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具有新型 LTK 融合的梭形细胞肿瘤 - 扩大激酶融合阳性软组织肿瘤谱。

Spindle cell neoplasms with novel LTK fusion - Expanding the spectrum of kinase fusion-positive soft tissue tumors.

机构信息

Department of Pathology, School of Clinical Medicine, The University of Hong Kong, Hong Kong.

Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, Ohio, USA.

出版信息

Genes Chromosomes Cancer. 2024 Mar;63(3):e23227. doi: 10.1002/gcc.23227.


DOI:10.1002/gcc.23227
PMID:38517106
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10963038/
Abstract

AIMS: Kinase fusion-positive soft tissue tumors represent an emerging, molecularly defined group of mesenchymal tumors with a wide morphologic spectrum and diverse activating kinases. Here, we present two cases of soft tissue tumors with novel LTK fusions. METHODS AND RESULTS: Both cases presented as acral skin nodules (big toe and middle finger) in pediatric patients (17-year-old girl and 2-year-old boy). The tumors measured 2 and 3 cm in greatest dimension. Histologically, both cases exhibited bland-looking spindle cells infiltrating adipose tissue and accompanied by collagenous stroma. One case additionally displayed perivascular hyalinization and band-like stromal collagen. Both cases exhibited focal S100 staining, and one case had patchy coexpression of CD34. Targeted RNA-seq revealed the presence of novel in-frame MYH9::LTK and MYH10::LTK fusions, resulting in upregulation of LTK expression. Of interest, DNA methylation-based unsupervised clustering analysis in one case showed that the tumor clustered with dermatofibrosarcoma protuberans (DFSP). One tumor was excised with amputation with no local recurrence or distant metastasis at 18-month follow-up. The other case was initially marginally excised with local recurrence after one year, followed by wide local excision, with no evidence of disease at 10 years of follow-up. CONCLUSIONS: This is the first reported case series of soft tissue tumors harboring LTK fusion, expanding the molecular landscape of soft tissue tumors driven by activating kinase fusions. Furthermore, studies involving a larger number of cases and integrated genomic analyses will be warranted to fully elucidate the pathogenesis and classification of these tumors.

摘要

目的:激酶融合阳性的软组织肿瘤代表了一组新兴的、分子定义明确的间叶性肿瘤,具有广泛的形态学谱和不同的激活激酶。在这里,我们报告了两例具有新型 LTK 融合的软组织肿瘤。

方法和结果:两例均为儿童患者(17 岁女孩和 2 岁男孩)四肢皮肤结节(大脚趾和中指)。肿瘤最大径为 2cm 和 3cm。组织学上,两例均表现为良性梭形细胞浸润脂肪组织,并伴有胶原基质。一例还显示血管周围玻璃样变和带状间质胶原。两例均有局灶性 S100 染色,一例有 CD34 斑片状共表达。靶向 RNA-seq 显示存在新型框内 MYH9::LTK 和 MYH10::LTK 融合,导致 LTK 表达上调。有趣的是,一例肿瘤的基于 DNA 甲基化的无监督聚类分析显示,该肿瘤与隆突性皮肤纤维肉瘤(DFSP)聚类。一例肿瘤行截肢切除,18 个月随访无局部复发或远处转移。另一例最初行边缘切除,一年后局部复发,随后行广泛局部切除,10 年随访无疾病证据。

结论:这是首例报道的 LTK 融合软组织肿瘤病例系列,扩大了由激活激酶融合驱动的软组织肿瘤的分子图谱。此外,需要进行更多病例的研究和综合基因组分析,以充分阐明这些肿瘤的发病机制和分类。

相似文献

[1]
Spindle cell neoplasms with novel LTK fusion - Expanding the spectrum of kinase fusion-positive soft tissue tumors.

Genes Chromosomes Cancer. 2024-3

[2]
MYH9::LTK Fusion in a Pediatric Acral Soft Tissue Spindle Cell Neoplasm.

Genes Chromosomes Cancer. 2024-10

[3]
Novel PPP1CB-ALK fusion in spindle cell tumor defined by S100 and CD34 coexpression and distinctive stromal and perivascular hyalinization.

Genes Chromosomes Cancer. 2020-8

[4]
A spindle cell neoplasm with MYH9::EGFR fusion and co-expression of S100 and CD34, further expanding the family of kinase fusion positive spindle cell neoplasms.

Genes Chromosomes Cancer. 2023-8

[5]
Soft tissue tumors characterized by a wide spectrum of kinase fusions share a lipofibromatosis-like neural tumor pattern.

Genes Chromosomes Cancer. 2020-10

[6]
GAB1-ABL1 fusions in tumors that have histologic overlap with NTRK-rearranged spindle cell tumors.

Genes Chromosomes Cancer. 2021-9

[7]
Kinase fusion positive intra-osseous spindle cell tumors: A series of eight cases with review of the literature.

Genes Chromosomes Cancer. 2024-1

[8]
Spindle Cell Lesions with Oncogenic EGFR Kinase Domain Aberrations: Expanding the Spectrum of Protein Kinase-Related Mesenchymal Tumors.

Mod Pathol. 2024-9

[9]
Spindle Cell Tumors With RET Gene Fusions Exhibit a Morphologic Spectrum Akin to Tumors With NTRK Gene Fusions.

Am J Surg Pathol. 2019-10

[10]
Spindle cell tumor with CD34 and S100 co-expression and distinctive stromal and perivascular hyalinization showing EML4-ALK fusion.

J Cutan Pathol. 2021-7

本文引用的文献

[1]
Rare Variants of Dermatofibrosarcoma Protuberans: Clinical, Histologic, and Molecular Features and Diagnostic Pitfalls.

Dermatopathology (Basel). 2023-1-29

[2]
Novel Fusion in a Primary Bone Sarcoma: Expanding the spectrum of Fusion Sarcoma.

Int J Surg Pathol. 2022-9

[3]
The CLIP1-LTK fusion is an oncogenic driver in non-small-cell lung cancer.

Nature. 2021-12

[4]
Dermatofibrosarcoma protuberans with platelet-derived growth factor-D rearrangement; two cases with morphologically distinct presentations.

J Cutan Pathol. 2022-3

[5]
Novel TNC-PDGFD fusion in fibrosarcomatous dermatofibrosarcoma protuberans: a case report.

Diagn Pathol. 2021-7-13

[6]
Sarcoma classification by DNA methylation profiling.

Nat Commun. 2021-1-21

[7]
Accurate and efficient detection of gene fusions from RNA sequencing data.

Genome Res. 2021-3

[8]
Broadening the spectrum of NTRK rearranged mesenchymal tumors and usefulness of pan-TRK immunohistochemistry for identification of NTRK fusions.

Mod Pathol. 2021-2

[9]
Soft tissue tumors characterized by a wide spectrum of kinase fusions share a lipofibromatosis-like neural tumor pattern.

Genes Chromosomes Cancer. 2020-10

[10]
Emerging soft tissue tumors with kinase fusions: An overview of the recent literature with an emphasis on diagnostic criteria.

Genes Chromosomes Cancer. 2020-8

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