A subset of prostatic basal cell carcinomas harbor the MYB rearrangement of adenoid cystic carcinoma

Justin A. Bishop, Raluca Yonescu, Jonathan Ira Epstein, William H. Westra

Research output: Contribution to journalArticle

Abstract

Summary Adenoid cystic carcinoma (ACC) is a basaloid tumor consisting of myoepithelial and ductal cells typically arranged in a cribriform pattern. Adenoid cystic carcinoma is generally regarded as a form of salivary gland carcinoma, but it can arise from sites unassociated with salivary tissue. A rare form of prostate carcinoma exhibits ACC-like features; it is no longer regarded as a true ACC but rather as prostatic basal cell carcinoma (PBCC) and within the spectrum of basaloid prostatic proliferations. True ACCs often harbor MYB translocations resulting in the MYB-NFIB fusion protein. MYB analysis could clarify the true nature of prostatic carcinomas that exhibit ACC features and thus help refine the classification of prostatic basaloid proliferations. Twelve PBCCs were identified from the pathology consultation files of Johns Hopkins Hospital. The histopathologic features were reviewed, and break-apart fluorescence in situ hybridization for MYB was performed. All 12 cases exhibited prominent basaloid histology. Four were purely solid, 7 exhibited a cribriform pattern reminiscent of salivary ACC, and 1 had a mixed pattern. The MYB rearrangement was detected in 2 (29%) of 7 ACC-like carcinomas but in none (0%) of the 5 PBCCs with a prominent solid pattern. True ACCs can arise in the prostate as is evidenced by the presence of the characteristic MYB rearrangement. When dealing with malignant basaloid proliferations in the prostate, recommendations to consolidate ACCs with other tumor types may need to be reassessed, particularly in light of the rapidly advancing field of biologic therapy where the identification of tumor-specific genetic alterations presents novel therapeutic targets.

Original languageEnglish (US)
Pages (from-to)1204-1208
Number of pages5
JournalHuman Pathology
Volume46
Issue number8
DOIs
StatePublished - Aug 1 2015

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Adenoid Cystic Carcinoma
Basal Cell Carcinoma
Carcinoma
Prostate
Myoepithelioma
Biological Therapy
Salivary Glands
Fluorescence In Situ Hybridization
Neoplasms
Histology
Referral and Consultation
Pathology

Keywords

  • Adenoid cystic carcinoma
  • Basal cell carcinoma
  • Fluorescence in situ hybridization
  • MYB-NFIB
  • Prostate

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Medicine(all)

Cite this

A subset of prostatic basal cell carcinomas harbor the MYB rearrangement of adenoid cystic carcinoma. / Bishop, Justin A.; Yonescu, Raluca; Epstein, Jonathan Ira; Westra, William H.

In: Human Pathology, Vol. 46, No. 8, 01.08.2015, p. 1204-1208.

Research output: Contribution to journalArticle

Bishop, Justin A. ; Yonescu, Raluca ; Epstein, Jonathan Ira ; Westra, William H. / A subset of prostatic basal cell carcinomas harbor the MYB rearrangement of adenoid cystic carcinoma. In: Human Pathology. 2015 ; Vol. 46, No. 8. pp. 1204-1208.
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AB - Summary Adenoid cystic carcinoma (ACC) is a basaloid tumor consisting of myoepithelial and ductal cells typically arranged in a cribriform pattern. Adenoid cystic carcinoma is generally regarded as a form of salivary gland carcinoma, but it can arise from sites unassociated with salivary tissue. A rare form of prostate carcinoma exhibits ACC-like features; it is no longer regarded as a true ACC but rather as prostatic basal cell carcinoma (PBCC) and within the spectrum of basaloid prostatic proliferations. True ACCs often harbor MYB translocations resulting in the MYB-NFIB fusion protein. MYB analysis could clarify the true nature of prostatic carcinomas that exhibit ACC features and thus help refine the classification of prostatic basaloid proliferations. Twelve PBCCs were identified from the pathology consultation files of Johns Hopkins Hospital. The histopathologic features were reviewed, and break-apart fluorescence in situ hybridization for MYB was performed. All 12 cases exhibited prominent basaloid histology. Four were purely solid, 7 exhibited a cribriform pattern reminiscent of salivary ACC, and 1 had a mixed pattern. The MYB rearrangement was detected in 2 (29%) of 7 ACC-like carcinomas but in none (0%) of the 5 PBCCs with a prominent solid pattern. True ACCs can arise in the prostate as is evidenced by the presence of the characteristic MYB rearrangement. When dealing with malignant basaloid proliferations in the prostate, recommendations to consolidate ACCs with other tumor types may need to be reassessed, particularly in light of the rapidly advancing field of biologic therapy where the identification of tumor-specific genetic alterations presents novel therapeutic targets.

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