Immunohistochemical Biomarkers of Mesenchymal Neoplasms in Endocrine Organs: Diagnostic Pitfalls and Recent Discoveries

Hung, Yin P.; Hornick, Jason L.

doi:10.1007/s12022-018-9513-z

Cited by 6 publications

(8 citation statements)

References 94 publications

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“…One tumor showed remnants of adrenocortical features—a precursor lesion?—in an otherwise dedifferentiated sarcoma [ 34 ]. If no adrenocortical features could be found, an adrenal sarcoma is likely [ 13 , 17 , 25 ]. Immunostainings are generally necessary for differentiation and, in single cases, molecular pathology [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Adrenal cancer: relevance of different grading systems and subtypes

2021

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Purpose The subclassification of adrenal cancers according to the WHO classification in ordinary, myxoid, oncocytic, and sarcomatoid as well as pediatric types is well established, but the criteria for each subtype are not sufficiently determined and the relative frequency of the different types of adrenal cancers has not been studied in large cohorts. Therefore, our large collection of surgically removed adrenal cancers should be reviewed o establish the criteria for the subtypes and to find out the frequency of the various types. Methods In our series of 521 adrenal cancers the scoring systems of Weiss et al., Hough et al., van Slooten et al. and the new Helsinki score system were used for the ordinary type of cancer (97% of our series) and the myxoid type (0.8%). For oncocytic carcinomas (2%), the scoring system of Bisceglia et al. was applied. Results Discrepancies between benign and malignant diagnoses from the first thee classical scoring systems are not rare (22% in our series) and could be resolved by the Helsinki score especially by Ki-67 index (more than 8% unequivocally malignant). Since all our cancer cases are positive in the Helsinki score, this system can replace the three elder systems. For identification of sarcomatoid cancer as rarest type in our series (0.2%), the scoring systems are not practical but additional immunostainings used for soft tissue tumors and in special cases molecular pathology are necessary to differentiate these cancers from adrenal sarcomas. According to the relative frequencies of the different subtypes of adrenal cancers the main type is the far most frequent (97%) followed by the oncocytic type (2%), the myxoid type (0.8%) and the very rare sarcomatoid type (0.2%). Conclusions The Helsinki score is the best for differentiating adrenal carcinomas of the main, the oncocytic, and the myxoid type in routine work. Additional scoring systems for these carcinomas are generally not any longer necessary. Signs of proliferation (mitoses and Ki-67 index) and necroses are the most important criteria for diagnosis of malignancy.

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Section: Discussionmentioning

confidence: 99%

Adrenal cancer: relevance of different grading systems and subtypes

2021

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“…The case reports diagnosed by FNAC generally were reported as malignant-most likely of the hematologic origin, except one case that was assigned as the SFN/FN category of TBSRTC [3, 73]. PEEF shows strong and diffuse membranous immunoreactivity for CD99, and the transcription factor NKX2-2 was also positive by ICC (positive 85–93% of cases) [74]. Ewing-like round cell sarcomas (CIC- rearranged round cell sarcoma, BCOR-CCNB3 sarcoma) and various other sarcomas should also be included to the differential diagnosis [74].…”

Section: Primary Neuroendocrine Carcinoma Of Thyroid/neuroblastoma/pe...mentioning

confidence: 99%

“…High mitotic index and necrosis were other common features [76]. Differently from Ewing sarcoma, ALES shows strong and diffuse positivity for P40 and P63 [74, 76]. Although focal and variable immunoreactivity might be seen in some cases, ALES cases generally are expected to be negative with NE markers.…”

Section: Primary Neuroendocrine Carcinoma Of Thyroid/neuroblastoma/pe...mentioning

confidence: 99%

“…Although focal and variable immunoreactivity might be seen in some cases, ALES cases generally are expected to be negative with NE markers. Almost all cases are negative with S100, NUT1, WT1, HPV, SMA, and Desmin [74][75][76]. There are 2 case reports that have been recently documented by FNAC [78,79].…”

Section: Primary Neuroendocrine Carcinoma Of Thyroid/ Neuroblastoma/p...mentioning

confidence: 99%

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Small-Cell Malignancies of Thyroid: Challenge Solved?

Canberk¹,

Thodou²,

Bongiovanni³

2022

Acta Cytologica

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“Small-cell malignancies of thyroid” is an unsolved dilemma. This term represents an umbrella terminology in thyroid, encompassing for a small group of tumors in which some of them are well-recognized tumors like medullary thyroid carcinoma, poorly differentiated thyroid carcinoma, and primary thyroid lymphomas and teratoma, whereas the remaining are less known as primary neuroendocrine carcinoma of thyroid, primary extraskeletal Ewing family tumors, and adamantinoma-like Ewing sarcoma. When the issue comes to evaluate a cytological sample predominantly composed of small-cell morphology, metastatic small-cell carcinomas to thyroid also should be excluded. In this review, our group focused on the main cytomorphological and clinical clues of each entity that help to set up a correct differential diagnosis. The literature discussions were also included for the entities that are not yet recognized by the mother publication WHO. A key point of the issue’s simple algorithm based on FNAC with small-cell morphology of thyroid was suggested by the authors.

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“…These hematopathologists provide insight into to disorders varying from Langerhan cell histiocytosis, Erdheim Chester disease, IgG4-related diseases, to lymphoproliferative disease involving endocrine tissues. Dr. Hung and Dr. Hornick from the USA review the challenging topic of diagnosing mesenchymal neoplasms arising in or near endocrine organs [8]. The importance of recognizing the histologic features and understanding the role of immunohistochemical biomarkers in this setting is important to avoid misdiagnosing these tumors and confusing them with endocrine neoplasms.…”

mentioning

confidence: 99%