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Expanding the clinicopathological spectrum of TGFBR3-PLAG1 rearranged salivary gland neoplasms with myoepithelial differentiation including evidence of high-grade transformation
- Source :
- Genes, chromosomescancer. 61(2)
- Publication Year :
- 2021
-
Abstract
- PLAG1 rearrangements have been described as a molecular hallmark of salivary gland pleomorphic adenoma (PA), carcinoma ex pleomorphic adenoma (CEPA), and myoepithelial carcinoma (MECA). Several fusion partners have been described, however, commonly no further assignment to the afore mentioned entities or a morphological prediction can be made based on the knowledge of the fusion partner alone. In contrast, TGFBR3-PLAG1 fusion has been specifically described and characterized as an oncogenic driver in MECA, and less common in MECA ex PA. Here, we describe the clinicopathological features of three TGFBR3-PLAG1 fusion positive salivary gland neoplasms, all of which arose in the deep lobe of the parotid gland. Histopathology showed high morphological similarities, encompassing encapsulation, a polylobular growth pattern, bland basaloid and oncocytoid cells with myoepithelial differentiation, and a distinct sclerotic background. All cases showed at least limited, unusual foci of minimal invasion into adjacent salivary gland tissue, including one case with ERBB2 (Her2/neu) amplified, TP53 mutated high-grade transformation and lymph node metastases. Of note, all cases illustrated focal ductal differentiation. Classification remains difficult, as morphological overlaps between myoepithelial-rich cellular pleomorphic adenoma, myoepithelioma and myoepithelial carcinoma were observed. However, evidence of minimal invasion advocates classification as low-grade myoepithelial carcinoma. This case series further characterizes the spectrum of uncommon cellular myoepithelial neoplasms harboring TGFBR3-PLAG1 fusion, which show recurrent minimal invasion of the adjacent salivary gland tissue, a predilection to the deep lobe of the parotid gland and potential high-grade transformation. This article is protected by copyright. All rights reserved. Keywords: (MeSH): Salivary gland neoplasms; adenoma; parotid gland; pleomorphic; transforming growth factor beta.
- Subjects :
- Adult
Male
Cancer Research
Pathology
medicine.medical_specialty
Adenoma
Myoepithelioma
Oncogene Proteins, Fusion
Adenoma, Pleomorphic
Biology
Cellular Pleomorphic Adenoma
stomatognathic system
Transforming Growth Factor beta
Genetics
medicine
Humans
Parotid Gland
Aged
Gene Rearrangement
Salivary gland
Myoepithelial cell
Salivary Gland Pleomorphic Adenoma
medicine.disease
Salivary Gland Neoplasms
Parotid gland
DNA-Binding Proteins
medicine.anatomical_structure
Carcinoma ex pleomorphic adenoma
Proteoglycans
Neoplasm Grading
Receptors, Transforming Growth Factor beta
Subjects
Details
- ISSN :
- 10982264
- Volume :
- 61
- Issue :
- 2
- Database :
- OpenAIRE
- Journal :
- Genes, chromosomescancer
- Accession number :
- edsair.doi.dedup.....c706216427c38a8172fb9e9120bfd398