Specific Histopathologic Features Aid in Distinguishing Diffuse-type Gastric Adenocarcinoma From Metastatic Lobular Breast Carcinoma.
Journal
The American journal of surgical pathology
ISSN: 1532-0979
Titre abrégé: Am J Surg Pathol
Pays: United States
ID NLM: 7707904
Informations de publication
Date de publication:
01 2020
01 2020
Historique:
pubmed:
14
8
2019
medline:
8
5
2020
entrez:
13
8
2019
Statut:
ppublish
Résumé
Metastatic invasive lobular carcinoma (mILC) may masquerade as primary diffuse gastric adenocarcinoma (PDGA) by demonstrating significant clinical and pathologic overlap. Accurate distinction is of therapeutic and prognostic significance. On the basis of anecdotal cases of mILC that lacked estrogen receptor and/or GATA3 expression, we analyzed the cytoarchitectural features of 28 mILC and 44 PDGA specimens obtained from women to assess features that would help in this distinction and prompt ancillary work-up. In addition to performing an interobserver agreement analysis among 3 pathologists, we also evaluated SATB2 expression in this setting. Eighteen of 20 (90%) patients had a history of ILC. The mean interval between initial diagnosis of breast cancer and metastasis was 7.3 years (range: 1 to 36 y). Compared with mILC, PDGA was significantly associated with full-thickness mucosal involvement (47% vs. 80%; P=0.015), a nested/sheet-like growth pattern (32% vs. 68%; P=0.004), anastomosing cords (0% vs. 100%; P=0.001), multivacuolated cells (0% vs. 61%; P<0.0001), pleomorphic nuclei (4% vs. 70%; P<0.0001) and enlarged nuclei (4% vs. 70%; P<0.0001). Single file growth pattern (P<0.0001) and superficial lamina propria involvement (P=0.009) were more common in mILC. Estrogen receptor and GATA3 were expressed in all but 5 mILC cases; SATB2 was only seen in 30% of PDGA cases. Our results demonstrate that in a biopsy specimen, careful morphologic assessment can be extremely helpful in distinguishing mILC from PDGA and guiding ancillary work-up, especially when a history of breast cancer may not be readily available or when the neoplasm lacks expression of conventional breast markers.
Identifiants
pubmed: 31403964
doi: 10.1097/PAS.0000000000001341
pii: 00000478-202001000-00009
doi:
Substances chimiques
GATA3 Transcription Factor
0
GATA3 protein, human
0
Receptors, Estrogen
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
77-86Références
Li CI, Anderson BO, Porter P, et al. Changing incidence rate of invasive lobular breast carcinoma among older women. Cancer. 2000;88:2561–2569.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7–34.
Borst MJ, Ingold JA. Metastatic patterns of invasive lobular versus invasive ductal carcinoma of the breast. Surgery. 1993;114:637–641; discussion 641–642.
McLemore EC, Pockaj BA, Reynolds C, et al. Breast cancer: presentation and intervention in women with gastrointestinal metastasis and carcinomatosis. Ann Surg Oncol. 2005;12:886–894.
Schwarz RE, Klimstra DS, Turnbull AD. Metastatic breast cancer masquerading as gastrointestinal primary. Am J Gastroenterol. 1998;93:111–114.
Jones GE, Strauss DC, Forshaw MJ, et al. Breast cancer metastasis to the stomach may mimic primary gastric cancer: report of two cases and review of literature. World J Surg Oncol. 2007;5:75–80.
Ciulla A, Castronovo G, Tomasello G, et al. Gastric metastases originating from occult breast lobular carcinoma: diagnostic and therapeutic problems. World J Surg Oncol. 2008;6:78–83.
Pectasides D, Psyrri A, Pliarchopoulou K, et al. Gastric metastases originating from breast cancer: report of 8 cases and review of the literature. Anticancer Res. 2009;29:4759–4763.
Critchley AC, Harvey J, Carr M, et al. Synchronous gastric and colonic metastases of invasive lobular breast carcinoma: case report and review of the literature. Ann R Coll Surg Engl. 2011;93:e49–e50.
Cormier WJ, Gaffey TA, Welch JM, et al. Linitis plastica caused by metastatic lobular carcinoma of the breast. Mayo Clin Proc. 1980;55:747–753.
Taal BG, Peterse H, Boot H. Clinical presentation, endoscopic features, and treatment of gastric metastases from breast carcinoma. Cancer. 2000;89:2214–2221.
Ferri LE, Onerheim R, Emond C. Linitis plastica as the first indication of metastatic lobular carcinoma of the breast: case report and literature review. Can J Surg J Can Chir. 1999;42:466–469.
Oda I, Kondo H, Yamao T, et al. Metastatic tumors to the stomach: analysis of 54 patients diagnosed at endoscopy and 347 autopsy cases. Endoscopy. 2001;33:507–510.
Carcoforo P, Raiji MT, Langan RC, et al. Infiltrating lobular carcinoma of the breast presenting as gastrointestinal obstruction: a mini review. J Cancer. 2012;3:328–332.
Montagna E, Pirola S, Maisonneuve P, et al. Lobular metastatic breast cancer patients with gastrointestinal involvement: features and outcomes. Clin Breast Cancer. 2018;18:e401–e405.
Kim DH, Son S-M, Choi YJ. Gastric metastasis from invasive lobular breast cancer, mimicking primary gastric cancer: a case report. Medicine (Baltimore). 2018;97:13–18.
Asmar N, Rey J-F, Sattonnet C, et al. Gastric metastasis mimicking linitis plastica 20 years after primary breast cancer. a case report. J GastrointestLiver Dis. 2018;27:469–471.
Salagean D, Streutker C, Faragalla H, et al. Efficacy of GATA3 versus BRST2 for the identification of metastatic breast carcinoma in the upper GI tract: which performs better? Appl Immunohistochem Mol Morphol. 2018;27:501–507.
Hui Y, Wang Y, Nam G, et al. Differentiating breast carcinoma with signet ring features from gastrointestinal signet ring carcinoma: assessment of immunohistochemical markers. Hum Pathol. 2018;77:11–19.
Zhang B, Copur-Dahi N, Kalmaz D, et al. Gastrointestinal manifestations of breast cancer metastasis. Dig Dis Sci. 2014;59:2344–2346.
Almubarak MM, Laé M, Cacheux W, et al. Gastric metastasis of breast cancer: a single centre retrospective study. Dig Liver Dis. 2011;43:823–827.
Tot T. The role of cytokeratins 20 and 7 and estrogen receptor analysis in separation of metastatic lobular carcinoma of the breast and metastatic signet ring cell carcinoma of the gastrointestinal tract. Acta Pathol Microbiol Immunol Scand. 2000;108:467–472.
Koyama T, Sekine S, Taniguchi H, et al. Hepatocyte nuclear factor 4A expression discriminates gastric involvement by metastatic breast carcinomas from primary gastric adenocarcinomas. Hum Pathol. 2011;42:1777–1784.
Kaufmann O, Deidesheimer T, Muehlenberg M, et al. Immunohistochemical differentiation of metastatic breast carcinomas from metastatic adenocarcinomas of other common primary sites. Histopathology. 1996;29:233–240.
Chu PG, Weiss LM. Immunohistochemical characterization of signet-ring cell carcinomas of the stomach, breast, and colon. Am J Clin Pathol. 2004;121:884–892.
O’Connell FP, Wang HH, Odze RD. Utility of immunohistochemistry in distinguishing primary adenocarcinomas from metastatic breast carcinomas in the gastrointestinal tract. Arch Pathol Lab Med. 2005;129:338–347.
Butler D, Rosa M. Pleomorphic lobular carcinoma of the breast: a morphologically and clinically distinct variant of lobular carcinoma. Arch Pathol Lab Med. 2013;137:1688–1692.
Eusebi V, Magalhaes F, Azzopardi JG. Pleomorphic lobular carcinoma of the breast: an aggressive tumor showing apocrine differentiation. Hum Pathol. 1992;23:655–662.
Vargas A-C, Lakhani SR, Simpson PT. Pleomorphic lobular carcinoma of the breast: molecular pathology and clinical impact. Future Oncol Lond Engl. 2009;5:233–243.
Sun X, Zuo K, Huang D, et al. Pancreatic metastasis from invasive pleomorphic lobular carcinoma of the breast: a rare case report. Diagn Pathol. 2017;12:52–56.
Ayantunde AA, Agrawal A, Parsons SL, et al. Esophagogastric cancers secondary to a breast primary tumor do not require resection. World J Surg. 2007;31:1597–1601.
Miettinen M, McCue PA, Sarlomo-Rikala M, et al. GATA3: a multispecific but potentially useful marker in surgical pathology: a systematic analysis of 2500 epithelial and nonepithelial tumors. Am J Surg Pathol. 2014;38:13–22.
Asch-Kendrick R, Cimino-Mathews A. The role of GATA3 in breast carcinomas: a review. Hum Pathol. 2016;48:37–47.
Wendroth SM, Mentrikoski MJ, Wick MR. GATA3 expression in morphologic subtypes of breast carcinoma: a comparison with gross cystic disease fluid protein 15 and mammaglobin. Ann Diagn Pathol. 2015;19:6–9.
van der Post RS, Bult P, Vogelaar IP, et al. HNF4A immunohistochemistry facilitates distinction between primary and metastatic breast and gastric carcinoma. Virchows Arch. 2014;464:673–679.
Moll R, Löwe A, Laufer J, et al. Cytokeratin 20 in human carcinomas. A new histodiagnostic marker detected by monoclonal antibodies. Am J Pathol. 1992;140:427–447.
Guarneri V, Giovannelli S, Ficarra G, et al. Comparison of HER-2 and hormone receptor expression in primary breast cancers and asynchronous paired metastases: impact on patient management. Oncologist. 2008;13:838–844.
Yeung C, Hilton J, Clemons M, et al. Estrogen, progesterone, and HER2/neu receptor discordance between primary and metastatic breast tumours-a review. Cancer Metastasis Rev. 2016;35:427–437.
López Deogracias M, Flores Jaime L, Arias-Camisón I, et al. Rectal metastasis from lobular breast carcinoma 15 years after primary diagnosis. Clin Transl Oncol. 2010;12:150–153.
Ma C, Lowenthal BM, Pai RK. SATB2 is superior to CDX2 in distinguishing signet ring cell carcinoma of the upper gastrointestinal tract and lower gastrointestinal tract. Am J Surg Pathol. 2018;42:1715–1722.