Difference between revisions of "Biphenotypic sinonasal sarcoma"
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'''Biphenotypic sinonasal sarcoma''' is a rare bland appearing [[cancer|malignant]] tumour of the [[head and neck pathology|head and neck]]. | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Biphenotypic Sinonasal Sarcoma LDRT 12255.tif | |||
| Width = | |||
| Caption = [[Micrograph]] showing a biphenotypic sinonasal sarcoma. [[H&E stain]]. (WC/LESTERTHEINVESTOR) | |||
| Synonyms = low-grade sinonasal sarcoma with neural and myogenic features | |||
| Micro = bland hypercellular stroma typically without many mitoses, invaginating glandular epithelium | |||
| Subtypes = | |||
| LMDDx = [[solitary fibrous tumour]], [[schwannoma]], [[sinonasal-type hemangiopericytoma]], benign [[nasal polyp]] | |||
| Stains = | |||
| IHC = S-100 +ve, actin +ve, beta-catenin +ve (nuclear) | |||
| EM = | |||
| Molecular = PAX3-MAML3 fusion - t(2;4)(q35;q31.1) | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Staging = | |||
| Site = [[head and neck pathology|head and neck]] - ethmoid sinus and/or nasal cavity | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = female predominant (3:1) | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = very rare ~ large series 28 individuals as of 2012 | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = | |||
| Tx = | |||
}} | |||
'''Biphenotypic sinonasal sarcoma''', abbreviated '''SNS''',<ref name=pmid24859338/> is a rare bland appearing [[cancer|malignant]] tumour of the [[head and neck pathology|head and neck]]. | |||
It is also known as '''low grade | It is also known as '''low-grade sinonasal sarcoma with neural and myogenic features'''.<ref name=pmid25488011>{{Cite journal | last1 = Powers | first1 = KA. | last2 = Han | first2 = LM. | last3 = Chiu | first3 = AG. | last4 = Aly | first4 = FZ. | title = Low-grade sinonasal sarcoma with neural and myogenic features--diagnostic challenge and pathogenic insight. | journal = Oral Surg Oral Med Oral Pathol Oral Radiol | volume = 119 | issue = 5 | pages = e265-9 | month = May | year = 2015 | doi = 10.1016/j.oooo.2014.10.007 | PMID = 25488011 }}</ref> | ||
==General== | ==General== | ||
*Rare. | *Rare - largest series published (as of 2012) 28 patients.<ref name=pmid22301502/> | ||
*Female predominant. | *Female predominant - (female:male = 3:1<ref name=pmid22301502>{{Cite journal | last1 = Lewis | first1 = JT. | last2 = Oliveira | first2 = AM. | last3 = Nascimento | first3 = AG. | last4 = Schembri-Wismayer | first4 = D. | last5 = Moore | first5 = EA. | last6 = Olsen | first6 = KD. | last7 = Garcia | first7 = JG. | last8 = Lonzo | first8 = ML. | last9 = Lewis | first9 = JE. | title = Low-grade sinonasal sarcoma with neural and myogenic features: a clinicopathologic analysis of 28 cases. | journal = Am J Surg Pathol | volume = 36 | issue = 4 | pages = 517-25 | month = Apr | year = 2012 | doi = 10.1097/PAS.0b013e3182426886 | PMID = 22301502 }}</ref>). | ||
Prognosis: | |||
*No (far away) [[metastasis]] or death in a series of 28 patients.<ref name=pmid22301502/> | |||
==Gross== | |||
*Usually ethmoid sinus and/or nasal cavity.<ref name=pmid22301502/> | |||
==Microscopic== | ==Microscopic== | ||
Features | Features: | ||
*Bland hypercellular stroma typically without many mitoses. | *Bland hypercellular stroma typically without many mitoses. | ||
*Invaginating glandular epithelium. | *Invaginating glandular epithelium. | ||
Note: | |||
*May have rhabdomyoblastic differentiation - case report.<ref name=pmid26371783>{{Cite journal | last1 = Huang | first1 = SC. | last2 = Ghossein | first2 = RA. | last3 = Bishop | first3 = JA. | last4 = Zhang | first4 = L. | last5 = Chen | first5 = TC. | last6 = Huang | first6 = HY. | last7 = Antonescu | first7 = CR. | title = Novel PAX3-NCOA1 Fusions in Biphenotypic Sinonasal Sarcoma With Focal Rhabdomyoblastic Differentiation. | journal = Am J Surg Pathol | volume = 40 | issue = 1 | pages = 51-9 | month = Jan | year = 2016 | doi = 10.1097/PAS.0000000000000492 | PMID = 26371783 }}</ref> | |||
DDx: | DDx: | ||
*[[Solitary fibrous tumour]]. | *[[Solitary fibrous tumour]]. | ||
*[[Schwannoma]]. | *[[Schwannoma]]. | ||
*[[hemangiopericytoma]]. | *[[Sinonasal-type hemangiopericytoma]]. | ||
*Benign [[nasal polyp]]. | |||
===Images=== | |||
<gallery> | |||
Image: Biphenotypic Sinonasal Sarcoma LDRT 12255.tif | BSS. (WC/LESTERTHEINVESTOR) | |||
Image: Biphenotypic Sinonasal Sarcoma LDRT 12256.tif | BSS. (WC/LESTERTHEINVESTOR) | |||
</gallery> | |||
==IHC== | ==IHC== | ||
*Actin +ve. | Features: | ||
*S-100 | *S-100 +ve - strong (28 +ve of 28 cases<ref name=pmid22301502/>). | ||
*Actin +ve (27 +ve of 28 cases<ref name=pmid22301502/>). | |||
*Beta-catenin - nuclear +ve.<ref>http://dx.doi.org/10.1016/j.humpath.2016.04.009 | |||
</ref><ref name=pmid25488011>{{Cite journal | last1 = Powers | first1 = KA. | last2 = Han | first2 = LM. | last3 = Chiu | first3 = AG. | last4 = Aly | first4 = FZ. | title = Low-grade sinonasal sarcoma with neural and myogenic features--diagnostic challenge and pathogenic insight. | journal = Oral Surg Oral Med Oral Pathol Oral Radiol | volume = 119 | issue = 5 | pages = e265-9 | month = May | year = 2015 | doi = 10.1016/j.oooo.2014.10.007 | PMID = 25488011 }}</ref> | |||
Others:<ref name=pmid25488011/> | |||
*Desmin -ve. | |||
*[[AE1/AE3]] -ve. | |||
*Vimentin +ve. | |||
===Images=== | |||
<gallery> | |||
Image: Biphenotypic Sinonasal Sarcoma LDRT 12255 S100.tif | BSS S-100. (WC/LESTERTHEINVESTOR) | |||
Image: Biphenotypic Sinonasal Sarcoma LDRT 12255 SMA.tif | BSS - SMA. (WC/LESTERTHEINVESTOR) | |||
</gallery> | |||
==Molecular== | |||
*PAX3-MAML3 fusion - t(2;4)(q35;q31.1).<ref name=pmid24859338>{{Cite journal | last1 = Wang | first1 = X. | last2 = Bledsoe | first2 = KL. | last3 = Graham | first3 = RP. | last4 = Asmann | first4 = YW. | last5 = Viswanatha | first5 = DS. | last6 = Lewis | first6 = JE. | last7 = Lewis | first7 = JT. | last8 = Chou | first8 = MM. | last9 = Yaszemski | first9 = MJ. | title = Recurrent PAX3-MAML3 fusion in biphenotypic sinonasal sarcoma. | journal = Nat Genet | volume = 46 | issue = 7 | pages = 666-8 | month = Jul | year = 2014 | doi = 10.1038/ng.2989 | PMID = 24859338 }}</ref> | |||
==See also== | ==See also== | ||
*[[Head and neck pathology]]. | *[[Head and neck pathology]]. | ||
*[[HPV-related multiphenotypic sinonasal carcinoma]]. | |||
==References== | ==References== |
Latest revision as of 14:20, 19 November 2018
Biphenotypic sinonasal sarcoma | |
---|---|
Diagnosis in short | |
Micrograph showing a biphenotypic sinonasal sarcoma. H&E stain. (WC/LESTERTHEINVESTOR) | |
| |
Synonyms | low-grade sinonasal sarcoma with neural and myogenic features |
| |
LM | bland hypercellular stroma typically without many mitoses, invaginating glandular epithelium |
LM DDx | solitary fibrous tumour, schwannoma, sinonasal-type hemangiopericytoma, benign nasal polyp |
IHC | S-100 +ve, actin +ve, beta-catenin +ve (nuclear) |
Molecular | PAX3-MAML3 fusion - t(2;4)(q35;q31.1) |
Site | head and neck - ethmoid sinus and/or nasal cavity |
| |
Clinical history | female predominant (3:1) |
Prevalence | very rare ~ large series 28 individuals as of 2012 |
Biphenotypic sinonasal sarcoma, abbreviated SNS,[1] is a rare bland appearing malignant tumour of the head and neck.
It is also known as low-grade sinonasal sarcoma with neural and myogenic features.[2]
General
- Rare - largest series published (as of 2012) 28 patients.[3]
- Female predominant - (female:male = 3:1[3]).
Prognosis:
- No (far away) metastasis or death in a series of 28 patients.[3]
Gross
- Usually ethmoid sinus and/or nasal cavity.[3]
Microscopic
Features:
- Bland hypercellular stroma typically without many mitoses.
- Invaginating glandular epithelium.
Note:
- May have rhabdomyoblastic differentiation - case report.[4]
DDx:
Images
IHC
Features:
- S-100 +ve - strong (28 +ve of 28 cases[3]).
- Actin +ve (27 +ve of 28 cases[3]).
- Beta-catenin - nuclear +ve.[5][2]
Others:[2]
- Desmin -ve.
- AE1/AE3 -ve.
- Vimentin +ve.
Images
Molecular
- PAX3-MAML3 fusion - t(2;4)(q35;q31.1).[1]
See also
References
- ↑ 1.0 1.1 Wang, X.; Bledsoe, KL.; Graham, RP.; Asmann, YW.; Viswanatha, DS.; Lewis, JE.; Lewis, JT.; Chou, MM. et al. (Jul 2014). "Recurrent PAX3-MAML3 fusion in biphenotypic sinonasal sarcoma.". Nat Genet 46 (7): 666-8. doi:10.1038/ng.2989. PMID 24859338.
- ↑ 2.0 2.1 2.2 Powers, KA.; Han, LM.; Chiu, AG.; Aly, FZ. (May 2015). "Low-grade sinonasal sarcoma with neural and myogenic features--diagnostic challenge and pathogenic insight.". Oral Surg Oral Med Oral Pathol Oral Radiol 119 (5): e265-9. doi:10.1016/j.oooo.2014.10.007. PMID 25488011.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Lewis, JT.; Oliveira, AM.; Nascimento, AG.; Schembri-Wismayer, D.; Moore, EA.; Olsen, KD.; Garcia, JG.; Lonzo, ML. et al. (Apr 2012). "Low-grade sinonasal sarcoma with neural and myogenic features: a clinicopathologic analysis of 28 cases.". Am J Surg Pathol 36 (4): 517-25. doi:10.1097/PAS.0b013e3182426886. PMID 22301502.
- ↑ Huang, SC.; Ghossein, RA.; Bishop, JA.; Zhang, L.; Chen, TC.; Huang, HY.; Antonescu, CR. (Jan 2016). "Novel PAX3-NCOA1 Fusions in Biphenotypic Sinonasal Sarcoma With Focal Rhabdomyoblastic Differentiation.". Am J Surg Pathol 40 (1): 51-9. doi:10.1097/PAS.0000000000000492. PMID 26371783.
- ↑ http://dx.doi.org/10.1016/j.humpath.2016.04.009