Original contributionPerilipin and adipophilin expression in sebaceous carcinoma and mimics☆
Introduction
Lipogenic pathways are up-regulated in neoplasms as tumors rely on anaerobic glycolysis [1]. Cells using lipogenesis require one or more lipid droplet-associated proteins for the formation and maintenance of lipid droplets [2]. These include perilipin (perilipin 1), adipophilin (adipose differentiation-related protein or perilipin 2), tail-interacting protein of 47 kd (or perilipin 3), and myocardial lipid droplet protein (or OXPAT) [2]. Although adipophilin and tail-interacting protein of 47 kd are nearly ubiquitously expressed, the expression of perilipin is thought to be restricted to adipocytes and certain steroidogenic cells [2], [3].
Recently, adipophilin has been reported to be a sensitive marker for sebaceous carcinoma [4], [5]. Although Ostler et al [4] documented that tumors with clear cell change such as hidradenoma and trichilemmoma were negative for adipophilin, the malignant counterparts of these tumors were not included in this study. Although these authors reported squamous cell carcinoma (SCC) exhibiting background granular staining [4], others have noted adipophilin positivity in the cells of SCC and SCC in situ, representing a pitfall in its distinction from sebaceous carcinoma [6], [7]. In addition, the expression of adipophilin has been reported in a variety of tumors including colonic adenocarcinoma, renal cell carcinoma, hepatocellular carcinomas, pulmonary carcinomas, mammary carcinomas, pancreatic carcinoma, and prostatic adenocarcinoma [7], thus supporting the notion that lipid droplet accumulation is a frequent feature of neoplastic cells.
We sought to investigate whether SCC with clear cell change and eccrine-apocrine carcinomas would have positive staining for adipophilin and the sensitivity and specificity of perilipin in comparison with adipophilin in distinguishing sebaceous carcinomas from SCC with clear cell change and eccrine-apocrine carcinomas.
Section snippets
Materials and methods
This study has been approved by the Massachusetts General Hospital Institutional Review Board (IRB no. 2011-P-2489). Archival materials of sebaceous carcinoma, clear cell SCC, apocrine carcinoma, eccrine carcinoma, aggressive digital papillary adenocarcinoma, hidradenocarcinoma, malignant spiradenoma, porocarcinoma, adenoid cystic carcinoma, malignant chondroid syringoma, malignant cylindroma, and pilomatrical carcinoma diagnosed between 1987 and 2012 were retrieved from the pathology files of
Sebaceous carcinoma
Of the 30 sebaceous carcinomas, 22 localized to the head and neck region (14 from eyelid) and 8 to the trunk. The ages of the patients ranged from 46 to 93 years (median, 72 years). The female-to-male ratio was 8:7. Of the sebaceous carcinomas, 26 were invasive tumors with 3 containing both invasive and in situ components, and 4 were only in situ carcinomas. There were 5, 12, and 9 tumors with well, moderate, and poor differentiation, respectively. The tumors were graded according to criteria
Discussion
Sebaceous carcinoma is an uncommon cutaneous malignancy, yet it is a common malignant eyelid tumor (2%-4%) [9]. Sebaceous carcinoma, especially the invasive and poorly differentiated forms, can mimic basal and squamous cell carcinomas. Studies have reported the initial histologic diagnosis to be incorrect in 23% to 77% of the cases [10]. The main histologic differential diagnosis for sebaceous carcinoma in situ would be a clear cell SCC in situ. Immunohistochemical staining with androgen
Acknowledgment
We thank Juana Jones for her technical assistance and Ethel Mitchell for her administrative support.
References (15)
The perilipin family of structural lipid droplet proteins: stabilization of lipid droplets and control of lipolysis
J Lipid Res
(2007)- et al.
Adipophilin expression in sebaceous tumors and other cutaneous lesions with clear cell histology: an immunohistochemical study of 117 cases
Mod Pathol
(2010) - et al.
Lipid droplet-associated PAT-proteins show frequent and differential expression in neoplastic steatogenesis
Mod Pathol
(2010) - et al.
Sebaceous carcinoma of the eyelids: personal experience with 60 cases
Ophthalmology
(2004) - et al.
PAT family proteins pervade lipid droplet cores
J Lipid Res
(2005) - et al.
Perilipin, a major hormonally regulated adipocyte-specific phosphoprotein associated with the periphery of lipid storage droplets
J Biol Chem
(1991) - et al.
A proposed model of fat packaging by exchangeable lipid droplet proteins
FEBS Lett
(2006)
Cited by (0)
- ☆
There was no funding for this work. The authors have no conflict of interest to declare.