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颅内间质瘤伴(新型)COX14::PTEN 重排。

Intracranial mesenchymal tumor with (novel) COX14::PTEN rearrangement.

机构信息

Unit of Anatomical Pathology, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy.

Unit of Human Anatomy and Histology, Department of Translational Biomedicine and Neuroscience (DiBraiN), University of Bari "Aldo Moro", Piazza Giulio Cesare 11, Bari, 70124, Italy.

出版信息

Acta Neuropathol Commun. 2023 Jun 13;11(1):95. doi: 10.1186/s40478-023-01596-9.

Abstract

Mesenchymal tumors of the central nervous system (CNS) include numerous entities, with different pathological features and biological behavior. Mesenchymal non-meningothelial tumors are rare and comprise neoplasms that are exclusive to the CNS or show peculiar features when occurring in the CNS compared with other sites. Within this group there are three new entities, classified on the basis of specific molecular alterations and included in the 5th edition of the WHO Classification of CNS Tumors: primary intracranial sarcoma; DICER1-mutant; CIC-rearranged sarcoma; intracranial mesenchymal tumor, FET::CREB fusion-positive. These tumors often show variable morphology, making diagnosis very challenging, although the implementation of molecular techniques has led to better characterization and more precise identification of these entities. However, many molecular alterations have yet to be discovered and some recently reported CNS tumors are currently missing an appropriate classification. Herein, we report the case of a 43-year-old man who presented with an intracranial mesenchymal tumor. Histopathological examination showed a wide spectrum of peculiar morphological features and a non-specific immunohistochemical profile. Whole transcriptome sequencing revealed the presence of a novel genetic rearrangement involving COX14 and PTEN genes, which has never been reported before in any other neoplasm. The tumor did not cluster in any defined methylation class of the brain tumor classifier, but resulted in a calibrated score of 0.89 for the methylation class "Sarcoma, MPNST-like", when analyzed by the sarcoma classifier. Our study is the first to report about this tumor with unique pathological and molecular features, characterized by a novel rearrangement between COX14 and PTEN genes. Other studies are necessary in order to define it as a new entity or as a novel rearrangement involving recently described and incompletely characterized CNS mesenchymal tumors.

摘要

中枢神经系统(CNS)的间叶性肿瘤包括许多实体,具有不同的病理特征和生物学行为。间叶性非脑膜内皮肿瘤罕见,包括仅发生在 CNS 的肿瘤或与其他部位相比在 CNS 中发生时具有特殊特征的肿瘤。在这一组中,有三个新实体,基于特定的分子改变进行分类,并包含在第 5 版 CNS 肿瘤 WHO 分类中:原发性颅内肉瘤;DICER1 突变;CIC 重排肉瘤;颅内间质性肿瘤,FET::CREB 融合阳性。这些肿瘤通常表现出不同的形态,使得诊断极具挑战性,尽管实施分子技术导致了对这些实体更好的特征描述和更精确的识别。然而,许多分子改变尚未被发现,一些最近报道的 CNS 肿瘤目前缺乏适当的分类。在此,我们报告了一名 43 岁男性的病例,他患有颅内间质性肿瘤。组织病理学检查显示出广泛的独特形态特征和非特异性免疫组织化学特征。全转录组测序显示存在一种新的基因重排,涉及 COX14 和 PTEN 基因,这在以前任何其他肿瘤中都从未报道过。该肿瘤未聚类到脑肿瘤分类器的任何定义甲基化类别中,但当通过肉瘤分类器分析时,其甲基化类别“肉瘤,MPNST 样”的校准评分为 0.89。我们的研究首次报道了具有独特病理和分子特征的这种肿瘤,其特征是 COX14 和 PTEN 基因之间的新型重排。需要进行其他研究以将其定义为新实体或涉及最近描述和不完全特征的 CNS 间质性肿瘤的新型重排。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/216e/10262555/e671ff578927/40478_2023_1596_Fig1_HTML.jpg

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