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Titolo:
Pleomorphic lobular carcinoma: Morphology, immunohistochemistry, and molecular analysis
Autore:
Middleton, LP; Palacios, DM; Bryant, BR; Krebs, P; Otis, CN; Merino, MJ;
Indirizzi:
NCI, Bethesda, MD 20892 USA NCI Bethesda MD USA 20892NCI, Bethesda, MD 20892 USA Tufts Univ, Sch Med, Baystate Med Ctr, Springfield, MA 01199 USA Tufts Univ Springfield MA USA 01199 te Med Ctr, Springfield, MA 01199 USA
Titolo Testata:
AMERICAN JOURNAL OF SURGICAL PATHOLOGY
fascicolo: 12, volume: 24, anno: 2000,
pagine: 1650 - 1656
SICI:
0147-5185(200012)24:12<1650:PLCMIA>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
SIGNET-RING CELLS; ONCOGENE PROTEIN; BREAST-CARCINOMA; DNA ANALYSIS; VARIANTS; FEATURES; THERAPY; CANCER;
Keywords:
breast; pleomorphic lobular carcinoma; prognostic markers; Her 2; p53;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Middleton, LP Univ Texas, MD Anderson Canc Ctr, Dept Pathol, Box 85,1515 Holcombe Blvd, Houston, TX 77030 USA Univ Texas Box 85,1515 Holcombe Blvd Houston TX USA 77030 SA
Citazione:
L.P. Middleton et al., "Pleomorphic lobular carcinoma: Morphology, immunohistochemistry, and molecular analysis", AM J SURG P, 24(12), 2000, pp. 1650-1656

Abstract

Infiltrating pleomorphic lobular carcinoma (PLC) is an aggressive variant of infiltrating lobular carcinoma. Recently, in situ changes identical to PLC (PLCIS) have been described. The role of prognostic markers and their correlation with therapeutics, clinical outcome, and genetic changes is not well established in PLC. The authors examined 38 cases of this entity to understand better this tumor's biology. Immunohistochemical (IHC) analysis wasperformed in 21 specimens for estrogen and progesterone steroid receptors,p53, Her 2 (p185), and GCDFP-15. Genomic deoxyribonucleic acid was obtained from microdissected tumor as well as normal control cells, and loss of heterozygosity was investigated at the ESR (16q24), p53 (TP53 17p), Her 2 (17q 11-12), and BRCA 1 (17q12-25) loci. In this series, the average patient age was 57.5 years (age range, 24-92 years). Twenty-seven women were postmenopausal. Tumor size ranged from 1.2 to 25 cm. Six patients were a pathologic stage I; 19, stage II; 12, stage III; and one, stage IV. Histologically, multifocal nodular aggregates of discohesive pleomorphic tumor cells were seen interspersed in dense and fibrotic breast parenchyma. Twenty-nine percent of the specimens demonstrated associated signet ring cells. The remainder had dishesive, globoid, plasmacytoid cells with high-grade nuclear features. PLCIS was identified in 17 of 38 patients (45%), and lobular carcinoma in situ (LCIS) was noted in 8 patients (21%). IHC analysis showed estrogen immunoreactivity in 81%, progesterone in 67%, GCDFP-15 in 71%, and Her 2 in81% (2+ to 3+ membranous staining) of specimens. Antibodies to p53 stainedthe tumor cell nuclei in 48% of the tumors. Loss of heterozygosity was identified in 52% of the specimens at the p53 locus, 18% at the ESR locus, 19%to 24% at the Her 2 loci, and 27% to 32% at the BRCA 1 locus. Follow-up was available in 19 patients and ranged from 12 months to 15 years (mean, 73 months). Seven patients had no evidence of disease at last examination (range, 1-15 years), three patients were alive with disease (range, 2-14 years), and nine patients were dead of disease (range, 2 months-9 years). Six patients had subsequent diagnoses of tumor in the contralateral breast. Analysis shows that PLC tends to appear in older postmenopausal women who presentwith locally advanced disease. PLCIS was found to be associated with PLC 45% of the time, The aggressive clinical course of patients with PLC is supported by tumor immunoreactivity with unfavorable markers Her 2 and p53. Overexpression of Her 2 in PLC may be therapeutically relevant, enabling the use of novel chemotherapeutic drugs like Herceptin. Interestingly, tumors that were Her 2, immunoreactive also maintained estrogen hormone immunoreactivity.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 16/07/20 alle ore 20:01:28