Hinds Brian, Agulló Pérez Alfredo D, LeBoit Philip E, McCalmont Timothy H, North Jeffrey P
Department of Dermatology, University of California San Francisco, San Francisco, California.
Department of Pathology, University of California San Francisco, San Francisco, California.
J Cutan Pathol. 2017 Aug;44(8):665-671. doi: 10.1111/cup.12965. Epub 2017 Jun 13.
Pleomorphic fibroma is a curious neoplasm that exhibits striking cytologic atypia, yet behaves in benign fashion. The cytologic features include single cells with pleomorphic nuclei and scattered giant cells resembling the neoplastic cells of pleomorphic lipoma, a tumor with known retinoblastoma (Rb) loss.
We assessed the demographic and histopathologic features of a cohort of 26 pleomorphic fibromas, including assessment with immunostaining for Rb, p16 and Ki-67. Array comparative genomic hybridization (aCGH) was used to assess a limited number of tumors for genomic aberrations.
Of the 26 pleomorphic fibromas analyzed, 19 occurred in women and 7 in men, with a mean age of 47 years. The anatomic locations were variable. Immunostaining showed loss of Rb protein expression in all cases and diffuse p16 expression in 85%. Ki-67 labeling rate was below 10% in 85%. Chromosome 13q loss was found in 7 of 7 pleomorphic fibromas assessed with aCGH. Recurrent loss of 17p, 16q and 10q were also found.
We report recurrent loss of RB1 on chromosome 13q in pleomorphic fibromas, confirmed by both protein expression loss and loss of 13q by aCGH. This result indicates pleomorphic fibroma shares the same genetic abnormalities as spindle cell and pleomorphic lipomas.
多形性纤维瘤是一种奇特的肿瘤,其细胞具有显著的异型性,但生物学行为呈良性。细胞特征包括具有多形性核的单个细胞和散在的巨细胞,类似于多形性脂肪瘤的肿瘤细胞,后者已知存在视网膜母细胞瘤(Rb)缺失。
我们评估了一组26例多形性纤维瘤的人口统计学和组织病理学特征,包括用免疫染色评估Rb、p16和Ki-67。采用阵列比较基因组杂交(aCGH)评估有限数量肿瘤的基因组畸变。
在分析的26例多形性纤维瘤中,19例发生于女性,7例发生于男性,平均年龄47岁。解剖部位各异。免疫染色显示所有病例Rb蛋白表达缺失,85%病例p16弥漫性表达。85%病例Ki-67标记率低于10%。在用aCGH评估的7例多形性纤维瘤中,7例发现13q染色体缺失。还发现17p、16q和10q反复缺失。
我们报告多形性纤维瘤中13q染色体上RB1反复缺失,蛋白表达缺失和aCGH检测到13q缺失均证实了这一点。这一结果表明多形性纤维瘤与梭形细胞脂肪瘤和多形性脂肪瘤具有相同的基因异常。