-
Pathologica Mar 2019
Topics: Adenocarcinoma; Female; Humans; Thyroid Cancer, Papillary; beta Catenin
PubMed: 31217615
DOI: 10.32074/1591-951X-66-18 -
Journal of Hepato-biliary-pancreatic... Jul 2015Pancreatic ductal adenocarcinoma (PDA) is one of the most lethal human malignancies. Dissecting the mechanisms underlying PDA development is important for developing... (Review)
Review
Pancreatic ductal adenocarcinoma (PDA) is one of the most lethal human malignancies. Dissecting the mechanisms underlying PDA development is important for developing early detection methods and effective prevention and therapies for the disease. PDA is considered to arise from distinct precursor lesions, including pancreatic intraepithelial neoplasia (PanIN) and intraductal papillary mucinous neoplasia (IPMN). However, little is known about molecular mechanisms of development of IPMN and IPMN-derived PDA. We have recently reported that loss of Brg1, a core subunit of SWI/SNF chromatin remodeling complexes, cooperates with oncogenic Kras to form cystic neoplastic lesions that resemble human IPMN and progress to PDA. Brg1 null IPMN-PDA is less lethal compared to PanIN-derived PDA (PanIN-PDA) driven by mutant Kras and hemizygous p53 deletion, mirroring prognostic trends in PDA patients. Brg1 null IPMN-PDA possesses a distinct molecular signature that supports less malignant potential compared to PanIN-PDA. Furthermore, Brg1 deletion inhibits Kras-dependent PanIN development from adult acinar cells, but promotes Kras-driven preneoplastic transformation in adult duct cells. Therefore, Brg1 is a determinant of context-dependent Kras-driven pancreatic tumorigenesis and chromatin remodeling may underlie the development of distinct PDA subsets. Understanding molecular mechanism of IPMN and IPMN-derived PDA could provide critical clues for novel diagnostic and therapeutic strategies of the disease.
Topics: Adenocarcinoma, Mucinous; Adenocarcinoma, Papillary; Animals; Carcinogenesis; Carcinoma, Pancreatic Ductal; Cell Proliferation; Cell Transformation, Neoplastic; Chromatin Assembly and Disassembly; DNA Helicases; Disease Progression; Humans; Nuclear Proteins; Prognosis; Proto-Oncogene Proteins p21(ras); Transcription Factors
PubMed: 25900667
DOI: 10.1002/jhbp.246 -
Modern Pathology : An Official Journal... Apr 2011Systemic chemotherapies for advanced or metastatic thyroid carcinomas have been of only limited effectiveness. For patients with differentiated or medullary carcinomas... (Review)
Review
Systemic chemotherapies for advanced or metastatic thyroid carcinomas have been of only limited effectiveness. For patients with differentiated or medullary carcinomas unresponsive to conventional treatments, novel therapies are needed to improve disease outcomes. Multiple novel therapies primarily targeting angiogenesis have entered clinical trials for metastatic thyroid carcinoma. Partial response rates up to 30% have been reported in single-agent studies, but prolonged disease stabilization is more commonly observed. The most successful agents target the vascular endothelial growth factor receptors, with potential targets including the mutant kinases associated with papillary and medullary oncogenesis. Two drugs approved for other malignancies, sorafenib and sunitinib, have had promising preliminary results reported, and are being used selectively for patients who do not qualify for clinical trials. At least one randomized, placebo-controlled phase III trial has been successfully completed, showing improved progression-free survival in patients with advanced or metastatic medullary thyroid carcinoma treated with vandetanib. Randomized trials for other agents are currently underway. Treatment for patients with metastatic or advanced thyroid carcinoma now emphasizes clinical trial opportunities for novel agents with considerable promise. Alternative options now exist for use of tyrosine kinase inhibitors that are well tolerated and may prove worthy of regulatory approval for this disease.
Topics: Adenocarcinoma, Follicular; Adenocarcinoma, Papillary; Antineoplastic Agents; Clinical Trials, Phase III as Topic; Molecular Targeted Therapy; Randomized Controlled Trials as Topic; Thyroid Neoplasms
PubMed: 21455200
DOI: 10.1038/modpathol.2010.165 -
International Journal of Surgery... Nov 2019Previous studies have indicated that there may be a difference in tumor biology between intraductal papillary mucinous carcinoma (IPMC) and pancreatic ductal... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Previous studies have indicated that there may be a difference in tumor biology between intraductal papillary mucinous carcinoma (IPMC) and pancreatic ductal adenocarcinoma (PDAC). However, the data are still controversial. The aim of this systematic review and meta-analysis was to summarize and compare the outcome of IPMC and PDAC after surgical resection.
METHODS
Studies comparing IPMC and PDAC were identified using Medline and Embase search engines. Primary outcomes of interest were survival and recurrence. Secondary outcomes were clinicopathological characteristics. Meta-analysis of data was conducted using a random-effects model.
RESULTS
A total of 14 studies were included. Pooled analysis revealed an improved 5-year overall survival (OS) for IPMC compared to PDAC (OR 0.23, 95% CI 0.09-0.56). Both colloid and tubular IPMC showed improved 5-year OS compared to PDAC (OR 0.12, 95% CI 0.05-0.25 and OR 0.38, 95% CI 0.26-0.54, respectively). Median survival time ranged from 21 to 58 months in the IPMC group compared to 12-23 months in the PDAC group. No meta-analysis could be performed on recurrence or on time-to-event data. Descriptive data showed no survival difference for higher TNM stages. IPMC was more often found at a TNM-stage of 1 (OR 4.40, 95% CI 2.71-7.15) and had lower rates of lymph node spread (OR 0.43, 95% CI 0.32-0.57).
CONCLUSION
Available data suggest that IPMC has a more indolent course with a better 5-year OS compared to PDAC. The histopathological features are less aggressive in IPMC. The reason may be earlier detection. However, for IPMC with higher TNM stages the survival seems to be similar to that of PDAC.
Topics: Adenocarcinoma, Mucinous; Adenocarcinoma, Papillary; Aged; Breast Neoplasms; Carcinoma, Ductal, Breast; Carcinoma, Pancreatic Ductal; Female; Humans; Middle Aged; Neoplasm Staging; Pancreatic Neoplasms; Survival Rate
PubMed: 31546033
DOI: 10.1016/j.ijsu.2019.09.014 -
Journal of Human Genetics Mar 2011Distinctive histological variants of lung cancer are increasingly recognized to have specific genetic changes that affect tumor biology and response to therapy. In this...
Distinctive histological variants of lung cancer are increasingly recognized to have specific genetic changes that affect tumor biology and response to therapy. In this study, we evaluated true papillary adenocarcinoma of the lung, proposed as a distinct diagnostic category with relatively poor response to therapy, to determine whether these tumors also have specific molecular alterations that would affect sensitivity to chemotherapy. Specifically, we measured protein levels of P53, excision repair cross-complementation 1 (ERCC1) and ribonucleotide reductase M1 (RRM1) by immunohistochemistry and evaluated the Kelch-like erythroid cell-derived protein with cap-n-collar homology (ECH)-associated protein 1 (KEAP1) gene for mutations, correlating mutations of this gene with total and nuclear expression of the nuclear factor erythroid-2-related factor 2 (NRF2). We found high levels of P53 in 23 of the 55 specimens (41.8%), similar to the rate of P53 gene mutations observed in general for pulmonary adenocarcinoma, and levels of ERCC1 and RRM1 also showed distributions similar to those reported generally for non-small lung cell cancer (NSCLC). However, KEAP1 alterations were observed at a significantly higher frequency in papillary adenocarcinoma tumors (60%) than what has been reported previously for NSCLC (3-19%). These mutations of KEAP1 were associated with increased nuclear accumulation of NRF2 in tumors, as expected for functional alterations. Thus, high rates of KEAP1 mutations and NRF2 overexpression in true papillary adenocarcinoma could be related to poor prognosis and chemotherapy resistance. Furthermore, this distinctive molecular characteristic supports the recognition of true papillary adenocarcinoma as a diagnostic entity.
Topics: Adenocarcinoma, Papillary; Base Sequence; DNA-Binding Proteins; Endonucleases; Humans; Intracellular Signaling Peptides and Proteins; Kelch-Like ECH-Associated Protein 1; Lung Neoplasms; Mutation; NF-E2-Related Factor 2; Ribonucleoside Diphosphate Reductase; Transcriptional Activation; Tumor Suppressor Protein p53; Tumor Suppressor Proteins
PubMed: 21248763
DOI: 10.1038/jhg.2010.172 -
Head and Neck Pathology Dec 2019Nasopharyngeal adenocarcinomas are rare tumours, and include neoplasms arising from the nasopharyngeal surface epithelium as well as those of minor salivary gland...
Nasopharyngeal adenocarcinomas are rare tumours, and include neoplasms arising from the nasopharyngeal surface epithelium as well as those of minor salivary gland origin, each of which is distinct from the other. The former encompasses nasopharyngeal papillary adenocarcinoma (NPAC), also known as low grade NPAC and thyroid-like NPAC, an extremely unusual malignancy bearing histomorphological similarity to papillary thyroid carcinoma, and displaying indolent clinical behaviour. We report the case of a 41-year-old lady who developed NPAC as a second malignancy five-and-a-half years after being diagnosed and treated for a diffuse astrocytoma in the frontal lobe. In addition, we discuss the differential diagnosis, as well as raise certain pathogenetic considerations with regard to this unique neoplasm.
Topics: Adenocarcinoma, Papillary; Adult; Astrocytoma; Brain Neoplasms; Female; Humans; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Neoplasms, Second Primary
PubMed: 29923095
DOI: 10.1007/s12105-018-0944-0 -
Medicine Nov 2017Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare malignant nasopharyngeal tumor with features resembling papillary... (Review)
Review
RATIONALE
Primary thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is an extremely rare malignant nasopharyngeal tumor with features resembling papillary thyroid carcinoma including nuclear positive expression of thyroid transcription factor-1 (TTF-1).
PATIENT CONCERNS
A 64-year-old male presented with nasal bleeding and a foreign body sensation of the nasopharynx. Laryngoscopy revealed a 2.0-cm broad-based mass with a smooth surface on the posterior wall of the nasopharynx. A biopsy was obtained.
DIAGNOSES
Histopathologic examination demonstrated tumor cells arranged in both papillary and glandular architecture. The tumor cells express nuclear immunoreactivity for TTF-1. The diagnosis of TL-LGNPPA was made.
INTERVENTIONS
After the patient was diagnosed with TL-LGNPPA, he underwent complete surgical resection.
OUTCOMES
There was no recurrence or evidence of metastatic disease at the 12-month follow-up.
LESSONS
TL-LGNPPA is easy to misdiagnose as metastatic papillary thyroid carcinoma or other relative primary adenocarcinomas. It is important to have a broad differential diagnosis and know the key features of each entity because the prognosis and clinical treatment of each may differ.
Topics: Adenocarcinoma, Papillary; Carcinoma, Papillary; Diagnosis, Differential; Humans; Immunohistochemistry; Male; Middle Aged; Nasopharyngeal Neoplasms; Nasopharynx; Thyroid Cancer, Papillary; Thyroid Neoplasms; Thyroid Nuclear Factor 1
PubMed: 29381996
DOI: 10.1097/MD.0000000000008851 -
Annals of Hepatology 2015We report the case of a 37-year-old woman with no relevant medical history. She was admitted to the hospital for epigastric pain related with food intake for 4 days; the... (Review)
Review
We report the case of a 37-year-old woman with no relevant medical history. She was admitted to the hospital for epigastric pain related with food intake for 4 days; the pain did not improve with symptomatic management. A laparoscopic cholecystectomy due to acute lithiasic cholecystitis was performed. However, after 4 days, postoperative painless jaundice was evident; thus, endoscopic retrograde cholangiopancreatography was performed, which revealed an amputation of intrapancreatic common bile duct, as well as secondary intra- and extrahepatic bile duct dilatation. Brushing of the distal portion of the common bile duct revealed a well-differentiated adenocarcinoma. Therefore, a Whipple procedure with pylorus preservation was performed. Pathologic diagnosis of a papillary in situ adenocarcinoma with two microscopic foci of microinvasion was established. The pathologic Tumor-Node-Metastasis (TNM) stage was pT1, pN0, pM0, R0. The patient is asymptomatic and disease-free 24 months after surgery. In general, adenocarcinomas of the extrahepatic bile ducts are uncommon and have a poor prognosis. However, symptomatic patients with early disease stages are even rarer and can be cured surgically.
Topics: Adenocarcinoma, Papillary; Adult; Bile Duct Neoplasms; Carcinoma in Situ; Cholangiopancreatography, Endoscopic Retrograde; Cholecystectomy, Laparoscopic; Common Bile Duct; Female; Humans
PubMed: 25864226
DOI: No ID Found -
Medicine Jan 2023Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare nasopharyngeal malignant tumor that is easy to misdiagnose. Immunohistochemistry...
BACKGROUND
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare nasopharyngeal malignant tumor that is easy to misdiagnose. Immunohistochemistry plays an indispensable role in distinguishing TL-LGNPPA from other malignancies. However, there is no article to summarize the immunohistochemical characteristics of TL-LGNPPA. Herein, we report a case of TL-LGNPPA and present the immunohistochemical results reported in the Chinese literature.
METHODS
An electronic search of the CNKI (China National Knowledge Infrastructure) database was performed. From our literature survey, 53 cases of TL-LGNPPA (including the case described in this report) have been identified in China. We summarize the Chinese literature's clinical characteristics, immunohistochemical results, treatments, and prognosis of 53 cases.
RESULTS
Based on our literature survey, 53 cases of TL-LGNPPA (including the case described in this report) have been reported in China. We found TL-LGNPPA and papillary thyroid carcinoma were positive for TTF-1 and CK19. TL-LGNPPA was negative for TG and PAX-8, whereas papillary thyroid carcinoma was positive for TG and PAX-8. However, negative expression of TTF-1 and positive expression of TG were also found in some TL-LGNPPA cases. Our literature survey found that all TL-LGNPPA cases were negative for PAX-8.Therefore, we suggest that simultaneous immunohistochemical determination of TTF-1 and CK19, as well as TG and PAX-8, can increase the diagnostic accuracy of TL-LGNPPA.
CONCLUSION
The 4th edition of the World Health Organization Classification of Head and Neck Tumors (WHO-HNT) indicates that NPPA with positive expression of cytokeratin 19 (CK19) and TTF-1 and negative expression of TG is called TL-LGNPPA.
Topics: Humans; Thyroid Cancer, Papillary; Adenocarcinoma, Papillary; Nasopharyngeal Neoplasms; Thyroid Neoplasms; Biomarkers, Tumor
PubMed: 36705380
DOI: 10.1097/MD.0000000000032655 -
Head and Neck Pathology Dec 2019Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare entity. Patients often present with complaints of nasal fullness, obstruction, and...
Thyroid-like low-grade nasopharyngeal papillary adenocarcinoma (TL-LGNPPA) is a rare entity. Patients often present with complaints of nasal fullness, obstruction, and epistaxis. It may be confused with metastatic papillary thyroid carcinoma due to its histologic similarity and overlapping immunohistochemical studies, but it is important to distinguish between the two because of differing treatment modalities and prognosis. A significant difference between the two is that despite both entities demonstrating TTF-1 positivity, TL-LGNPPA usually does not stain for thyroglobulin. TL-LGNPPA exhibits indolent growth, with no incidence of metastasis or recurrence after surgical excision.
Topics: Adenocarcinoma, Papillary; Adult; Biomarkers, Tumor; DNA-Binding Proteins; Female; Humans; Nasopharyngeal Carcinoma; Nasopharyngeal Neoplasms; Transcription Factors
PubMed: 29995295
DOI: 10.1007/s12105-018-0947-x