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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Hum+Pathol
2009 ; 40
(3
): 283-92
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Molecular and phenotypic analysis of poorly differentiated sinonasal neoplasms:
an integrated approach for early diagnosis and classification
#MMPMID19150107
Cordes B
; Williams MD
; Tirado Y
; Bell D
; Rosenthal DI
; Al-Dhahri SF
; Hanna EY
; El-Naggar AK
Hum Pathol
2009[Mar]; 40
(3
): 283-92
PMID19150107
show ga
Primary poorly differentiated (small round and non-small) sinonasal neoplasms
comprise histogenetically and biologically diverse entities with overlapping
morphologic features. Because of the limited initial biopsy tissue materials,
differential diagnostic difficulties may arise and complicate timely management
of some cases. We used immunohistochemical and molecular marker analyses in a
large cohort of these tumors to optimize their early diagnosis and
classification. Fifty-two tumors of the skull base and sinonasal regions and, for
comparison, 19 poorly differentiated neoplasms of other head and neck sites were
analyzed by a panel of immunohistochemical markers including those of epithelial,
mesenchymal, melanocytic, and neuroectodermal origin using tissue microarray.
Reverse transcriptase-polymerase chain reaction analysis of messenger RNA for
EWS-FLI1 and PAX-FKHR fusion transcripts and the human achaete-scute homolog-1
gene was performed on 24 of the 52 sinonasal tumors and the 19 tumors of other
sites for comparison. The immunohistochemical results substantiated the
phenotypic assessment and the initial diagnosis in 49 of the 52 tumors. In 4
instances the integrated markers and phenotypic analyses led to reclassification
of 3 tumors and confirmed the histogenesis of a mesenchymal tumor with aberrant
cytokeratin expression. Molecular analysis of the EWS-FLI1 fusion gene transcript
revealed 4 (9.3%) of the 43 tumors to be positive; all were Ewing sarcomas. The
human achaete-scute homolog-1 gene transcript was identified in 10 (23.8%) of 42
tumors: 3 of 6 neuroblastomas, all 4 neuroendocrine carcinomas, and 1 each in
sinonasal undifferentiated carcinoma, rhabdomyosarcoma, and melanoma. The
PAX-FKHR fusion transcript was not detected in any tumors. We conclude that (1)
an integrated morphologic and biomarker algorithm may better optimize the early
diagnosis of poorly differentiated sinonasal and skull-base tumors; (2) molecular
analysis may assist in future biological stratification of certain classes of
these tumors; and (3) the human achaete-scute homolog-1 gene transcript is a
nonspecific marker for the diagnosis of neuroblastoma.