Journal of Pathology and Translational Medicine

Original Article

TRPS1 expression in non-melanocytic cutaneous neoplasms: an immunohistochemical analysis of 200 cases: Yi A. Liu, Phyu P. Aung, Yunyi Wang, Jing Ning, Priyadharsini Nagarajan, Jonathan L. Curry, Carlos A. Torres-Cabala, Doina Ivan, Victor G. Prieto, Qingqing Ding, Woo Cheal Cho; J Pathol Transl Med. 2024;58(2):72-80. Published online February 26, 2024; DOI: https://doi.org/10.4132/jptm.2024.01.23

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Abstract PDF Supplementary Material: Background
Although trichorhinophalangeal syndrome type 1 (TRPS1) was initially thought to be highly sensitive and specific for carcinomas and mesenchymal tumors of mammary origin, more recent data suggest its expression is not limited to breast neoplasms but also can be seen in other cutaneous neoplasms, such as extramammary Paget disease and squamous cell carcinoma (SCC) in situ.
Methods
Two-hundred cases of non-melanocytic cutaneous neoplasm, including basal cell carcinomas (BCCs) (n = 41), SCCs (n = 35), Merkel cell carcinomas (MCCs) (n = 25), and adnexal neoplasms (n = 99), were tested for TRPS1 expression using a monoclonal anti- TRPS1 rabbit anti-human antibody.
Results
TRPS1 expression was present in almost all cases of SCC (94%), with a median H-score of 200, while it was either absent or only focally present in most BCCs (90%), with a median H-score of 5. The difference between BCCs and SCCs in H-score was significant (p < .001). All MCCs (100%) lacked TRPS1 expression. TRPS1 expression was frequently seen in most adnexal neoplasms, benign and malignant, in variable intensity and proportion but was consistently absent in apocrine carcinomas. All endocrine mucin-producing sweat gland carcinomas (EMPSGCs) (100%, 6/6) showed diffuse and strong TRPS1 immunoreactivity, with a median H-score of 300, which was significantly different (p < .001) than that of BCCs.
Conclusions
Our study shows that TRPS1 may be an effective discriminatory marker for BCCs and SCCs. It also has a role in distinguishing BCCs from EMPSGCs.

Review

Standardization of the pathologic diagnosis of appendiceal mucinous neoplasms: Dong-Wook Kang, Baek-hui Kim, Joon Mee Kim, Jihun Kim, Hee Jin Chang, Mee Soo Chang, Jin-Hee Sohn, Mee-Yon Cho, So-Young Jin, Hee Kyung Chang, Hye Seung Han, Jung Yeon Kim, Hee Sung Kim, Do Youn Park, Ha Young Park, So Jeong Lee, Wonae Lee, Hye Seung Lee, Yoo Na Kang, Younghee Choi; J Pathol Transl Med. 2021;55(4):247-264. Published online July 8, 2021; DOI: https://doi.org/10.4132/jptm.2021.05.28

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Although the understanding of appendiceal mucinous neoplasms (AMNs) and their relationship with disseminated peritoneal mucinous disease have advanced, the diagnosis, classification, and treatment of AMNs are still confusing for pathologists and clinicians. The Gastrointestinal Pathology Study Group of the Korean Society of Pathologists (GPSG-KSP) proposed a multicenter study and held a workshop for the “Standardization of the Pathologic Diagnosis of the Appendiceal Mucinous Neoplasm” to overcome the controversy and potential conflicts. The present article is focused on the diagnostic criteria, terminologies, tumor grading, pathologic staging, biologic behavior, treatment, and prognosis of AMNs and disseminated peritoneal mucinous disease. In addition, GPSG-KSP proposes a checklist of standard data elements of appendiceal epithelial neoplasms to standardize pathologic diagnosis. We hope the present article will provide pathologists with updated knowledge on how to handle and diagnose AMNs and disseminated peritoneal mucinous disease.

Citations

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Lower Gastrointestinal Bleeding Secondary to Appendiceal Mucinous Neoplasm: A Report of Two Cases and a Review of the Literature
Jesús Omar Soto Llanes, Samanta Kin Dosal Limón, Ana Jimena Iberri Jaime, Mario Zambrano Lara, Billy Jiménez Bobadilla
Cureus.2024;[Epub] CrossRef
Appendiceal perforation secondary to endometriosis with intestinal metaplasia: A case report
Minghua Wang, Jing Liu, Boxin Hu, Simin Wang, Ping Xie, Ping Li
Experimental and Therapeutic Medicine.2023;[Epub] CrossRef
Primary and secondary tumors of the peritoneum: key imaging features and differential diagnosis with surgical and pathological correlation
Javier Miguez González, Francesc Calaf Forn, Laura Pelegrí Martínez, Pilar Lozano Arranz, Rafael Oliveira Caiafa, Jordi Català Forteza, Lina Maria Palacio Arteaga, Ferrán Losa Gaspà, Isabel Ramos Bernadó, Pedro Barrios Sánchez, Juan Ramón Ayuso Colella
Insights into Imaging.2023;[Epub] CrossRef
Muzinöse Tumoren des Peritoneums
Anne Kristin Fischer, Andrea Tannapfel, Alexander Quaas
Die Chirurgie.2023; 94(10): 823. CrossRef
Landscape of Genetic Mutations in Appendiceal Cancers
Marian Constantin, Cristina Mătanie, Livia Petrescu, Alexandra Bolocan, Octavian Andronic, Coralia Bleotu, Mihaela Magdalena Mitache, Sorin Tudorache, Corneliu Ovidiu Vrancianu
Cancers.2023; 15(14): 3591. CrossRef
Delivery of an Incidental Appendiceal Mucinous Neoplasm
Madison Bowles, Jessica Y Ng, Hajir Nabi
Cureus.2022;[Epub] CrossRef
Unearthing novel fusions as therapeutic targets in solid tumors using targeted RNA sequencing
Sungbin An, Hyun Hee Koh, Eun Sol Chang, Juyoung Choi, Ji-Young Song, Mi-Sook Lee, Yoon-La Choi
Frontiers in Oncology.2022;[Epub] CrossRef

Original Article

Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast: Yunjeong Jang, Hera Jung, Han-Na Kim, Youjeong Seo, Emad Alsharif, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Yeon Hee Park, Eun Yoon Cho, Soo Youn Cho; J Pathol Transl Med. 2020;54(1):95-102. Published online November 13, 2019; DOI: https://doi.org/10.4132/jptm.2019.10.24

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Abstract PDF

Background
Pure mucinous carcinoma (PMC) is a rare type of breast cancer, estimated to represent 2% of invasive breast cancer. PMC is typically positive for estrogen receptors (ER) and progesterone receptors (PR) and negative for human epidermal growth factor receptor 2 (HER2). The clinicopathologic characteristics of HER2-positive PMC have not been investigated.
Methods
Pathology archives were searched for PMC diagnosed from January 1999 to April 2018. Clinicopathologic data and microscopic findings were reviewed and compared between HER2-positive PMC and HER2-negative PMC. We also analyzed the differences in disease-free survival (DFS) and overall survival according to clinicopathologic parameters including HER2 status in overall PMC cases.
Results
There were 21 HER2-positive cases (4.8%) in 438 PMCs. The average tumor size of HER2-positive PMC was 32.21 mm (± 26.55). Lymph node metastasis was present in seven cases. Compared to HER2-negative PMC, HER2-positive PMC presented with a more advanced T category (p < .001), more frequent lymph node metastasis (p = .009), and a higher nuclear and histologic grade (p < .001). Microscopically, signet ring cells were frequently observed in HER2-positive PMC (p < .001), whereas a micropapillary pattern was more frequent in HER2-negative PMC (p = .012). HER2-positive PMC was more frequently negative for ER (33.3% vs. 1.2%) and PR (28.6% vs. 7.2%) than HER2-negative PMC and showed a high Ki-67 labeling index. During follow-up, distant metastasis and recurrence developed in three HER2-positive PMC patients. Multivariate analysis revealed that only HER2-positivity and lymph node status were significantly associated with DFS.
Conclusions
Our results suggest that HER2-positive PMC is a more aggressive subgroup of PMC. HER2 positivity should be considered for adequate management of PMC.

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Comprehensive Immunohistochemical Analysis of Mesonephric Marker Expression in Low-grade Endometrial Endometrioid Carcinoma
Yurimi Lee, Sangjoon Choi, Hyun-Soo Kim
International Journal of Gynecological Pathology.2024; 43(3): 221. CrossRef
Pure Mucinous Carcinoma of the Breast: Radiologic-Pathologic Correlation
Cherie M Kuzmiak, Benjamin C Calhoun
Journal of Breast Imaging.2023;[Epub] CrossRef
Role of circ-FOXO3 and miR-23a in radiosensitivity of breast cancer
Elahe Abdollahi, Hossein Mozdarani, Behrooz Z. Alizadeh
Breast Cancer.2023; 30(5): 714. CrossRef
On Ultrasonographic Features of Mucinous Carcinoma with Micropapillary Pattern
Wei-Sen Yang, Yang Li, Ya Gao
Breast Cancer: Targets and Therapy.2023; Volume 15: 473. CrossRef
Spectrum of Mucin-containing Lesions of the Breast: Multimodality Imaging Review with Pathologic Correlation
Janice N. Thai, Melinda F. Lerwill, Shinn-Huey S. Chou
RadioGraphics.2023;[Epub] CrossRef
Mesonephric-like Adenocarcinoma of the Ovary: Clinicopathological and Molecular Characteristics
Hyun Hee Koh, Eunhyang Park, Hyun-Soo Kim
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Alveolar Soft Part Sarcoma of the Uterus: Clinicopathological and Molecular Characteristics
Yurimi Lee, Kiyong Na, Ha Young Woo, Hyun-Soo Kim
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Metastasis of the Mucionous adenocarcinoma of breast to the mandibular gingiva: Rare case report
Ivana Mijatov, Aleksandra Fejsa Levakov, Aleksandar Spasić, Jelena Nikolić, Saša Mijatov
Medicine.2022; 101(38): e30732. CrossRef
Endometrioid Carcinomas of the Ovaries and Endometrium Involving Endocervical Polyps: Comprehensive Clinicopathological Analyses
Jihee Sohn, Yurimi Lee, Hyun-Soo Kim
Diagnostics.2022; 12(10): 2339. CrossRef
Serous Carcinoma of the Endometrium with Mesonephric-Like Differentiation Initially Misdiagnosed as Uterine Mesonephric-Like Adenocarcinoma: A Case Report with Emphasis on the Immunostaining and the Identification of Splice Site TP53 Mutation
Sangjoon Choi, Yoon Yang Jung, Hyun-Soo Kim
Diagnostics.2021; 11(4): 717. CrossRef
HER2 positive mucinous carcinoma of breast with micropapillary features: Report of a case and review of literature
Dinesh Chandra Doval, Rupal Tripathi, Sunil Pasricha, Pankaj Goyal, Chaturbhuj Agrawal, Anurag Mehta
Human Pathology: Case Reports.2021; 25: 200531. CrossRef
Carcinoma mucosecretor de mama HER2-positivo, un caso clínico
A.M. González Aranda, E. Martínez Gómez, A. Santana Costa, F. Arnanz Velasco, M.H. González de Diego, A. Zapico Goñi
Clínica e Investigación en Ginecología y Obstetricia.2021; 48(4): 100685. CrossRef
Clinicopathologic features of unexpectedly HER2 positive breast carcinomas: An institutional experience
Carissa LaBoy, Kalliopi P. Siziopikou, Lauren Rosen, Luis Z. Blanco, Jennifer L. Pincus
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Mesonephric-like Differentiation of Endometrial Endometrioid Carcinoma: Clinicopathological and Molecular Characteristics Distinct from Those of Uterine Mesonephric-like Adenocarcinoma
Sujin Park, Go Eun Bae, Jiyoung Kim, Hyun-Soo Kim
Diagnostics.2021; 11(8): 1450. CrossRef
Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
Hyunjin Kim, Kiyong Na, Go Eun Bae, Hyun-Soo Kim
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Case Studies

Coexisting Mucinous Cystic Neoplasm of the Pancreas and Type 1 Autoimmune Pancreatitis: Mee-Jeong Kim, Tae Jun Song, Hyoung Jung Kim, Song-Cheol Kim, Myung-Hwan Kim, Seung-Mo Hong; J Pathol Transl Med. 2019;53(2):125-128. Published online November 14, 2018; DOI: https://doi.org/10.4132/jptm.2018.10.25

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Abstract PDF

Type 1 autoimmune pancreatitis (AIP1) is an IgG4-related systemic disease that mimics tumors. We report a rare case of AIP1 accompanied by mucinous cystic neoplasm (MCN). A pancreatic lesion was incidentally detected in a woman in her 60s. After 6 years of follow-up, the lesion abruptly increased in size. Computed tomography showed a 3.5 cm unilocular cyst in the tail of the pancreas and distal pancreatectomy was performed. On microscopic examination, the cyst was lined by mucinous and non-mucinous epithelial cells with mild cytologic atypia. The surrounding stroma comprised ovarian-type spindle cells with progesterone receptor positivity. The pericystic pancreas exhibited multifocal lymphoid follicles, lymphoplasmacytic infiltrations, obliterative phlebitis, and storiform fibrosis. IgG4-positive plasma cell infiltration (215 cells high-power field) and the IgG4/IgG ratio (57%) were increased. Cases of MCN coexisting with AIP1 are extremely rare; only two such cases have been reported in the English-language literature. This third case featured low-grade MCN with AIP1.

Citations

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Histological features of autoimmune pancreatitis and IgG4-related sclerosing cholangitis with a correlation with imaging findings
Kenji NOTOHARA
Choonpa Igaku.2023; 50(1): 55. CrossRef
Imaging Features and Risk Factors of Pancreatic Cystic Lesions Complicating Autoimmune Pancreatitis: A Retrospective Study
Bin-Bin Zhang, Xin-Meng Hou, Yu-Qi Chen, Jian-Wei Huo, Er-Hu Jin
Current Medical Imaging Formerly Current Medical Imaging Reviews.2023;[Epub] CrossRef
Histological features of autoimmune pancreatitis and IgG4-related sclerosing cholangitis with a correlation with imaging findings
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Mucinous cystic neoplasm of the pancreas with type-1 autoimmune pancreatitis-like lesion
Kevin Gowing, David F. Schaeffer, Hui-Min Yang
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Primary Cutaneous Mucinous Carcinoma with Extramammary Paget’s Disease: Eccrine or Apocrine?: Sun-Ju Oh, Young-Ok Kim; J Pathol Transl Med. 2018;52(4):238-242. Published online January 25, 2018; DOI: https://doi.org/10.4132/jptm.2017.11.21

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Abstract PDF

Primary cutaneous mucinous carcinoma (PCMC) is an uncommon tumor of the sweat gland origin. The occurrence of PCMC is mostly in middle-aged and older patients, with a slight male predominance. Most cases of PCMC arise on the head, with a preference for eyelids. The histogenesis of PCMC, whether eccrine or apocrine, remains controversial. We report a rare case of PCMC with secondary extramammary Paget’s disease in the groin of a 75-year-old man, which favored an apocrine origin. Furthermore, based on a review of the literature, we provide several histologic clues that can be used to differentiate PCMC from metastatic mucinous carcinoma.

Citations

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Primary cutaneous mucinous carcinoma of the scalp masquerading as a benign dermatological mass – A case report
Fadi Alnehlaoui, Nafad Mohamed Lotfy Elhadidi, Shafik Fwakhrji, Shekhar V. Shikare, Majid Hassan Alhammadi, Salman Yousuf Guraya
International Journal of Surgery Case Reports.2024; 114: 109175. CrossRef
Primary Cutaneous Mucinous Carcinoma: A Review of the Literature
Timothy Freeman, Aaron J. Russell, M. Laurin Council
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A Case of Eccrine Mucinous Carcinoma Involving Scalp
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Original Article

Prognostic Significance of a Micropapillary Pattern in Pure Mucinous Carcinoma of the Breast: Comparative Analysis with Micropapillary Carcinoma: Hyun-Jung Kim, Kyeongmee Park, Jung Yeon Kim, Guhyun Kang, Geumhee Gwak, Inseok Park; J Pathol Transl Med. 2017;51(4):403-409. Published online June 9, 2017; DOI: https://doi.org/10.4132/jptm.2017.03.18

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Abstract PDF

Background
Mucinous carcinoma of the breast is an indolent tumors with a favorable prognosis; however, micropapillary features tend to lead to aggressive behavior. Thus, mucinous carcinoma and micropapillary carcinoma exhibit contrasting biologic behaviors. Here, we review invasive mucinous carcinoma with a focus on micropapillary features and correlations with clinicopathological factors.
Methods
A total of 64 patients with invasive breast cancer with mucinous or micropapillary features were enrolled in the study. Of 36 pure mucinous carcinomas, 17 (47.2%) had micropapillary features and were termed mucinous carcinoma with micropapillary features (MUMPC), and 19 (52.8%) had no micropapillary features and were termed mucinous carcinoma without micropapillary features. MUMPC were compared with 15 invasive micropapillary carcinomas (IMPC) and 13 invasive ductal and micropapillary carcinomas (IDMPC).
Results
The clinicopathological factors of pure mucinous carcinoma and MUMPC were not significantly different. In contrast to IMPC and IDMPC, MUMPC had a low nuclear grade, lower mitotic rate, higher expression of hormone receptors, negative human epidermal growth factor receptor 2 (HER2) status, lower Ki-67 proliferating index, and less frequent lymph node metastasis (p < .05). According to univariate analyses, progesterone receptor, HER2, T-stage, and lymph node metastasis were significant risk factors for overall survival; however, only T-stage remained significant in a multivariate analysis (p < .05).
Conclusions
In contrast to IMPC and IDMPC, the micropapillary pattern in mucinous carcinoma does not contribute to aggressive behavior. However, further analysis of a larger series of patients is required to clarify the prognostic significance of micropapillary patterns in mucinous carcinoma of the breast.

Citations

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Pure mucinous adenocarcinoma of the breast with the rare lymphoplasmacytic infiltration: A case report with review of literature
Yash Hasmukhbhai Prajapati, Vishal Bhabhor, Kahan Samirkumar Mehta, Mithoon Barot, Husen Boriwala, Mohamed Omar
Clinical Case Reports.2024;[Epub] CrossRef
Expression of autocrine motility factor receptor (AMFR) in human breast and lung invasive micropapillary carcinomas
Jing Xu, Hongfei Ma, Qi Wang, Hui Zhang
International Journal of Experimental Pathology.2023; 104(1): 43. CrossRef
The Spectrum of Mucinous Lesions of the Breast
Upasana Joneja, Juan Palazzo
Archives of Pathology & Laboratory Medicine.2023; 147(1): 19. CrossRef
Pure Mucinous Carcinoma of the Breast: Radiologic-Pathologic Correlation
Cherie M Kuzmiak, Benjamin C Calhoun
Journal of Breast Imaging.2023; 5(2): 180. CrossRef
On Ultrasonographic Features of Mucinous Carcinoma with Micropapillary Pattern
Wei-Sen Yang, Yang Li, Ya Gao
Breast Cancer: Targets and Therapy.2023; Volume 15: 473. CrossRef
Micropapillary Breast Carcinoma: From Molecular Pathogenesis to Prognosis
Georgios-Ioannis Verras, Levan Tchabashvili, Francesk Mulita, Ioanna Maria Grypari, Sofia Sourouni, Evangelia Panagodimou, Maria-Ioanna Argentou
Breast Cancer: Targets and Therapy.2022; Volume 14: 41. CrossRef
Mucinous carcinoma of the breast: distinctive histopathologic and genetic characteristics
Minjung Jung
Kosin Medical Journal.2022; 37(3): 176. CrossRef
Triple-Positive Breast Carcinoma: Histopathologic Features and Response to Neoadjuvant Chemotherapy
Jennifer Zeng, Marcia Edelweiss, Dara S. Ross, Bin Xu, Tracy-Ann Moo, Edi Brogi, Timothy M. D'Alfonso
Archives of Pathology & Laboratory Medicine.2021; 145(6): 728. CrossRef
HER2 positive mucinous carcinoma of breast with micropapillary features: Report of a case and review of literature
Dinesh Chandra Doval, Rupal Tripathi, Sunil Pasricha, Pankaj Goyal, Chaturbhuj Agrawal, Anurag Mehta
Human Pathology: Case Reports.2021; 25: 200531. CrossRef
Sonographic Features of Pure Mucinous Breast Carcinoma With Micropapillary Pattern
Wu Zhou, Yong-Zhong Li, Li-Min Gao, Di-Ming Cai
Frontiers in Oncology.2021;[Epub] CrossRef
Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast
Yunjeong Jang, Hera Jung, Han-Na Kim, Youjeong Seo, Emad Alsharif, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Yeon Hee Park, Eun Yoon Cho, Soo Youn Cho
Journal of Pathology and Translational Medicine.2020; 54(1): 95. CrossRef
Mucinous carcinoma with micropapillary features is morphologically, clinically and genetically distinct from pure mucinous carcinoma of breast
Peng Sun, Zaixuan Zhong, Qianyi Lu, Mei Li, Xue Chao, Dan Chen, Wenyan Hu, Rongzhen Luo, Jiehua He
Modern Pathology.2020; 33(10): 1945. CrossRef
Micropapillary pattern in pure mucinous carcinoma of the breast – does it matter or not?
Xiaoli Xu, Rui Bi, Ruohong Shui, Baohua Yu, Yufan Cheng, Xiaoyu Tu, Wentao Yang
Histopathology.2019; 74(2): 248. CrossRef
An Update of Mucinous Lesions of the Breast
Beth T. Harrison, Deborah A. Dillon
Surgical Pathology Clinics.2018; 11(1): 61. CrossRef
The clinicopathological significance of micropapillary pattern in colorectal cancers
Jung-Soo Pyo, Mee Ja Park, Dong-Wook Kang
Human Pathology.2018; 77: 159. CrossRef
The sonographic findings of micropapillary pattern in pure mucinous carcinoma of the breast
Heqing Zhang, Li Qiu, Yulan Peng
World Journal of Surgical Oncology.2018;[Epub] CrossRef
Diagnostic dilemma of micropapillary variant of mucinous breast cancer
Geok Hoon Lim, Zhiyan Yan, Mihir Gudi
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Case Studies

Mucinous Cystadenoma of the Testis: A Case Report with Immunohistochemical Findings: Gilhyang Kim, Dohee Kwon, Hee Young Na, Sehui Kim, Kyung Chul Moon; J Pathol Transl Med. 2017;51(2):180-184. Published online February 13, 2017; DOI: https://doi.org/10.4132/jptm.2016.08.30

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Abstract PDF

Mucinous cystadenoma of the testis is a very rare tumor. Herein, we report a case of mucinous cystadenoma arising in the testis of a 61-year-old man, along with a literature review. Computed tomography showed a 2.5-cm-sized poorly enhancing cystic mass. Grossly, the tumor was a unilocular cystic mass filled with mucinous material and confined to the testicular parenchyma. Histologically, the cyst had a fibrotic wall lined by mucinous columnar epithelium without atypia. Immunohistochemical staining was positive for cytokeratin 20 and CDX2, as well as focally positive for cytokeratin 7. The pathologic diagnosis was mucinous cystadenoma.

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Edgar Estuardo González López, Carlos Gonzalo Estrada Pazos
Revista Guatemalteca de Urología.2023; 10(2): 16. CrossRef
Primary borderline mucinous tumor of the testis with postoperative metastasis: A rare case report
Yingyu Shi, Ling Song, Yan Luo
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Case report: Misdiagnosis of primary mucinous cystadenoma of the testicle by ultrasound
Linlin Zhang, Jianyuan Xuan, Manxi Li, Mei Zhang, Yu Song, Ziang Pan, Bo Fan, Lin Lu, Hongyan Zhou, Yang Li
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Primary Borderline Mucinous Testicular Tumor: A Case Report and Literature Review
Changjuan Hao, Chunsong Kang, Xiaoyan Kang, Zhuanzhuan Yu, Tingting Li, Jiping Xue
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Michelle S Lin, Alberto G Ayala, Jae Y Ro
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Borderline Mucinous Testicular Tumour: Diagnostic and Management difficulties
Krishan Pratap, Marlon Perera, Frances Malczewski, Rachel Esler
BMJ Case Reports.2018; : bcr-2017-223787. CrossRef
Mucinous tumor arising in a giant sacrococcygeal teratoma
Fengtian Zhang, Xiaolong Yu, Jin Zeng, Min Dai
Medicine.2017; 96(47): e8759. CrossRef

Mucinous Carcinoma with Extensive Signet Ring Cell Differentiation: A Case Report: Hye Min Kim, Eun Kyung Kim, Ja Seung Koo; J Pathol Transl Med. 2017;51(2):176-179. Published online December 5, 2016; DOI: https://doi.org/10.4132/jptm.2016.08.17

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Abstract PDF

Breast cancers that present with mucin include mucinous carcinoma and carcinoma with signet ring cell differentiation. The former shows extracellular mucin and the latter shows abundant intracellular mucin. Here, we report a case of breast cancer showing both extracellular mucin and extensive signet ring cell differentiation due to abundant intracellular mucin. Unlike mucinous carcinoma, this case had the features of high-grade nuclear pleomorphism, high mitotic index, estrogen receptor negativity, progesterone receptor negativity, human epidermal growth factor receptor-2 positivity, and ductal type with positivity for E-cadherin. In a case with signet ring cell differentiation, differential diagnosis with metastatic signet ring cell carcinoma of the stomach and colon is essential. In this case, the presence of accompanied ductal carcinoma in situ component and mammaglobin and gross cystic disease fluid protein-15 positivity were findings that suggested the breast as the origin.

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Research on the Histological Features and Pathological Types of Gastric Adenocarcinoma With Mucinous Differentiation
Nian-Long Meng, Yang-kun Wang, Hai-Li Wang, Jun-Ling Zhou, Su-nan Wang
Frontiers in Medicine.2022;[Epub] CrossRef
Clinicopathologic characteristics of HER2-positive pure mucinous carcinoma of the breast
Yunjeong Jang, Hera Jung, Han-Na Kim, Youjeong Seo, Emad Alsharif, Seok Jin Nam, Seok Won Kim, Jeong Eon Lee, Yeon Hee Park, Eun Yoon Cho, Soo Youn Cho
Journal of Pathology and Translational Medicine.2020; 54(1): 95. CrossRef
Human Epidermal Growth Factor Receptor 2-positive Mucinous Carcinoma with Signet Ring Cell Differentiation, Which Showed Complete Response after Neoadjuvant Chemotherapy
Yunjeong Jang, Eun Yoon Cho, Soo Youn Cho
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Original Article

Size of Non-lepidic Invasive Pattern Predicts Recurrence in Pulmonary Mucinous Adenocarcinoma: Morphologic Analysis of 188 Resected Cases with Reappraisal of Invasion Criteria: Soohyun Hwang, Joungho Han, Misun Choi, Myung-Ju Ahn, Yong Soo Choi; J Pathol Transl Med. 2017;51(1):56-68. Published online October 16, 2016; DOI: https://doi.org/10.4132/jptm.2016.09.17

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Abstract PDF

Background
We reviewed a series of 188 resected pulmonary mucinous adenocarcinomas (MAs) to clarify the prognostic significance of lepidic and non-lepidic patterns.
Methods
Non-lepidic patterns were divided into bland, non-distorted acini with uncertain invasiveness (pattern 1), unequivocal invasion into stroma (pattern 2), or invasion into alveolar spaces (pattern 3).
Results
The mean proportion of invasive patterns (patterns 2 and 3) was lowest in small (≤ 3 cm) tumors, and gradually increased in intermediate (> 3 cm and ≤ 7 cm) and large (> 7 cm) tumors (8.4%, 34.3%, and 50.1%, respectively). Adjusted T (aT) stage, as determined by the size of invasive patterns, was positively correlated with adverse histologic and clinical features including older age, male sex, and ever smokers. aTis tumors, which were exclusively composed of lepidic pattern (n = 9), or a mixture of lepidic and pattern 1 (n = 40) without any invasive patterns, showed 100% disease- free survival (DFS). The aT1mi tumors, with minimal (≤ 5 mm) invasive patterns (n = 63), showed a 95.2% 5-year DFS, with recurrences (n = 2) limited to tumors greater than 3 cm in total size (n = 23). Both T and aT stage were significantly associated with DFS; however, survival within the separate T-stage subgroups was stratified according to the aT stage, most notably in the intermediatestage subgroups. In multivariate analysis, the size of invasive patterns (p = .020), pleural invasion (p < .001), and vascular invasion (p = .048) were independent predictors of recurrence, whereas total size failed to achieve statistical significance (p = .121).
Conclusions
This study provides a rationale for histologic risk stratification in pulmonary MA based on the extent of invasive growth patterns with refined criteria for invasion.

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Dong Woog Yoon, Soohyun Hwang, Tae Hee Hong, Yoon-La Choi, Hong Kwan Kim, Yong Soo Choi, Jhingook Kim, Young Mog Shim, Jong Ho Cho
Annals of Surgical Oncology.2024; 31(1): 201. CrossRef
Pulmonary invasive mucinous adenocarcinoma
Wei‐Chin Chang, Yu Zhi Zhang, Andrew G Nicholson
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Micropapillary Pattern in Invasive Mucinous Adenocarcinoma of the Lung: Comparison With Invasive Non-Mucinous Adenocarcinoma
Hui He, Lue Li, Yuan-yuan Wen, Li-yong Qian, Zhi-qiang Yang
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Case Studies

A Pyloric Gland-Phenotype Ovarian Mucinous Tumor Resembling Lobular Endocervical Glandular Hyperplasia in a Patient with Peutz-Jeghers Syndrome: Eun Na Kim, Gu-Hwan Kim, Jiyoon Kim, In Ah Park, Jin Ho Shin, Yun Chai, Kyu-Rae Kim; J Pathol Transl Med. 2017;51(2):159-164. Published online August 22, 2016; DOI: https://doi.org/10.4132/jptm.2016.07.01

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Abstract PDF

We describe an ovarian mucinous neoplasm that histologically resembles lobular endocervical glandular hyperplasia (LEGH) containing pyloric gland type mucin in a patient with Peutz-Jeghers syndrome (PJS). Although ovarian mucinous tumors rarely occur in PJS patients, their pyloric gland phenotype has not been clearly determined. The histopathologic features of the ovarian mucinous tumor were reminiscent of LEGH. The cytoplasmic mucin was stained with periodic acid-Schiff reaction after diastase treatment but was negative for Alcian blue pH 2.5, suggesting the presence of neutral mucin. Immunohistochemically, the epithelium expressed various gastric markers, including MUC6, HIK1083, and carbonic anhydrase-IX. Multiple ligation-dependent probe amplification detected a germline heterozygous deletion mutation at exons 1–7 of the STK11 gene (c.1-?_920+?del) in peripheral blood leukocytes and mosaic loss of heterozygosity in ovarian tumor tissue. Considering that LEGH and/or gastric-type cervical adenocarcinoma can be found in patients with PJS carrying germline and/or somatic STK11 mutations, our case indicates that STK11 mutations have an important role in the proliferation of pyloric-phenotype mucinous epithelium at various anatomical locations.

Citations

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Ovarian Mucinous Tumor Presenting Atypical Lobular Endocervical Glandular Hyperplasia-Like Appearance in a Patient With Germline STK11 p.F354L Variant: A Case Report
Hiroshi Yoshida, Kengo Hiranuma, Mariko Nakahara, Mayumi Kobayashi-Kato, Yasuhito Tanase, Masaya Uno, Kouya Shiraishi, Mitsuya Ishikawa, Tomoyasu Kato
International Journal of Surgical Pathology.2024; 32(2): 394. CrossRef
Preoperative multimodal ultrasonic imaging in a case of Peutz-Jeghers syndrome complicated by atypical lobular endocervical glandular hyperplasia: a case report and literature review
Liwen Yang, Duan Duan, Ying Xiong, Tianjiao Liu, Lijun Zhao, Fan Lai, Dingxian Gu, Liuying Zhou
Hereditary Cancer in Clinical Practice.2024;[Epub] CrossRef
Gastric‐type glandular lesions of the female genital tract excluding the cervix: emerging pathological entities
Richard W‐C Wong, Karen L Talia, W Glenn McCluggage
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Gastric-phenotype Mucinous Carcinoma of the Fallopian Tube with Secondary Ovarian Involvement in a Woman with Peutz-Jeghers Syndrome: A Case Report
Mónica Bronte Anaut, Javier Arredondo Montero, Maria Pilar Fernández Seara, Rosa Guarch Troyas
International Journal of Surgical Pathology.2023; 31(1): 92. CrossRef
Molecular characterization of gastric-type endocervical adenocarcinoma using next-generation sequencing
Swati Garg, Teddy S. Nagaria, Blaise Clarke, Orit Freedman, Zanobia Khan, Joerg Schwock, Marcus Q. Bernardini, Amit M. Oza, Kathy Han, Adam C. Smith, Tracy L. Stockley, Marjan Rouzbahman
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The developing spectrum of gastric-type cervical glandular lesions
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ThinPrep Cytological Findings of Desmoplastic Small Round Cell Tumor with Extensive Glandular Differentiation: A Case Study: Hyun-Jung Kim, Byeong Seok Sohn, Ji-Eun Kwon, Jeong Yeon Kim, Kyeongmee Park; Korean J Pathol. 2013;47(2):182-187. Published online April 24, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.2.182

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Abstract PDF

Desmoplastic small round cell tumor (DSRCT) is a rare and highly aggressive neoplasm. The cytological diagnosis of this tumor has only been reported in a few cases. In most of these cases, the diagnosis was made using fine-needle aspiration cytology. Most DSRCTs resemble disseminated carcinomatoses in their clinical manifestation as well as cytomorphologically, even in young-adult patients. These authors report a case of using peritoneal-washing and pleural-effusion ThinPrep cytology to diagnose DSRCT, with extensive glandular differentiation and mucin vacuoles. We found that fibrillary stromal fragment, clinical setting, and adjunctive immunocytochemical staining were most helpful for avoiding misdiagnosis.

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Intra-abdominal desmoplastic small round cell tumour
Andrés Alejandro Briseño-Hernández, Deissy Roxana Quezada-López, Lilia Edith Corona-Cobián, Agar Castañeda-Chávez, Alfonso Tonatiuh Duarte-Ojeda, Michel Dassaejv Macías-Amezcua
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Original Article

Microsatellite Instability Status in Gastric Cancer: A Reappraisal of Its Clinical Significance and Relationship with Mucin Phenotypes: Joo-Yeun Kim, Na Ri Shin, Ahrong Kim, Hyun-Jeong Lee, Won-young Park, Jee-Yeon Kim, Chang-Hun Lee, Gi-Young Huh, Do Youn Park; Korean J Pathol. 2013;47(1):28-35. Published online February 25, 2013; DOI: https://doi.org/10.4132/KoreanJPathol.2013.47.1.28

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Abstract PDF

Background

Gastric cancers with microsatellite instabilities (MSI) have been reported to be associated with favorable prognosis. However, the significance of the effect of MSI on the clinicopathological features, as well as its association with mucin phenotype, remains unclear.

Methods

MSI status was assessed in 414 cases of gastric cancer using polymerase chain reaction analysis of five microsatellite loci, as recommended by National Cancer Institution criteria. The expression of mucins (MUC5AC, MUC6, MUC2, and CD10) was assessed.

Results

Out of 414 total cases of gastric cancer, 380 (91.7%), 11 (2.7%), and 23 (5.6%) were microsatellite stable (MSS), low-level MSI (MSI-L), and high-level MSI (MSI-H), respectively. Compared to MSS/MSI-L, MSI-H gastric cancers were associated with older age (p=0.010), tumor size (p=0.014), excavated gross (p=0.042), intestinal type (p=0.028), aggressive behaviors (increase of T stage [p=0.009]), perineural invasion [p=0.022], and lymphovascular emboli [p=0.027]). MSI-H gastric cancers were associated with tumor necrosis (p=0.041), tumor-infiltrating lymphocytes (≥2/high power field, p<0.001), expanding growth patterns (p=0.038), gastric predominant mucin phenotypes (p=0.028), and MUC6 expression (p=0.016). Tumor necrosis (≥10% of mass, p=0.031), tumor-infiltrating lymphocytes (p<0.001), intestinal type (p=0.014), and gastric mucin phenotypes (p=0.020) could represent independent features associated with MSI-H gastric cancers. MSI-H intestinal type gastric cancers had a tendency for poor prognosis in univariate analysis (p=0.054) but no association in Cox multivariate analysis (p=0.197).

Conclusions

Our data suggest that MSI-H gastric cancers exhibit distinct aggressive biologic behaviors and a gastric mucin phenotype. This contradicts previous reports that describe MSI-H gastric cancer as being associated with favorable prognosis.

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Case Reports

Primary Mucinous Cystadenocarcinoma of the Breast: Cytologic Finding and Expression of MUC5 Are Different from Mucinous Carcinoma: Sung Eun Kim, Ji Hye Park, SoonWon Hong, Ja Seung Koo, Joon Jeong, Woo-Hee Jung; Korean J Pathol. 2012;46(6):611-616. Published online December 26, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.6.611

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Abstract PDF

Mucinous cystadenocarcinoma (MCA) in the breast is a rare neoplasm. There have been 13 cases of primary breast MCA reported. The MCA presents as a large, partially cystic mass in postmenopausal woman with a good prognosis. The microscopic findings resemble those of ovarian, pancreatic, or appendiceal MCA. The aspiration findings showed mucin-containing cell clusters in the background of mucin and necrotic material. The cell clusters had intracytoplasmic mucin displacing atypical nuclei to the periphery. Histologically, the tumor revealed an abundant mucin pool with small floating clusters of mucin-containing tumor cells. There were also small cysts lined by a single layer of tall columnar mucinous cells, resembling those of the uterine endocervix. The cancer cells were positive for mucin (MUC) 5 and negative for MUC2 and MUC6. This mucin profile is different from ordinary mucinous carcinoma and may be a unique characteristic of breast MCA.

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Primary Thymic Mucinous Adenocarcinoma: A Case Report: Jamshid Abdul-Ghafar, Suk-Joong Yong, Woocheol Kwon, Il Hwan Park, Soon-Hee Jung; Korean J Pathol. 2012;46(4):377-381. Published online August 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.4.377

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Abstract PDF

Primary thymic mucinous adenocarcinoma is an extremely rare aggressive subtype of thymic carcinoma. With a review of literatures, only nine cases have been reported up to present. A 36-year-old woman was admitted for further evaluation and treatment of a mediastinal mass. The patient had no medical history of cancer. The clinicoradiological examination disclosed no tumor elsewhere. After the surgical excision of mediastinal mass, it was grossly a round semi-solid mass with mucin-filled cystic areas. Microscopically solid areas showed cords, small nests and dilated glands infiltrating the fibrotic parenchyma, while the cystic areas were lined by mucinous epithelium with tumor cells floating in extracellular-mucin pools. Some cystic walls underwent malignant transformation of the benign thymic epithelium. Immunohistochemically, the tumor cells were positive for cytokeratin (CK) 7, CK20, CD5, and CDX-2, and negative for thyroid transcription factor-1. In conclusion, the mucinous thymic adenocarcinoma should be recognized as a separate histopathological entity and considered in the differential diagnosis of mediastinal carcinomas.

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Urachal Mucinous Tumor of Uncertain Malignant Potential: A Case Report: Jung-Woo Choi, Ju-Han Lee, Young-Sik Kim; Korean J Pathol. 2012;46(1):83-86. Published online February 23, 2012; DOI: https://doi.org/10.4132/KoreanJPathol.2012.46.1.83

8,649 View
51 Download
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Abstract PDF

Urachal mucinous tumor of uncertain malignant potential is very rare and is characterized by a multilocular cyst showing the proliferation of atypical mucin-secreting cells without stromal invasion. As in ovarian and appendiceal borderline tumors, it represents a transitional stage of mucinous carcinogenesis in the urachus. In addition, this tumor may recur locally and develop into pseudomyxoma peritonei. Due to its scarcity and diagnostic challenges, we report a mucinous tumor of uncertain malignant potential arising in the urachus.

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