RESUMEN
Gene fusion transcripts containing PRDM10 were recently identified in low-grade undifferentiated pleomorphic sarcomas (UPS). Here, we describe the morphologic and clinical features of 9 such tumors from 5 men and 4 women (age: 20 to 61 y). Three cases had previously been diagnosed as UPS, 3 as superficial CD34-positive fibroblastic tumor (SCD34FT), 2 as pleomorphic liposarcoma, and 1 as pleomorphic hyalinizing angiectatic tumor. The tumors were located in the superficial and deep soft tissues of the thigh/knee region (4 cases), shoulder (2 cases), foot, trunk, and perineum (1 case each) ranging in size from 1 to 6 cm. All showed poorly defined cellular fascicles of pleomorphic cells within a fibrous stroma with frequent myxoid change and a prominent inflammatory infiltrate. All displayed highly pleomorphic nuclear features, but a low mitotic count. Most tumors were well circumscribed. One of 9 tumors recurred locally, but none metastasized. Immunohistochemically, all were CD34 and showed nuclear positivity for PRDM10; focal positivity for cytokeratins was seen in 5/6 cases. PRDM10 immunoreactivity was evaluated in 50 soft tissue tumors that could mimic PRDM10-rearranged tumors, including 4 cases exhibiting histologic features within the spectrum of SCD34FT. Except for 2/6 pleomorphic liposarcomas and 1/4 myxofibrosarcomas, other tumors did not show nuclear positivity but displayed weak to moderate cytoplasmic immunoreactivity. In conclusion, PRDM10-rearranged soft tissue tumor is characterized by pleomorphic morphology and a low mitotic count. Its morphologic spectrum overlaps with SCD34FT. Clinical features of this small series suggest an indolent behavior, justifying its distinction from UPS and other sarcomas.
Asunto(s)
Proteínas de Unión al ADN/genética , Sarcoma/genética , Sarcoma/patología , Neoplasias de los Tejidos Blandos/genética , Neoplasias de los Tejidos Blandos/patología , Factores de Transcripción/genética , Adulto , Femenino , Reordenamiento Génico , Humanos , Masculino , Persona de Mediana Edad , Sarcoma/clasificación , Neoplasias de los Tejidos Blandos/clasificación , Adulto JovenRESUMEN
Amongst involvement in diverse physiological and pathological processes, TIMP-3 may have an important role in tumour development, growth and metastasis by interaction with metalloproteases in the extracellular matrix. We studied the role and prognostic effect of TIMP-3 in esophageal adenocarcinoma (EADC). TIMP-3 gene methylation and TIMP-3 mRNA expression were analysed in 5 esophageal cell lines and 24 resected EADCs. TIMP-3 protein expression was examined in the 5 cell lines and 79 resected EADCs with known clinicopathological features. TIMP-3 methylation signal was only detected in the OE33 EADC cell line. In tissues, 0% of case-matched normal, 72% of BE and 90% of EADC were positive for methylation. TIMP-3 mRNA was detected in all the cell lines and normal, metaplastic and tumour tissues. TIMP-3 protein was localised to the cytoplasm in cell lines and tissues. Demethylating treatment of OE33 increased protein expression. At the invading edge of tumours, protein staining was equal to, or reduced, compared to normal tissues. Reduction of protein expression was associated with disease stage (p = 0.046) and poor patient survival (OR 2.1, 95% CI 1.2-3.5, p = 0.007). Mean survival time was halved in patients with reduced tumour TIMP-3 expression, from 49 to 24 months. These studies have demonstrated association between methylation of the TIMP-3 gene and BE and EADC. Reduced expression of TIMP-3 protein in EADC is associated with increased tumour invasiveness and reduced patient survival.
