ERG expression in multiple myeloma—A potential diagnostic pitfall

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• 作者：Juliana Knief^a ; ^{Juliana.Knief@uksh.de} ; Katharina Reddemann^a ; Jan Gliemroth^b ; Swantje Brede^c ; Tobias Bartscht^c ; Christoph Thorns^a
• 关键词：ERG expression ; Plasmacytoma ; Multiple myeloma
• 刊名：Pathology - Research and Practice
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：213
• 期：2
• 页码：130-132
• 全文大小：1280 K
• 卷排序：213

文摘

ERG expression has been described as a frequent event in prostate cancer indicating poor prognosis and promoting oncogenesis. It has also been demonstrated in Ewing’s sarcoma, acute myeloid leukemia and acute T-lymphoblastic leukemia but could not be found in other epithelial tumors, Hodgkin’s or Non-Hodgkin’s lymphoma. We aimed to analyze ERG expression in multiple myeloma, following an index case of a patient with metastases of unknown origin in the spine strongly expressing ERG, which were thought to be of prostatic origin but turned out to be plasmacytic lesions.Material and methodsWe subsequently selected 12 formalin-fixed, paraffin-embedded tissue samples of multiple myeloma from our archives and performed immunohistochemical staining for ERG.ResultsAll 12 analyzed cases showed strong nuclear expression of ERG in >90% of tumor cells (myeloma cells).ConclusionsThis report highlights a potential and critical diagnostic pitfall in biopsy specimens where morphology is only of limited assistance in reaching the correct diagnosis. It urges pathologists to exercise caution in cases where strong ERG-positivity implicates the presence of a prostatic neoplasia and illustrates the need for further immunohistochemical examination.