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Annals of Diagnostic Pathology Jun 2021So-called oncocytic papillary renal cell carcinoma (OPRCC) is a poorly defined variant of papillary renal cell carcinoma. Since its first description, several studies...
So-called oncocytic papillary renal cell carcinoma (OPRCC) is a poorly defined variant of papillary renal cell carcinoma. Since its first description, several studies were published with conflicting results, and thus precise definition is lacking. A cohort of 39 PRCCs composed of oncocytic cells were analyzed. Cases were divided into 3 groups based on copy number variation (CNV) pattern. The first group consisted of 23 cases with CNV equal to renal oncocytoma. The second group consisted of 7 cases with polysomy of chromosomes 7 and 17 and the last group of 9 cases included those with variable CNV. Epidemiologic, morphologic and immunohistochemical features varied among the groups. There were not any particular histomorphologic features correlating with any of the genetic subgroups. Further, a combination of morphologic, immunohistochemical, and molecular-genetic features did not allow to precisely predict biologic behavior. Owing to variable CNV pattern in OPRCC, strict adherence to morphology and immunohistochemical profile is recommended, particularly in limited samples (i.e., core biopsy). Applying CNV pattern as a part of a diagnostic algorithm can be potentially misleading. OPRCC is a highly variable group of tumors, which might be misdiagnosed as renal oncocytoma. Using the term OPRCC as a distinct diagnostic entity is, thanks to its high heterogeneity, questionable.
Topics: Adenoma, Oxyphilic; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Biopsy, Large-Core Needle; Carcinoma, Renal Cell; Chromosome Aberrations; DNA Copy Number Variations; Diagnosis, Differential; Diagnostic Errors; Female; Genes, Overlapping; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Kidney Neoplasms; Male; Middle Aged; Neoplasm Staging; Oxyphil Cells
PubMed: 33838490
DOI: 10.1016/j.anndiagpath.2021.151734 -
Endocrine-related Cancer Apr 2021Hürthle cell carcinoma (HCC) is a distinct type of thyroid cancer genetically characterized by DNA copy number alterations (CNA), typically of genome haploidization...
Hürthle cell carcinoma (HCC) is a distinct type of thyroid cancer genetically characterized by DNA copy number alterations (CNA), typically of genome haploidization type (GH-type). However, whether CNA also occurs in benign Hürthle cell adenomas (HCA) or Hürthle cell hyperplastic nodules (HCHN), and have diagnostic impact in fine-needle aspiration (FNA) samples, remains unknown. To address these questions, we (1) analyzed 26 HCC, 24 HCA, and 8 HCHN tissues for CNA and other mutations using ThyroSeq v3 (TSv3) next-generation sequencing panel, and (2) determined cancer rate in 111 FNA samples with CNA and known surgical outcome. We identified CNA, more often of the GH-type, in 81% of HCC and in 38% HCA, but not in HCHN. Among four HCC with distant metastasis, all had CNA and three TERT mutations. Overall, positive TSv3 results were obtained in 24 (92%) HCC, including all with ATA high risk of recurrence or metastasis. Among 111 FNA cases with CNA, 38 (34%) were malignant and 73 (66%) benign. A significant correlation between cancer rate and nodule size was observed, particularly among cases with GH-type CNA, where every additional centimeter of nodule size increased the malignancy odds by 1.9 (95% CI 1.3-2.7; P = 0.001). In summary, the results of this study demonstrate that CNA characteristic of HCC also occur in HCA, although with lower frequency, and probability of cancer in nodules with CNA increases with nodule size. Detection of CNA, in conjunction with other mutations and nodule size, is helpful in predicting malignancy in thyroid nodules.
Topics: Adenoma, Oxyphilic; Biopsy, Fine-Needle; Carcinoma, Hepatocellular; Humans; Hyperplasia; Liver Neoplasms; Oxyphil Cells; Thyroid Neoplasms; Thyroid Nodule
PubMed: 33792557
DOI: 10.1530/ERC-20-0435 -
Cancer Cytopathology Aug 2021The salivary gland neoplasm of unknown malignant potential (SUMP) category reflects the cytomorphologic overlap and complexity of reporting salivary gland cytology in...
Analysis of the risk of malignancy associated with the basaloid and oncocytic subtypes of the salivary gland neoplasm of unknown malignant potential (SUMP) category in the Milan system.
BACKGROUND
The salivary gland neoplasm of unknown malignant potential (SUMP) category reflects the cytomorphologic overlap and complexity of reporting salivary gland cytology in the Milan system. It includes neoplasms for which a diagnosis of a specific entity cannot be made and, more importantly, for which a carcinoma cannot be entirely excluded. For risk stratification, the subcategorization of SUMP based on the predominant cell type is recommended. This study was aimed at evaluating the risk of neoplasm (RON) and the risk of malignancy (ROM) of the basaloid and oncocytic subtypes of the SUMP category.
METHODS
A retrospective analysis of 482 salivary gland fine-needle aspirations from 2012 to 2019 resulted in 48 SUMP cases. The cytology of these cases was reviewed and reclassified as the basaloid or oncocytic subtype. Surgical follow-up was available for 36 cases. The RON and ROM for each subtype were calculated.
RESULTS
The RON and ROM were 100% and 23%, respectively, for monomorphic basaloid tumors and 88% and 58.8%, respectively, for monomorphic oncocytic tumors. The ROM for basaloid tumors was 8.3% without matrix/with minimal matrix and 60% with an nonfibrillary matrix. The ROM for oncocytic tumors was 50% without a cystic background and 60% with a cystic or mucinous background. The difference was not statistically significant for either of the subgroups.
CONCLUSIONS
Even though statistically not significant in our study, the differential ROMs within the oncocytic and basaloid subgroups help in the risk stratification of SUMP cases. Further subcategorization based on the stroma and background helps in limiting the differential diagnosis but does not necessarily add to the value of the risk stratification.
Topics: Biopsy, Fine-Needle; Humans; Oxyphil Cells; Retrospective Studies; Salivary Gland Neoplasms; Salivary Glands
PubMed: 33788998
DOI: 10.1002/cncy.22427 -
Beijing Da Xue Xue Bao. Yi Xue Ban =... Dec 2020To summarize and analyze the clinical data and prognosis of the patients with Hürthle cell tumor (HCT) in order to raise the clinicians' awareness of the disease.
OBJECTIVE
To summarize and analyze the clinical data and prognosis of the patients with Hürthle cell tumor (HCT) in order to raise the clinicians' awareness of the disease.
METHODS
The clinical data on patients with histopathologically proven HCT, without other thyroid carcinomas, were collected retrospectively in Peking University First Hospital from January 2001 to February 2017. All the patients underwent surgery due to thyroid nodules. The follow-up information was also collected.
RESULTS
A total of 100 patients were enrolled in the current study. All of them were diagnosed with Hürthle cell adenoma (HCA). There were 77 females and 23 males, with the male-to-female ratio of 1 : 3.3. The average age of these patients was (52±14) years at the time of operation. Fifty-one patients were found their thyroid nodules accidentally by ultrasonography during their health check-ups. 69.4% of the 49 symptomatic patients presented with painless cervical nodules. 83.0% HCA patients were combined with multinodular goiters (MNGs). 88.4% (76/86) patients were euthyroid and 53.8% (21/39) had increasing thyroglobulin levels. The mean longest diameter of HCAs was (3.2±1.5) cm (range: 0.9-7.3 cm) on ultrasonography. There were a series of sonographic features of HCA, such as larger, solidity, hypoecho, a smooth outline, intranodular vascularization, perinodular vascularization, absence of calcification in nodules and absence of enlarged cervical lymph nodes. Compared with the histological diagnosis, the diagnostic accuracy by frozen section (FS) during operation was 97.4%. Twenty-nine patients were followed up with an average period of (49.2±22.1) months and none of them had local recurrence or cervical lymph node metastasis. Six patients accepted thyroid hormone replacement treatment and one had thyrotoxicosis due to over-dose.
CONCLUSION
HCA is more common in women. It is often found accidentally by ultrasonography during their health check-ups or presented with painless cervical nodules. It is combined with MNG frequently. HCA exhibits numerous sonographic features but not unique. FS during operation is a reliable method to identify HCA with high diagnostic accuracy. Patients with thyroid hormone administration should be monitored for thyroid function after thyroid surgery.
Topics: Adenoma, Oxyphilic; Adult; Aged; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Oxyphil Cells; Retrospective Studies; Thyroid Neoplasms
PubMed: 33331320
DOI: 10.19723/j.issn.1671-167X.2020.06.018 -
Cancer Cytopathology Jun 2021Identifying crystalloids, which includes amylase and tyrosine crystalloids, is relatively uncommon in salivary gland fine-needle aspiration (FNA) cytology. Although it...
BACKGROUND
Identifying crystalloids, which includes amylase and tyrosine crystalloids, is relatively uncommon in salivary gland fine-needle aspiration (FNA) cytology. Although it has been suggested that the presence of crystalloids favors a benign process, the full significance has not been well established.
METHODS
The authors performed a review of slides from all salivary gland FNA cases received in their laboratory from January 2017 to September 2019 to identify cases with crystalloids (screened cohort). In addition, the departmental archives were searched retrospectively for all salivary gland FNA cases that had specifically reported crystalloids. Cytologic findings as well as correlation with surgical pathology and clinical follow-up were examined.
RESULTS
There were 664 cases in the screened cohort. Crystalloids were present in 37 cases (incidence, 5.6%). Amylase crystalloids were the most commonly identified (n = 28; 75%), followed by tyrosine crystalloids (n = 4; 11%), and collagenous crystalloids (n = 1; 3%). Four cases with crystalloids could not be further classified because of low quantity (n = 4; 11%). An additional 54 cases were identified in the 10-year retrospective review. Diagnostic categorization for the total cohort (N = 91) was as follows: nondiagnostic, 30 cases (33%); nonneoplastic/benign, 42 cases (46%); neoplasm: benign, 10 cases (11%); and atypia of undetermined significance, 9 cases (10%). Twenty-six cases had subsequent resection findings, including oncocytic cyst/cystadenoma in 8 cases (31%), chronic sialadenitis/ductal obstructive change in 7 cases (27%), pleomorphic adenoma in 5 cases (27%), developmental cyst in 3 cases (12%), lymphoepithelial cyst in 2 cases (8%), and Warthin tumor in 1 case (4%).
CONCLUSIONS
This cohort represents the largest FNA series of salivary gland crystalloids. All cases were associated with nonneoplastic or benign neoplastic lesions.
Topics: Adenoma, Pleomorphic; Adolescent; Adult; Aged; Aged, 80 and over; Amylases; Biopsy, Fine-Needle; Child; Cytodiagnosis; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Male; Middle Aged; Oxyphil Cells; Prognosis; Retrospective Studies; Salivary Gland Neoplasms; Tyrosine; Young Adult
PubMed: 33296146
DOI: 10.1002/cncy.22395 -
Diagnostic Cytopathology Feb 2021Mucoepidermoid carcinoma is the most common malignant salivary gland neoplasm comprising approximately 10% of all tumours of the major salivary gland. Owing to a...
Mucoepidermoid carcinoma is the most common malignant salivary gland neoplasm comprising approximately 10% of all tumours of the major salivary gland. Owing to a plethora of morphological variations, it poses a diagnostic challenge on fine-needle aspiration cytology. Oncocytic variant of mucoepidermoid carcinoma is a rare subtype seen in the age group of 20-80 years. It is crucial to make the correct diagnosis on cytology as it has therapeutic implications. Oncocytes can be present in a wide range of salivary gland lesions ranging from non-neoplastic conditions to benign and malignant lesions. We report a case of oncocytic mucoepidermoid carcinoma of the parotid gland in a 12-year-old boy which is the youngest age reported for the same. On cytology, this case was initially diagnosed as Warthin's tumour and was supported by radiology. However, histomorphological findings clinched the diagnosis of an oncocytic variant of mucoepidermoid carcinoma with the aid of immunohistochemistry.
Topics: Biopsy, Fine-Needle; Carcinoma, Mucoepidermoid; Child; Cytodiagnosis; Humans; Male; Oxyphil Cells; Parotid Gland; Parotid Neoplasms; Salivary Gland Neoplasms; Salivary Glands
PubMed: 33237638
DOI: 10.1002/dc.24581 -
Histopathology Sep 2021Salivary gland intraductal carcinoma (IDC) is a complex ductal neoplasm surrounded by a layer of myoepithelial cells. Recent insights have shown that there are three...
AIMS
Salivary gland intraductal carcinoma (IDC) is a complex ductal neoplasm surrounded by a layer of myoepithelial cells. Recent insights have shown that there are three different types: intercalated duct-like, with frequent NCOA4-RET fusions; apocrine, with salivary duct carcinoma-like mutations; and mixed intercalated duct-like/apocrine, with RET fusions, including TRIM27-RET. In addition, an oncocytic IDC has been described, but it remains unclear whether it represents a fourth variant or simply oncocytic metaplasia of another IDC type. Our aim was to more completely characterize oncocytic IDC.
METHODS AND RESULTS
Six IDCs with oncocytic changes were retrieved from the authors' archives, from three men and three women ranging in age from 45 to 75 years (mean, 63 years). Five arose in the parotid gland, with one in an accessory parotid gland. Four patients with follow-up were free of disease after 1-23 months. Several immunostains (S100, mammaglobin, androgen receptor, and p63/p40) and molecular tools (RNA sequencing, RET fluorescence in-situ hybridisation, BRAF V600E VE1 immunohistochemistry, and Sanger sequencing) were applied. Histologically, the tumours were variably cystic with solid intracystic nodules often difficult to recognise as intraductal. In all, tumour ducts were positive for S100 and mammaglobin, negative for androgen receptor, and completely surrounded by myoepithelial cells positive for p63/p40. Molecular analysis revealed TRIM33-RET in two of six cases, NCOA4-RET in one of six cases, and BRAF V600E in two of six cases. One case had no identifiable alterations.
CONCLUSIONS
Oncocytic IDC shares similarities with intercalated duct-like IDC. Although additional verification is needed, the oncocytic variant appears to be sufficiently unique to be now regarded as the fourth distinct subtype of IDC. Because of its indolent nature, oncocytic IDC should be distinguished from histological mimics.
Topics: Adult; Aged; Biomarkers, Tumor; Carcinoma, Ductal; Carcinoma, Intraductal, Noninfiltrating; Diagnosis, Differential; Female; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Male; Middle Aged; Mutation; Oncogene Fusion; Oxyphil Cells; Proto-Oncogene Proteins B-raf; Proto-Oncogene Proteins c-ret; Salivary Gland Neoplasms; Salivary Glands; Sequence Analysis, RNA; Transcription Factors
PubMed: 33135196
DOI: 10.1111/his.14296 -
Cancer Cytopathology May 2021
Topics: Humans; Oxyphil Cells; Thyroid Neoplasms
PubMed: 33045148
DOI: 10.1002/cncy.22377 -
Pathology Feb 2021
Review
Topics: Adenocarcinoma; Biomarkers, Tumor; Diagnosis, Differential; Humans; Oxyphil Cells; Parietal Cells, Gastric; Stomach Neoplasms
PubMed: 32981699
DOI: 10.1016/j.pathol.2020.06.023 -
Singapore Dental Journal Dec 2019Oncocytosis is a rare, benign, non-neoplastic lesion that can be further classified into diffuse oncocytosis or multifocal adenomatous oncocytic hyperplasia. This tumour...
Oncocytosis is a rare, benign, non-neoplastic lesion that can be further classified into diffuse oncocytosis or multifocal adenomatous oncocytic hyperplasia. This tumour has been estimated to account for 0.1% of all parotid gland tumours. Here, we report a rare case of a patient who presented to the Oral and Maxillofacial Surgery Department with a 3-cm swelling of his left parotid gland. Histopathological results from a superficial parotidectomy revealed the lesion to be a multifocal adenomatous oncocytic hyperplasia of the parotid gland. A description of this rare disease and its management are included in this article.
Topics: Adenoma, Oxyphilic; Humans; Hyperplasia; Oxyphil Cells; Parotid Gland; Singapore
PubMed: 32948099
DOI: 10.1142/S2214607519720039