BRST5:Phyllodes tumour: Difference between revisions

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==Primary Author(s)*==
{{DISPLAYTITLE:Phyllodes tumour}}


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[[BRST5:Table_of_Contents|Breast Tumours (WHO Classification, 5th ed.)]]


__TOC__
{{Under Construction}}


==Cancer Category/Type==
<br />
==Primary Author(s)*==
Emilie Lalonde, PhD, London Health Sciences Center and Western University, London, Ontario, Canada


Put your text here
H. Evin Gulbahce, MD, MSCI, University of Utah, UT, USA


==Cancer Sub-Classification / Subtype==
Katherine Geiersbach, MD, Mayo Clinic - Rochester, MN, USA


Put your text here
==WHO Classification of Disease==


==Definition / Description of Disease==
{| class="wikitable"
!Structure
!Disease
|-
|Book
|Breast Tumours (5th ed.)
|-
|Category
|Fibroepithelial tumours and hamartomas of the breast
|-
|Family
|Fibroepithelial tumours and hamartomas of the breast: Introduction
|-
|Type
|Phyllodes tumour
|-
|Subtype(s)
|N/A
|}


Put your text here
==Related Terminology==


==Synonyms / Terminology==
Put your text here
==Epidemiology / Prevalence==
Put your text here
==Clinical Features==
Put your text here and fill in the table
{| class="wikitable"
{| class="wikitable"
|'''Signs and Symptoms'''
|+
|EXAMPLE Asymptomatic (incidental finding on complete blood counts)
|Acceptable
 
|N/A
EXAMPLE B-symptoms (weight loss, fever, night sweats)
 
EXAMPLE Fatigue
 
EXAMPLE Lymphadenopathy (uncommon)
|-
|-
|'''Laboratory Findings'''
|Not Recommended
|EXAMPLE Cytopenias
|Cystosarcoma phyllodes
 
EXAMPLE Lymphocytosis (low level)
|}
|}


==Sites of Involvement==
==Gene Rearrangements==


Put your text here
==Morphologic Features==
Put your text here
==Immunophenotype==
Put your text here and fill in the table


<br />
{| class="wikitable sortable"
{| class="wikitable sortable"
|-
|-
!Finding!!Marker
!Driver Gene!!Fusion(s) and Common Partner Genes!!Molecular Pathogenesis!!Typical Chromosomal Alteration(s)
!Prevalence -Common >20%, Recurrent 5-20% or Rare <5% (Disease)
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T
!Established Clinical Significance Per Guidelines - Yes or No (Source)
!Clinical Relevance Details/Other Notes
|-
|-
|Positive (universal)||EXAMPLE CD1
|''EGFR''
|N/A
|Intragenic deletion of exons 2–7 in ''EGFR'' removes the ligand-binding domain, resulting in a constitutively active tyrosine kinase with downstream activation of multiple oncogenic pathways.
|N/A
|Recurrent
|D, P, T
|
|
|-
|-
|Positive (subset)||EXAMPLE CD2
|
|-
|
|Negative (universal)||EXAMPLE CD3
|
|-
|
|Negative (subset)||EXAMPLE CD4
|
|
|
|
|}
|}


==Chromosomal Rearrangements (Gene Fusions)==
Put your text here and fill in the table


==Individual Region Genomic Gain/Loss/LOH==
<br />
{| class="wikitable sortable"
{| class="wikitable sortable"
|-
|-
!Chromosomal Rearrangement!!Genes in Fusion (5’ or 3’ Segments)!!Pathogenic Derivative!!Prevalence
!Chr #!!Gain, Loss, Amp, LOH!!Minimal Region Cytoband and/or Genomic Coordinates [Genome Build; Size]!!Relevant Gene(s)
!Diagnostic Significance (Yes, No or Unknown)
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T
!Prognostic Significance (Yes, No or Unknown)
!Established Clinical Significance Per Guidelines - Yes or No (Source)
!Therapeutic Significance (Yes, No or Unknown)
!Clinical Relevance Details/Other Notes
!Notes
|-
|1
|Gain
|1q (whole arm)
|
|
|
|Frequency in benign tumors varies, up to 33% across studies<ref name=":0">{{Cite journal|last=Laé|first=Marick|last2=La Rosa|first2=Philippe|last3=Mandel|first3=Jonas|last4=Reyal|first4=Fabien|last5=Hupé|first5=Philippe|last6=Terrier|first6=Philippe|last7=Couturier|first7=Jérôme|date=2016-12|title=Whole-genome profiling helps to classify phyllodes tumours of the breast|url=https://pubmed.ncbi.nlm.nih.gov/27207013|journal=Journal of Clinical Pathology|volume=69|issue=12|pages=1081–1087|doi=10.1136/jclinpath-2016-203684|issn=1472-4146|pmid=27207013}}</ref><ref name=":1">{{Cite journal|last=Jones|first=A. M.|last2=Mitter|first2=R.|last3=Springall|first3=R.|last4=Graham|first4=T.|last5=Winter|first5=E.|last6=Gillett|first6=C.|last7=Hanby|first7=A. M.|last8=Tomlinson|first8=I. P. M.|last9=Sawyer|first9=E. J.|date=2008-04|title=A comprehensive genetic profile of phyllodes tumours of the breast detects important mutations, intra-tumoral genetic heterogeneity and new genetic changes on recurrence|url=https://pubmed.ncbi.nlm.nih.gov/18288784|journal=The Journal of Pathology|volume=214|issue=5|pages=533–544|doi=10.1002/path.2320|issn=0022-3417|pmid=18288784}}</ref><ref name=":2">{{Cite journal|last=Lv|first=Shuhua|last2=Niu|first2=Yun|last3=Wei|first3=Li|last4=Liu|first4=Qingjie|last5=Wang|first5=Xiaowei|last6=Chen|first6=Yan|date=2008-12|title=Chromosomal aberrations and genetic relations in benign, borderline and malignant phyllodes tumors of the breast: a comparative genomic hybridization study|url=https://pubmed.ncbi.nlm.nih.gov/18189161|journal=Breast Cancer Research and Treatment|volume=112|issue=3|pages=411–418|doi=10.1007/s10549-007-9876-1|issn=1573-7217|pmid=18189161}}</ref>
|-
|7
|Amp
|7p11.2
|''EGFR''
|
|
|Amplification and/or rearrangement (most commonly loss of exons 2-7) in 33% of borderline and malignant tumors<ref name=":3">{{Cite journal|last=Gatalica|first=Zoran|last2=Vranic|first2=Semir|last3=Ghazalpour|first3=Anatole|last4=Xiu|first4=Joanne|last5=Ocal|first5=Idris Tolgay|last6=McGill|first6=John|last7=Bender|first7=Ryan P.|last8=Discianno|first8=Erin|last9=Schlum|first9=Aaron|date=2016-01-12|title=Multiplatform molecular profiling identifies potentially targetable biomarkers in malignant phyllodes tumors of the breast|url=https://pubmed.ncbi.nlm.nih.gov/26625196|journal=Oncotarget|volume=7|issue=2|pages=1707–1716|doi=10.18632/oncotarget.6421|issn=1949-2553|pmc=4811491|pmid=26625196}}</ref>
|-
|-
|EXAMPLE t(9;22)(q34;q11.2)||EXAMPLE 3'ABL1 / 5'BCR||EXAMPLE der(22)||EXAMPLE 20% (COSMIC)
|7
EXAMPLE 30% (add reference)
|Gain
|Yes
|7q
|No
|
|Yes
|
|EXAMPLE
|
 
|Observed in 39-57% of malignant tumors, 7-13% of borderline tumors; not observed in benign tumors<ref name=":1" />
The t(9;22) is diagnostic of CML in the appropriate morphology and clinical context (add reference). This fusion is responsive to targeted therapy such as Imatinib (Gleevec) (add reference).
|-
|}
|8
|Gain
==Individual Region Genomic Gain/Loss/LOH==
|8q
 
|
Put your text here and fill in the table
|
 
|
{| class="wikitable sortable"
|Significantly more common in malignant vs. borderline tumors<ref name=":0" /><ref name=":1" />
|-
|9
|Loss
|9p21
|''CDKN2A'', ''CDKN2B''
|P
|
|Borderline and malignant tumors; associated with recurrence<ref name=":4">{{Cite journal|last=Tsang|first=Julia Y.|last2=Shao|first2=Yan|last3=Poon|first3=Ivan K.|last4=Ni|first4=Yun-Bi|last5=Kwan|first5=Johnny S.|last6=Chow|first6=Chit|last7=Shea|first7=Ka-Ho|last8=Tse|first8=Gary M.|date=2022-10|title=Analysis of recurrent molecular alterations in phyllodes tumour of breast: insights into prognosis and pathogenesis|url=https://pubmed.ncbi.nlm.nih.gov/35691725|journal=Pathology|volume=54|issue=6|pages=678–685|doi=10.1016/j.pathol.2022.03.008|issn=1465-3931|pmid=35691725}}</ref>
|-
|-
!Chr #!!Gain / Loss / Amp / LOH!!Minimal Region Genomic Coordinates [Genome Build]!!Minimal Region Cytoband
|10
!Diagnostic Significance (Yes, No or Unknown)
|Loss
!Prognostic Significance (Yes, No or Unknown)
|10q23.31
!Therapeutic Significance (Yes, No or Unknown)
|''PTEN''
!Notes
|P
|
|Mostly borderline and malignant tumors<ref>{{Cite journal|last=Kim|first=Ji-Yeon|last2=Yu|first2=Jong Han|last3=Nam|first3=Seok Jin|last4=Kim|first4=Seok Won|last5=Lee|first5=Se Kyung|last6=Park|first6=Woong-Yang|last7=Noh|first7=Dong-Young|last8=Nam|first8=Do-Hyun|last9=Park|first9=Yeon Hee|date=2018-02|title=Genetic and Clinical Characteristics of Phyllodes Tumors of the Breast|url=https://pubmed.ncbi.nlm.nih.gov/29145046|journal=Translational Oncology|volume=11|issue=1|pages=18–23|doi=10.1016/j.tranon.2017.10.002|issn=1936-5233|pmc=5684533|pmid=29145046}}</ref><ref>{{Cite journal|last=Nozad|first=Sahar|last2=Sheehan|first2=Christine E.|last3=Gay|first3=Laurie M.|last4=Elvin|first4=Julia A.|last5=Vergilio|first5=Jo-Anne|last6=Suh|first6=James|last7=Ramkissoon|first7=Shakti|last8=Schrock|first8=Alexa B.|last9=Hirshfield|first9=Kim M.|date=2017-04|title=Comprehensive genomic profiling of malignant phyllodes tumors of the breast|url=https://pubmed.ncbi.nlm.nih.gov/28210881|journal=Breast Cancer Research and Treatment|volume=162|issue=3|pages=597–602|doi=10.1007/s10549-017-4156-1|issn=1573-7217|pmid=28210881}}</ref><ref name=":0" /><ref name=":1" />
|-
|-
|EXAMPLE
|13
 
|Loss
7
|13q14.2
|EXAMPLE Loss
|''RB1''
|EXAMPLE
|
 
|
chr7:1- 159,335,973 [hg38]
|Mostly borderline and malignant tumors<ref name=":0" /><ref name=":1" /><ref name=":2" />
|EXAMPLE
 
chr7
|Yes
|Yes
|No
|EXAMPLE
 
Presence of monosomy 7 (or 7q deletion) is sufficient for a diagnosis of AML with MDS-related changes when there is ≥20% blasts and no prior therapy (add reference).  Monosomy 7/7q deletion is associated with a poor prognosis in AML (add reference).
|-
|-
|EXAMPLE
|
 
|
8
|
|EXAMPLE Gain
|
|EXAMPLE
|
 
|
chr8:1-145,138,636 [hg38]
|
|EXAMPLE
 
chr8
|No
|No
|No
|EXAMPLE
 
Common recurrent secondary finding for t(8;21) (add reference).
|}
|}
==Characteristic Chromosomal Patterns==


Put your text here


==Characteristic Chromosomal or Other Global Mutational Patterns==
<br />
{| class="wikitable sortable"
{| class="wikitable sortable"
|-
|-
!Chromosomal Pattern
!Chromosomal Pattern
!Diagnostic Significance (Yes, No or Unknown)
!Molecular Pathogenesis
!Prognostic Significance (Yes, No or Unknown)
!Prevalence -
!Therapeutic Significance (Yes, No or Unknown)
Common >20%, Recurrent 5-20% or Rare <5% (Disease)
!Notes
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T
!Established Clinical Significance Per Guidelines - Yes or No (Source)
!Clinical Relevance Details/Other Notes
|-
|-
|EXAMPLE
|
|
|
|
|
|
|}


Co-deletion of 1p and 18q
|Yes
|No
|No
|EXAMPLE:


See chromosomal rearrangements table as this pattern is due to an unbalanced derivative translocation associated with oligodendroglioma (add reference).
|}
==Gene Mutations (SNV/INDEL)==
==Gene Mutations (SNV/INDEL)==
 
<br />
Put your text here and fill in the table
 
{| class="wikitable sortable"
{| class="wikitable sortable"
|-
|-
!Gene; Genetic Alteration!!'''Presumed Mechanism (Tumor Suppressor Gene [TSG] / Oncogene / Other)'''!!'''Prevalence (COSMIC /  TCGA / Other)'''!!'''Concomitant Mutations'''!!'''Mutually Exclusive Mutations'''
!Gene!!Genetic Alteration!!Tumor Suppressor Gene, Oncogene, Other!!Prevalence -
!'''Diagnostic Significance (Yes, No or Unknown)'''
Common >20%, Recurrent 5-20% or Rare <5% (Disease)
!Prognostic Significance (Yes, No or Unknown)
!Diagnostic, Prognostic, and Therapeutic Significance - D, P, T  
!Therapeutic Significance (Yes, No or Unknown)
!Established Clinical Significance Per Guidelines - Yes or No (Source)
!Notes
!Clinical Relevance Details/Other Notes
|-
|-
|EXAMPLE: TP53; Variable LOF mutations
|''FLNA''
|
|Oncogene
|Common
|
|
|No significant difference between benign, borderline, and malignant tumors<ref name=":4" /><ref name=":5">{{Cite journal|last=Tan|first=Jing|last2=Ong|first2=Choon Kiat|last3=Lim|first3=Weng Khong|last4=Ng|first4=Cedric Chuan Young|last5=Thike|first5=Aye Aye|last6=Ng|first6=Ley Moy|last7=Rajasegaran|first7=Vikneswari|last8=Myint|first8=Swe Swe|last9=Nagarajan|first9=Sanjanaa|date=2015-11|title=Genomic landscapes of breast fibroepithelial tumors|url=https://pubmed.ncbi.nlm.nih.gov/26437033|journal=Nature Genetics|volume=47|issue=11|pages=1341–1345|doi=10.1038/ng.3409|issn=1546-1718|pmid=26437033}}</ref>
|-
|''MED12''
|G44 residue is a hotspot
|Oncogene
|Common
|D
|
|No significant difference between benign, borderline, and malignant tumors. Frequently co-mutated with ''RARA'', ''TERT'' promoter, ''SETD2'', ''EGFR''.<ref>{{Cite journal|last=Cani|first=Andi K.|last2=Hovelson|first2=Daniel H.|last3=McDaniel|first3=Andrew S.|last4=Sadis|first4=Seth|last5=Haller|first5=Michaela J.|last6=Yadati|first6=Venkata|last7=Amin|first7=Anmol M.|last8=Bratley|first8=Jarred|last9=Bandla|first9=Santhoshi|date=2015-04|title=Next-Gen Sequencing Exposes Frequent MED12 Mutations and Actionable Therapeutic Targets in Phyllodes Tumors|url=https://pubmed.ncbi.nlm.nih.gov/25593300|journal=Molecular cancer research: MCR|volume=13|issue=4|pages=613–619|doi=10.1158/1541-7786.MCR-14-0578|issn=1557-3125|pmc=4936398|pmid=25593300}}</ref><ref name=":5" /><ref name=":4" /> ''MED12'' is also frequently mutated in fibroadenoma, a related fibroepthelial tumor.<ref name=":5" />
|-
|''RARA''
|
|Oncogene
|Common
|P
|
|Frequently co-mutated with ''MED12''<ref name=":4" /><ref name=":6">{{Cite journal|last=Yeong|first=Joe|last2=Thike|first2=Aye Aye|last3=Young Ng|first3=Cedric Chuan|last4=Md Nasir|first4=Nur Diyana|last5=Loh|first5=Kiley|last6=Teh|first6=Bin Tean|last7=Tan|first7=Puay Hoon|date=2017-12|title=A genetic mutation panel for differentiating malignant phyllodes tumour from metaplastic breast carcinoma|url=https://pubmed.ncbi.nlm.nih.gov/29066183|journal=Pathology|volume=49|issue=7|pages=786–789|doi=10.1016/j.pathol.2017.07.011|issn=1465-3931|pmid=29066183}}</ref> and correlated with recurrence<ref name=":4" />
|-
|''TERT''
|promoter mutation
|Oncogene
|Common
|
|
|No significant difference between benign, borderline, and malignant tumors. Frequently co-mutated with ''MED12''.<ref name=":4" /><ref name=":6" />
|-
|''CDKN2A''
|Inactivating mutations
|Tumor suppressor gene
|Recurrent
|
|
|More common in malignant tumors.<ref name=":4" />
|-
|''EGFR''


EXAMPLE:
<br />
 
|Exon 18-21 activating mutations
EGFR; Exon 20 mutations
|Oncogene
 
|Recurrent
EXAMPLE: BRAF; Activating mutations
|T
|EXAMPLE: TSG
|
|EXAMPLE: 20% (COSMIC)
|More common in malignant tumors<ref name=":4" /><ref name=":3" />
 
|-
EXAMPLE: 30% (add Reference)
|''KMT2D''
|EXAMPLE: IDH1 R123H
|Inactivating mutations
|EXAMPLE: EGFR amplification
|Tumor Suppressor Gene
|Recurrent
|
|
|Inactivation results in aberrant transcription regulation via epigenetic changes. No significant difference between benign, borderline, and malignant tumors.<ref name=":4" />
|-
|''NF1''
|
|Tumor suppressor gene
|Recurrent
|
|
|More common in malignant tumors.<ref name=":4" /><ref name=":6" />
|-
|''PIK3CA''
|
|Oncogene
|Recurrent
|
|
|More common in borderline and malignant tumors.<ref name=":4" /><ref name=":6" />
|-
|''RB1''
|
|Tumor suppressor gene
|Recurrent
|
|
|More common in malignant tumors. Gene deletions also common.<ref name=":6" /><ref name=":4" />
|-
|''SETD2''
|
|Other
|Recurrent
|
|
|
|Frequently co-mutated with ''MED12''. No significant difference between benign, borderline, and malignant tumors.<ref name=":6" /><ref name=":4" />
|-
|''TP53''
|Inactivating mutations
|Tumor suppressor gene
|Recurrent
|
|
|
|
|EXAMPLE:  Excludes hairy cell leukemia (HCL) (add reference).
|More common in malignant tumors.<ref name=":4" /> Germline mutations have been associated with phyllodes tumors.<ref>{{Cite journal|last=Rosenberger|first=Laura H.|last2=Thomas|first2=Samantha M.|last3=Nimbkar|first3=Suniti N.|last4=Hieken|first4=Tina J.|last5=Ludwig|first5=Kandice K.|last6=Jacobs|first6=Lisa K.|last7=Miller|first7=Megan E.|last8=Gallagher|first8=Kristalyn K.|last9=Wong|first9=Jasmine|date=2020-10|title=Germline Genetic Mutations in a Multi-center Contemporary Cohort of 550 Phyllodes Tumors: An Opportunity for Expanded Multi-gene Panel Testing|url=https://pubmed.ncbi.nlm.nih.gov/32504368|journal=Annals of Surgical Oncology|volume=27|issue=10|pages=3633–3640|doi=10.1245/s10434-020-08480-z|issn=1534-4681|pmc=9945652|pmid=32504368}}</ref>
<br />
|}Note: A more extensive list of mutations can be found in [https://www.cbioportal.org/ <u>cBioportal</u>], [https://cancer.sanger.ac.uk/cosmic <u>COSMIC</u>], and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content.
|}
 
Note: A more extensive list of mutations can be found in cBioportal (https://www.cbioportal.org/), COSMIC (https://cancer.sanger.ac.uk/cosmic), ICGC (https://dcc.icgc.org/) and/or other databases. When applicable, gene-specific pages within the CCGA site directly link to pertinent external content.


==Epigenomic Alterations==
==Epigenomic Alterations==


Put your text here


==Genes and Main Pathways Involved==
==Genes and Main Pathways Involved==


Put your text here and fill in the table
 
Put your text here and fill in the table <span style="color:#0070C0">(''Instructions: Please include references throughout the table. Do not delete the table.)''</span>
{| class="wikitable sortable"
{| class="wikitable sortable"
|-
|-
!Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome
!Gene; Genetic Alteration!!Pathway!!Pathophysiologic Outcome
|-
|-
|EXAMPLE: BRAF and MAP2K1; Activating mutations
|<span class="blue-text">EXAMPLE:</span> ''BRAF'' and ''MAP2K1''; Activating mutations
|EXAMPLE: MAPK signaling
|<span class="blue-text">EXAMPLE:</span> MAPK signaling
|EXAMPLE: Increased cell growth and proliferation
|<span class="blue-text">EXAMPLE:</span> Increased cell growth and proliferation
|-
|-
|EXAMPLE: CDKN2A; Inactivating mutations
|<span class="blue-text">EXAMPLE:</span> ''CDKN2A''; Inactivating mutations
|EXAMPLE: Cell cycle regulation
|<span class="blue-text">EXAMPLE:</span> Cell cycle regulation
|EXAMPLE: Unregulated cell division
|<span class="blue-text">EXAMPLE:</span> Unregulated cell division
|-
|-
|EXAMPLE:  KMT2C and ARID1A; Inactivating mutations
|<span class="blue-text">EXAMPLE:</span> ''KMT2C'' and ''ARID1A''; Inactivating mutations
|EXAMPLE:  Histone modification, chromatin remodeling
|<span class="blue-text">EXAMPLE:</span> Histone modification, chromatin remodeling
|EXAMPLE:  Abnormal gene expression program
|<span class="blue-text">EXAMPLE:</span> Abnormal gene expression program
|-
|
|
|
|}
|}
==Genetic Diagnostic Testing Methods==
==Genetic Diagnostic Testing Methods==
 
Next generation sequencing. Chromosomal microarray for CNV detection can be considered if NGS testing does not call CNVs. Detection of CNVs can help differentiate between fibroadenomas and phyllodes tumors. FISH for EGFR amplification can also be considered in the absence of chromosome microarray or appropriate NGS assays.
Put your text here
 
==Familial Forms==
==Familial Forms==
 
Patients with Li-Fraumeni syndrome (germline TP53 pathogenic mutations) are at increased risk of phyllodes tumor.
Put your text here
 
==Additional Information==
==Additional Information==
Due to the rarity of phyllodes tumors, most genomic studies are limited in number, and studies including patient follow-up information are very rare. Thus, the true mutation rate for rare events may vary compared to the numbers presented. In addition, very few studies have evaluated the prognostic value of genomic abnormalities.
==Links==
https://www.pathologyoutlines.com/topic/breastphyllodesgeneral.html
==Notes==


Put your text here


==Links==
<nowiki>*</nowiki>Primary authors will typically be those that initially create and complete the content of a page.  If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the [[Leadership|''<u>Associate Editor</u>'']] or other CCGA representative.  When pages have a major update, the new author will be acknowledged at the beginning of the page, and those who contributed previously will be acknowledged below as a prior author.


Put your text placeholder here (use "Link" icon at top of page)
Prior Author(s):


<br />
==References==
==References==
<references />
<br /><references />
(use "Cite" icon at top of page)
<nowiki>*</nowiki>''Citation of this Page'': “Phyllodes tumour”. Compendium of Cancer Genome Aberrations (CCGA), Cancer Genomics Consortium (CGC), updated {{REVISIONMONTH}}/{{REVISIONDAY}}/{{REVISIONYEAR}}, <nowiki>https://ccga.io/index.php/BRST5:Phyllodes tumour</nowiki>.
 
[[Category:BRST5]]
'''EXAMPLE Book'''
[[Category:DISEASE]]
 
[[Category:Diseases P]]
#Arber DA, et al., (2017). Acute myeloid leukaemia with recurrent genetic abnormalities, in World Health Organization Classification of Tumours of Haematopoietic and Lymphoid Tissues, Revised 4th edition. Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, and Siebert R, Editors. IARC Press: Lyon, France, p129-171.
 
==Notes==
<nowiki>*</nowiki>Primary authors will typically be those that initially create and complete the content of a page.  If a subsequent user modifies the content and feels the effort put forth is of high enough significance to warrant listing in the authorship section, please contact the CCGA coordinators (contact information provided on the homepage).  Additional global feedback or concerns are also welcome.