Immunohistochemical analysis of invasive micropapillary carcinoma pattern in four cases of gastric cancer

Ohtsuki, Yuji; Yunoki, Sho; Murakami, Serami; Mizukami, Yuji; Okada, Yuhei; Iguchi, Mitsuko; Lee, Gang-Hong; Furihata, Mutsuo

doi:10.1007/s00795-013-0037-9

Cited by 21 publications

(22 citation statements)

References 20 publications

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“…Previous studies have confirmed the presence of these structures in malignancies of the digestive system (9). In addition, it has been demonstrated that the presence of a micropapillary component in tumors indicates aggressiveness and poor clinical outcome (14)(15)(16)(17)(18).…”

Section: Introductionmentioning

confidence: 84%

“…The spaces are separated from one another by thin bands of fibrous tissue and form a structure comparable to a sponge. Nests may also form with fusiform-like cancer cells filling up single spaces (6,7), and are often observed in invasive tumor margins or less frequently in the tumor center (1,(7)(8)(9). The micropapillary structure may constitute one of the morphological tumor components and coexist with other histological types of cancer, or it can be the only morphological feature (3,5,8).…”

Section: Introductionmentioning

confidence: 99%

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Invasive micropapillary component and its clinico-histopathological significance in patients with colorectal cancer

2016

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Abstract. Micropapillary components are located in distinct, empty spaces resembling lymphatic vessels and consist of clusters of cancer cells that adhere tightly to one another. These structures do not have a fibrovascular core. Invasive micropapillary components (IMPCs) exhibit reverse polarity, which results in a characteristic 'inside-out' structure. The aim of the present study was to examine the histological significance of the micropapillary component in colorectal carcinoma compared with conventional colorectal adenocarcinoma. Among 115 patients, 5 (4.3%) were diagnosed with a micropapillary colorectal component based on hematoxylin and eosin staining and immunohistochemical analysis. To exclude identification of poorly-differentiated clusters of adenocarcinoma cells in the lymphatic vessels, immunohistochemical analysis with D2-40 was performed, and epithelial membrane antigen was used to confirm the specific 'inside-out' structure of IMPCs. IMPCs were observed to positively correlate with histopathological type (P=0.001) and tumor invasion in venous vessels (P= 0.033). Furthermore, the presence and number of lymph node metastases was greater in IMPC cases compared with conventional carcinoma cases; however, these differences were not statistically significant (P=0.087 and P=0.094, respectively). In addition, IMPC cases were not significantly associated with the presence of inflammatory infiltrate in the invasive front of the tumor (P= 0.098). Therefore, the present study indicates that the IMPC serves a histopathological and prognostic role in the diagnosis of colorectal cancer due to its aggressive and invasive behavior. IMPC is rare in cases of colorectal cancer and remains a great diagnostic challenge in pathomorphology with further detailed investigation required in the future.

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Section: Introductionmentioning

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Invasive micropapillary component and its clinico-histopathological significance in patients with colorectal cancer

2016

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“…They are also seen in breast [28,29], urothelial [30,31], gastric [32,33] and colorectal carcinoma [34,35]. Two studies reported differences in DNA ploidy in the micropapillary component of urothelial carcinoma [30,31].…”

Section: Discussionmentioning

confidence: 99%

Mapping of actionable mutations to histological subtype domains in lung adenocarcinoma: implications for precision medicine

Wright

Weiss

et al. 2014

Oncotarget

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Precision medicine depends on the accurate identification of actionable mutations in a tumor sample. It is unknown how heterogeneous the distribution of such mutations can be in a tumor. Morphological (i.e. histopathological) heterogeneity is well described in lung adenocarcinoma and has been specifically recognized in the most recent official clinico-pathological classification. The most predominant subtype present is now used to classify each lung adenocarcinoma. No molecular profile exists to explain the intratumoral differences in lung adenocarcinoma morphology, despite the consistently observed association between specific predominant subtypes and poorer survival. Given a recent proposal stratifying lung adenocarcinoma into subtypes of differing metastatic potential, we questioned the assumption that major mutations are present uniformly throughout tumors; especially those showing discrete different subtypes.We selected formalin-fixed paraffin embedded lung adenocarcinoma specimens that showed discrete areas of different subtypes, extracted subtype DNA samples from those areas and screened for mutations in hotspot regions of the EGFR, KRAS and BRAF genes using high resolution melting. Sanger sequencing was used to confirm all identified mutations. Chromogenic in situ hybridization (CISH) was used to identify mutant allele specific imbalances in tumors with EGFR mutations.Interestingly, we found that KRAS and BRAF mutations could be confined to morphological domains of higher grade. On the other hand, EGFR mutations were found through all histological subtypes in each tumor consistent with the driver status of this mutation.Intratumoral heterogeneity has major implications for tumorigenesis, chemoresistance and the role of histopathology in molecular screening for precision medicine. This study not only confirms that intratumoral mutational heterogeneity does occur, but also that it is associated with morphologically distinct regions in some tumors. From a practical perspective, small biopsies may not adequately represent a tumor's full mutational profile, particularly for later arising but prognostically important mutations such as those in the KRAS and BRAF genes.

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“…Ayrıca ampullo-pankreatikobilier bölgede de İMPK bildirilmiştir (57). Fakat olgu sayısı gastrointestinal İMPK'un immünohistokimyasal profili ve kliniği hakkında bilgi edinmek için yetersizdir (13).…”

Section: Gastroi̇ntesti̇nal Traktta İnvazi̇v Mi̇kropapi̇ller Karsi̇nomunclassified

Micropapillary carcinoma: pathogenesis, histological and clinical features

Behzatoğlu¹,

Hacıhasanoğlu²

2017

JCurrPath

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ÖzeTİnvaziv mikropapiller karsinom, ilk defa 1993 yılında tanımlanan, meme, mesane, akciğer, tükürük bezleri, over gibi pek çok anatomik bölgede görülen nadir bir karsinom tipidir. Histolojisi, fibrovasküler koru olmayan hücre kümeleri ve onları çevreleyen, lenfatik kanalları andıran boşluklar ile karakterizedir. Mikropapiller karsinom, genellikle bulunduğu organın konvansiyonel karsinomu veya diğer karsinom varyantları ile bir arada görülmektedir. Saf mikropapiller karsinom oldukça nadirdir. Odaksal da olsa mikropapiller büyüme paterni gösteren tümörlerin lenfovasküler invazyon, lenf nodu metastazı ve uzak metastaz yapma eğilimi konvansiyonel karsinomlardan yüksektir. tümöründe invaziv mikropapiller komponent bulunan hastalar ileri evrede prezente olmakta ve aynı organın konvansiyonel karsinomlarıyla karşılaştırıldığında daha düşük oranda sağkalım göstermektedir. Agresif seyir gösteren bu karsinom tipinin tanınması hasta takibi ve tedavi açısından önem taşımaktadır. Bu derlemede mikropapiller karsinomun patogenezine değinilmiş, farklı organ ve bölgelerdeki mikropapiller karsinomların klinik, histolojik ve immunohistokimyasal özellikleri tartışılmıştır.Anahtar Sözcükler: Mikropapiller karsinom, Patogenez, İmmunhistokimya, Klinik, tedavi aBSTRaCT Invasive micropapillary carcinoma is a rare variant of carcinoma which was first described in 1993. It has been recognized in various anatomic sites including breast, urinary bladder, lung, salivary glands and ovary, since then. Histologically, it is characterized by tight clusters of neoplastic cells and clear spaces around them resembling lymphatic vessels. Micropapillary growth patern is usually mixed with conventional carcinoma or other variants of carcinoma. Pure micropapillary carcinoma is very rare. tumors with micropapillary growth pattern tend to make lymphovascular invasion, lymph node metastasis and distant metastasis more frequently than conventional carcinomas. Furthermore, patients present with high-stage disease and have poor prognosis compared to patients with conventional carcinoma of the same organ. Recognition of this aggressive type of carcinoma is important for treatment choice and clinical follow-up of the patient. this review discusses the pathogenesis, clinical, morphological, and immunohistochemical features of micropapillary carcinoma of various organs/sites. GİRİşİnvaziv mikropapiller karsinom (İMPK), özellikle son 20 yılda oldukça ilgi çeken agresif bir özel karsinom tipidir. Özellikle ileri evrede saptanması, yüksek lenfovasküler invazyon, lenf nodu metastazı ve uzak metastaz oranları ile dikkat çeken mikropapiller karsinom, ilk kez 1993 yılında Siriaunkgul ve tavassoli tarafından memede tarif edilmiştir (1). Memede farklı bir antite olarak tanımlanmasından sonra mesane, akciğer, tükürük bezi, gastrointestinal sistem gibi birçok anatomik bölgede çok sayıda olgu bildirilmiştir (1-21). Bu yazıda genelde İMPK ifadesini daha çok kullanacağız. Çünkü meme ve tükürük bezi duktal karsinomlarında ve mesane ürotelyal karsinomlarında in situ karsinom o...

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Immunohistochemical analysis of invasive micropapillary carcinoma pattern in four cases of gastric cancer

Cited by 21 publications

References 20 publications

Invasive micropapillary component and its clinico-histopathological significance in patients with colorectal cancer

Invasive micropapillary component and its clinico-histopathological significance in patients with colorectal cancer

Mapping of actionable mutations to histological subtype domains in lung adenocarcinoma: implications for precision medicine

Micropapillary carcinoma: pathogenesis, histological and clinical features

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