NFATc2-rearranged sarcomas: clinicopathologic, molecular, and cytogenetic study of 7 cases with evidence of AGGRECAN as a novel diagnostic marker
NFATc2 -rearranged sarcomas ( NFATc2 -Sarcomas) are infrequent round cell tumors characterized by EWSR1-NFATc2 fusions and FUS-NFATc2 fusions. Although our knowledge on these neoplasms has increased recently, novel diagnostic tools and more comprehensive series are still needed. Here, we describe th...
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01.10.2020
Elsevier Limited Nature Publishing Group: Open Access Hybrid Model Option B |
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| Abstract | NFATc2
-rearranged sarcomas (
NFATc2
-Sarcomas) are infrequent round cell tumors characterized by
EWSR1-NFATc2
fusions and
FUS-NFATc2
fusions. Although our knowledge on these neoplasms has increased recently, novel diagnostic tools and more comprehensive series are still needed. Here, we describe the features of a series of seven molecularly confirmed
NFATc2
-Sarcomas (
EWSR1
-
NFATc2
,
n
= 4;
FUS
-
NFATc2
,
n
= 3) and demonstrate the utility of AGGRECAN immunohistochemistry for their identification. Patients were four males and three females, ranging in age from 19 to 66 years (median: 33). All were primary bone tumors (femur,
n
= 4; tibia,
n
= 2; ilium,
n
= 1), frequently infiltrating the surrounding soft tissues. Treatment often consisted of neoadjuvant chemotherapy and surgery. Follow-up was available for six patients (median 18 months, range 5–102 months), three patients died of disease and four patients are currently alive. Histologically, tumors consisted of monotonous round cells growing in lobules and sheets in variable amounts of fibrous to myxoid stroma. Other findings included spindle cells, corded and trabecular architecture, nuclear pleomorphism, cartilaginous differentiation, and osteoid-like matrix. Histological response to neoadjuvant chemotherapy was poor in all resection specimens available for review (
n
= 4). Tumors were diffusely positive for AGGRECAN and CD99 (7/7), and a subset expressed Pan-Keratin (AE1-AE3; 3/6), S100 (2/6), BCOR (2/6), ETV-4 (2/5), WT1 (2/6), and ERG (2/5). Desmin, NKX3-1, and SATB2 were negative (0/6). Diffuse AGGRECAN staining was also seen in 8/129 round cell sarcomas used for comparison, including mesenchymal chondrosarcoma (7/26) and
CIC
-sarcoma (1/26). Array-CGH showed complex karyotypes with recurrent deletions of tumor suppressor genes (
CDKN2A/B, TUSC7, and DMD)
in three
FUS-NFATC2
cases and a simpler profile without homozygous losses in one
EWSR1
-
NFATc2
case. Segmental chromosomal gains covering the loci of the fusion genes were detected in both variants. Overall, our study confirms and expands previous observations on
NFATc2
-sarcomas and supports that AGGRECAN is a useful biomarker of these tumors. |
|---|---|
| AbstractList | NFATc2
-rearranged sarcomas (
NFATc2
-Sarcomas) are infrequent round cell tumors characterized by
EWSR1-NFATc2
fusions and
FUS-NFATc2
fusions. Although our knowledge on these neoplasms has increased recently, novel diagnostic tools and more comprehensive series are still needed. Here, we describe the features of a series of seven molecularly confirmed
NFATc2
-Sarcomas (
EWSR1
-
NFATc2
,
n
= 4;
FUS
-
NFATc2
,
n
= 3) and demonstrate the utility of AGGRECAN immunohistochemistry for their identification. Patients were four males and three females, ranging in age from 19 to 66 years (median: 33). All were primary bone tumors (femur,
n
= 4; tibia,
n
= 2; ilium,
n
= 1), frequently infiltrating the surrounding soft tissues. Treatment often consisted of neoadjuvant chemotherapy and surgery. Follow-up was available for six patients (median 18 months, range 5–102 months), three patients died of disease and four patients are currently alive. Histologically, tumors consisted of monotonous round cells growing in lobules and sheets in variable amounts of fibrous to myxoid stroma. Other findings included spindle cells, corded and trabecular architecture, nuclear pleomorphism, cartilaginous differentiation, and osteoid-like matrix. Histological response to neoadjuvant chemotherapy was poor in all resection specimens available for review (
n
= 4). Tumors were diffusely positive for AGGRECAN and CD99 (7/7), and a subset expressed Pan-Keratin (AE1-AE3; 3/6), S100 (2/6), BCOR (2/6), ETV-4 (2/5), WT1 (2/6), and ERG (2/5). Desmin, NKX3-1, and SATB2 were negative (0/6). Diffuse AGGRECAN staining was also seen in 8/129 round cell sarcomas used for comparison, including mesenchymal chondrosarcoma (7/26) and
CIC
-sarcoma (1/26). Array-CGH showed complex karyotypes with recurrent deletions of tumor suppressor genes (
CDKN2A/B, TUSC7, and DMD)
in three
FUS-NFATC2
cases and a simpler profile without homozygous losses in one
EWSR1
-
NFATc2
case. Segmental chromosomal gains covering the loci of the fusion genes were detected in both variants. Overall, our study confirms and expands previous observations on
NFATc2
-sarcomas and supports that AGGRECAN is a useful biomarker of these tumors. NFATc2-rearranged sarcomas (NFATc2-Sarcomas) are infrequent round cell tumors characterized by EWSR1-NFATc2 fusions and FUS-NFATc2 fusions. Although our knowledge on these neoplasms has increased recently, novel diagnostic tools and more comprehensive series are still needed. Here, we describe the features of a series of seven molecularly confirmed NFATc2-Sarcomas (EWSR1-NFATc2, n = 4; FUS-NFATc2, n = 3) and demonstrate the utility of AGGRECAN immunohistochemistry for their identification. Patients were four males and three females, ranging in age from 19 to 66 years (median: 33). All were primary bone tumors (femur, n = 4; tibia, n = 2; ilium, n = 1), frequently infiltrating the surrounding soft tissues. Treatment often consisted of neoadjuvant chemotherapy and surgery. Follow-up was available for six patients (median 18 months, range 5-102 months), three patients died of disease and four patients are currently alive. Histologically, tumors consisted of monotonous round cells growing in lobules and sheets in variable amounts of fibrous to myxoid stroma. Other findings included spindle cells, corded and trabecular architecture, nuclear pleomorphism, cartilaginous differentiation, and osteoid-like matrix. Histological response to neoadjuvant chemotherapy was poor in all resection specimens available for review (n = 4). Tumors were diffusely positive for AGGRECAN and CD99 (7/7), and a subset expressed Pan-Keratin (AE1-AE3; 3/6), S100 (2/6), BCOR (2/6), ETV-4 (2/5), WT1 (2/6), and ERG (2/5). Desmin, NKX3-1, and SATB2 were negative (0/6). Diffuse AGGRECAN staining was also seen in 8/129 round cell sarcomas used for comparison, including mesenchymal chondrosarcoma (7/26) and CIC-sarcoma (1/26). Array-CGH showed complex karyotypes with recurrent deletions of tumor suppressor genes (CDKN2A/B, TUSC7, and DMD) in three FUS-NFATC2 cases and a simpler profile without homozygous losses in one EWSR1-NFATc2 case. Segmental chromosomal gains covering the loci of the fusion genes were detected in both variants. Overall, our study confirms and expands previous observations on NFATc2-sarcomas and supports that AGGRECAN is a useful biomarker of these tumors.NFATc2-rearranged sarcomas (NFATc2-Sarcomas) are infrequent round cell tumors characterized by EWSR1-NFATc2 fusions and FUS-NFATc2 fusions. Although our knowledge on these neoplasms has increased recently, novel diagnostic tools and more comprehensive series are still needed. Here, we describe the features of a series of seven molecularly confirmed NFATc2-Sarcomas (EWSR1-NFATc2, n = 4; FUS-NFATc2, n = 3) and demonstrate the utility of AGGRECAN immunohistochemistry for their identification. Patients were four males and three females, ranging in age from 19 to 66 years (median: 33). All were primary bone tumors (femur, n = 4; tibia, n = 2; ilium, n = 1), frequently infiltrating the surrounding soft tissues. Treatment often consisted of neoadjuvant chemotherapy and surgery. Follow-up was available for six patients (median 18 months, range 5-102 months), three patients died of disease and four patients are currently alive. Histologically, tumors consisted of monotonous round cells growing in lobules and sheets in variable amounts of fibrous to myxoid stroma. Other findings included spindle cells, corded and trabecular architecture, nuclear pleomorphism, cartilaginous differentiation, and osteoid-like matrix. Histological response to neoadjuvant chemotherapy was poor in all resection specimens available for review (n = 4). Tumors were diffusely positive for AGGRECAN and CD99 (7/7), and a subset expressed Pan-Keratin (AE1-AE3; 3/6), S100 (2/6), BCOR (2/6), ETV-4 (2/5), WT1 (2/6), and ERG (2/5). Desmin, NKX3-1, and SATB2 were negative (0/6). Diffuse AGGRECAN staining was also seen in 8/129 round cell sarcomas used for comparison, including mesenchymal chondrosarcoma (7/26) and CIC-sarcoma (1/26). Array-CGH showed complex karyotypes with recurrent deletions of tumor suppressor genes (CDKN2A/B, TUSC7, and DMD) in three FUS-NFATC2 cases and a simpler profile without homozygous losses in one EWSR1-NFATc2 case. Segmental chromosomal gains covering the loci of the fusion genes were detected in both variants. Overall, our study confirms and expands previous observations on NFATc2-sarcomas and supports that AGGRECAN is a useful biomarker of these tumors. NFATc2-rearranged sarcomas (NFATc2-Sarcomas) are infrequent round cell tumors characterized by EWSR1-NFATc2 fusions and FUS-NFATc2 fusions. Although our knowledge on these neoplasms has increased recently, novel diagnostic tools and more comprehensive series are still needed. Here, we describe the features of a series of seven molecularly confirmed NFATc2-Sarcomas (EWSR1-NFATc2, n = 4; FUS-NFATc2, n = 3) and demonstrate the utility of AGGRECAN immunohistochemistry for their identification. Patients were four males and three females, ranging in age from 19 to 66 years (median: 33). All were primary bone tumors (femur, n = 4; tibia, n = 2; ilium, n = 1), frequently infiltrating the surrounding soft tissues. Treatment often consisted of neoadjuvant chemotherapy and surgery. Follow-up was available for six patients (median 18 months, range 5-102 months), three patients died of disease and four patients are currently alive. Histologically, tumors consisted of monotonous round cells growing in lobules and sheets in variable amounts of fibrous to myxoid stroma. Other findings included spindle cells, corded and trabecular architecture, nuclear pleomorphism, cartilaginous differentiation, and osteoid-like matrix. Histological response to neoadjuvant chemotherapy was poor in all resection specimens available for review (n = 4). Tumors were diffusely positive for AGGRECAN and CD99 (7/7), and a subset expressed Pan-Keratin (AE1-AE3; 3/6), S100 (2/6), BCOR (2/6), ETV-4 (2/5), WT1 (2/6), and ERG (2/5). Desmin, NKX3-1, and SATB2 were negative (0/6). Diffuse AGGRECAN staining was also seen in 8/129 round cell sarcomas used for comparison, including mesenchymal chondrosarcoma (7/26) and CIC-sarcoma (1/26). Array-CGH showed complex karyotypes with recurrent deletions of tumor suppressor genes (CDKN2A/B, TUSC7, and DMD) in three FUS-NFATC2 cases and a simpler profile without homozygous losses in one EWSR1-NFATc2 case. Segmental chromosomal gains covering the loci of the fusion genes were detected in both variants. Overall, our study confirms and expands previous observations on NFATc2-sarcomas and supports that AGGRECAN is a useful biomarker of these tumors. |
| Author | Coindre, Jean-Michel Le Loarer, François Meurgey, Alexandra Larousserie, Frédérique Pierron, Gaëlle Perret, Raul Hoeller, Sylvia Tirode, Franck Escuriol, Julien Soubeyran, Isabelle Velasco, Valérie Le Guellec, Sophie Mayeur, Laetitia Aubert, Sébastien Weingertner, Noelle Polivka, Marc Karanian, Marie Delfour, Christophe |
| Author_xml | – sequence: 1 givenname: Raul orcidid: 0000-0003-2698-0249 surname: Perret fullname: Perret, Raul email: r.perret@bordeaux.unicancer.fr organization: Department of Biopathology, Bergonie Institute – sequence: 2 givenname: Julien surname: Escuriol fullname: Escuriol, Julien organization: Department of Biopathology, Bergonie Institute, Bordeaux University – sequence: 3 givenname: Valérie surname: Velasco fullname: Velasco, Valérie organization: Department of Biopathology, Bergonie Institute – sequence: 4 givenname: Laetitia surname: Mayeur fullname: Mayeur, Laetitia organization: Department of Biopathology, Bergonie Institute – sequence: 5 givenname: Isabelle surname: Soubeyran fullname: Soubeyran, Isabelle organization: Department of Biopathology, Bergonie Institute, INSERM U1218, ACTION Unit – sequence: 6 givenname: Christophe surname: Delfour fullname: Delfour, Christophe organization: Department of Pathology, Montpellier University Hospital – sequence: 7 givenname: Sébastien surname: Aubert fullname: Aubert, Sébastien organization: Department of Pathology, Institut de Pathologie, Univ. Lille, CHU Lille – sequence: 8 givenname: Marc surname: Polivka fullname: Polivka, Marc organization: Department of Pathology, APHP, Hôpital Cochin, DMU Imagina, Université de Paris – sequence: 9 givenname: Marie surname: Karanian fullname: Karanian, Marie organization: Department of Pathology, Leon Berard Center, Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon – sequence: 10 givenname: Alexandra surname: Meurgey fullname: Meurgey, Alexandra organization: Department of Pathology, Leon Berard Center – sequence: 11 givenname: Sophie surname: Le Guellec fullname: Le Guellec, Sophie organization: Department of Pathology, Claudius Regaud Institute, Toulouse-Oncopole – sequence: 12 givenname: Noelle surname: Weingertner fullname: Weingertner, Noelle organization: Department of Pathology, Strasbourg Regional University Hospital (Hautepierre Hospital) – sequence: 13 givenname: Sylvia surname: Hoeller fullname: Hoeller, Sylvia organization: Department of Pathology, Hospital of the University of Basel – sequence: 14 givenname: Jean-Michel surname: Coindre fullname: Coindre, Jean-Michel organization: Department of Biopathology, Bergonie Institute, Bordeaux University – sequence: 15 givenname: Frédérique surname: Larousserie fullname: Larousserie, Frédérique organization: Department of Pathology, APHP-Cochin Hospital – sequence: 16 givenname: Gaëlle surname: Pierron fullname: Pierron, Gaëlle organization: Department of Tumor Biology, Curie Institute – sequence: 17 givenname: Franck orcidid: 0000-0003-4731-7817 surname: Tirode fullname: Tirode, Franck organization: Univ Lyon, Université Claude Bernard Lyon 1, INSERM 1052, CNRS 5286, Centre Léon Bérard, Cancer Research Center of Lyon – sequence: 18 givenname: François orcidid: 0000-0001-8582-9819 surname: Le Loarer fullname: Le Loarer, François email: f.le-loarer@bordeaux.unicancer.fr organization: Department of Biopathology, Bergonie Institute, Bordeaux University, INSERM U1218, ACTION Unit |
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| ContentType | Journal Article |
| Copyright | The Author(s), under exclusive licence to United States & Canadian Academy of Pathology 2020 The Author(s), under exclusive licence to United States & Canadian Academy of Pathology 2020. Distributed under a Creative Commons Attribution 4.0 International License |
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| PublicationSubtitle | Publishing innovative clinical and translational research in the pathology of human disease |
| PublicationTitle | Modern pathology |
| PublicationTitleAbbrev | Mod Pathol |
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| PublicationYear | 2020 |
| Publisher | Nature Publishing Group US Elsevier Limited Nature Publishing Group: Open Access Hybrid Model Option B |
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| Snippet | NFATc2
-rearranged sarcomas (
NFATc2
-Sarcomas) are infrequent round cell tumors characterized by
EWSR1-NFATc2
fusions and
FUS-NFATc2
fusions. Although our... NFATc2-rearranged sarcomas (NFATc2-Sarcomas) are infrequent round cell tumors characterized by EWSR1-NFATc2 fusions and FUS-NFATc2 fusions. Although our... |
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| SubjectTerms | 13/51 14/32 14/63 38/39 38/43 38/91 692/699/67/1344 692/699/67/1798 Adult Aged Aggrecan Aggrecans - metabolism Biomarkers, Tumor - metabolism Bone cancer Bone Neoplasms - diagnosis Bone Neoplasms - genetics Bone Neoplasms - metabolism Bone tumors Cancer CD99 antigen Chemotherapy Chondrosarcoma Cytogenetics Desmin Female Femur FLI-1 protein Humans Ilium Immunohistochemistry Karyotypes Keratin Laboratory Medicine Life Sciences Male Medical diagnosis Medicine Medicine & Public Health Mesenchyme Middle Aged Neoplasia NFATC Transcription Factors - genetics Oncogene Fusion Oncogene Proteins, Fusion - genetics Osteoid Pathology Patients Pleomorphism Sarcoma Sarcoma - diagnosis Sarcoma - genetics Sarcoma - metabolism Soft tissues Stroma Surgery Tibia Tumor suppressor genes Tumors |
| Title | NFATc2-rearranged sarcomas: clinicopathologic, molecular, and cytogenetic study of 7 cases with evidence of AGGRECAN as a novel diagnostic marker |
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