Genomic analysis of a case of multifocal adenocarcinoma in ulcerative colitis.
Long-standing ulcerative colitis is associated with an elevated risk of developing colonic adenocarcinoma. A very limited group of patients present with multiple synchronous cancers. This could be due to either a multifocal presentation of the same neoplastic clone or different tumors arising in a large area of polyclonal dysplastic colonic mucosa ("field cancerization"). Here, we describe a patient with long-standing colitis and three different tumors in the rectosigmoid part of the large bowel. Clonal evaluation of the lesions was performed by array-based comparative genomic hybridization. These three neoplasms showed a comparable pattern of genomic alterations characterized by gains of chromosomes 12, 13, and 20. Noteworthy, dysplastic mucosa distal to the three cancers displayed a completely different pattern of genomic changes indicating that different cell lineages were present. In addition, all three carcinomas were microsatellite stable and revealed identical immunoprofiles for several cancer-associated genes. We conclude that these three multifocal tumors must have originated from the same preneoplastic lineage.
van Dekken
Herman
H
Department of Pathology, Erasmus Medical Center, Josephine Nefkens Institute, Dr. Molewaterplein 50, 3015GE Rotterdam, The Netherlands. h.vandekken@erasmusmc.nl
Wink
Josiane C
JC
Vissers
Kees J
KJ
van Marion
Ronald
R
Franken
Patrick F
PF
Hoogmans
Monique M C P
MM
Dinjens
Winand N M
WN
Schouten
W Ruud
WR
Kuipers
Ernst J
EJ
van der Woude
C Janneke
CJ
D000230:Adenocarcinoma / Q000209:etiology / Q000235:genetics*; D000368:Aged; D000369:Aged, 80 and over; D002869:Chromosome Aberrations; D003093:Colitis, Ulcerative / Q000150:complications*; D003110:Colonic Neoplasms / Q000209:etiology / Q000235:genetics*; D005260:Female; D006801:Humans; D053842:Microsatellite Instability; D009693:Nucleic Acid Hybridization