Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing
Yıl: 2023 Cilt: 20 Sayı: 2 Sayfa Aralığı: 105 - 112 Metin Dili: İngilizce DOI: 10.4274/tjod.galenos.2023.73549 İndeks Tarihi: 07-06-2023
Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing
Öz: Objective: Gestational trophoblastic tumors are very rare neoplasms. We determined the distinctive morphological, immunohistochemical, and clinical features of placental site trophoblastic tumors (PSTT) and epithelioid trophoblastic tumors (ETT) in our cohort. Materials and Methods: Nine cases of PSTT and four cases of ETT were retrieved from the archives. Histomorphologic, immunohistochemical, and clinical features were noted. A molecular study was performed on one PSTT and one ETT case using next-generation sequencing. Results: While the nodular pattern, geographic necrosis, and extracellular eosinophilic globules were peculiar to ETTs, vessel wall affinity, marked pleomorphism, intranuclear pseudoinclusion, spindle tumor cell, and vacuolar degeneration were more specific for PSTTs in our series. An immunohistochemical panel of p63, hPL, and CD146 were helpful for the exact typing of the tumor. p63 positivity supports the ETT and diffuse staining of hPL and CD146 supports the PSTT diagnosis. Three of the patients with metastatic disease (lung and brain metastasis) except one have a high mitotic count (12 and 8) and a long interval between (8 and 10 years) antecedent pregnancy and diagnosis. While KIT and TP53 mutations were observed only in PSTT, amino acid changes in KDR, APC, and SMAD4 genes were detected both in the ETT and PSTT cases. Conclusion: In the prediction of metastasis, the long intervals between antecedent pregnancy and diagnosis, deep myometrial invasion, mitotic count, and Ki67 proliferation index were involved rather than other histomorphological parameters, but none of the parameters is an absolute predictor of the metastasis.
Anahtar Kelime: İntermediate trofoblastların gestasyonel trofoblastik neoplazisi: Epitelioid trofoblastik tümör ve plasental site trofoblastik tümörlerin morfolojik, immünohistokimyasal ve yeni nesil dizileme çalışması
Öz: Amaç: Bu çalışmanın amacı nadir görülen gestasyonel trofoblastik neoplaziler olan Plasental Site Trofoblastik Tümör (PSTT) ve Epiteloid trofoblastik tümör (ETT) için ayırt edici klinik, morfolojik, immünohistokimyasal ve moleküler genetik özellikleri belirlemektir. Gereç ve Yöntemler: Hacettepe Üniversitesi’nde 2001-2020 yılları arasında tanı alan 9 PSTT ve 4 ETT olgusu incelenmiş olup karakteristik histomorfolojik, immünhistokimyasal ve klinik özellikler kaydedilmiştir. Bir PSTT ve bir ETT olgusuna uygulanmış olan yeni nesil dizileme çalışmasının verileri değerlendirilmiştir. Bulgular: Morfolojik olarak nodüler patern, coğrafi nekroz ve ekstraselüler eozinofilik globüller ETT’ye özgü iken; damar duvarı afinitesi, belirgin pleomorfizm, intranükleer psödoinklüzyonlar, iğsi tümör hücreleri ve vakuolar dejenerasyon PSTT’ye daha spesifiktir. İmmünohistokimyasal olarak p63 pozitifliği ETT’yi, hPL ve CD146’nın yaygın boyaması PSTT’yi desteklemektedir. p63, hPL ve CD146’dan oluşan bir panelin kullanılmasının tümörün tiplendirilmesi için oldukça yardımcı olabileceği görülmüştür. KIT ve TP53 mutasyonları sadece PSTT’de gözlenirken, hem ETT hem de PSTT olgusunda KDR, APC ve SMAD4 genlerinde amino asit değişiklikleri tespit edilmiştir. İzleminde metastatik hastalığı olan üç hastanın biri hariç diğerlerinde yüksek mitoz sayısı (12 ve 8) ve bununla korele olarak yüksek Ki67 proliferasyon indeksi (%28 ve %30), derin myometrial invazyon ve önceki gebelik ile tanı arasında uzun bir zaman aralığı (8 ve 10 yıl) olduğu kaydedilmiştir. Sonuç: ETT ve PSTT’lerde kötü prognoz ve metastaz tahmininde, histomorfolojik parametrelerden ziyade, önceki gebelik ile tanı arasında uzun bir zaman aralığı olması, derin myometriyal invazyon, mitotik aktivite ve Ki67 proliferasyon indeksi önem taşımaktadır; ancak hiçbir parametre metastaz için mutlak bir belirleyici değildir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | Oz Atalay F, Gundogdu F, Tasar Kapakli G, Güneş A, Guler Tezel G, Usubutun A (2023). Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. , 105 - 112. 10.4274/tjod.galenos.2023.73549 |
| Chicago | Oz Atalay Fatma,Gundogdu Fatma,Tasar Kapakli Gozde Elif,Güneş Ali Can,Guler Tezel Gaye,Usubutun Alp Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. (2023): 105 - 112. 10.4274/tjod.galenos.2023.73549 |
| MLA | Oz Atalay Fatma,Gundogdu Fatma,Tasar Kapakli Gozde Elif,Güneş Ali Can,Guler Tezel Gaye,Usubutun Alp Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. , 2023, ss.105 - 112. 10.4274/tjod.galenos.2023.73549 |
| AMA | Oz Atalay F,Gundogdu F,Tasar Kapakli G,Güneş A,Guler Tezel G,Usubutun A Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. . 2023; 105 - 112. 10.4274/tjod.galenos.2023.73549 |
| Vancouver | Oz Atalay F,Gundogdu F,Tasar Kapakli G,Güneş A,Guler Tezel G,Usubutun A Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. . 2023; 105 - 112. 10.4274/tjod.galenos.2023.73549 |
| IEEE | Oz Atalay F,Gundogdu F,Tasar Kapakli G,Güneş A,Guler Tezel G,Usubutun A "Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing." , ss.105 - 112, 2023. 10.4274/tjod.galenos.2023.73549 |
| ISNAD | Oz Atalay, Fatma vd. "Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing". (2023), 105-112. https://doi.org/10.4274/tjod.galenos.2023.73549 |
| APA | Oz Atalay F, Gundogdu F, Tasar Kapakli G, Güneş A, Guler Tezel G, Usubutun A (2023). Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. Turkish Journal of Obstetrics and Gynecology, 20(2), 105 - 112. 10.4274/tjod.galenos.2023.73549 |
| Chicago | Oz Atalay Fatma,Gundogdu Fatma,Tasar Kapakli Gozde Elif,Güneş Ali Can,Guler Tezel Gaye,Usubutun Alp Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. Turkish Journal of Obstetrics and Gynecology 20, no.2 (2023): 105 - 112. 10.4274/tjod.galenos.2023.73549 |
| MLA | Oz Atalay Fatma,Gundogdu Fatma,Tasar Kapakli Gozde Elif,Güneş Ali Can,Guler Tezel Gaye,Usubutun Alp Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. Turkish Journal of Obstetrics and Gynecology, vol.20, no.2, 2023, ss.105 - 112. 10.4274/tjod.galenos.2023.73549 |
| AMA | Oz Atalay F,Gundogdu F,Tasar Kapakli G,Güneş A,Guler Tezel G,Usubutun A Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. Turkish Journal of Obstetrics and Gynecology. 2023; 20(2): 105 - 112. 10.4274/tjod.galenos.2023.73549 |
| Vancouver | Oz Atalay F,Gundogdu F,Tasar Kapakli G,Güneş A,Guler Tezel G,Usubutun A Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing. Turkish Journal of Obstetrics and Gynecology. 2023; 20(2): 105 - 112. 10.4274/tjod.galenos.2023.73549 |
| IEEE | Oz Atalay F,Gundogdu F,Tasar Kapakli G,Güneş A,Guler Tezel G,Usubutun A "Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing." Turkish Journal of Obstetrics and Gynecology, 20, ss.105 - 112, 2023. 10.4274/tjod.galenos.2023.73549 |
| ISNAD | Oz Atalay, Fatma vd. "Gestational trophoblastic neoplasia of intermediate trophoblasts: Epithelioid trophoblastic tumor and placental site trophoblastic tumor, a study of morphologic, immunohistochemical, and next generation sequencing". Turkish Journal of Obstetrics and Gynecology 20/2 (2023), 105-112. https://doi.org/10.4274/tjod.galenos.2023.73549 |
