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Granular necrosis: a distinctive form of cell death in malignant tumours.
Pathology. 2020 Aug; 52(5):507-514.P

Abstract

Foci of necrosis are frequently seen in malignant tumours and may be due to a variety of causes. Different types of necrosis are given various names based upon their morphological features and presumed pathogenesis, such as coagulative, liquefactive and fibrinoid necrosis. Here, we propose the term 'granular necrosis' (GN) for a specific form of tumour necrosis characterised by the presence of well-defined necrotic foci being sharply demarcated from adjacent viable tumour. A constant feature is loss of architecture resulting in an amorphous necrotic mass containing granular nuclear and cytoplasmic debris, without an associated neutrophilic infiltrate. There is usually extensive karyorrhexis, which in larger tumours is more prominent at the periphery. These foci are often microscopic but may range up to several millimetres or larger in size. This distinctive form of necrosis has been erroneously given a variety of names in the literature including coagulative necrosis and microscopic necrosis, which on the basis of the aforementioned gross and microscopic findings is inappropriate. It is apparent that this is a specific form of necrosis, hence the descriptive term 'granular necrosis' that differentiates this form of necrosis from other types. The presence of GN is recognised as occurring in a variety of tumour types, being commonly seen in renal cell carcinoma, where it has been shown to have independent prognostic significance. In some epithelial and stromal tumours of the uterus, the presence of GN also has prognostic significance and is a defining feature for the differentiation of uterine leiomyoma and leiomyosarcoma. The pathogenesis of GN is unresolved. It does not show the features of apoptosis and in recent studies has been shown to have some of the molecular changes associated with necroptosis.

Authors+Show Affiliations

Aquesta Uropathology and University of Queensland, Brisbane, Qld, Australia.Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand. Electronic address: brett.delahunt@otago.ac.nz.Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada.Department of Molecular Oncology, Queen Mary University Hospital, London, United Kingdom.Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.Department of Laboratory Information Support Systems, University Health Network, Toronto, ON, Canada.Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences and Cancer Genomics Unit, Clinical Genomics Center, Nagasaki University Hospital, Sakamoto, Nagasaki, Japan.Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brazil.Department of Pathology and Urology, Case Western Reserve University, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.Department of Pathology and Diagnostics, School of Medicine and Surgery, University of Verona, Verona, Italy.University and University Hospital Zurich, Department of Pathology and Molecular Pathology, Zurich, Switzerland.Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan.Departments of Pathology and Surgery (Section of Urology) University of Chicago, Chicago, IL, USA.Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University, Houston, TX, USA.Department of Pathology and Molecular Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington, New Zealand.Department of Surgical Pathology, Aichi Medical University, School of Medicine, Nagakute, Japan.Department of Pathology and Laboratory Medicine, Baylor St Luke's Medical Center and Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, USA.Department of Pathology, Princess Margaret Cancer Center, University Health Network, Toronto, ON, Canada.Department of Cellular Pathology, University Hospital of Wales, Cardiff, UK.Department of Pathology, Cleveland Clinic, Cleveland, OH, USA.Department of Medicine, University of Queensland, Wesley Urology Clinic, Royal Brisbane and Womens Hospital, Brisbane, Qld, Australia.Department of Oncology and Pathology, Karolinska Institutet, Stockholm, Sweden.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

32561208

Citation

Samaratunga, Hemamali, et al. "Granular Necrosis: a Distinctive Form of Cell Death in Malignant Tumours." Pathology, vol. 52, no. 5, 2020, pp. 507-514.
Samaratunga H, Delahunt B, Srigley JR, et al. Granular necrosis: a distinctive form of cell death in malignant tumours. Pathology. 2020;52(5):507-514.
Samaratunga, H., Delahunt, B., Srigley, J. R., Berney, D. M., Cheng, L., Evans, A., Furusato, B., Leite, K. R. M., MacLennan, G. T., Martignoni, G., Moch, H., Pan, C. C., Paner, G., Ro, J., Thunders, M., Tsuzuki, T., Wheeler, T., van der Kwast, T., Varma, M., ... Egevad, L. (2020). Granular necrosis: a distinctive form of cell death in malignant tumours. Pathology, 52(5), 507-514. https://doi.org/10.1016/j.pathol.2020.06.002
Samaratunga H, et al. Granular Necrosis: a Distinctive Form of Cell Death in Malignant Tumours. Pathology. 2020;52(5):507-514. PubMed PMID: 32561208.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Granular necrosis: a distinctive form of cell death in malignant tumours. AU - Samaratunga,Hemamali, AU - Delahunt,Brett, AU - Srigley,John R, AU - Berney,Daniel M, AU - Cheng,Liang, AU - Evans,Andrew, AU - Furusato,Bungo, AU - Leite,Katia R M, AU - MacLennan,Gregory T, AU - Martignoni,Guido, AU - Moch,Holger, AU - Pan,Chin-Chen, AU - Paner,Gladell, AU - Ro,Jae, AU - Thunders,Michelle, AU - Tsuzuki,Toyonori, AU - Wheeler,Thomas, AU - van der Kwast,Theodorus, AU - Varma,Murali, AU - Williamson,Sean R, AU - Yaxley,John W, AU - Egevad,Lars, Y1 - 2020/06/16/ PY - 2020/05/15/received PY - 2020/06/11/revised PY - 2020/06/11/accepted PY - 2020/6/21/pubmed PY - 2020/6/21/medline PY - 2020/6/21/entrez KW - Carcinoma KW - granular necrosis KW - high grade KW - necrosis KW - pathogenesis KW - prognosis KW - sarcoma SP - 507 EP - 514 JF - Pathology JO - Pathology VL - 52 IS - 5 N2 - Foci of necrosis are frequently seen in malignant tumours and may be due to a variety of causes. Different types of necrosis are given various names based upon their morphological features and presumed pathogenesis, such as coagulative, liquefactive and fibrinoid necrosis. Here, we propose the term 'granular necrosis' (GN) for a specific form of tumour necrosis characterised by the presence of well-defined necrotic foci being sharply demarcated from adjacent viable tumour. A constant feature is loss of architecture resulting in an amorphous necrotic mass containing granular nuclear and cytoplasmic debris, without an associated neutrophilic infiltrate. There is usually extensive karyorrhexis, which in larger tumours is more prominent at the periphery. These foci are often microscopic but may range up to several millimetres or larger in size. This distinctive form of necrosis has been erroneously given a variety of names in the literature including coagulative necrosis and microscopic necrosis, which on the basis of the aforementioned gross and microscopic findings is inappropriate. It is apparent that this is a specific form of necrosis, hence the descriptive term 'granular necrosis' that differentiates this form of necrosis from other types. The presence of GN is recognised as occurring in a variety of tumour types, being commonly seen in renal cell carcinoma, where it has been shown to have independent prognostic significance. In some epithelial and stromal tumours of the uterus, the presence of GN also has prognostic significance and is a defining feature for the differentiation of uterine leiomyoma and leiomyosarcoma. The pathogenesis of GN is unresolved. It does not show the features of apoptosis and in recent studies has been shown to have some of the molecular changes associated with necroptosis. SN - 1465-3931 UR - https://www.unboundmedicine.com/medline/citation/32561208/Granular_necrosis:_a_distinctive_form_of_cell_death_in_malignant_tumours L2 - https://linkinghub.elsevier.com/retrieve/pii/S0031-3025(20)30840-0 DB - PRIME DP - Unbound Medicine ER -
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