Comment on ‘Cytokeratin 20-negative Merkel cell carcinoma is infrequently associated with the Merkel cell polyomavirus‘

Iwasaki, Takeshi; Matsushita, Michiko; Nonaka, Daisuke; Murakami, Ichiro; Hayashi, Kazuhiko

doi:10.1038/modpathol.2015.69

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Iwasaki et al have reported additional CK20-negative MCCs. They concluded that the negativity of both cytokeratin 20 and MCPyV might be associated with poorly differentiated MCC features pertaining to their previous study that demonstrated severe nuclear atypia and pleomorphism in MCPyV-negative MCCs compared to MCPyV-positive MCCs ( 36 , 37 ). However, they did not find a significant relationship between CK20 negativity and MCC-specific death.…”

Section: Discussionmentioning

confidence: 95%

Histopathologic features for overall survival in merkel cell carcinoma: a case series with intact mismatch repair protein expression

Kestel¹,

Öğüt²,

Inan³

et al. 2023

TJPATH

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Objective: In a study of Merkel cell carcinoma (MCC), a fusion transcript between MLH1 and SPATA4 was identified. This fusion has the potential to generate the inactive or dominant-negative form of the protein. Therefore, we aimed to investigate whether mismatch repair protein deficiency occurr in MCC cases or not, in addition to the overall survival association with histopathologic features. Material and Methods: A retrospective review of 15 patients diagnosed with a biopsy-proven Merkel Cell Carcinoma between 2012 and 2019 was performed. Mismatch repair (MMR) protein expressions were evaluated by immunohistochemistry. Results: The median follow-up time was 36 months (mean 41, range 2-103 months). Six (40%) patients died during follow-up. The overall survival (OS) at 1 year, 2 years, 3 years, and 5 years were 87%, 80%, 62%, and 53%, respectively. The patients diagnosed at <60 years had an improved OS compared to those ≥60 years of age (p=0.016). Patients in clinical stage I had better OS than patients in clinical stage IV (p=0.011). Cases with pathological tumor stage (pT) 1 had better OS than pT3 and pT4 (p=0.045). Adjuvant radiotherapy or adjuvant radiotherapy+chemotherapy treatment improved OS compared to adjuvant chemotherapy (p=0.003). MMR protein nuclear expression was intact in 12 cases available for immunohistochemical study. Conclusion: To the best of our knowledge, this is the second study that preferentially investigated the mismatch repair protein status of Merkel Cell Carcinoma. No mismatch repair protein deficiency of MCC cases was identified in the current study.

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Section: Discussionmentioning

confidence: 95%

Histopathologic features for overall survival in merkel cell carcinoma: a case series with intact mismatch repair protein expression

Kestel¹,

Öğüt²,

Inan³

et al. 2023

TJPATH

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“…Moreover, Merkel cell polyomavirus (MCPyV) was recently shown to be significantly associated with the pathogenesis of MCC, including the expression of Cytokeratin 20 (CK20) [3]. The diagnosis is often difficult because histopathological results require a number of differential diagnoses through immunohistochemical (IHC) stains with other cutaneous malignancies.…”

Section: Introductionmentioning

confidence: 99%

Cytokeratin 20 negative Merkel cell carcinoma consistent with negative Merkel cell polyomavirus

Kwon

Chung

Park

2017

Yeungnam Univ J Med

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Merkel cell carcinoma (MCC) is a rare neuroendocrine tumor that is highly aggressive in nature and indolent in progression. The common risk factors for MCC are senility, prolonged exposure to sunlight, and immune deficient states. Moreover, Merkel cell polyomavirus has recently been characterized to be significantly associated with pathogenesis of MCC, including the expression of Cytokeratin 20 (CK20). Diagnosis is often difficult since histopathological results require a number of differential diagnoses through immunohistochemical (IHC) stains with other cutaneous malignancies. A 67-year-old man presented with a solitary domeshaped erythematous round mass on the left upper arm for 2 months. Biopsy and IHC studies revealed findings consistent with Merkel Cell Carcinoma of neuroendocrine origin. Common IHC stains usually confirm positive findings for CK20, which is also recognized as the key component in making the diagnosis. We present a CK20 negative MCC in light of expanding the knowledge of unusually stained IHC results in MCC.

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Unusual Neuroendocrine Differentiation in a Small Round Cell Angiosarcoma: A Potential Histologic Mimicker of Superficial Ewing Sarcoma

Machado

Santonja

Huerta

et al. 2018

The American Journal of Dermatopathology

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Neuroendocrine differentiation or aberrant expression of neuroendocrine markers is very uncommon in angiosarcomas (AS) and creates a challenging differential diagnosis with other superficial or soft tissue tumors. Herein, we report a new case of superficial AS presenting as a tumor lesion on the little finger of the right hand of a 52-year-old man. The tumor displayed CD56, chromogranin-A, and synaptophysin immunoreactivity. Tumor cells were positive for vascular markers (CD31, FLI1, ERG, D2-40, VE-cadherin, VEGR1,2, and 3), CD99, and EMA, but were negative for S100, CK (AE1/AE3), CK20, polyomavirus, and myogenic (desmin and myogenin) and melanocyte markers (melan-A and HMB45). Ki67 immunostains indicated high proliferative activity (>50%). The whole-body computed tomography did not reveal distant disease. The initial assessment considered several tumor subtypes as possible histological diagnoses, including Ewing sarcoma, Ewing-like sarcoma, Merkel cell carcinoma, and undifferentiated "small round cell sarcoma". Fluorescence in situ hybridization analysis was negative for EWSR1 translocation and molecular analysis failed to detect any EWSR1, CIC, SYT or BCOR rearrangement. As a follow-up investigation, we tested 17 cutaneous/superficial AS for neuroendocrine markers; however, only one of these showed focal CD56 and synaptophysin expression. In conclusion, the present findings indicate that neuroendocrine differentiation is a very infrequent feature in AS. We report an AS of the finger with an uncommon histological appearance and immunohistochemical profile: predominant round cell tumor proliferation and neuroendocrine differentiation. Pathologists should be aware of these potential histological and immunohistochemical pitfalls in AS.

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Comment on ‘Cytokeratin 20-negative Merkel cell carcinoma is infrequently associated with the Merkel cell polyomavirus‘

Cited by 3 publications

References 6 publications

Histopathologic features for overall survival in merkel cell carcinoma: a case series with intact mismatch repair protein expression

Histopathologic features for overall survival in merkel cell carcinoma: a case series with intact mismatch repair protein expression

Cytokeratin 20 negative Merkel cell carcinoma consistent with negative Merkel cell polyomavirus

Unusual Neuroendocrine Differentiation in a Small Round Cell Angiosarcoma: A Potential Histologic Mimicker of Superficial Ewing Sarcoma

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