ALK is a Specific Diagnostic Marker for Inflammatory Myofibroblastic Tumor of the Uterus.

2.50
Hdl Handle:
http://hdl.handle.net/11287/620800
Title:
ALK is a Specific Diagnostic Marker for Inflammatory Myofibroblastic Tumor of the Uterus.
Authors:
Mohammad, N. [et al]; Cope, Nichola
Abstract:
Inflammatory myofibroblastic tumor (IMT) is a myofibroblastic/fibroblastic neoplasm of intermediate malignant potential. It is frequently characterized by genetic fusion of ALK with a variety of partner genes, which results in the activated ALK signaling pathway that can be targeted with kinase inhibitors. IMTs can occur in the gynecologic tract, with the uterus (corpus and cervix) being the most frequent site. Recent studies suggest that IMTs in the gynecologic tract are underrecognized, and a low-threshold for performing ALK immunohistochemistry has been proposed. The aim of this study was to evaluate the specificity of ALK immunohistochemistry for IMTs among uterine mesenchymal and mixed epithelial/mesenchymal tumors. We performed ALK immunohistochemistry on 14 molecularly confirmed uterine IMTs and 260 other uterine pure mesenchymal and mixed epithelial/mesenchymal tumors. Cases showing any positive cytoplasmic and/or membranous staining of the tumor cells were considered to be ALK positive. All 14 IMTs were confirmed to harbor ALK genetic fusion by RNA sequencing, and ALK immunostaining in the form of granular cytoplasmic positivity with paranuclear accentuation was observed in all 14 cases. ALK was negative (complete absence of staining) in all the other pure mesenchymal tumors and in all mixed epithelial/mesenchymal tumors examined. Our findings show that ALK is a highly specific diagnostic immunohistochemical marker for ALK fusion in uterine mesenchymal tumors. In the work-up of uterine mesenchymal tumors, particularly smooth muscle tumors showing myxoid stromal changes, a diagnosis of IMT should be strongly considered if ALK positivity is observed.
Citation:
ALK is a Specific Diagnostic Marker for Inflammatory Myofibroblastic Tumor of the Uterus. 2018 Am. J. Surg. Pathol.
Publisher:
Wolters Kluwer
Journal:
The American journal of surgical pathology
Issue Date:
13-Jul-2018
URI:
http://hdl.handle.net/11287/620800
DOI:
10.1097/PAS.0000000000001120
PubMed ID:
30015720
Additional Links:
http://dx.doi.org/10.1097/PAS.0000000000001120
Type:
Journal Article
Language:
en
ISSN:
1532-0979
Appears in Collections:
Exeter Clinical Laboratory International (Blood Sciences, Genetics, Cellular Pathology & Microbiology); 2018 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMohammad, N. [et al]en
dc.contributor.authorCope, Nicholaen
dc.date.accessioned2018-07-25T11:51:35Z-
dc.date.available2018-07-25T11:51:35Z-
dc.date.issued2018-07-13-
dc.identifier.citationALK is a Specific Diagnostic Marker for Inflammatory Myofibroblastic Tumor of the Uterus. 2018 Am. J. Surg. Pathol.en
dc.identifier.issn1532-0979-
dc.identifier.pmid30015720-
dc.identifier.doi10.1097/PAS.0000000000001120-
dc.identifier.urihttp://hdl.handle.net/11287/620800-
dc.description.abstractInflammatory myofibroblastic tumor (IMT) is a myofibroblastic/fibroblastic neoplasm of intermediate malignant potential. It is frequently characterized by genetic fusion of ALK with a variety of partner genes, which results in the activated ALK signaling pathway that can be targeted with kinase inhibitors. IMTs can occur in the gynecologic tract, with the uterus (corpus and cervix) being the most frequent site. Recent studies suggest that IMTs in the gynecologic tract are underrecognized, and a low-threshold for performing ALK immunohistochemistry has been proposed. The aim of this study was to evaluate the specificity of ALK immunohistochemistry for IMTs among uterine mesenchymal and mixed epithelial/mesenchymal tumors. We performed ALK immunohistochemistry on 14 molecularly confirmed uterine IMTs and 260 other uterine pure mesenchymal and mixed epithelial/mesenchymal tumors. Cases showing any positive cytoplasmic and/or membranous staining of the tumor cells were considered to be ALK positive. All 14 IMTs were confirmed to harbor ALK genetic fusion by RNA sequencing, and ALK immunostaining in the form of granular cytoplasmic positivity with paranuclear accentuation was observed in all 14 cases. ALK was negative (complete absence of staining) in all the other pure mesenchymal tumors and in all mixed epithelial/mesenchymal tumors examined. Our findings show that ALK is a highly specific diagnostic immunohistochemical marker for ALK fusion in uterine mesenchymal tumors. In the work-up of uterine mesenchymal tumors, particularly smooth muscle tumors showing myxoid stromal changes, a diagnosis of IMT should be strongly considered if ALK positivity is observed.en
dc.language.isoenen
dc.publisherWolters Kluweren
dc.relation.urlhttp://dx.doi.org/10.1097/PAS.0000000000001120en
dc.rightsArchived with thanks to The American journal of surgical pathologyen
dc.subjectWessex Classification Subject Headings::Oncology. Pathology.en
dc.titleALK is a Specific Diagnostic Marker for Inflammatory Myofibroblastic Tumor of the Uterus.en
dc.typeJournal Articleen
dc.identifier.journalThe American journal of surgical pathologyen
dc.type.versionIn press (epub ahead of print)en

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