Study of EWS/FLI-1 Rearrangement in 18 Cases of CK20+/CM2B4+ Merkel Cell Carcinoma Using FISH and Correlation to the Differential Diagnosis of Ewing Sarcoma/Peripheral Neuroectodermal Tumor

Q4 · MEDICINE

Article

Author: Fernandez-Flores, Angel ; Suarez-Penaranda, Jose M. ; Alonso, Soledad

Merkel cell carcinoma (MCC) and primary cutaneous Ewing sarcoma/primitive neuroectodermal tumors (PCES/PNET) pose a challenging morphologic differential diagnosis. Approximately 90% of Ewing sarcoma/primitive neuroectodermal tumors (PNETs) have a specific translocation, t(11;22) (q24;q12). The EWS-friend leukemia integration-1 (FLI-1) fusion results in FLI-1 overexpression. EWS/FLI-1 rearrangement has been suggested as a useful tool in the diagnosis of PCES/PNET. In contrast, Merkel cell polyomavirus was found to be an infective agent related to the pathogenesis of MCC. Merkel cell polyomavirus can be immunohistochemically detected with the antibody CM2B4. To the best of our knowledge, there is no case of any cytokeratin (CK)20-/CM2B4+ PNET. The goal of our study was to investigate whether EWS/FLI-1 rearrangement was present in cases of MCC. We have studied 18 cases of MCC. To make sure that the cases investigated by fluorescent in situ hybridization were genuine MCC, we considered only CK20+/CM2B4+ cases. Six cases met this criterion. EWS/FLI-1 rearrangement was not evidenced in any of the 18 cases (including the 6 "genuine" cases of MCC). Although our findings were somewhat expected, we think that they fill a gap in the literature: the confirmation that MCC is devoid of the EWS/FLI-1 rearrangement.

01 Dec 2011·The American Journal of DermatopathologyQ4 · MEDICINE

The Differential Diagnosis Between Primary Cutaneous Large B-cell Lymphoma and Cutaneous Follicular Lymphoma: Prognostic and Therapeutic Implications

Q4 · MEDICINE

Review

Author: Manjon, Jose A ; Escalante, Fernando ; Fernandez-Flores, Angel ; Smucler-Simonovich, Alicia

The differential diagnosis between primary cutaneous diffuse large B-cell lymphoma and cutaneous follicular lymphoma is one of the most difficult aspects of dermatopathology, even though morphological criteria are well established and a wide panel of antibodies is available to every laboratory. Such diagnosis is, however, not trivial because it has important prognostic and therapeutic implications. Nevertheless, when the literature is reviewed, there is a feeling that the diagnostic deficits from the past could perhaps be responsible for the differences observed in the therapeutic results with less aggressive treatments, such as rituximab. The current report briefly revises some cases of primary cutaneous diffuse large B-cell lymphoma treated with rituximab, which have been reported in the literature. It also presents an additional case emphasizing the current approach to the differential diagnosis.

01 Oct 2011·Biotechnic & HistochemistryQ4 · ENGINEERING & TECHNOLOGY

A review of amyloid staining: methods and artifacts

Q4 · ENGINEERING & TECHNOLOGY

Review

Author: Fernandez-Flores, A

Amyloid detection is very precise at this time, because several methods are available to the pathologist. Awareness of potential nonspecific staining, possible pitfalls and methods for improving the detection process are basic to enhancing the staining of amyloid and interpreting this staining. The role of the pathologist has progressed through history from the basic detection of amyloid as a substance to immunophenotypical classification of the particular amyloid present.

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