Cathepsin K expression in a wide spectrum of perivascular epithelioid cell neoplasms (<scp>PEC</scp>omas): a clinicopathological study emphasizing extrarenal <scp>PEC</scp>omas

Rao, Qiu; Liu, Cheng; Xia, Qiuyuan; Liu, Biao; Li, Li; Shi, Qun li; Shi, Shan shan; Yu, Bo; Zhang, Ru song; Hui, Heng; Lu, Zhen; Tu, Pin; Zhou, Xiao

doi:10.1111/his.12059

Cited by 74 publications

(38 citation statements)

References 37 publications

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“…The PEC cell has abundant clear to eosinophilic granular cytoplasm (Figures 9a and b) and variably stains for melanocytic markers (HMB45, MelanA, MiTF, cathepsinK, and TFE3) (Figures 9c and d) with variable expression of smooth muscle markers. [87][88][89][90][91][92] A strong association with lymphangiomyomatosis and tuberous sclerosis exists. 88,90,91 PEComa may share with epithelioid leiomyosarcoma the following features: (1) Among smooth muscle markers, desmin followed by actin and h-caldesmon are most commonly expressed especially in the spindle areas of the tumor.…”

Section: Tumor Cell Necrosismentioning

confidence: 99%

Practical issues in uterine pathology from banal to bewildering: the remarkable spectrum of smooth muscle neoplasia

Oliva

2016

Modern Pathology

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Among mesenchymal tumors of the uterus, smooth muscle neoplasms are most common. The wide morphologic spectrum, especially within the category of leiomyomas, is responsible for diagnostic problems more frequently with leiomyosarcoma (including mitotically active, apoplectic, and leiomyoma with bizarre nuclei) but also with endometrial stromal tumors. In the former scenario, clinical information, gross appearance as well as strict utilization of morphologic criteria including cytologic atypia, mitotic activity, and tumor cell necrosis are clues in establishing the correct diagnosis. It is important to keep in mind that mitotic rate thresholds vary for the different subtypes of leiomyosarcoma. Of note, p16 should be used with caution in supporting a diagnosis of leiomyosarcoma as it is often positive in leiomyomas with bizarre nuclei and leiomyomas with apoplectic change (in the latter most frequently and more intense near areas of necrosis). MED12 mutations have also a very limited role in this differential diagnosis. Endometrial stromal tumors are by far, less common than smooth muscle tumors, but can be confused with leiomyosarcomas if they are associated with an undifferentiated uterine sarcoma and the low-grade component is overlooked or they have a myxoid/fibroblastic morphology. The differential diagnosis may be confounded if the latter is associated with a high-grade endometrial stromal sarcoma. It is important to highlight that CD10 is not a reliable marker in these differentials and should be used as a part of a panel of antibodies that also includes desmin and h-caldesmon. Two other recently categorized tumors in the uterus that merit special mention are PEComa and inflammatory myofibroblastic tumor as they enter in the differential diagnosis of smooth muscle tumors. PEComa may be part of the tuberous sclerosis syndrome and may show either a predominantly epithelioid or spindle morphology or combination thereof. Rarely, it may contain melanin pigment. There is variable positivity for HMB-45, MelanA, MiTF, and CathepsinK, and some tumors have been shown to express TFE-3 especially when associated with "clear cell" morphology. Patients with adverse outcome have tumors with ≥ 2 of the following features: ≥ 5 cm, infiltration, high-grade cytologic features, mitotic rate ≥ 1/50 high-power fields, necrosis, or lymphovascular invasion. Inflammatory myofibroblastic tumor is important to recognize as it often mimics myxoid smooth muscle tumors, either benign or malignant. The presence of an associated lymphoplasmacytic infiltrate should alert to that possibility and ALK studies (immunostain or FISH) are helpful in establishing this diagnosis. These tumors can behave in a malignant manner if large, associated with abundant myxoid change, brisk mitotic rate or show tumor cell necrosis.

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Section: Tumor Cell Necrosismentioning

confidence: 99%

Practical issues in uterine pathology from banal to bewildering: the remarkable spectrum of smooth muscle neoplasia

Oliva

2016

Modern Pathology

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“…In approximately 70% of cases, immune reaction for SMA was reported, while an immuno-positivity for vimentin and/or desmin was observed, though less frequently [6,12,31]. Cathepsin K expression was also reported to be useful in the diagnosis of PEComas [32].…”

Section: Immunohistochemical Featuresmentioning

confidence: 99%

Perivascular epithelioid cell neoplasm (PEComa) of the uterus: A systematic review

Musella

Felice

Kyriacou

et al. 2015

International Journal of Surgery

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“…Cathepsins participate in a number of processes in healthy cells, but have also been reported to be involved in certain pathological processes, including cancer progression (4)(5)(6)(7). In a number of cancer types, increased expression of cysteine cathepsins and alterations in their subcellular trafficking were reported (8)(9)(10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Cathepsin L is involved in proliferation and invasion of ovarian cancer cells

Zhang

Wei

Shen

et al. 2014

Molecular Medicine Reports

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Abstract. Cathepsin L (CTSL) is a lysosomal cysteine protease that has been found to be overexpressed in ovarian cancer (OC). The aim of the present study was to investigate the possible involvement of CTSL in the development of OC. In this study, RNA interference with a CTSL small hairpin RNA (CTSL-shRNA), and a plasmid carrying CTSL were used to identify the effects of this enzyme on the regulation of the malignant behavior of OC cells. OV-90 and SKOV3 human ovarian cancer cell lines were selected as cell models in vitro and in vivo. The results showed that downregulation of CTSL significantly inhibits the proliferative and invasive capability of SKOV3 cells, and that upregulation of CTSL in OV-90 cells leads to opposite effects. Compared with parental OC cells, cells in which CTSL was silenced exhibited a reduced capacity to develop into tumors in nude mice, while the growth of tumor xenografts derived from these cells was markedly constrained. In conclusion, the results suggested that CTSL contributes to the proliferation and metastasis of OC, and that CTSL may be a novel molecular target for OC treatment.

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Cathepsin K expression in a wide spectrum of perivascular epithelioid cell neoplasms (PEComas): a clinicopathological study emphasizing extrarenal PEComas

Abstract: Cathepsin K appears to be more powerful than other commonly used markers in diagnosing a wide spectrum of PEComas and distinguishing them from the majority of human cancers.

Cited by 74 publications

References 37 publications

Practical issues in uterine pathology from banal to bewildering: the remarkable spectrum of smooth muscle neoplasia

Practical issues in uterine pathology from banal to bewildering: the remarkable spectrum of smooth muscle neoplasia

Perivascular epithelioid cell neoplasm (PEComa) of the uterus: A systematic review

Cathepsin L is involved in proliferation and invasion of ovarian cancer cells

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