Department of Pathology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Studničkova 2, 128 00, Prague 2, Czech Republic.
Department of Abdominal, Thoracic Surgery and Traumatology, First Faculty of Medicine, Charles University and General University Hospital in Prague, U Nemocnice 2, 128 00, Prague 2, Czech Republic.
Diagn Pathol. 2023 Jan 27;18(1):9. doi: 10.1186/s13000-023-01304-0.
BACKGROUND: Clear cell (hemangioblastoma-like) stromal tumor of the lung (CCSTL) is a rare pulmonary neoplasm. Recently, 9 cases of CCSTL harboring the YAP1-TFE3 gene fusion have been described, and it has been suggested that this aberration could be a characteristic feature of this tumor. CASE PRESENTATION: We here report another case of CCSTL in a 57-year-old male, which presented as a solitary lung nodule 45 mm in the greatest dimension. Microscopically, the tumor consisted of epithelioid to spindled cells with mild-to-moderate nuclear atypia, finely granular or vesicular chromatin, and small nucleoli. Nuclear indentations were a common finding. There were up to 3 mitoses per 10 HPF. The cytoplasm was slightly eosinophilic or clear. Scattered non-tumor large multinucleated cells were present. Immunohistochemically, the tumor cells showed diffuse positivity for TFE3, CD10, vimentin, and IFITM1. Other markers examined were negative, and the expression of lineage-specific markers was not found. NGS analysis revealed a fusion transcript of the YAP1 and TFE3 genes, and a pathogenic variant of the MUTYH gene. CONCLUSION: Our finding supports the recent data suggesting that CCSTL represents a distinct entity characterized by the recurrent YAP1-TFE3 fusion.
背景:肺透明细胞(血管母细胞瘤样)间质瘤(CCSTL)是一种罕见的肺部肿瘤。最近,已经描述了 9 例携带 YAP1-TFE3 基因融合的 CCSTL 病例,并且有人提出这种异常可能是该肿瘤的一个特征。
病例介绍:我们在此报告另 1 例 57 岁男性的 CCSTL 病例,其表现为最大径为 45mm 的孤立性肺结节。镜下,肿瘤由上皮样至梭形细胞组成,细胞核具有轻至中度异型性,细颗粒状或泡状染色质,小核仁。核内凹陷是常见的发现。每 10 个高倍视野中最多有 3 个有丝分裂象。细胞质呈轻度嗜酸性或透明。散在分布的非肿瘤性多核巨细胞。免疫组化染色显示肿瘤细胞弥漫性表达 TFE3、CD10、波形蛋白和 IFITM1。其他检查的标志物均为阴性,也未发现谱系特异性标志物的表达。NGS 分析显示 YAP1 和 TFE3 基因融合转录本和 MUTYH 基因的致病性变异。
结论:我们的发现支持最近的数据表明,CCSTL 代表一种以 YAP1-TFE3 融合为特征的独特实体。
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