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HER2 heterogeneity in gastric/gastroesophageal cancers: From benchside to practice

World Journal of Gastroenterology 2016年第26期22卷 5879-5887页

作者： Federica Grillo Matteo Fassan Francesca Sarocchi roberto fiocca Luca Mastracci Department of Surgical and Diagnostic Sciences Pathology Unit University of Genoa 16132 Genoa Italy Institute for Research and Cure of Cancer (IRCCS) S. Martino-IST University Hospital 16132 Genoa Italy Department of Medicine (DIMED) Surgical Pathology Unit University of Padua 35121 Padua Italy

HER2 is overexpressed in approximately 10%-20% of gastric and gastroesophageal junction carcinomas. In these types of cancer, accurate assessment of HER2 status is mandatory, for selecting patients who may benefit from targeted therapies with anti-HER2 drugs such as Trastuzumab. This manuscript focuses on HER2 in gastric carcinogenesis, on optimal evaluation of HER2 and on the possible causes which may contribute to inaccurate HER2 evaluation. Similarly to breast cancer HER2 evaluation, standardization of HER2 testing in gastric cancer is necessary in diagnostic practice. The three principle aspects which require consideration are:(1) the choice of sample with regards to cancer morphology- intestinal vs diffuse areas;(2) the choice of scoring criteria- use of HER2 scoring criteria specific for gastric cancer; and(3) the choice of HER2 evaluation methods- use of an algorithm in which both immunohistochemistry and in situ hybridization play a role. Problematic issues include:(1) pre-analytic variables with particular emphasis on fixation;(2) recommended methodology for HER2 assessment(immunohistochemistry vs in situ hybridization);(3) HER2 heterogeneity both within the primary tumor and between primary tumor and metastases;(4) reliability of biopsies in HER 2 evaluation; and(5) quantity of sample(FFPE blocks from surgical specimens or endoscopic biopsies) necessary for an adequate assessment.

关键词： Gastric cancer HER2 Heterogeneity Immunohistochemistry FISH

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Pancreatic metastasis from mycosis fungoides mimicking primary pancreatic tumor

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World Journal of Gastroenterology 2016年第12期22卷 3496-3501页

作者： Paola Ceriolo Valentina Fausti Elisa Cinotti Silvia Bonadio Lizzia Raffaghello Giovanna Bianchi Giulio Fraternali Orcioni roberto fiocca Franco Rongioletti Vito Pistoia Giacomo Borgonovo Course in Paediatric Science Fetal-Perinatal and Paediatric Pathology University of Genoa Pathology Unit Istituto Giannina Gaslini Section of Dermatology IRCCS AOU San Martino-IST Pathology Unit IRCCS AOU San Martino-IST Laboratory of Oncology Istituto Giannina Gaslini Pathology Unit IRCCS AOU San Martino-IST and University of Genoa Surgery Unit IRCCS AOU San Martino-IST and University of Genoa

Mycosis fungoides(MF) is a cutaneous T-cell lymphoma that can undergo local progression with possible systemic dissemination. We report a case of a patient affected by MF with a pancreatic mass that was a diagnostic challenge between primitive tumor and pancreatic metastasis from MF. Clinical setting findings and imaging studies raised the suspicion of a pancreatic primary neoplasm. A diagnostic clue was provided by the combined histomorphologic/immunohistochemical study of pancreatic and cutaneous biopsies, which revealed a pancreatic localization of MF. Considering the rarity of metastatic localization of MF to the pancreas, we next investigated whether chemokinechemokine receptor interactions could be involved in the phenomenon to provide new insight into the possible mechanisms underlying metastatic localization of MF to the pancreas. Histological analyses of archival pancreatic tissue demonstrated that glucagon-secreting cells of the pancreatic islets expressed the CCL27 chemokine, which may have attracted in our case metastatic MF cells expressing the complementary receptor CCR10.

关键词： Differential diagnosis Pancreatic mass Extracutaneous localization Mycosis fungoides CCL27 CCR10

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