浅表血管粘液瘤中的上皮成分:附件发育的模拟,以及间质向上皮的转变。

IF 4.1 2区 医学 Q2 CELL BIOLOGY
Histopathology Pub Date : 2025-06-03 DOI:10.1111/his.15478
Carlos Monteagudo, Liria Terrádez, Esther Alvarez, Paloma Masiá, Mónica Espino, María Ortega
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引用次数: 0

摘要

目的:浅表血管粘液瘤的一个子集含有上皮成分。很少,特别是在卡尼的复杂患者中,存在树突性附件增生,一些作者提出它们可能是真正的附件肿瘤。我们的目的是确定上皮成分是否被困在附件上皮,由粘液样肿瘤细胞引发的上皮外生物或真正的肿瘤。方法和结果:我们研究了43例浅表血管粘液瘤的临床病理和免疫表型特征(免疫组织化学和双免疫荧光),其中包括一例卡尼综合征患者。在7例患者中发现了毛囊的基板/胚芽形成;伸长和/或分支的分泌细胞4例,实性/囊性基底管样增生性上皮10例。s100a4阳性间充质凝聚物包围靠近黏液样肿瘤细胞的滤泡和内分泌上皮芽,但只有后者表现出可变的PRKAR1A缺失。在卡尼的复杂病例中,发现突出的分泌管分支类似于纤维滤泡瘤,静脉蛋白阳性细胞聚集与已有的上皮连接并融合。通过双免疫荧光,它们显示出细胞角蛋白和e -钙粘蛋白的免疫反应性,同时仍然表达vimentin,这是间质向上皮转变的证据。结论:我们的研究结果表明,附件上皮细胞通过参与滤泡和内分泌细胞的s100a4阳性间充质壁龛来复制其胚胎发生。这些小生境接近PRKAR1A缺失的粘液样细胞,而复杂的上皮结构保留了PRKAR1A,这表明前者诱导后者的非肿瘤性生长。最后,我们提供的证据表明,在卡尼氏复杂病例中,间质到上皮的转变在分泌管上皮分支中的作用,可能继发于蛋白激酶A激活。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Epithelial elements in superficial angiomyxomas: mimicry of adnexal development, and mesenchymal-to-epithelial transition

Epithelial elements in superficial angiomyxomas: mimicry of adnexal development, and mesenchymal-to-epithelial transition

Aims

A subset of superficial angiomyxomas contains epithelial elements. Rarely, especially in Carney's complex patients, arborizing adnexal proliferations are present, with some authors proposing that they could be authentic adnexal neoplasms. Our aim was to determine if the epithelial elements are trapped adnexal epithelium, epithelial outgrowths triggered by myxoid tumour cells or genuinely neoplastic.

Methods and results

We studied the clinicopathological and immunophenotypic features (immunohistochemistry and double immunofluorescence) of 43 superficial angiomyxomas, including one from a Carney's complex patient. We found hair follicle placode/germ formation in 7 cases; elongated and/or branched eccrine elements in 4 cases and solid/cystic infundibular-like hyperplastic epithelium in 10 cases. S100A4-positive mesenchymal condensates surrounded follicular and eccrine epithelial buds close to myxoid tumour cells, but only the latter showed variable PRKAR1A loss. In the Carney's complex case, prominent eccrine duct branching was found mimicking fibrofolliculoma, with vimentin-positive cell aggregates connecting and integrating with the pre-existing epithelium. By double immunofluorescence, they showed cytokeratin and E-cadherin immunoreactivity while still expressing vimentin as evidence of mesenchymal-to-epithelial transition.

Conclusions

Our results suggest that adnexal epithelial elements reproduce their embryogenesis through the involvement of S100A4-positive mesenchymal niches in both follicular and eccrine elements. These niches are close to myxoid cells with PRKAR1A loss, whereas the complex epithelial structures retain PRKAR1A, which suggests that the former induce non-neoplastic growth of the latter. Finally, we provide evidence for the role of mesenchymal-to-epithelial transition in the branching of the eccrine duct epithelium in the Carney's complex case, probably secondary to protein kinase A activation.

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来源期刊
Histopathology
Histopathology 医学-病理学
CiteScore
10.20
自引率
4.70%
发文量
239
审稿时长
1 months
期刊介绍: Histopathology is an international journal intended to be of practical value to surgical and diagnostic histopathologists, and to investigators of human disease who employ histopathological methods. Our primary purpose is to publish advances in pathology, in particular those applicable to clinical practice and contributing to the better understanding of human disease.
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