{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:34:11Z","timestamp":1790829251114,"version":"4.1.0"},"reference-count":19,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:p>\n                    Glioma-associated oncogene 1 (\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    ) alterations have been described in pericytoma with t(7;12), gastroblastoma, plexiform fibromyxoma, and an emerging class of\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    -rearranged or amplified mesenchymal neoplasms including \u201cnested glomoid neoplasm\u201d. The immunophenotype of these tumor types is nonspecific, making some cases difficult to diagnose without sequencing. The utility of GLI1 immunohistochemistry (IHC) in distinguishing nested glomoid neoplasms and pericytomas with t(7;12) from morphologic mimics is unknown. To investigate the diagnostic value of GLI1 IHC, we determined its sensitivity and specificity in a \u201ctest cohort\u201d of 23 mesenchymal neoplasms characterized by\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    alterations, including 12 nested glomoid neoplasms (7\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    -rearranged, 4\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    amplified, and 1 unknown\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    status), 9 pericytomas with t(7;12), 1 gastroblastoma, and 1 malignant epithelioid neoplasm with\n                    <jats:italic toggle=\"yes\">PTCH1<\/jats:italic>\n                    ::\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    fusion. GLI1 IHC was 91.3% sensitive in this cohort; all tumors except 2 pericytomas with t(7;12) expressed GLI1. GLI1 was also expressed in 1 of 8 (12%) plexiform fibromyxomas. Nineteen of 22 GLI1-positive tumors showed nuclear and cytoplasmic staining, while 3 showed nuclear staining only. GLI1 IHC was 98.0% specific; among morphologic mimics [40 well-differentiated neuroendocrine tumors, 10 atypical lung carcinoids, 20 paragangliomas, 20 glomus tumors, 20 solitary fibrous tumors, 10 Ewing sarcomas, 10 alveolar rhabdomyosarcomas (ARMS), 10\n                    <jats:italic toggle=\"yes\">BCOR<\/jats:italic>\n                    -altered sarcomas, 10 myoepitheliomas, 9 myopericytomas, 9 epithelioid schwannomas, 9 ossifying fibromyxoid tumors, 10 biphasic synovial sarcomas, 10 PEComas, 31 gastrointestinal stromal tumors, 10 inflammatory fibroid polyps, 11 pseudoendocrine sarcomas], 5 of 249 tumors expressed GLI1 (2 well-differentiated neuroendocrine tumors, 1 ARMS, 1 Ewing sarcoma, 1\n                    <jats:italic toggle=\"yes\">BCOR<\/jats:italic>\n                    -altered sarcoma). GLI1 IHC was also performed on a separate cohort of 13 molecularly characterized mesenchymal neoplasms in which\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    copy number gain was identified as a putatively secondary event by DNA sequencing (5 dedifferentiated liposarcoma [DDLPS], 2 adenosarcomas, 2 unclassified uterine sarcomas, 1 leiomyosarcoma, 1 ARMS, 1 intimal sarcoma, 1 osteosarcoma); 2 DDLPS, 1 ARMS, and 1 unclassified uterine sarcoma expressed GLI1. Lastly, because pleomorphic sarcomas sometimes show\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    amplification or copy number gain, GLI1 IHC was performed on a separate \u201cpleomorphic sarcoma\u201d cohort: GLI1 was expressed in 1 of 27 DDLPS, 1 of 9 leiomyosarcomas, and 2 of 10 pleomorphic liposarcomas, and it was negative in 23 well-differentiated liposarcomas and 9 unclassified pleomorphic sarcomas. Overall, GLI1 IHC was 91.3% sensitive and 98.0% specific for mesenchymal tumor types with driver\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    alterations among morphologic mimics. GLI1 expression was less frequent in other tumor types with\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    copy number gain. Given its specificity, in the appropriate morphologic context, GLI1 IHC may be a useful diagnostic adjunct for mesenchymal neoplasms with\n                    <jats:italic toggle=\"yes\">GLI1<\/jats:italic>\n                    alterations.\n                  <\/jats:p>","DOI":"10.1097\/pas.0000000000002018","type":"journal-article","created":{"date-parts":[[2023,1,24]],"date-time":"2023-01-24T19:00:05Z","timestamp":1674586805000},"page":"453-460","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":49,"title":["GLI1 Immunohistochemistry Distinguishes Mesenchymal Neoplasms With GLI1 Alterations From Morphologic Mimics"],"prefix":"10.1097","volume":"47","author":[{"given":"Paige H.","family":"Parrack","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Mari\u00f1o-Enr\u00edquez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher D.M.","family":"Fletcher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason L.","family":"Hornick","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7746-3546","authenticated-orcid":false,"given":"David J.","family":"Papke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,1,23]]},"reference":[{"key":"R1-20250608","doi-asserted-by":"crossref","first-page":"1047","DOI":"10.1016\/S0002-9297(07)62934-6","article-title":"The sonic hedgehog-patched-GLI pathway in human development and disease","volume":"67","author":"Villavicencio","year":"2000","journal-title":"Am J Hum Genet"},{"key":"R2-20250608","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/s12964-018-0220-7","article-title":"A highlight on Sonic hedgehog pathway","volume":"16","author":"Carballo","year":"2018","journal-title":"Cell Commun Signal"},{"key":"R3-20250608","first-page":"5407","article-title":"Amplification of the gli Gene in Childhood Sarcomas","volume":"49","author":"Roberts","year":"1989","journal-title":"Cancer Res"},{"key":"R4-20250608","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1002\/(SICI)1098-2264(200006)28:2<220::AID-GCC11>3.0.CO;2-T","article-title":"A novel and consistent amplicon at 13q31 associated with alveolar rhabdomyosarcoma","volume":"28","author":"Gordon","year":"2000","journal-title":"Genes Chromosomes Cancer"},{"key":"R5-20250608","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1097\/PAS.0000000000001010","article-title":"A distinct malignant epithelioid neoplasm with GLI1 gene rearrangements, frequent S100 protein expression, and metastatic potential: expanding the spectrum of pathologic entities with ACTB\/MALAT1\/PTCH1-GLI1 fusions","volume":"42","author":"Antonescu","year":"2018","journal-title":"Am J Surg Pathol"},{"key":"R6-20250608","doi-asserted-by":"crossref","first-page":"1617","DOI":"10.1038\/s41379-019-0293-x","article-title":"GLI1-amplifications expand the spectrum of soft tissue neoplasms defined by GLI1 gene fusions","volume":"32","author":"Agaram","year":"2019","journal-title":"Mod Pathol"},{"key":"R7-20250608","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1097\/PAS.0000000000001844","article-title":"GLI1 gene alterations in neoplasms of the genitourinary and gynecologic tract","volume":"46","author":"Argani","year":"2022","journal-title":"Am J Surg Pathol"},{"key":"R8-20250608","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1097\/PAS.0000000000001439","article-title":"Head and Neck Mesenchymal Neoplasms with GLI1 Gene Alterations: A Pathologic Entity with Distinct Histologic Features and Potential for Distant Metastasis","volume":"44","author":"Xu","year":"2020","journal-title":"Am J Surg Pathol"},{"key":"R9-20250608","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1007\/s00428-021-03224-0","article-title":"GLI1-altered mesenchymal tumor: a clinicopathological and molecular analysis of ten additional cases of an emerging entity","volume":"480","author":"Liu","year":"2022","journal-title":"Virchows Arch"},{"key":"R10-20250608","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1097\/PAS.0000000000001979","article-title":"Distinctive nested glomoid neoplasm: Clinicopathologic analysis of 20 cases of a mesenchymal neoplasm with frequent GLI1 alterations and indolent behavior","volume":"47","author":"Papke","year":"2023","journal-title":"Am J Surg Pathol"},{"key":"R11-20250608","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1038\/modpathol.2017.68","article-title":"Gastroblastoma harbors a recurrent somatic MALAT1-GLI1 fusion gene","volume":"30","author":"Graham","year":"2017","journal-title":"Mod Pathol"},{"key":"R12-20250608","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1177\/1066896919900548","article-title":"A malignant neoplasm from the jejunum with a MALAT1-GLI1 fusion and 26-year survival history","volume":"28","author":"Prall","year":"2020","journal-title":"Int J Surg Pathol"},{"key":"R13-20250608","first-page":"1835","article-title":"Characterization of the 12q amplicons in lipomatous soft tissue tumors by multiplex ligation-dependent probe amplification-based copy number analysis","volume":"35","author":"Creytens","year":"2015","journal-title":"Anticancer Res"},{"key":"R14-20250608","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1097\/PAS.0000000000001751","article-title":"Pseudoendocrine sarcoma: Clinicopathologic analysis of 23 cases of a distinctive soft tissue neoplasm with metastatic potential, recurrent CTNNB1 mutations, and a predilection for truncal locations","volume":"46","author":"Papke","year":"2022","journal-title":"Am J Surg Pathol"},{"key":"R15-20250608","doi-asserted-by":"crossref","first-page":"751","DOI":"10.5858\/arpa.2016-0527-OA","article-title":"Validation of oncopanel a targeted next-generation sequencing assay for the detection of somatic variants in cancer","volume":"141","author":"Garcia","year":"2017","journal-title":"Arch Pathol Lab Med"},{"key":"R16-20250608","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1002\/path.4730","article-title":"Recurrent MALAT1-GLI1 oncogenic fusion and GLI1 up-regulation define a subset of plexiform fibromyxoma","volume":"239","author":"Spans","year":"2016","journal-title":"J Pathol"},{"key":"R17-20250608","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1016\/S0002-9440(10)63723-6","article-title":"Activation of the GLI oncogene through fusion with the \u03b2-Actin gene (ACTB) in a group of distinctive pericytic neoplasms: Pericytoma with t(7;12)","volume":"164","author":"Dahl\u00e9n","year":"2004","journal-title":"Am J Pathol"},{"key":"R18-20250608","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1097\/PAS.0000000000001360","article-title":"Pericytoma with t(7;12) and ACTB-GLI1 fusion: Reevaluation of an unusual entity and its relationship to the spectrum of GLI1 fusion-related neoplasms","volume":"43","author":"Kerr","year":"2019","journal-title":"Aerican J Surg Pathol"},{"key":"R19-20250608","first-page":"1890","article-title":"GLI gene expression in bone and soft tissue sarcomas of adult patients correlates with tumor grade","volume":"59","author":"Stein","year":"1999","journal-title":"Cancer Res"}],"container-title":["American Journal of Surgical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/PAS.0000000000002018","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,8]],"date-time":"2025-06-08T17:01:29Z","timestamp":1749402089000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/PAS.0000000000002018"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1,23]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.1097\/pas.0000000000002018","relation":{},"ISSN":["0147-5185"],"issn-type":[{"value":"0147-5185","type":"print"}],"subject":[],"published":{"date-parts":[[2023,1,23]]}}}