分子证实肾移植后女性供体向男性传播小叶性乳腺癌。

IF 3.5 4区 医学 Q3 CELL BIOLOGY
Pathobiology Pub Date : 2023-01-01 DOI:10.1159/000524479
Jonah M Cooper, Benzion Samueli, Elad Mazor, Waleed Kian, Hadar Goldvaser, Gal Ben-Arie
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引用次数: 2

摘要

小叶性乳腺癌占女性乳腺癌的10%-15%,但在男性中几乎不存在,这与男性乳腺组织中典型的解剖性乳腺小叶结构缺失有关。我们描述供体转移小叶癌转移到男性肾移植后。确定移植后癌症是否与移植相关、供体传播或供体来源有关,对于治疗、预后以及其他器官受体的可能管理具有重要意义。病例报告:一名74岁白人男性因下腹部疼痛和大量血尿而被送往急诊室。既往病史包括两次肾移植。计算机断层扫描发现原生左肾有一个4-5厘米的占位性病变。行左侧原生肾切除术。组织学病理检查显示小叶(相对于导管)乳腺癌。荧光原位杂交探针鉴定X和y染色体显示肿瘤细胞为XX基因型,而周围宿主细胞为XY基因型。这些发现证实了肿瘤在XY原生男性(当前患者)组织中的女性起源(供体)。讨论/结论:由于供体和受体性别之间的不一致,荧光原位杂交作为一种分子技术可以正确识别移植后个体癌症的起源。转移性乳腺癌表现得比通常所见的更为懒散。扩大标准捐献者(ECD)是指那些不能按照器官移植标准捐献的人;扩大的标准扩大了潜在的器官供体池,代价是增加了移植后并发症的风险(例如,移植失败,恶性肿瘤的传播)。该病例提供了一个潜在的未来研究领域,考虑允许具有较远癌症病史且传播风险极低的ecd,当受体的生化环境在不太可能发生传播的情况下,诱导肿瘤进入惰性临床过程。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Molecularly Confirmed Female Donor-Transmitted Lobular Breast Cancer to Male following Renal Transplantation.

Introduction: Lobular breast cancer represents 10%-15% of breast cancers in women but is virtually nonexistent in men, related to the typical absence of the anatomic breast lobule structure in male breast tissue. We describe donor-transmitted metastatic lobular carcinoma to a male after kidney transplantation. Determining whether a post-transplant cancer is transplant associated, donor transmitted, or donor derived is significant for treatment, prognosis, and possibly management of other organ recipients.

Case report: A 74-year-old Caucasian male presented to the emergency department with lower abdominal pain and macro-hematuria. Past medical history included two renal transplantations. Computed tomography identified a 4-5-cm space-occupying lesion in the native left kidney. A left native nephrectomy was performed. Histology pathologic examination demonstrated lobular (as opposed to ductal) breast carcinoma. Fluorescent in situ hybridization probes to identify X- and Y-chromosomes showed tumor cells with an XX genotype, whereas the surrounding host cells were of XY genotype. These findings confirmed the female-sex origin (donor) of the tumor within the XY native male (current patient) tissues.

Discussion/conclusion: Due to discordance between the donor and recipient sex, fluorescent in situ hybridization as a molecular technique correctly identified the origin of an individual's cancer in the post-transplant setting. The metastatic breast cancer behaved more indolently than usually seen. Expanded criteria donors (ECD) are those who cannot donate under standard criteria for organ transplantation; expanded criteria widen the potential organ donor pool at the expense of increased risk for post-transplant complications (e.g., graft failure, the transmission of malignancy). The case provides a potential area of future research into considering allowing ECDs with a distant history of cancer with very low transmission risk when the biochemical environment of the recipient would, in the unlikely event of transmission, induce the tumor to pursue an indolent clinical course.

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来源期刊
Pathobiology
Pathobiology 医学-病理学
CiteScore
8.50
自引率
0.00%
发文量
47
审稿时长
>12 weeks
期刊介绍: ''Pathobiology'' offers a valuable platform for the publication of high-quality original research into the mechanisms underlying human disease. Aiming to serve as a bridge between basic biomedical research and clinical medicine, the journal welcomes articles from scientific areas such as pathology, oncology, anatomy, virology, internal medicine, surgery, cell and molecular biology, and immunology. Published bimonthly, ''Pathobiology'' features original research papers and reviews on translational research. The journal offers the possibility to publish proceedings of meetings dedicated to one particular topic.
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