Yoshida Akihiko
Department of Diagnostic Pathology, National Cancer Center Hospital, Tokyo, Japan.
Rare Cancer Center, National Cancer Center, Tokyo, Japan.
Histopathology. 2024 Jan;84(1):86-101. doi: 10.1111/his.15063. Epub 2023 Oct 24.
NUT carcinoma and thoracic SMARCA4-deficient undifferentiated tumour are unique entities in the 5th edition of the World Health Organisation (WHO) Classification of Thoracic Tumours, whose definitions include molecular genetic abnormalities. These aggressive tumours require rapid work-ups on biopsies, but a broad list of differential diagnoses poses challenges for practising pathologists. This review provides an update on their key clinicopathological and molecular characteristics, as well as controversies regarding tumour classification and diagnostic strategy. Phenotypical assessment plays a substantial role in diagnosis because recurrent and predictable clinicopathological findings exist, including robust immunohistochemical phenotypes. Accurate diagnosis is crucial for appropriate management and a clearer understanding of the disease.
NUT癌和胸段SMARCA4缺陷型未分化肿瘤是世界卫生组织(WHO)《胸段肿瘤分类》第5版中的独特实体,其定义包括分子遗传学异常。这些侵袭性肿瘤需要对活检组织进行快速检查,但众多的鉴别诊断给病理科医生带来了挑战。本综述提供了关于它们关键的临床病理和分子特征的最新信息,以及关于肿瘤分类和诊断策略的争议。表型评估在诊断中起着重要作用,因为存在反复出现且可预测的临床病理表现,包括强大的免疫组化表型。准确诊断对于恰当的管理和更清晰地了解该疾病至关重要。