CK20-/MCPyV+ Merkel cell carcinoma: a detailed immunohistochemical and in situ hybridization study

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Oral Surgery Oral Medicine Oral Pathology Oral Radiology Pub Date : 2025-03-14 DOI:10.1016/j.oooo.2025.01.013

Gabriela Fonseca Rocha, Heitor Abergoni da Silveira, Herberth Campos Silva, Fernando Chahud, Mariangela Ottoboni Brunaldi, Ana Terezinha Marques Mesquita, Jorge Esquiche León

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Abstract

Merkel cell carcinoma (MCC) is an uncommon aggressive neoplasm of neural crest origin, usually arising in sun-exposed skin of the head and neck. By immunohistochemistry, CK20 and MCPyV positivity are found in about 80% of MCC cases. A 78-year-old male was referred and presented a tumor mass on the right maxilla 4 months ago. Computed tomography revealed an extensive osteolytic lesion in the maxillary sinus extending into the nasal cavity. Microscopy revealed extensive necrosis areas admixed by sheets of hyperchromatic basophilic round cells exhibiting a “salt and pepper” chromatin pattern, which showed immunopositivity for pan-CKAE1/3, EMA, CD56, CD99 (weak), CD138, S100 (focal), synaptophysin, Fli-1, INSM1, MCPyV, SATB2, Rb (intact), p53 (wild-type) and Ki-67 (40%). Relevantly, CK20 and TTF-1, as well as high-risk HPV and EBER (by ISH), were negative. This case illustrates that a detailed immunohistochemical study is essential to adequately classify high-grade neuroendocrine carcinomas, especially CK20-MCC.

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CK20-/MCPyV+默克尔细胞癌：详细的免疫组织化学和原位杂交研究

默克尔细胞癌（MCC）是一种罕见的神经嵴起源的侵袭性肿瘤，通常发生在暴露在阳光下的头颈部皮肤。免疫组化结果显示，约80%的MCC病例中CK20和MCPyV呈阳性。一个78岁的男性，4个月前在右上颌骨出现肿瘤肿块。计算机断层扫描显示上颌窦广泛的溶骨性病变延伸至鼻腔。显微镜下显示广泛的坏死区域，由呈“盐和胡椒”染色质模式的深着色嗜碱性圆形细胞片混合，pan-CKAE1/3， EMA, CD56, CD99（弱），CD138, S100（局灶性），synaptophysin, fl -1, INSM1, MCPyV, SATB2, Rb（完整），p53（野生型）和Ki-67（40%）呈免疫阳性。CK20、TTF-1及高危HPV、EBER （ISH）均为阴性。该病例表明，详细的免疫组织化学研究对于充分分类高级别神经内分泌癌，特别是CK20-MCC至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oral Surgery Oral Medicine Oral Pathology Oral Radiology DENTISTRY, ORAL SURGERY & MEDICINE-

CiteScore

3.80

自引率

6.90%

发文量

1217

审稿时长

2-4 weeks

期刊介绍： Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology is required reading for anyone in the fields of oral surgery, oral medicine, oral pathology, oral radiology or advanced general practice dentistry. It is the only major dental journal that provides a practical and complete overview of the medical and surgical techniques of dental practice in four areas. Topics covered include such current issues as dental implants, treatment of HIV-infected patients, and evaluation and treatment of TMJ disorders. The official publication for nine societies, the Journal is recommended for initial purchase in the Brandon Hill study, Selected List of Books and Journals for the Small Medical Library.