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Pleomorphic anaplastic neuroblastoma

January 01, 1970

Pleomorphic anaplastic neuroblastoma (PAN) is a striking aspect of neuroblastoma first described by Cozzutto and Carbone in 1988.[1] Another case was thereafter reported by Cowan, et al. with cytogenetic and immunohistological analysis in a 28-year-old man.[2] The case described by Navarro, et al. showed MYCN amplification (more than 10 copies) and a 1p36 deletion as measured with FISH in 13% of cells.[3] Additionally there was a main cell population with a DNA index of 2 indicating a tetraploid DNA content and a high expression of MIBI (Ki-67), bel 2, p53, and P-glycoprotein, either correlated with rapid progression of disease.

Histopathology edit

Appearance of focal or diffuse presence of pleomorphic and anaplastic cells is the hallmark of this neuroblastoma variant.[1][4][5] Hyperchromatic and bizarre nuclei in neuroblasts and ganglion cells in undifferentiated or poorly differentiated foci are far too pathognomonic, although anaplastic expressions can be found in differentiating foci alike.[1][4][5] Undifferentiated neuroblasts may show enlarged and vesicular nuclei with thick nuclear membranes and prominent nucleoli, often a clue to forthcoming anaplastic change.[citation needed]

Controversy edit

Whether pleomorphism-anaplasia warrants a worse prognosis has not been fully assessed so far. Chatten argued that increasing anaplasia in stage IV in comparison with stage III found in her cases suggested a trend toward higher stage (and worse prognosis) with anaplasia.[6] However, within-stage differences were not significant, although cases without anaplasia fared better in each stage than those with. Abramowsky's et al. series of 7 children with anaplastic large cell neuroblastoma showed a better survival than previously reported cases.[7] Joshi, et al. did not find any meaningful difference in clinical outcome between cases with or without anaplasia.[8] Dehner pointed out the importance of recognizing this variant for differential diagnostic purposes.[9] Expressions of pleomorphism-anaplasia have been fully acknowledged among the multifarious features of neuroblastoma in the classification by the International Neuroblastoma Pathology Committee.[10] Recently Tornòczky et al. described 7 cases of large cell neuroblastoma characterized by larger nuclei with thick nuclear membranes and prominent nucleoli suggesting they might represent a distinct phenotype of neuroblastoma with aggressive clinical behavior.[11]

References edit

  1. ^ a b c Cozzutto C, Carbone A (1988). Pleomorphic (Anaplastic) neuroblastoma. Arch Pathol Lab Med 112:621-625.
  2. ^ Cowan J, Dayal Y, Schaitzberg S, Tischler AS (1997). Cytogenetic and immunohistological analysis of an adult anaplastic neuroblastoma. Am J Surg Pathol 21(8):957-963.
  3. ^ Navarro S, Noguera R, Pellin A, Mejia C, Ruiz A, Llombart-Bosch A (2000). Pleomorphic anaplastic neuroblastoma. Med Pediat Oncol 35:449-502.
  4. ^ a b Fletcher CDM (2007). Diagnostic Histopatholoy of tumors. Churchill Livingstone, p. 1774. Rosai (2004).
  5. ^ a b Rosai and Ackerman's Surgical Pathology. Philadelphia, Mosby, p.1128.
  6. ^ Chatten J (1989). Anaplastic neuroblastomas. Letter to the editor. Arch Pathol Lab Med 113:9-10.
  7. ^ Abramowsky CR, Katzenstein HM, Alvarado CS, Shehata BM (2009). Anaplastic large cell neuroblastoma. Pediat Devel Pathol 12(1):1-5.
  8. ^ Joshi VV, Cantor AB, Altshuler G, Larkin EW et al. (1992). Age-linked prognostic categorization based on a new histologic grading system of neuroblastomas. A clinicopathologic study of 211 cases from the pediatric oncology group. Cancer 69:2197-2211.
  9. ^ Dehner LP (1989). Anaplasia in solid malignant tumors of childhood. Arch Pathol Lab Med 113:11-12.
  10. ^ Shimada H, Ambros IM, Dehner LP, Joshi VV, Roald B (1999). Terminology and morphologic criteria of neuroblastic tumors. Recommendations by the International Neuroblastoma Pathology Committee. Cancer 86(2):349-363.
  11. ^ Tornòczky T, Kàlmàn E, Kajtàr PG, Nyàri T, Pearson AD, Tweddle DA, Board J, Shimada H (2004) Large cell neuroblastoma. A distinctive phenotype of neuroblastoma with aggressive clinical behavior. Cancer 100(2):390-397.
  • Shimada H, Ambros IM, Dehner LP, Hata J, Joshi VV, Roald B (1999). Terminology and morphologic criteria of neuroblastic tumors. Recommendations by the International Neuroblastoma Pathology Committee. Cancer 86(2) 349–363.

January 01, 1970
pleomorphic, anaplastic, neuroblastoma, striking, aspect, neuroblastoma, first, described, cozzutto, carbone, 1988, another, case, thereafter, reported, cowan, with, cytogenetic, immunohistological, analysis, year, case, described, navarro, showed, mycn, ampli. Pleomorphic anaplastic neuroblastoma PAN is a striking aspect of neuroblastoma first described by Cozzutto and Carbone in 1988 1 Another case was thereafter reported by Cowan et al with cytogenetic and immunohistological analysis in a 28 year old man 2 The case described by Navarro et al showed MYCN amplification more than 10 copies and a 1p36 deletion as measured with FISH in 13 of cells 3 Additionally there was a main cell population with a DNA index of 2 indicating a tetraploid DNA content and a high expression of MIBI Ki 67 bel 2 p53 and P glycoprotein either correlated with rapid progression of disease Contents 1 Histopathology 2 Controversy 3 ReferencesHistopathology editAppearance of focal or diffuse presence of pleomorphic and anaplastic cells is the hallmark of this neuroblastoma variant 1 4 5 Hyperchromatic and bizarre nuclei in neuroblasts and ganglion cells in undifferentiated or poorly differentiated foci are far too pathognomonic although anaplastic expressions can be found in differentiating foci alike 1 4 5 Undifferentiated neuroblasts may show enlarged and vesicular nuclei with thick nuclear membranes and prominent nucleoli often a clue to forthcoming anaplastic change citation needed Controversy editWhether pleomorphism anaplasia warrants a worse prognosis has not been fully assessed so far Chatten argued that increasing anaplasia in stage IV in comparison with stage III found in her cases suggested a trend toward higher stage and worse prognosis with anaplasia 6 However within stage differences were not significant although cases without anaplasia fared better in each stage than those with Abramowsky s et al series of 7 children with anaplastic large cell neuroblastoma showed a better survival than previously reported cases 7 Joshi et al did not find any meaningful difference in clinical outcome between cases with or without anaplasia 8 Dehner pointed out the importance of recognizing this variant for differential diagnostic purposes 9 Expressions of pleomorphism anaplasia have been fully acknowledged among the multifarious features of neuroblastoma in the classification by the International Neuroblastoma Pathology Committee 10 Recently Tornoczky et al described 7 cases of large cell neuroblastoma characterized by larger nuclei with thick nuclear membranes and prominent nucleoli suggesting they might represent a distinct phenotype of neuroblastoma with aggressive clinical behavior 11 References edit a b c Cozzutto C Carbone A 1988 Pleomorphic Anaplastic neuroblastoma Arch Pathol Lab Med 112 621 625 Cowan J Dayal Y Schaitzberg S Tischler AS 1997 Cytogenetic and immunohistological analysis of an adult anaplastic neuroblastoma Am J Surg Pathol 21 8 957 963 Navarro S Noguera R Pellin A Mejia C Ruiz A Llombart Bosch A 2000 Pleomorphic anaplastic neuroblastoma Med Pediat Oncol 35 449 502 a b Fletcher CDM 2007 Diagnostic Histopatholoy of tumors Churchill Livingstone p 1774 Rosai 2004 a b Rosai and Ackerman s Surgical Pathology Philadelphia Mosby p 1128 Chatten J 1989 Anaplastic neuroblastomas Letter to the editor Arch Pathol Lab Med 113 9 10 Abramowsky CR Katzenstein HM Alvarado CS Shehata BM 2009 Anaplastic large cell neuroblastoma Pediat Devel Pathol 12 1 1 5 Joshi VV Cantor AB Altshuler G Larkin EW et al 1992 Age linked prognostic categorization based on a new histologic grading system of neuroblastomas A clinicopathologic study of 211 cases from the pediatric oncology group Cancer 69 2197 2211 Dehner LP 1989 Anaplasia in solid malignant tumors of childhood Arch Pathol Lab Med 113 11 12 Shimada H Ambros IM Dehner LP Joshi VV Roald B 1999 Terminology and morphologic criteria of neuroblastic tumors Recommendations by the International Neuroblastoma Pathology Committee Cancer 86 2 349 363 Tornoczky T Kalman E Kajtar PG Nyari T Pearson AD Tweddle DA Board J Shimada H 2004 Large cell neuroblastoma A distinctive phenotype of neuroblastoma with aggressive clinical behavior Cancer 100 2 390 397 Shimada H Ambros IM Dehner LP Hata J Joshi VV Roald B 1999 Terminology and morphologic criteria of neuroblastic tumors Recommendations by the International Neuroblastoma Pathology Committee Cancer 86 2 349 363 Retrieved from https en wikipedia org w index php title Pleomorphic anaplastic neuroblastoma amp oldid 1050548776, wikipedia, wiki, book, books, library,

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