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Difference between revisions of "Lynch syndrome"
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[[Image:Tumour-infiltrating lymphocytes - 2 -- very high mag.jpg|thumb|right|250px||[[Micrograph]] showing [[tumour infiltrating lymphocytes]], a finding seen in Lynch syndrome.]] | |||
'''Lynch syndrome''', also '''hereditary non-polyposis colorectal cancer syndrome''' (abbreviated '''HNPCC'''), is a constellation of clinical findings caused by a mutation in a mismatch repair gene, of which there are several.<ref name=OMIM120435>{{OMIM|120435}}</ref> | '''Lynch syndrome''', also '''hereditary non-polyposis colorectal cancer syndrome''' (abbreviated '''HNPCC'''), is a constellation of clinical findings caused by a mutation in a mismatch repair gene, of which there are several.<ref name=OMIM120435>{{OMIM|120435}}</ref> | ||
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*MLH1 gene<ref name=OMIM120436>{{OMIM|120436}}</ref> - second most common. | *MLH1 gene<ref name=OMIM120436>{{OMIM|120436}}</ref> - second most common. | ||
*PMS2 gene.<ref name=OMIM600259>{{OMIM|600259}}</ref> | *PMS2 gene.<ref name=OMIM600259>{{OMIM|600259}}</ref> | ||
*MSH6 gene | *MSH6 gene<ref name=OMIM600678>{{OMIM|600678}}</ref> - tend to present in older individuals compared to individuals with MLH1 or MSH2 mutations.<ref name=pmid24056992>{{Cite journal | last1 = Stewart | first1 = A. | title = Genetic testing strategies in newly diagnosed endometrial cancer patients aimed at reducing morbidity or mortality from lynch syndrome in the index case or her relatives. | journal = PLoS Curr | volume = 5 | issue = | pages = | month = | year = 2013 | doi = 10.1371/currents.eogt.b59a6e84f27c536e50db4e46aa26309c | PMID = 24056992 }}</ref> | ||
*Others. | *Others. | ||
===Associations=== | ===Associations=== | ||
*[[Colorectal carcinoma]]. | *[[Colorectal carcinoma]]. | ||
*Non-endometrioid [[endometrial carcinoma]],<ref name=pmid20396392>{{cite journal |author=Okuda T, Sekizawa A, Purwosunu Y, ''et al.'' |title=Genetics of endometrial cancers |journal=Obstet Gynecol Int |volume=2010 |issue= |pages=984013 |year=2010 |pmid=20396392 |pmc=2852605 |doi=10.1155/2010/984013 |url=}}</ref> e.g. [[endometrial clear cell carcinoma]].<ref name=pmid19638537>{{Cite journal | last1 = Garg | first1 = K. | last2 = Soslow | first2 = RA. | title = Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma. | journal = J Clin Pathol | volume = 62 | issue = 8 | pages = 679-84 | month = Aug | year = 2009 | doi = 10.1136/jcp.2009.064949 | PMID = 19638537 | url = http://jcp.bmj.com/content/62/8/679.long }}</ref> | *[[Endometrial carcinoma]]. | ||
**Morphologic features are not [[sensitivity|sensitive]] - IHC required. | |||
**Non-endometrioid [[endometrial carcinoma]],<ref name=pmid20396392>{{cite journal |author=Okuda T, Sekizawa A, Purwosunu Y, ''et al.'' |title=Genetics of endometrial cancers |journal=Obstet Gynecol Int |volume=2010 |issue= |pages=984013 |year=2010 |pmid=20396392 |pmc=2852605 |doi=10.1155/2010/984013 |url=}}</ref> e.g. [[endometrial clear cell carcinoma]].<ref name=pmid19638537>{{Cite journal | last1 = Garg | first1 = K. | last2 = Soslow | first2 = RA. | title = Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma. | journal = J Clin Pathol | volume = 62 | issue = 8 | pages = 679-84 | month = Aug | year = 2009 | doi = 10.1136/jcp.2009.064949 | PMID = 19638537 | url = http://jcp.bmj.com/content/62/8/679.long }}</ref> | |||
**[[Endometrioid endometrial carcinoma]].<ref name=pmid11873308>{{Cite journal | last1 = Lax | first1 = SF. | title = [Dualistic model of molecular pathogenesis in endometrial carcinoma]. | journal = Zentralbl Gynakol | volume = 124 | issue = 1 | pages = 10-6 | month = Jan | year = 2002 | doi = 10.1055/s-2002-20303 | PMID = 11873308 }}</ref> | |||
**Suggestive features: lower uterine segment, [[tumour infiltrating lymphocytes]].<ref name=pmid9638537>{{Cite journal | last1 = Garg | first1 = K. | last2 = Soslow | first2 = RA. | title = Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma. | journal = J Clin Pathol | volume = 62 | issue = 8 | pages = 679-84 | month = Aug | year = 2009 | doi = 10.1136/jcp.2009.064949 | PMID = 19638537 }}</ref> | **Suggestive features: lower uterine segment, [[tumour infiltrating lymphocytes]].<ref name=pmid9638537>{{Cite journal | last1 = Garg | first1 = K. | last2 = Soslow | first2 = RA. | title = Lynch syndrome (hereditary non-polyposis colorectal cancer) and endometrial carcinoma. | journal = J Clin Pathol | volume = 62 | issue = 8 | pages = 679-84 | month = Aug | year = 2009 | doi = 10.1136/jcp.2009.064949 | PMID = 19638537 }}</ref> | ||
*[[Stomach carcinoma]],<ref name=OMIM120435>{{OMIM|120435}}</ref> intestinal-type.<ref name=pmid3581033>{{Cite journal | last1 = Cristofaro | first1 = G. | last2 = Lynch | first2 = HT. | last3 = Caruso | first3 = ML. | last4 = Attolini | first4 = A. | last5 = DiMatteo | first5 = G. | last6 = Giorgio | first6 = P. | last7 = Senatore | first7 = S. | last8 = Argentieri | first8 = A. | last9 = Sbano | first9 = E. | title = New phenotypic aspects in a family with Lynch syndrome II. | journal = Cancer | volume = 60 | issue = 1 | pages = 51-8 | month = Jul | year = 1987 | doi = | PMID = 3581033 }}</ref> | *[[Stomach carcinoma]],<ref name=OMIM120435>{{OMIM|120435}}</ref> intestinal-type.<ref name=pmid3581033>{{Cite journal | last1 = Cristofaro | first1 = G. | last2 = Lynch | first2 = HT. | last3 = Caruso | first3 = ML. | last4 = Attolini | first4 = A. | last5 = DiMatteo | first5 = G. | last6 = Giorgio | first6 = P. | last7 = Senatore | first7 = S. | last8 = Argentieri | first8 = A. | last9 = Sbano | first9 = E. | title = New phenotypic aspects in a family with Lynch syndrome II. | journal = Cancer | volume = 60 | issue = 1 | pages = 51-8 | month = Jul | year = 1987 | doi = | PMID = 3581033 }}</ref> | ||
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**Papillary lesions > flat lesions.<ref name=pmid12673555>{{Cite journal | last1 = Hartmann | first1 = A. | last2 = Dietmaier | first2 = W. | last3 = Hofstädter | first3 = F. | last4 = Burgart | first4 = LJ. | last5 = Cheville | first5 = JC. | last6 = Blaszyk | first6 = H. | title = Urothelial carcinoma of the upper urinary tract: inverted growth pattern is predictive of microsatellite instability. | journal = Hum Pathol | volume = 34 | issue = 3 | pages = 222-7 | month = Mar | year = 2003 | doi = 10.1053/hupa.2003.22 | PMID = 12673555 }}</ref> | **Papillary lesions > flat lesions.<ref name=pmid12673555>{{Cite journal | last1 = Hartmann | first1 = A. | last2 = Dietmaier | first2 = W. | last3 = Hofstädter | first3 = F. | last4 = Burgart | first4 = LJ. | last5 = Cheville | first5 = JC. | last6 = Blaszyk | first6 = H. | title = Urothelial carcinoma of the upper urinary tract: inverted growth pattern is predictive of microsatellite instability. | journal = Hum Pathol | volume = 34 | issue = 3 | pages = 222-7 | month = Mar | year = 2003 | doi = 10.1053/hupa.2003.22 | PMID = 12673555 }}</ref> | ||
**Extensive inverted growth pattern suggestive of MSI.<ref name=pmid12673555/> | **Extensive inverted growth pattern suggestive of MSI.<ref name=pmid12673555/> | ||
**MSH2 mutations have an increased risk of urothelial carcinoma relative to MLH1 and MSH6 mutations.<ref name=pmid20591884>{{Cite journal | last1 = van der Post | first1 = RS. | last2 = Kiemeney | first2 = LA. | last3 = Ligtenberg | first3 = MJ. | last4 = Witjes | first4 = JA. | last5 = Hulsbergen-van de Kaa | first5 = CA. | last6 = Bodmer | first6 = D. | last7 = Schaap | first7 = L. | last8 = Kets | first8 = CM. | last9 = van Krieken | first9 = JH. | title = Risk of urothelial bladder cancer in Lynch syndrome is increased, in particular among MSH2 mutation carriers. | journal = J Med Genet | volume = 47 | issue = 7 | pages = 464-70 | month = Jul | year = 2010 | doi = 10.1136/jmg.2010.076992 | PMID = 20591884 }}</ref> | |||
Lame mnemonic ''GP CUBE'': | Lame mnemonic ''GP CUBE'': | ||