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  • 1
    Online Resource
    Online Resource
    Mesenchymal lesions of the breast
    Wiley ; 2023
    In:  Histopathology Vol. 82, No. 1 ( 2023-01), p. 83-94
    Details
    In: Histopathology, Wiley, Vol. 82, No. 1 ( 2023-01), p. 83-94
    Abstract: Mesenchymal lesions of the breast are a heterogeneous range of entities with diverse clinical, histological, and molecular features, as well as biological behaviour. Their morphologic overlap with non‐mesenchymal lesions (such as metaplastic carcinoma and phyllodes tumour) and relative rarity also pose significant diagnostic challenges. In this review, we summarize the salient features of selected mesenchymal lesions of the breast, emphasizing those that are the most common and problematic. Vascular, fibroblastic/myofibroblastic, adipocytic, and smooth muscle lesions are each covered with regard to their clinicopathological features and differential diagnosis, while recent advances and the role of immunohistochemistry and molecular tests are also highlighted.
    Type of Medium: Online Resource
    ISSN: 0309-0167 , 1365-2559
    URL: Issue
    URL: Article
    DOI: 10.1111/his.v82.1
    DOI: 10.1111/his.14810
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 2
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    Large cell calcifying Sertoli cell tumour: molecular and immunohistochemical assessment of a series comprising non‐metastasising and metastasising neoplasms
    Wiley ; 2023
    In:  Histopathology Vol. 82, No. 7 ( 2023-06), p. 1079-1088
    Details
    In: Histopathology, Wiley, Vol. 82, No. 7 ( 2023-06), p. 1079-1088
    Abstract: Large cell calcifying Sertoli cell tumour (LCCSCT) is a type of testicular sex cord‐stromal tumour that may occur sporadically or in the context of Carney complex and other genetic syndromes. A subset is clinically malignant, and the molecular mechanisms that drive such aggressive behaviour remain unknown. Methods and results We analysed 21 samples from 20 patients with LCCSCT (12 non‐metastasising and eight metastasising) using PRKAR1A immunohistochemistry (IHC) and next‐generation sequencing. All tumours except two (cases 17 and 20, both metastasising) demonstrated loss of PRKAR1A expression. Among 11 cases with interpretable sequencing results, all harboured pathogenic single nucleotide variants of PRKAR1A . Evidence of loss of heterozygosity (LOH) of PRKAR1A was present in all tumours with interpretable zygosity data, but the mechanisms of LOH were different for non‐metastasising and metastasising tumours. Non‐metastasising tumours demonstrated only copy‐neutral LOH, while metastasising tumours demonstrated a spectrum of mechanisms of LOH, including copy‐loss LOH, two concurrent mutations or copy‐neutral LOH. Relevant molecular findings in non‐metastasising LCCSCT were limited to PRKAR1A variants. In contrast, all metastasising LCCSCTs with interpretable data harboured additional pathogenic variants, including (but not restricted to) BRCA2 mutations with evidence of LOH and bi‐allelic CDKN2A/B deletions. Three patients harboured PRKAR1A variants of inferred germline origin, including one with Carney complex and two without known syndromic features. Conclusions This study further confirms that PRKAR1A IHC is a useful diagnostic tool for both non‐metastasising and metastasising tumours and suggests that molecular analyses can be helpful to identify non‐metastasising tumours with malignant potential in selected patients. Importantly, these results highlight that germline assessment could be beneficial for all patients presenting with LCCSCT.
    Type of Medium: Online Resource
    ISSN: 0309-0167 , 1365-2559
    URL: Issue
    URL: Article
    DOI: 10.1111/his.v82.7
    DOI: 10.1111/his.14895
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2023
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  • 3
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    Micronodular PEComas of the appendix
    Wiley ; 2021
    In:  Histopathology Vol. 78, No. 7 ( 2021-06), p. 1047-1050
    Details
    In: Histopathology, Wiley, Vol. 78, No. 7 ( 2021-06), p. 1047-1050
    Abstract: Perivascular epithelioid cell tumours (PEComas) of the appendix have been reported very rarely. In this study, we describe three cases of a distinctive micronodular proliferation in the appendix consistent with a variant of PEComa. Although known as ‘granular degeneration of smooth muscle’ in prior reports, we reappraise its clinicopathological, immunohistochemical and ultrastructural features which support a change in classification. Methods and results Patients were two females (aged 33 and 41 years) and one male (aged 41). None had a history of tuberous sclerosis. Histologically, each case demonstrated a multifocal nodular proliferation towards the distal tip of the appendix, composed of epithelioid cells with abundant granular eosinophilic to clear cytoplasm. By immunohistochemistry, the lesional cells were positive for muscle markers [smooth muscle actin (SMA) and desmin], melanocytic markers (HMB45, melan A), cathepsin K and the lysosomal marker NKI‐C3 in each case. MITF was positive in two of three cases. None expressed S100 protein. Electron microscopy in one case revealed striated electron‐dense structures consistent with pre‐melanosomes. Follow‐up, available in one case, showed no recurrence at 5 years. Conclusions We propose the term ‘micronodular PEComa’ for this appendiceal lesion to reflect more accurately its histological and immunohistochemical characteristics, which include consistent positivity for both muscle and melanocytic markers. Micronodular PEComa seems to follow an indolent course, consistent with its uniformly low‐grade histological features, and appears to be unassociated with tuberous sclerosis.
    Type of Medium: Online Resource
    ISSN: 0309-0167 , 1365-2559
    URL: Issue
    URL: Article
    DOI: 10.1111/his.v78.7
    DOI: 10.1111/his.14341
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2021
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  • 4
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    Online Resource
    Large cell calcifying Sertoli cell tumour: a contemporary multi‐institutional case series highlighting the diagnostic utility of PRKAR1A immunohistochemistry
    Wiley ; 2022
    In:  Histopathology Vol. 80, No. 4 ( 2022-03), p. 677-685
    Details
    In: Histopathology, Wiley, Vol. 80, No. 4 ( 2022-03), p. 677-685
    Abstract: Large cell calcifying Sertoli cell tumour (LCCSCT) is a rare testicular sex cord‐stromal tumour that primarily affects young patients and is associated with Carney complex. We sought to characterise the clinicopathological features of a series of LCCSCT and evaluate the diagnostic utility of PRKAR1A immunohistochemistry (IHC). Methods and results The LCCSCT cohort ( n  = 15) had a median age of 16 years (range = 2–30 years). Four patients were known to have Carney complex. PRKAR1A IHC was performed in each case. For comparison, PRKAR1A IHC was also assessed in other sex cord‐stromal tumours, including Sertoli cell tumour, not otherwise specified (SCT, NOS; n  = 10), intratubular large cell hyalinising Sertoli cell tumour ( n  = 1) and Leydig cell tumour ( n  = 23). Loss of cytoplasmic PRKAR1A expression was observed in all but one LCCSCT (14 of 15; 93%). PRKAR1A expression was retained in all SCTs, NOS (10 of 10; 100%), the majority of Leydig cell tumours (22 of 23; 96%) and an intratubular large cell hyalinising Sertoli cell tumour (1 of 1; 100%). One Leydig cell tumour showed equivocal staining (multifocal weak expression). Conclusions Overall, PRKAR1A loss is both sensitive (93%) and highly specific (97%) for the diagnosis of LCCSCT. PRKAR1A loss may aid its diagnosis, particularly in sporadic cases and those that are the first presentation of Carney complex.
    Type of Medium: Online Resource
    ISSN: 0309-0167 , 1365-2559
    URL: Issue
    URL: Article
    DOI: 10.1111/his.v80.4
    DOI: 10.1111/his.14599
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2022
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  • 5
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    Molecular and immunohistochemical characterisation of mesothelioma of the tunica vaginalis *
    Wiley ; 2022
    In:  Histopathology Vol. 81, No. 1 ( 2022-07), p. 65-76
    Details
    In: Histopathology, Wiley, Vol. 81, No. 1 ( 2022-07), p. 65-76
    Abstract: Malignant mesothelioma (MM) of the tunica vaginalis (TV) is a rare and aggressive tumour, and the molecular features and staining profile with contemporary immunohistochemical (IHC) biomarkers are largely unexplored. We characterise the clinicopathological, molecular and IHC features of MM ( n  = 13) and mesothelial neoplasms of uncertain malignant potential (MUMP) ( n  = 4). Methods and results Targeted next‐generation sequencing was performed on seven MMs and two MUMPs. IHC was performed for methylthioadenosine phosphorylase (MTAP), BRCA1‐associated protein 1 (BAP1) and SRY‐box transcription factor 6 (SOX6). Thirteen adenomatoid tumours were also assessed with SOX6. MM were epithelioid (seven of 13) or biphasic (six of 13). In MM, NF2 (five of seven; 71%), CDKN2A (three of seven; 43%) and BAP1 (two of seven; 29%) were most frequently altered. Non‐recurrent driver events were identified in PTCH1 and TSC1 . In contrast, none of these alterations were identified in MUMPs; however, one MUMP harboured a TRAF7 missense mutation. By IHC, loss of MTAP (two of 12; 17%) and BAP1 (two of nine; 22%) was infrequent in MM, whereas both were retained in the MUMPs. SOX6 was positive in nine of 11 (82%) MMs and negative in all MUMPs and adenomatoid tumours. Conclusions Testicular MM exhibit a similar mutational profile to those of the pleura/peritoneum; however, alterations in CDKN2A and BAP1 are less common. These findings suggest that although MTAP and BAP1 IHC are specific for MM, their sensitivity in testicular MMs appears lower. In addition, rare tumours may harbour targetable alterations in driver genes ( PTCH1 and TSC1 ) that are unusual in MMs at other anatomical sites. SOX6 is sensitive for MM; accordingly, the presence of SOX6 expression argues against a benign neoplastic process.
    Type of Medium: Online Resource
    ISSN: 0309-0167 , 1365-2559
    URL: Issue
    URL: Article
    DOI: 10.1111/his.v81.1
    DOI: 10.1111/his.14669
    RVK:
    XA 10000
    Language: English
    Publisher: Wiley
    Publication Date: 2022
    detail.hit.zdb_id: 2006447-0
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