Solid pseudopapillary neoplasms of the pancreas are rare pancreatic tumors with mostly benign behavior, affecting almost exclusively women. Their histogenetic origin is still unsolved, but a recently reported EWS/FLI-1 translocation t(11;22)(q24;q21) and the consistent expression of CD56 and the progesterone receptor, both genes located on the long arm of chromosome 11, point to chromosome 11q as a potential locus of gene aberration in solid pseudopapillary neoplasms. To further elucidate this issue, we studied 30 cases of solid pseudopapillary neoplasms by comparative genomic hybridization (CGH), fluorescent in situ hybridization (FISH) and immunohistochemistry. Immunohistochemically, 38% showed nuclear expression of FLI-1 and all cases revealed positivity for CD56 and the progesterone receptor, whereas no solid pseudopapillary neoplasm expressed CD34. No translocation of the EWS gene was found by FISH and no gross chromosomal gain or loss was detected by CGH. It is concluded that FLI-1 expression in solid pseudopapillary neoplasms is not associated with an EWS/FLI-1 translocation. In addition, there are no chromosomal gains or losses, especially on chromosome 11, where the FLI-1 gene is located adjacent to the gene for CD56 (NCAM). These data add another feature to the complex phenotypic appearance of solid pseudopapillary neoplasms. (Figure 1) and show a striking female preponderance. 1 Ninety to 95% of these unusual pancreatic neoplasms behave benignly, whereas others are malignant, developing metastases in the mesenterium and the liver. So far, no specific marker for predicting the course of the disease exists, unless the tumor shows clear histological signs of malignancy. 2 Although a number of studies have been performed, it is still unknown what the direction of differentiation is for the pancreatic solid pseudopapillary neoplasm. Nor do we have much knowledge about genetic changes in solid pseudopapillary neoplasms. At the molecular level, it was recently shown that solid pseudopapillary neoplasms harbor a mutation in exon 3 of the b-catenin gene, which is associated with aberrant nuclear expression of b-catenin. 3,4 Other genetic aberrations of solid pseudopapillary neoplasms include an EWS/FLI-1 translocation t(11;22)(q24;q12), 5 a translocation t(13;17)(q14;p11), 6 derivatives of chromosomes 1, 14, and 20 7 and trisomy 3. 8 A solid pseudopapillary neoplasm investigated by comparative genomic hybridization (CGH) did not show any gross aberrations. 9 To elucidate the role of a probable EWS/FLI-1 translocation and the involvement of chromosome 11, we studied 30 well-characterized cases by CGH, fluorescent in situ hybridization (FISH) and with an additional panel of antibodies in order to screen this tumor entity for gross genetic aberrations. With this, we hoped to gain more information about the origin of solid pseudopapillary neoplasms and identify putative predictors of their clinical course.
Materials and methodsThe study was performed on tumor resection specimens from 30 patients with solid pseudo...