Histopathological and molecular profiling of lung adenocarcinoma skin metastases reveals specific features

Forest, Fabien; Laville, David; Habougit, Cyril; Cruz, Vanessa Da; Casteillo, François; Yvorel, Violaine; Bard-Sorel, Sandrine; Godard, W; Picot, Tiphanie; Tiffet, Olivier; Perrot, Jean‐Luc; Péoc’h, Michel

doi:10.1111/his.14463

Cited by 5 publications

(8 citation statements)

References 39 publications

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“…In these cases, a broad IHC panel and the correlation with radiological findings are necessary (Table 5A). In a recent study, about 70% of the skin metastases of lung adenocarcinomas were negative for TTF1, which might be due to the frequent poorly differentiated nature of the adenocarcinoma in skin metastases 30 …”

Section: Discussionmentioning

confidence: 96%

“…In a recent study, about 70% of the skin metastases of lung adenocarcinomas were negative for TTF1, which might be due to the frequent poorly differentiated nature of the adenocarcinoma in skin metastases. 30 The distinction between primary skin adnexal carcinoma and metastatic adenocarcinoma, especially breast and salivary gland, can be challenging because these tumours can exhibit similar morphological patterns and immunohistochemical profiles. 28,31 Depending on the tumour type, several IHC panels are recommended (Table 5B).…”

Section: Discussionmentioning

confidence: 99%

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Cutaneous metastases of internal malignancies: a single‐institution experience

Vernemmen

Roemen

et al. 2022

Histopathology

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Aims Cutaneous metastases of internal malignancies occur in 1–10% of cancer patients. The diagnosis can sometimes be challenging, especially in cases with an unknown primary cancer. Materials and methods A retrospective case review was performed including all cases of skin metastases from primary internal malignancies diagnosed at the Department of Pathology at the Maastricht University Medical Centre+ from 2007 to 2021. The clinicopathological data were collected and immunohistochemical and molecular diagnostic tests were performed to confirm the primary origin of the metastases. Results We identified 152 cases (71 female; 31 male patients) of cutaneous metastases of internal malignancies. 28 patients (20 women and 8 men) were diagnosed with multiple cutaneous metastases. Among the female patients, the most common primary tumour was breast cancer (50% of the cases), followed by lung (13.6%), gynaecological (7.3%), and gastrointestinal origin (7.3%). Among the male patients, the most common primary sites were gastrointestinal and lung origin (altogether, 50% of the cases). In 19 patients, the cutaneous metastasis was the first presentation of a clinically silent internal malignancy (18.6%), of which most (78.9%) represented metastatic lung carcinomas. Finally, metastasizing patterns were different across tumour types and gender. Conclusion Breast, lung, gastrointestinal, and gynaecologic cancers are the most common primary tumours demonstrating skin metastases. Infrequently, cutaneous metastases can be the first clinically visual manifestation of an underlying not yet diagnosed internal malignancy; therefore, occasional broad immunohistochemical profiling, molecular clonal analysis, and a continuous high level of awareness are necessary for a precise diagnosis of cutaneous metastases of internal malignancies.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Cutaneous metastases of internal malignancies: a single‐institution experience

Vernemmen

Roemen

et al. 2022

Histopathology

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“…Molecular testing was performed as previously described [ 4 , 13 ]. EGFR (epidermal growth factor receptor) mutations were screened using a peptic nucleic acid (PNA) clamp detection kit (Entrogen detection kit, Entrogen Inc., Woddland Hill, CA, USA) or via next-generation sequencing (NGS) on the Personal Genome Machine (Thermofisher, Dardilly, France).…”

Section: Methodsmentioning

confidence: 99%

Anti-CK7/CK20 Immunohistochemistry Did Not Associate with the Metastatic Site in TTF-1-Negative Lung Cancer

et al. 2022

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Anti-CK7 and anti-CK20 immunohistochemistry is sometimes used to establish a diagnosis of primary lung cancer. We performed a retrospective study on the value of anti-CK7 and anti-CK20 immunohistochemistry in 359 biopsies of patients with suspected lung carcinoma in order to assess the usefulness of these antibodies in the evaluation of lung tumors in biopsies. Our results showed TTF-1 positivity in 73.3% of patients. EGFR mutations and ALK rearrangements were significantly different between TTF-1 positive and TTF-1 negative tumors (p < 0.001 and p = 0.023, respectively). Our results show a significant difference (p < 0.001) between TTF-1 positive and TTF-1 negative carcinomas with a median survival of 21.97 months (CI95% = 17.48–30.9 months) and 6.52 months (CI95% = 3.34–10.3 months), respectively. In the group of TTF-1 negative patients, anti-CK7 and CK20 immunohistochemistry was performed in 70 patients and showed CK7+/CK20- staining in 61 patients (87.1%), CK7-/CK20- in 4 patients (5.7%), CK7+/CK20+ in 3 patients (4.3%), and CK7-/CK20- in 2 patients (2.8%). No specific or molecular pattern was found in these groups of CK7/CK20 combinations. In total, this work brings arguments concerning the uselessness of anti-CK7/CK20 immunohistochemistry in the case of suspicion of primary lung cancer in biopsies.

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“…Molecular testing was performed as previously described 4. Next-generation sequencing (NGS) was performed on the Personal Genome Machine (Thermofisher).…”

Section: Methodsmentioning

confidence: 99%

“…Molecular testing was performed as previously described. 4 Next-generation sequencing (NGS) was performed on the Personal Genome Machine (Thermofisher). Library preparation was carried out using amplicon technology with the Ion AmpliSeq Colon and Lung V2 ready-to-use panel (Thermofisher.…”

Section: Molecular Analysismentioning

confidence: 99%

Challenging Metastatic Melanoma to the Lung With p40 Expression: A Diagnostic Pitfall, Case Report

Thierry

Juberthie

Gyenes

et al. 2022

Applied Immunohistochemistry &Amp; Molecular Morphology

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p40 immunohistochemistry is a cornerstone of histopathological examination for non-small cell lung carcinoma. p40 is an isoform of p63 and is reported to be highly specific for the diagnosis of squamous cell carcinoma. Very rare pitfalls are reported for this antibody, and p40 is typically negative in melanoma. A 66-year-old patient was admitted for multiple hemorrhagic brain tumors evocative of secondary tumors. On imaging, a 26 mm lung tumor was detected, and a biopsy of the lung tumor was performed. The tumor was stained by melanic markers and diffusely stained by p40 and p63. Molecular analysis found a somatic p.Asn581Ser (c.1742A>G) point mutation in exon 15 of BRAF and a p.Arg80Ter (c.238C>T) germline variant of CDKN2A, a predisposing mutation to melanoma. This case report highlights the importance of clinical, pathologic, and molecular correlation.

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Histopathological and molecular profiling of lung adenocarcinoma skin metastases reveals specific features

Cited by 5 publications

References 39 publications

Cutaneous metastases of internal malignancies: a single‐institution experience

Cutaneous metastases of internal malignancies: a single‐institution experience

Anti-CK7/CK20 Immunohistochemistry Did Not Associate with the Metastatic Site in TTF-1-Negative Lung Cancer

Challenging Metastatic Melanoma to the Lung With p40 Expression: A Diagnostic Pitfall, Case Report

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