Kim Moon Joo, Liu Yi A, Wang Yunyi, Ning Jing, Cho Woo Cheal
Department of Anatomic Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Department of Pathology and Laboratory Medicine, Royal Columbian Hospital, University of British Columbia, New Westminster, BC V3L 3W7, Canada.
Dermatopathology (Basel). 2024 Jul 15;11(3):200-208. doi: 10.3390/dermatopathology11030021.
Although extensively studied in cutaneous epithelial neoplasms, the TRPS1 immunoreactivity in cutaneous mesenchymal neoplasms and tumors of uncertain differentiation (CMNTUDs), such as atypical fibroxanthoma (AFX), remains largely unexplored. We assessed TRPS1 immunoreactivity in 135 CMNTUDs, comprising 46 fibrohistiocytic/fibroblastic tumors, 28 vascular tumors, 24 peripheral nerve sheath tumors (PNSTs), 21 tumors of uncertain differentiation, and 16 smooth muscle tumors. Additionally, we included selected cases of melanoma with spindled cell morphology or desmoplastic features (n = 9) and sarcomatoid squamous cell carcinoma (SSCC) (n = 5) to compare TRPS1 expression patterns with those of AFX. TRPS1 expression was prevalent in dermatofibromas (24/24), leiomyomas (8/8), AFXs/pleomorphic dermal sarcoma (PDS) (20/21), dermatofibrosarcomas protuberans (14/22), and leiomyosarcomas (6/8). It was uncommon in angiosarcomas (3/20), Kaposi sarcomas (2/8), and neurofibromas (5/17) and absent in perineuriomas (0/2). AFXs/PDS exhibited the highest median H-score of 240, contrasting with minimal TRPS1 immunoreactivity in vascular neoplasms and PNSTs, with median H-scores consistently below 10. Significant differences in H-score were observed between AFXs/PDS and angiosarcomas ( < 0.001), melanomas ( < 0.001), and leiomyosarcomas ( = 0.029). However, no significant difference was found compared to SSCCs, suggesting limited discriminatory power of TRPS1 in this context. This study sheds light on TRPS1 expression patterns in a subset of CMNTUDs, extending beyond prior studies primarily focused on epithelial tumors, while underscoring potential pitfalls associated with TRPS1 immunohistochemistry.
尽管在皮肤上皮性肿瘤中对TRPS1免疫反应性进行了广泛研究，但在皮肤间叶性肿瘤和分化不确定的肿瘤（CMNTUDs），如非典型纤维黄色瘤（AFX）中，TRPS1免疫反应性在很大程度上仍未得到探索。我们评估了135例CMNTUDs中的TRPS1免疫反应性，其中包括46例纤维组织细胞/成纤维细胞肿瘤、28例血管肿瘤、24例周围神经鞘瘤（PNSTs）、21例分化不确定的肿瘤和16例平滑肌肿瘤。此外，我们纳入了具有梭形细胞形态或促纤维增生特征的黑色素瘤（n = 9）和肉瘤样鳞状细胞癌（SSCC）（n = 5）的选定病例，以比较TRPS1表达模式与AFX的表达模式。TRPS1表达在皮肤纤维瘤（24/24）、平滑肌瘤（8/8）、AFX/多形性真皮肉瘤（PDS）（20/21）、隆突性皮肤纤维肉瘤（14/22）和平滑肌肉瘤（6/8）中普遍存在。在血管肉瘤（3/20）、卡波西肉瘤（2/8）和神经纤维瘤（5/17）中不常见，在神经束膜瘤（0/2）中不存在。AFX/PDS的中位H评分为240，是最高的，与之形成对比的是血管肿瘤和PNSTs中TRPS1免疫反应性极低，中位H评分始终低于10。在AFX/PDS与血管肉瘤（<0.001）、黑色素瘤（<0.001）和平滑肌肉瘤（=0.029）之间观察到H评分有显著差异。然而，与SSCC相比未发现显著差异，这表明在此背景下TRPS1的鉴别能力有限。本研究揭示了CMNTUDs亚组中的TRPS1表达模式，扩展了以往主要集中在上皮性肿瘤的研究，同时强调了与TRPS1免疫组织化学相关的潜在陷阱。
