High-grade Adenocarcinoma Research Articles

Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations

Paraneoplastic Leukemoid Reaction in High-Grade Lung Adenocarcinoma Complicated by Triple Co-Mutations

MA12.06 Integrative Multi-Omics Analyses Reveal Molecular Subtypes with Distinct Prognosis of Early-Stage High-Grade Lung Adenocarcinoma

MA12.06 Integrative Multi-Omics Analyses Reveal Molecular Subtypes with Distinct Prognosis of Early-Stage High-Grade Lung Adenocarcinoma

Genomic and Evolutionary Characterization of Concurrent Intraductal Carcinoma and Adenocarcinoma of the Prostate.

The genomic, transcriptomic, and epigenomic characterization of concurrent intraductal carcinoma and adenocarcinoma of the prostate deepens the biological understanding of this lethal disease and provides a genetic basis for developing targeted therapies.

S3188 Synchronous Low-Grade Tubulogalndular Adenocarcinoma and High-Grade Adenocarcinoma in a 28-Year-Old Man with Ulcerative Colitis

S3188 Synchronous Low-Grade Tubulogalndular Adenocarcinoma and High-Grade Adenocarcinoma in a 28-Year-Old Man with Ulcerative Colitis

Müsinöz Olmayan Akciğer Adenokarsinomlarında Caspase-3 ve GRIM-19 Ekspresyonu ile Bu Proteinlerin Klinikopatolojik Önemi

Aim: The current study aimed to investigate apoptotic proteins such as caspase-3 and GRIM-19 protein expression in non-mucinous lung adenocarcinomas and their clinicopathologic significance. Material and Methods: This study was performed on 81 patients diagnosed with non-mucinous lung adenocarcinoma between January 1, 2010, and June 1, 2020. Immunohistochemical analysis was performed to examine the expressions of caspase-3 and GRIM-19, and the association between these proteins and clinicopathological parameters was investigated. Results: Caspase-3 nuclear positivity was more common in high-grade non-mucinous lung adenocarcinomas (p<0.001). Caspase-3 cytoplasmic expression was stronger in tumors with advanced-stage (p=0.021) and lymph node metastases (p=0.020). GRIM-19 expression was low in tumors with high-grade non-mucinous lung adenocarcinomas (p=0.002), and tumors with lymphovascular invasion (p=0.021). The median follow-up time was 31.7 (range, 1-145 months. The overall 5-year survival rate of patients with low and high GRIM-19 expression tumors was 48% and 92%, respectively. GRIM-19 expression significantly affected the 5-year overall survival rate (p=0.008), but not the 5-year disease-free survival rate (p=0.368). Conclusion: We revealed a significant association between caspase-3 and GRIM-19 expressions and poor clinicopathologic features and prognosis. For the first time in the literature, we revealed an association between low GRIM-19 expression and worse clinical outcomes in patients with non-mucinous lung adenocarcinoma. Caspase-3 and GRIM-19 may become potential therapeutic targets and novel potential predictive biomarkers for non-mucinous lung adenocarcinoma patients.

Maximum Standardized Uptake Value (SUV max) and Total Lesion Glycolysis Values (TLG) Measured in 18-Flourodeoxy Glucose (FDG) PET CT in Prediction of Histopathological Grading of Bronchogenic Carcinoma

Abstract Quantitative analysis of glucose consumption measured by maximum standardized uptake value (SUVmax) and Total lesion glycolysis (TLG) in lung bronchogenic carcinoma is the first aim of this work to evaluate the correlation between SUV max, TLG and different histopathologic subtypes and grades of Bronchogenic carcinoma, also their correlation with TNM pathologic staging. Glucose consumption of primary tumor was quantified using SUVmax and TLG in 20 patients with histologically-confirmed bronchogenic carcinoma .Tumors were classified according to their histopathological reports into 4 different histological subtypes (Adenocarcinoma, Squamous cell, Small cell, Undifferentiated). Adenocarcinomas were grouped according to the histological tumor grade into : low grade (adenocarcinoma grade 1,2), and high grade (adenocarcinoma grade 3, 4). Tumors were grouped according to TNM pathological staging into 4 grades and their subtypes and correlated to SUVmax and TLG. Comparisons between SUVmax, TLG and histologic Types, Grades, stages were performed using the KruskalWallis test followed by a Dunn’s multiple comparison tests. The Mann Whitney-U test was used to assess differences when two groups were studied in Comparing High and Low grades. According to Clinico-pathological characteristics of 20 patients with bronchogenic cancer, Association between SUVmax, TLG of the primary tumor and subtypes, stage showed that no significant difference between histological types regarding SUVmax and TLG (P value > 0.05). Association between SUVmax, TLG and histopathological grades shows statistical significant difference between histological Grades regarding SUVmax and TLG (P value < 0.05). Low SUVmax and TLG were associated with low-grade (grade 2) tumors, and higher with higher (3, 4 grades) grades. The sensitivity for SUV max is 100% and specificity is 85.7%.The sensitivity for TLG is 100% and specificity is 100% .

KMT2C expression and DNA homologous recombination repair factors in lung cancers with a high-grade fetal adenocarcinoma component.

High-grade fetal adenocarcinoma of the lung (H-FLAC) is a rare variant of pulmonary adenocarcinoma. Our previous study showed a high frequency of KMT2C mutations in lung cancers with an H-FLAC component, showing that KMT2C dysfunction may be associated with the biological features of H-FLACs. In this study, we performed RNA sequencing and immunohistochemical analysis to identify the differentially expressed genes and corresponding pathways associated with H-FLACs, compared with common adenocarcinomas. Ingenuity pathway analysis based on RNA sequencing data revealed that DNA homologous recombination repair (HRR) pathways were significantly inactivated in H-FLAC. Expression of KMT2C, ATM, ATR, and BRCA2 was significantly lower in H-FLACs than in common adenocarcinomas, and BRCA1 expression showed a decreasing trend. Pearson correlation analyses for all cases revealed that KMT2C expression showed a strong positive correlation (R>0.7) with the expression of ATR, BRCA1, and BRCA2 genes and a moderately positive correlation with ATM expression (R=0.47). Immunohistochemical analysis showed significantly lower levels of KMT2C, ATM, ATR, and BRCA2 expression in H-FLACs than in common adenocarcinomas, and a trend of lower BRCA1 levels. Additionally, KMT2C expression showed a weak to moderate correlation with that of ATM, ATR, BRCA1, and BRCA2. Cancers containing H-FLAC components showed lower levels of KMT2C and HRR factors than common lung adenocarcinomas, and their levels exhibited a positive correlation. These results support the hypothesis that loss of KMT2C function decreases the expression of the HRR factors in H-FLACs. H-FLACs with low KMT2C expression may be a good indication for poly (ADP-ribose) polymerase (PARP) inhibitor-based therapy.

HER-2 overexpression in female genital tract clear cell carcinomas: Evaluation of different scoring guidelines, clinicopathological features and prognostic impact

BackgroundClear cell carcinoma (CCC) is a rare high-grade adenocarcinoma associated with poor response to platinum-based chemotherapy agents in the female genital tract. Human epidermal growth factor receptor 2 (HER2) overexpression is routinely used as a biomarker for targeted therapy in breast and gastric carcinomas, but its role in CCC remains unclear. MethodsIn this study, HER2 overexpression was evaluated by immunohistochemistry (IHC) using College of American Pathologists (CAP) HER2 scoring guidelines for breast and endometrial serous carcinoma (ESC) on tissue microarray blocks. In equivocal and positive cases, fluorescence in situ hybridization (FISH) was performed. IHC score 3, and all amplified cases on FISH test were considered positive. ResultsThirty-six cases of ovarian (OCCC), 36 endometrial (ECCC), and 2 cervical CCC were included. According to ESC and breast scoring guidelines, 20 % and 15.1 % of ECCC and 14.7 % and 6 % of OCCC were HER2 positive, respectively. Both cases of cervical CCC were negative. Scoring based on breast carcinoma guideline showed higher concordance (100 %) with gene amplification results, in comparison with ESC guideline (82.7 %). On multivariate survival analysis, HER2 positive ECCC and OCCC (based on ESC scoring methods) had significantly lower overall and disease-free survivals (OS, DFS) (P < 0.05). ConclusionHER2 immunoscoring based on ESC guideline can yield a higher sensitivity with relevant clinical and prognostic features in OCCC and ECCC. HER2 can be considered a potential biomarker for targeted therapy and future clinical trials.

Clinical and Pathological Characteristics and Prognosis of Lung Adenocarcinoma With High-Grade Fetal Features: A Retrospective Analysis.

Fetal adenocarcinoma of the lung is a rare tumor. The clinical and pathological characteristics, treatment, and prognosis of patients with lung adenocarcinoma with fetal lung-like morphology were retrospectively investigated. The tumors of 9 patients with lung adenocarcinoma contained fetal lung-like morphology. One patient had pure-type high-grade fetal adenocarcinoma. Two patients had more than 50% high-grade fetal adenocarcinoma. Six specimens accounted for < 50% of the high-grade fetal features. It occurred in 7 men and 2 women. The median age at diagnosis was 62.0 years. Thyroid transcription factor-1 was frequently expressed in 8 specimens. All 9 specimens showed high rates of immunopositivity for β-catenin and E-cadherin. Three specimens showed nuclear β-catenin staining. Some patients showed immune expression of CDX2, α-fetoprotein (AFP), SALL4, and Glypican-3. Three of these specimens were diffusely strongly positive for p53, including 1 mixed-type high-grade fetal adenocarcinoma and 2 lung adenocarcinomas with high-grade fetal features. However, the other 6 patients had wild-type p53, including 1 pure-type high-grade fetal adenocarcinoma. PD-L1 was not expressed in all patients. Epidermal growth factor receptor mutations were detected in 1 patient. All patients were diagnosed using surgical samples. During the follow-up period of 36 months (range: 1-92 months), 3 patients received chemotherapy. One patient underwent radiotherapy. Two patients experienced recurrences. No patient died. PD-L1 expression status suggests a poor response to immune checkpoint therapy. The prognosis of the patient was relatively good.

Intraoperative predictors of appendiceal abnormalities in patients with mucinous ovarian neoplasms.

To evaluate intraoperative factors predicting appendiceal pathology during gynecologic oncology surgery for suspected mucinous ovarian neoplasms. We conducted a retrospective study on 225 patients with mucinous ovarian neoplasms who underwent surgery for an adnexal mass with concurrent appendectomy between 2000 and 2018. Regression analyses were used to evaluate intraoperative factors, such as frozen section of the ovarian mass and surgeon's impression of the appendix in predicting appendiceal pathology. Most patients (77.8%) had a normal appendix on final pathology. Abnormal appendix cases (n = 26) included: metastasis from high-grade adenocarcinoma of the ovary (n = 1), neuroendocrine tumor of the appendix (n = 4), and low-grade appendiceal mucinous neoplasms (n = 26; 23 associated with a mucinous ovarian adenocarcinoma, 2 with a benign mucinous ovarian cystadenoma, and 1 with a borderline mucinous ovarian tumor). Combining normal intraoperative appearance of the appendix with benign or borderline frozen section yielded a negative predictive value of 85.1%, with 14.9% of patients being misclassified, and 6.0% having a neuroendocrine tumor or low-grade appendiceal neoplasm. Benign or borderline frozen section of an ovarian mucinous neoplasm and normal appearing appendix have limited predictive value for appendiceal pathology. Appendectomy with removal of the mesoappendix should be considered in all cases of mucinous ovarian neoplasm, regardless of intraoperative findings.

Grading of lung adenocarcinomas with simultaneous segmentation by artificial intelligence (GLASS-AI)

Preclinical genetically engineered mouse models (GEMMs) of lung adenocarcinoma are invaluable for investigating molecular drivers of tumor formation, progression, and therapeutic resistance. However, histological analysis of these GEMMs requires significant time and training to ensure accuracy and consistency. To achieve a more objective and standardized analysis, we used machine learning to create GLASS-AI, a histological image analysis tool that the broader cancer research community can utilize to grade, segment, and analyze tumors in preclinical models of lung adenocarcinoma. GLASS-AI demonstrates strong agreement with expert human raters while uncovering a significant degree of unreported intratumor heterogeneity. Integrating immunohistochemical staining with high-resolution grade analysis by GLASS-AI identified dysregulation of Mapk/Erk signaling in high-grade lung adenocarcinomas and locally advanced tumor regions. Our work demonstrates the benefit of employing GLASS-AI in preclinical lung adenocarcinoma models and the power of integrating machine learning and molecular biology techniques for studying the molecular pathways that underlie cancer progression.

High-grade non-intestinal type sinonasal adenocarcinoma with ETV6::NTRK3 fusion, distinct from secretory carcinoma by immunoprofile and morphology

We report 2 cases of high-grade sinonasal adenocarcinoma with a distinct morphological and immunohistochemical phenotype. Albeit histologically different from secretory carcinoma of the salivary glands, both tumors presented here share an ETV6::NTRK3 fusion. The highly cellular tumors were composed of solid and dense cribriform nests, often with comedo-like necroses in the center, and minor areas with papillary, microcystic, and trabecular formations without secretions, mostly located at the periphery of the lesion. The cells displayed high-grade features, with enlarged, crowded, and often vesicular nuclei with conspicuous nucleoli and brisk mitotic activity. The tumor cells were immunonegative for mammaglobin while showing immunopositivity for p40/p63, S100, SOX10, and GATA3, as well as for cytokeratins 7, 18, and 19. For the first time, we describe 2 cases of primary high-grade non-intestinal type adenocarcinomas of the nasal cavity, distinct from secretory carcinoma by morphology and immunoprofile, harboring the ETV6::NTRK3 fusion.

Appl1, Sortilin and Syndecan-1 immunohistochemistry on intraductal carcinoma of the prostate provides evidence of retrograde spread

The presence of intraductal carcinoma of the prostate (IDCP) correlates with late-stage disease and poor outcomes for patients with prostatic adenocarcinoma, but the accurate and reliable staging of disease severity remains challenging. Immunohistochemistry (IHC) has been utilised to overcome problems in assessing IDCP morphology, but the current markers have only demonstrated limited utility in characterising the complex biology of this lesion. In a retrospective study of a cohort of patients who had been diagnosed with IDCP, we utilised IHC on radical prostatectomy sections with a biomarker panel of Appl1, Sortilin and Syndecan-1, to interpret different architectural patterns and to explore the theory that IDCP occurs from retrograde spread of high-grade invasive prostatic adenocarcinoma. Cribriform IDCP displayed strong Appl1, Sortilin and Syndecan-1 labelling patterns, while solid IDCP architecture had high intensity Appl1 and Syndecan-1 labelling, but minimal Sortilin labelling. Notably, the expression pattern of the biomarker panel in regions of IDCP was similar to that of adjacent invasive prostatic adenocarcinoma, and also comparable to prostate cancer showing perineural and vascular invasion. The Appl1, Sortilin, and Syndecan-1 biomarker panel in IDCP provides evidence for the model of retrograde spread of invasive prostatic carcinoma into ducts/acini, and supports the inclusion of IDCP into the five-tier Gleason grading system.

Molecular profiling and characterization of the tumor immune microenvironment (TME) in appendiceal carcinoma (AC).

3622 Background: The rarity of AC presents challenges in understanding disease pathogenesis. We previously showed that AC has higher rates of mutations in KRAS and GNAS and lower rates of TP53, APC, and PIK3CA than CRC. The appendix also has many lymphoid clusters and regulates IgA production in the large bowel, suggesting that AC may be subject to more lymphocytic regulation than CRC. We sought to characterize the molecular profile and TME across AC histopathological types. Methods: AC samples were analyzed by DNA sequencing (592 genes, NextSeq, or whole exome sequencing, NovaSeq), whole transcriptome sequencing (WTS, NovaSeq), and immunohistochemistry (IHC) for molecular profiling, including microsatellite instability (MSI), mismatch repair (MMR), PD-L1 (SP142), and tumor mutational burden (TMB). Microenvironment Cell Population-counter Quantiseq was used to quantify tumor immune contexture using WTS. AC histopathology was derived from pathology reports. Mann-Whitney U and ChiSquare tests were applied as appropriate, with P-values adjusted for multiple comparisons using Benjamini-Hochberg. Results: AC (N = 731) were grouped by histology: 5% goblet cell (GC), 6% high-grade adenocarcinoma (HGA), 14% low grade mucinous (LGM), 33% mucinous adenocarcinoma (MA), 1% pseudomyxoma peritonei (PMP), 6% signet ring cell carcinoma (SRC), and 35% adenocarcinoma not otherwise specified (NOS) (see Table). Age at collection and PD-L1+ (0-5.2%) did not differ by histopathology. Seven patients had dMMR (4 NOS and 3 MA). Median TMB was significantly higher in NOS vs. GC (4 mutations/megabase vs 2, q &lt; 0.001), NOS vs. LGM (4 vs 3, q = 0.048), MA vs. GC (4 vs 2, q &lt; 0.001), and MA vs. LGM (4 vs 3, q = 0.037). Distinct TME patterns were observed in NOS vs. MA (median cell fraction: dendritic cells 0.07 vs 0, q &lt; 0.01; M2 macrophages 0.055 vs 0.042, q = 0.030; natural killer cells 0.034 vs 0.031, q = 0.011; CD4 T cells 0.006 vs 0, q = 0.044) and GC vs. MA (M1 macrophages 0.039 vs 0.057, q = 0.021; dendritic cells 0.012 vs 0, q &lt; 0.01; B cells 0.061 vs 0.050, q = 0.013; M2 macrophages 0.074 vs 0.042, q &lt; 0.01; natural killer cells 0.041 vs 0.031, q = 0.01; and neutrophils 0.017 vs 0.038 q = 0.045). T cell inflamed signature (TIS) and immune-oncology (IO) marker gene expression were higher in HGA and lower in LGM and MA. Somatic mutation rates differed by histopathology (see Table). Conclusions: There is significant heterogeneity in TMB, TME, and mutational profiles across AC histologies. MA has a particularly immune-cold TME shown by lower infiltration of lymphocytes, TIS, and IO gene expression. These findings are critical to identify novel biomarkers and develop new therapeutic strategies for AC. [Table: see text]

A Young Woman with High-Grade Rectosigmoid Adenocarcinoma, no Other Specified, T2n2aM0: A Case Report and Literature Review

BACKGROUND: Colorectal cancer (CRC) is the fourth most common cancer in which the majority of CRCs are diagnosed between the ages of 50 and 70 years. Based on current trends, the incidence of colon and rectal cancers can increase by 124% in people aged 35–49 years and at the age of 20–34 will increase by 28% and 46%. OBJECTIVES: To report a case of a 24-year-old female patient with CRC. CASE REPORT: A 24-year-old female patient came to the Emergency Room at Bendan Hospital, Pekalongan City, with complaints of bleeding since 1 year ago. There are complaints in the past 6 months; the patient’s weight has decreased by up to 20 kg. Rectal toucher examination revealed normal (+) anal sphincter tone, a palpable mass in the anal canal, and was fragile; there were feces and blood in gloves. Abdominal ultrasonography found a solid tumor mass in the rectum area with a volume of 181 cc, suggesting a malignancy of the rectum. During a colonoscopy, a circular, fragile, and easily bleeding tumor was found, approximately 1 cm from the anal verge, and then biopsy was performed. Histopathological examination of the colon biopsy suggests a well-differentiated, rectosigmoid, NOS adenocarcinoma. The patient then underwent surgery using the Miles procedure technique. The patient’s condition after the operation improved, so after a week of treatment, the patient was able to undergo outpatient treatment. CONCLUSION: A complete history, physical examination, and supporting investigation are very useful in early detection of colorectal carcinoma, especially in young patients.

Somatic Variants in DNA Damage Response Genes in Ovarian Cancer Patients Using Whole-exome Sequencing.

Several clinical trials have investigated homologous recombination deficiency and BRCA1/2 status to select ovarian cancer patients for treatment with poly(ADP-ribose) polymerase-inhibitors (PARPi), but less attention has been given to other DNA-damage response (DDR) pathways. Therefore, we investigated somatic single/multiple nucleotide variants and small insertions/deletions in exonic and splice-site regions of 356 DDR genes to examine whether genes other than BRCA1/2 are altered. Whole-exome sequencing data from eight high-grade serous adenocarcinoma (HGSC) and four clear cell carcinoma (oCCC) patients were analyzed. Forty-two variants (pathogenic, likely pathogenic or variants of uncertain significance) in 28 genes from DDR pathways were identified. Seven out of nine TP53 variants were previously described in The Cancer Genome Atlas Ovarian Cancer; other variants were found in 23 out of 28 unique genes, whereas no variants were reported in FAAP24, GTF2H4, POLE4, RPA3, and XRCC4. As the identified variants were not only limited to well-known TP53, BRCA1/2, and HR-associated genes, our study might contribute to the better understanding of which DDR pathways potentially influence disease progression. Moreover, they may display a potential role as biomarkers to predict platinum-based chemotherapy or PARPi treatment response or disease progression, as differences in disrupted DDR pathways were observed between patients with long and short overall survival in HGSC and oCCC groups.

Association of high-grade prostatic intraepithelial neoplasia immunohistochemical profile with acinar adenocarcinoma of the prostate.

Prostate carcinoma is the second leading cause of cancer and the fifth cause of cancer death in men worldwide. To know high-grade prostatic intraepithelial neoplasia and prostate acinar adenocarcinoma immunohistochemical profiles. Observational, analytical, cross-sectional, retrospective study of specimens obtained by cutting needle biopsy and prostate resection from subjects diagnosed with acinar adenocarcinoma of the prostate and high-grade prostatic intraepithelial neoplasia between January 2015 and December 2020. Tissue microarrays were performed and, subsequently, immunohistochemical studies for BCL2, EGFR, p53, Her2/neu and Ki67. Descriptive statistics were used to analyze clinicopathological factors. Qualitative variables were compared with Fisher's exact test. Twenty-three patients were studied; eight (34%) with angiolymphatic invasion, 14 (60.8%) with perineural invasion, five (21.2%) with prostatitis, and four (17.3%) with fibroadenomatous hyperplasia. HER2/neu (p = 0.1023), p53 (p = 1) and BCL2 expression (p = 0.4136) was observed. HER2/neu increased expression was identified in high-grade prostatic intraepithelial neoplasia and acinar adenocarcinoma of the prostate.

Primary Cutaneous Apocrine Adenocarcinoma of the Axilla in Klinefelter’s Syndrome: A Case Report

Background: Primary Cutaneous Apocrine Adenocarcinoma (PCAA) is a rare cutaneous malignancy that arises from areas rich in apocrine glands, particularly the axilla. There are less than 200 cases described in the literature. However, none has been reported in patients with Klinefelter syndrome, who are known to have an increased risk of breast cancer, Case Presentation: We present a 66-year-old man with a significant family history of breast cancer who developed a right axillary mass initially thought to be hidradenitis suppurativa. On physical examination, he had bilateral gynecomastia. Laboratory workup was significant for hyper-gonadotrophic hypogonadism. Mammography showed bilateral gynecomastia with no radiologic evidence of malignancy in the breast, while magnetic resonance imaging of the breast revealed two suspicious masses seen in the right breast. Excision biopsy of the right axillary mass revealed a high-grade invasive adenocarcinoma involving the dermis and subcutis; the cells had prominent nucleoli vesicular chromatin pattern and voluminous eosinophilic cytoplasm consistent with primary cutaneous apocrine adenocarcinoma. Immunohistochemistry was positive for GATA-3, GCDFP-15, E-cadherin, ER Positive, PR negative, HER 2 by IHC 3 +, and androgen receptor-positive 100 %. Positron emission tomography showed mildly hypermetabolic asymmetric gynecomastia, right greater than left, but no abnormal hypermetabolic activity to suggest malignancy. Karyotype confirmed 47 XXY chromosomes which on. The patient underwent bilateral mastectomy due to his preference; excised breast tissue was negative for malignancy. Conclusion: We presented the first case report of PCAA of axillary in Klinefelter syndrome. Awareness of this association and differentiation from breast carcinoma should be undertaken.

Association of high-grade prostatic intraepithelial neoplasia immunohistochemical profile with acinar adenocarcinoma of the prostate

Prostate carcinoma is the second leading cause of cancer and the fifth cause of cancer death in men worldwide. To know high-grade prostatic intraepithelial neoplasia and prostate acinar adenocarcinoma immunohistochemical profiles. Observational, analytical, cross-sectional, retrospective study of specimens obtained by cutting needle biopsy and prostate resection from subjects diagnosed with acinar adenocarcinoma of the prostate and high-grade prostatic intraepithelial neoplasia between January 2015 and December 2020. Tissue microarrays were performed and, subsequently, immunohistochemical studies for BCL2, EGFR, p53, Her2/neu and Ki67. Descriptive statistics were used to analyze clinicopathological factors. Qualitative variables were compared with Fisher's exact test. Twenty-three patients were studied; eight (34%) with angiolymphatic invasion, 14 (60.8%) with perineural invasion, five (21.2%) with prostatitis, and four (17.3%) with fibroadenomatous hyperplasia. HER2/neu (p = 0.1023), p53 (p = 1) and BCL2 expression (p = 0.4136) was observed. HER2/neu increased expression was identified in high-grade prostatic intraepithelial neoplasia and acinar adenocarcinoma of the prostate.

MP11-17 SIGNET RING CELLS ON PROSTATE BIOPSY IN THE SETTING OF PRIMARY ACINAR ADENOCARCINOMA

You have accessJournal of UrologyCME1 Apr 2023MP11-17 SIGNET RING CELLS ON PROSTATE BIOPSY IN THE SETTING OF PRIMARY ACINAR ADENOCARCINOMA Daniel Nemirovsky, Zoe Blake, Alexander Kenigsberg, Neil Mendrihatta, Jacob Enders, Michael Rothberg, Antoun Toubaji, Sandeep Gurram, and Peter Pinto Daniel NemirovskyDaniel Nemirovsky More articles by this author , Zoe BlakeZoe Blake More articles by this author , Alexander KenigsbergAlexander Kenigsberg More articles by this author , Neil MendrihattaNeil Mendrihatta More articles by this author , Jacob EndersJacob Enders More articles by this author , Michael RothbergMichael Rothberg More articles by this author , Antoun ToubajiAntoun Toubaji More articles by this author , Sandeep GurramSandeep Gurram More articles by this author , and Peter PintoPeter Pinto More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003226.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Signet ring cells (SRC) on pathology are typically associated with gastric carcinoma, but are also rarely seen in other malignancies, including prostate cancer (PCa). Though primary SRC adenocarcinoma of the prostate is a well-described aggressive malignancy, there is a paucity of literature describing the oncologic significance of SRC on prostate biopsy in patients with primary acinar adenocarcinoma. In this study, we aimed to describe the clinicopathologic characteristics and outcomes of these patients. METHODS: A prospectively collected database of patients with PCa was queried for presence of SRC on prostate biopsy. Patients with primary SRC adenocarcinoma were excluded. Demographics, imaging, pathological and treatment data were collected. Patients who received radical prostatectomy (RP) without neoadjuvant therapy were examined for adverse features, including extraprostatic extension (EPE), seminal vesicle invasion (SVI), lymphovascular invasion (LVI), as well as post-RP biochemical recurrence (BCR). RESULTS: Between 2014-2022, 46 patients with SRC on biopsy were found. Clinicopathologic data is displayed in Table 1. Patients had a mean of 2.2 cores with SRC on biopsy, and 40/46 (87.0%) of these cores were GG ≥4. Oncologic outcomes are shown in Table 2. Every lesion containing SRC was MRI-visible, 93.3% of which were PIRADS 4 or 5. Of 14 patients with available whole-mount pathology data after RP, 12/14 (85.7%) had Gleason grade group ≥ 3 disease. 5/14 (35.7%) patients had EPE, 4/14 (28.6%) had SVI, and 3/14 (21.4%) had LVI. 3/14 (21.4%) patients experienced BCR post-RP, with a median time to BCR of 12 months (3-28). CONCLUSIONS: Signet ring cells on biopsy were typically identified in the setting of MRI-visible high-grade acinar adenocarcinoma and frequently associated with adverse features on whole mount pathology. While the biological significance of signet ring features in prostate cancer remains to be elucidated, clinical and pathologic correlates suggest an association with high risk disease and should prompt further study of this entity. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e131 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Daniel Nemirovsky More articles by this author Zoe Blake More articles by this author Alexander Kenigsberg More articles by this author Neil Mendrihatta More articles by this author Jacob Enders More articles by this author Michael Rothberg More articles by this author Antoun Toubaji More articles by this author Sandeep Gurram More articles by this author Peter Pinto More articles by this author Expand All Advertisement PDF downloadLoading ...