, including inflammatory myofibroblastic tumor and epithelioid fibrous histiocytoma. We present an ALK-rearranged ... ...

    Abstract Gene rearrangements involving the anaplastic lymphoma kinase (ALK) receptor tyrosine kinase gene have been identified in various neoplasms, including inflammatory myofibroblastic tumor and epithelioid fibrous histiocytoma. We present an ALK-rearranged cutaneous soft tissue tumor with unique morphologic and immunophenotypic features that are not shared by other entities with ALK rearrangements. The six cases involved two females and four males, aged 18-84 (mean 51) years old. Three tumors were on the back and three on the lower extremities (thigh, knee, shin); ranging from 0.5 to 5.6 (mean 2.1) cm. Four were confined to the dermis; two involved the subcutis. All six cases were characterized by the presence of spindled to ovoid cells arranged in concentric whorls and cords against a myxoid to myxohyaline stroma and relatively cellular aggregates of plump ovoid to epithelioid cells. Four cases showed distinct hyalinized blood vessels. Both cases that involved the subcutis showed peripheral lipofibromatosis-like areas. Tumor-infiltrating lymphocytes were absent to moderate. Severe cytologic atypia or conspicuous mitotic activity was not identified. Immunohistochemically, all tumors diffusely expressed ALK (D5F3) and CD34. All but one tumor was diffusely positive for S100 protein. All tumors were negative for EMA, AE1/AE3, SMA, and SOX10. Next-generation sequencing revealed ALK fusions with FLNA (3 cases), MYH10 (2 cases), and HMBOX1 (1 case) as the partner genes. In all six cases, the breakpoints involved exon 20 of ALK, which preserves the receptor tyrosine kinase domains of ALK in the fusion product. Of the four cases with limited follow-up information (2-18 months), none recurred. In conclusion, we report an ALK-rearranged cutaneous soft tissue tumor characterized by the presence of myxoid spindle cell whorls and cords, and co-expression of ALK, CD34, and frequently S100 protein, we term "superficial ALK-rearranged myxoid spindle cell neoplasm".
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anaplastic Lymphoma Kinase/genetics ; Female ; Gene Rearrangement ; Humans ; Immunophenotyping ; Male ; Middle Aged ; Oncogene Fusion ; Skin Neoplasms/genetics ; Skin Neoplasms/pathology ; Soft Tissue Neoplasms/genetics ; Soft Tissue Neoplasms/pathology
    Chemical Substances ALK protein, human (EC 2.7.10.1) ; Anaplastic Lymphoma Kinase (EC 2.7.10.1)
    Language English
    Publishing date 2021-06-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 645073-8
    ISSN 1530-0285 ; 0893-3952
    ISSN (online) 1530-0285
    ISSN 0893-3952
    DOI 10.1038/s41379-021-00830-w
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  6. Article ; Online: Solitary Fibrous Tumor of Breast and Axilla: Clinicopathological Profile of Five Tumors With Comparison of Risk Stratification Models.

    Hoda, Raza S / Duckworth, Lauren A / Gilmore, Hannah L / Cui, Xiaoyan / McIntire, Patrick J / Sciallis, Andrew P / Van Arnam, John S / Zhang, Gloria / Rowe, J Jordi / Xiao, Huijun / Azzato, Elizabeth M / Goldblum, John R / Fritchie, Karen / Downs, Erinn P

    International journal of surgical pathology

    2023  , Page(s) 10668969231204957

    Abstract: Introduction: ...

    Abstract Introduction:
    Language English
    Publishing date 2023-10-30
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1336393-1
    ISSN 1940-2465 ; 1066-8969
    ISSN (online) 1940-2465
    ISSN 1066-8969
    DOI 10.1177/10668969231204957
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Combined utility of p16 and BRAF V600E in the evaluation of spitzoid tumors: Superiority to PRAME and correlation with FISH.

    McAfee, John L / Scarborough, Richard / Jia, Xuefei Sophia / Azzato, Elizabeth M / Astbury, Caroline / Ronen, Shira / Andea, Aleodor A / Billings, Steven D / Ko, Jennifer S

    Journal of cutaneous pathology

    2022  Volume 50, Issue 2, Page(s) 155–168

    Abstract: Background: Spitzoid melanocytic neoplasms are diagnostically challenging; criteria for malignancy continue to evolve. The ability to predict chromosomal abnormalities with immunohistochemistry (IHC) could help select cases requiring chromosomal ... ...

    Abstract Background: Spitzoid melanocytic neoplasms are diagnostically challenging; criteria for malignancy continue to evolve. The ability to predict chromosomal abnormalities with immunohistochemistry (IHC) could help select cases requiring chromosomal evaluation.
    Methods: Fluorescence in situ hybridization (FISH)-tested spitzoid neoplasms at our institution (2013-2021) were reviewed. p16, BRAF V600E, and preferentially expressed antigen in melanoma (PRAME) IHC results were correlated with FISH.
    Results: A total of 174 cases (1.9F:1M, median age 28 years; range, 5 months-74 years) were included; final diagnoses: Spitz nevus (11%), atypical Spitz tumor (47%), spitzoid dysplastic nevus (9%), and spitzoid melanoma (32%). Sixty (34%) were FISH positive, most commonly with absolute 6p25 gain (RREB1 > 2). Dermal mitotic count was the only clinicopathologic predictor of FISH. Among IHC-stained cases, p16 was lost in 55 of 134 cases (41%); loss correlated with FISH positive (p < 0.001, Fisher exact test). BRAF V600E (14/88, 16%) and PRAME (15/56, 27%) expression did not correlate with FISH alone (p = 0.242 and p = 0.359, respectively, Fisher exact test). When examined together, however, p16-retained/BRAF V600E-negative lesions had low FISH-positive rates (5/37, 14%; 4/37, 11% not counting isolated MYB loss); all other marker combinations had high rates (56%-75% of cases; p < 0.001).
    Conclusions: p16/BRAF V600E IHC predicts FISH results. "Low-risk" lesions (p16
    MeSH term(s) Humans ; Proto-Oncogene Proteins B-raf/genetics ; In Situ Hybridization, Fluorescence ; Melanoma/diagnosis ; Melanoma/genetics ; Melanoma/metabolism ; Skin Neoplasms/diagnosis ; Skin Neoplasms/genetics ; Skin Neoplasms/metabolism ; Chromosome Aberrations ; Nevus, Epithelioid and Spindle Cell/diagnosis ; Nevus, Epithelioid and Spindle Cell/genetics ; Diagnosis, Differential ; Antigens, Neoplasm
    Chemical Substances Proto-Oncogene Proteins B-raf (EC 2.7.11.1) ; BRAF protein, human (EC 2.7.11.1) ; PRAME protein, human ; Antigens, Neoplasm
    Language English
    Publishing date 2022-11-04
    Publishing country United States
    Document type Journal Article
    ZDB-ID 187078-6
    ISSN 1600-0560 ; 0303-6987
    ISSN (online) 1600-0560
    ISSN 0303-6987
    DOI 10.1111/cup.14342
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: EWSR1-SMAD3 rearranged fibroblastic tumor: Case series and review.

    Habeeb, Omar / Korty, Katelen E / Azzato, Elizabeth M / Astbury, Caroline / Farkas, Daniel H / Ko, Jennifer S / Billings, Steven D

    Journal of cutaneous pathology

    2020  Volume 48, Issue 2, Page(s) 255–262

    Abstract: We report the largest series to date (N = 6) of EWSR1-SMAD3 rearranged fibroblastic tumor. Initially described in 2018, the tumor features a marked female predominance (F:M, 5:1, mean age 44-years, median age 45.5 years; range 27-57), with most cases (5/ ... ...

    Abstract We report the largest series to date (N = 6) of EWSR1-SMAD3 rearranged fibroblastic tumor. Initially described in 2018, the tumor features a marked female predominance (F:M, 5:1, mean age 44-years, median age 45.5 years; range 27-57), with most cases (5/6, 83%) arising in acral locations (4 on foot/toe, 1 on hand). One case presented on the lower extremity. The lesions presented as nodules and were composed of short, variably cellular, intersecting fascicles of uniform spindled cells in a collagenous to myxoid stroma. In four cases, the tumor abutted the epidermis without a grenz zone. In one case, there was an abrupt transition to a central, acellular hyalinized area. Two other cases had admixed smaller collagenous areas, reminiscent of collagen rosettes. One had a concentric arrangement of tumor cells around blood vessels. Mitotic activity was low (<1/10 HPFs). All were positive for ERG by immunohistochemistry and negative for CD34 (6/6). An EWSR1-SMAD3 fusion was identified in three cases tested by next-generation sequencing (3/3). Rearrangement of EWSR1 by fluorescence in situ hybridization was showed in 1/1 case. Our series reaffirms prior findings and expands the known histopathologic spectrum of this emerging entity.
    MeSH term(s) Adult ; Female ; Gene Rearrangement ; High-Throughput Nucleotide Sequencing ; Humans ; In Situ Hybridization, Fluorescence ; Male ; Middle Aged ; Neoplasms, Fibrous Tissue/genetics ; Neoplasms, Fibrous Tissue/metabolism ; Neoplasms, Fibrous Tissue/pathology ; Oncogene Proteins, Fusion/genetics ; Oncogene Proteins, Fusion/metabolism ; RNA-Binding Protein EWS/genetics ; RNA-Binding Protein EWS/metabolism ; Skin Neoplasms/genetics ; Skin Neoplasms/metabolism ; Skin Neoplasms/pathology ; Smad3 Protein/genetics ; Smad3 Protein/metabolism
    Chemical Substances EWSR1 protein, human ; Oncogene Proteins, Fusion ; RNA-Binding Protein EWS ; SMAD3 protein, human ; Smad3 Protein
    Language English
    Publishing date 2020-11-08
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ZDB-ID 187078-6
    ISSN 1600-0560 ; 0303-6987
    ISSN (online) 1600-0560
    ISSN 0303-6987
    DOI 10.1111/cup.13870
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  9. Article: Gene Fusion Identification Using Anchor-Based Multiplex PCR and Next-Generation Sequencing.

    Cheng, Yu-Wei / Meyer, Anders / Jakubowski, Maureen A / Keenan, Sean O / Brock, Jay E / Azzato, Elizabeth M / Weindel, Michael / Farkas, Daniel H / Rubin, Brian P

    The journal of applied laboratory medicine

    2021  Volume 6, Issue 4, Page(s) 917–930

    Abstract: Background: Methods for identifying gene fusion events, such as fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), and transcriptome analysis, are either single gene approaches or require bioinformatics expertise not generally ... ...

    Abstract Background: Methods for identifying gene fusion events, such as fluorescence in situ hybridization (FISH), immunohistochemistry (IHC), and transcriptome analysis, are either single gene approaches or require bioinformatics expertise not generally available in clinical laboratories. We analytically validated a customized next-generation sequencing (NGS) panel targeting fusion events in 34 genes involving soft-tissue sarcomas.
    Methods: Specimens included 87 formalin-fixed paraffin-embedded (FFPE) tissues with known gene fusion status. Isolated total nucleic acid was used to identify fusion events at the RNA level. The potential fusions were targeted by gene-specific primers, followed by primer extension and nested PCR to enrich for fusion candidates with subsequent bioinformatics analysis.
    Results: The study generated results using the following quality metrics for fusion detection: (a) ≥100 ng total nucleic acid, (b) RNA average unique start sites per gene-specific primer control ≥10, (c) quantitative PCR assessing input RNA quality had a crossing point <30, (d) total RNA percentage ≥30%, and (e) total sequencing fragments ≥500 000.
    Conclusions: The test validation study demonstrated analytical sensitivity of 98.7% and analytical specificity of 90.0%. The NGS-based panel generated highly concordant results compared to alternative testing methods.
    MeSH term(s) Gene Fusion ; High-Throughput Nucleotide Sequencing ; Humans ; Immunohistochemistry ; In Situ Hybridization, Fluorescence ; Multiplex Polymerase Chain Reaction
    Language English
    Publishing date 2021-02-03
    Publishing country England
    Document type Journal Article
    ISSN 2576-9456
    ISSN 2576-9456
    DOI 10.1093/jalm/jfaa230
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  10. Article ; Online: PRRX1-NCOA1-rearranged fibroblastic tumour: a clinicopathological, immunohistochemical and molecular genetic study of six cases of a potentially under-recognised, distinctive mesenchymal tumour.

    Dermawan, Josephine K / Azzato, Elizabeth M / Jebastin Thangaiah, Judith / Gjorgova-Gjeorgievski, Sandra / Rubin, Brian P / Folpe, Andrew L / Agaimy, Abbas / Fritchie, Karen J

    Histopathology

    2021  Volume 79, Issue 6, Page(s) 997–1003

    Abstract: Aims: PRRX1-NCOA1-rearranged fibroblastic tumour is a recently described, rare mesenchymal tumour. Only four cases have been previously reported. The aim of this article is to report six additional cases of this unusual mesenchymal neoplasm, with an ... ...

    Abstract Aims: PRRX1-NCOA1-rearranged fibroblastic tumour is a recently described, rare mesenchymal tumour. Only four cases have been previously reported. The aim of this article is to report six additional cases of this unusual mesenchymal neoplasm, with an emphasis on its differential diagnosis.
    Methods and results: The six cases were from three females and three males (age, 20-49 years; median, 42 years). Three tumours were located on the abdominal wall; two from the shoulder/axillary areas, and one on the lateral hip. All presented as slow-growing subcutaneous nodules, ranging from 26 to 55 mm (median, 40 mm). The tumours consisted of circumscribed, variably cellular nodules composed of relatively bland plump spindled to epithelioid cells arranged singly, in cords, and occasionally in nests, embedded in hyalinised and collagenous stroma. Small hypocellular myxoid zones with ropey collagen fibres were present, as were irregularly dilated, gaping, crescent-shaped or staghorn-like thin-walled vessels, best appreciated at the periphery. Immunohistochemistry for CD34, S100, MUC4 and STAT6 was consistently negative. RNA-sequencing revealed PRRX1-NCOA1 fusions in all cases. Of the four cases with limited follow-up (1.5-4 months), none recurred following local surgical excision.
    Conclusions: The morphological features of PRRX1-NCOA1-rearranged fibroblastic tumour overlap with those of RB1-deficient soft-tissue tumours, solitary fibrous tumour, and low-grade fibromyxoid sarcoma/sclerosing epithelioid fibrosarcoma. This differential diagnosis can be resolved with a combination of careful morphological study and the application of a panel of immunostains, although molecular genetic study is most definitive. The natural history of PRRX1-NCOA1-rearranged fibroblastic tumour appears to be quite favourable, although longer-term study of a larger number of cases is warranted.
    MeSH term(s) Adult ; Female ; Gene Rearrangement ; Homeodomain Proteins/genetics ; Humans ; Male ; Middle Aged ; Nuclear Receptor Coactivator 1/genetics ; Oncogene Proteins, Fusion/genetics ; Soft Tissue Neoplasms/genetics ; Soft Tissue Neoplasms/pathology
    Chemical Substances Homeodomain Proteins ; Oncogene Proteins, Fusion ; PRRX1 protein, human ; NCOA1 protein, human (EC 2.3.1.48) ; Nuclear Receptor Coactivator 1 (EC 2.3.1.48)
    Language English
    Publishing date 2021-09-03
    Publishing country England
    Document type Journal Article
    ZDB-ID 131914-0
    ISSN 1365-2559 ; 0309-0167
    ISSN (online) 1365-2559
    ISSN 0309-0167
    DOI 10.1111/his.14454
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