Strong expression of PD-L1 in invasive front of MELF pattern in endometrioid carcinoma

2021 ◽  
pp. 153699
Author(s):  
Shinichiro Tahara ◽  
Masaharu Kohara ◽  
Kazuaki Sato ◽  
Eiichi Morii
Keyword(s):  
Endometrioid Carcinoma ◽  
Invasive Front ◽  
Strong Expression

scholarly journals Immunohistochemical Expression of “HE4” in Endometrial Hyperplasia versus Endometrial Endometrioid Carcinoma

2021 ◽  
Vol 9 (A) ◽  
pp. 669-675
Author(s):  
Amany Talaat Abd El-Hamed ◽  
Samira Abd-Allah Mahmoud ◽  
Ahmed A. Soliman ◽  
Dina F. El-Yasergy
Keyword(s):  
Endometrial Carcinoma ◽  
Endometrial Hyperplasia ◽  
Prognostic Significance ◽  
Atypical Hyperplasia ◽  
Cancer Tissue ◽  
Endometrioid Carcinoma ◽  
Immunohistochemical Expression ◽  
Atypical Endometrial Hyperplasia ◽  
Strong Expression

Aim Endometrial cancer is the most common cancer of the female genital tract. No effective biomarkers currently exist to allow for an efficient risk classification of endometrial carcinoma. Human epididymis protein 4 (HE4) overexpression is first observed in ovarian cancer tissue and subsequent research has shown that the HE4 overexpression has also been observed in patients with endometrial carcinoma. To our knowledge, this marker was evaluated in small number of research studies in cases of endometrial carcinoma versus hyperplasia. This has inspired us to test for immunohistochemical expression of HE4 in endometrial endometrioid carcinoma and hyperplastic endometria and to correlate HE4 expression with various prognostic pathological parameters including International Federation of Gynecology and Obstetrics (FIGO) grading and staging. Methods Immunohistochemical staining for HE4 was performed on paraffin-embedded sections of forty cases of endometrial endometrioid carcinoma and thirty cases of endometrial hyperplasia: including 15 cases of non-atypical hyperplasia and 15 cases of atypical hyperplasia. A histochemical score was used to evaluate HE4 expression by the tumor cells. Results In this study, HE4 overexpression level was significantly higher in endometrial endometrioid carcinoma than endometrial hyperplasia and significantly higher than non-atypical endometrial hyperplasia (P<0.05). HE4 strong expression was detected in 20% of atypical endometrial hyperplasia, but no statistical significance was detected between atypical hyperplasia and endometrial carcinoma. HE4 overexpression showed statistically significant positive correlation with FIGO grading, FIGO staging, and depth of myometrial invasion. Conclusion: During interpretation of endometrial biopsies of atypical hyperplasia, HE4 strong expression might raise the possibility of the presence of coexisting adenocarcinoma not biopsied or even warning of a near future malignant transformation. Also, strong expression of HE4 by tissue biopsy of adenocarcinoma should be reported as this might predict higher grade and stage of the tumor, a point that should be considered by surgeons while performing hysterectomy. These results should be further confirmed by extending the study on a large scale, correlation of HE4 expression with the molecular classification of Tumor Cancer Genome Atlas and long term follow up are required to establish the prognostic significance of HE4 expression in endometrial carcinoma and atypical hyperplasia. Keywords: Endometrial carcinoma, Endometrial hyperplasia, HE4, Immunohistochemistry.

scholarly journals Mixed Neuroendocrine/Non-neuroendocrine Neoplasm (MiNEN) of the Ovary Arising from Endometriosis: Molecular Pathology Analysis in Support of a Pathogenetic Paradigm

2021 ◽  
Author(s):  
Roberta Maragliano ◽  
Laura Libera ◽  
Ileana Carnevali ◽  
Valeria Pensotti ◽  
Giovanna De Vecchi ◽  
...  
Keyword(s):  
Large Cell ◽  
Neuroendocrine Neoplasm ◽  
Molecular Profile ◽  
Neuroendocrine Neoplasms ◽  
Fish Analysis ◽  
Sequencing Analysis ◽  
Endometrioid Carcinoma ◽  
Preneoplastic Lesions ◽  
Ovarian Endometriosis ◽  
Neuroendocrine Carcinomas

AbstractPrimary ovarian neuroendocrine neoplasms (Ov-NENs) are infrequent and mainly represented by well-differentiated forms (neuroendocrine tumors — NETs — or carcinoids). Poorly differentiated neuroendocrine carcinomas (Ov-NECs) are exceedingly rare and only few cases have been reported in the literature. A subset of Ov-NECs are admixed with non-neuroendocrine carcinomas, as it occurs in other female genital organs, as well (mostly endometrium and uterine cervix), and may be assimilated to mixed neuroendocrine/non-neuroendocrine neoplasms (MiNENs) described in digestive and extra-digestive sites. Here, we present a case of large cell Ov-NEC admixed with an endometrioid carcinoma of the ovary, arising in the context of ovarian endometriosis, associated with a uterine endometrial atypical hyperplasia (EAH). We performed targeted next-generation sequencing analysis, along with a comprehensive immunohistochemical study and FISH analysis for TP53 locus, separately on the four morphologically distinct lesions (Ov-NEC, endometrioid carcinoma, endometriosis, and EAH). The results of our study identified molecular alterations of cancer-related genes (PIK3CA, CTNNB1, TP53, RB1, ARID1A, and p16), which were present with an increasing gradient from preneoplastic lesions to malignant proliferations, both neuroendocrine and non-neuroendocrine components. In conclusion, our findings underscored that the two neoplastic components of this Ov-MiNEN share a substantially identical molecular profile and they progress from a preexisting ovarian endometriotic lesion, in a patient with a coexisting preneoplastic proliferation of the endometrium, genotypically and phenotypically related to the ovarian neoplasm. Moreover, this study supports the inclusion of MiNEN in the spectrum ovarian and, possibly, of all gynecological NENs, among which they are currently not classified.

Diagnostic Pitfalls Related to Morular Metaplasia in Endometrioid Carcinoma: An Underestimated Issue

Pathobiology ◽  
2021 ◽  
pp. 1-6
Author(s):  
Antonio Travaglino ◽  
Antonio Raffone ◽  
Annarita Gencarelli ◽  
Serena Saracinelli ◽  
Fulvio Zullo ◽  
...  
Keyword(s):  
Patient Management ◽  
Hormone Receptors ◽  
Immunohistochemical Analysis ◽  
Endometrioid Carcinoma ◽  
Rectosigmoid Colon ◽  
Solid Carcinoma ◽  
Colorectal Origin ◽  
A Minor ◽  
Diagnostic Pitfalls

Here, we present a case that highlights the crucial pitfalls related to the presence of morular metaplasia (MM) in endometrioid carcinoma, which are insufficiently recognized in the routine pathology practice. A 45-year-old woman underwent hysterectomy with rectosigmoidectomy due to a 11-cm mass involving uterus, right ovary, and rectosigmoid colon. Histologically, the lesion appeared as a predominantly solid carcinoma with a minor glandular component. Results of the first immunohistochemical analysis suggested a colorectal origin (PAX8-, CK7-, WT1-, hormone receptors-, and CDX2+ in the absence of mucinous features). Subsequent immunohistochemistry (nuclear β-catenin+, CD10+, and low ki67 in the solid areas) supported a diagnosis of endometrioid carcinoma with diffuse MM. This case remarks that morphological and immunohistochemical features of MM may conceal the glandular architecture and the typical immunophenotype of endometrioid carcinomas. Acknowledging the diagnostic issues related to MM appears crucial to avoid misdiagnosis and inappropriate patient management.

scholarly journals Mixed large and small cell neuroendocrine carcinoma and endometrioid carcinoma of the endometrium with high microsatellite instability: A case report and literature review

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199920
Author(s):  
Kotaro Inoue ◽  
Kentaro Kai ◽  
Shimpei Sato ◽  
Haruto Nishida ◽  
Koji Hirakawa ◽  
...  
Keyword(s):  
Microsatellite Instability ◽  
Neuroendocrine Carcinoma ◽  
Immune Checkpoint Blockade ◽  
Japanese Woman ◽  
Endometrial Biopsy ◽  
Small Cell ◽  
Endometrioid Carcinoma ◽  
Small Cell Neuroendocrine Carcinoma ◽  
Mutation Burden ◽  
Solid Part

A 65-year-old, gravida 3, para 2 Japanese woman was referred to our hospital for symptomatic thickening of the endometrial lining. Endocervical and endometrial cytology revealed an adenocarcinoma. The endometrial biopsy specimen was mixed, with a glandular part diagnosed as endometrioid carcinoma and a solid part diagnosed as high-grade mixed large and small cell neuroendocrine carcinoma (L/SCNEC). She underwent extra-fascial hysterectomy with bilateral salpingo-oophorectomy, complete pelvic and para-aortic lymphadenectomy, and omentectomy (FIGO IIIB, pT3b pN0 M0). She currently has no deleterious germline mutation, but high tumor mutation burden and high microsatellite instability (MSI) were identified. She underwent six cycles of platinum-based frontline chemotherapy and achieved complete remission. Immune checkpoint blockade therapy is a promising second-line therapy for MSI-high solid tumors. However, the MSI or mismatch repair (MMR) status of endometrial L/SCNEC remains unclear in the literature. Universal screening for MSI/MMR status is needed, particularly for a rare and aggressive disease.

scholarly journals Impact of CD68/(CD3+CD20) Ratio at the Invasive Front of Primary Tumors on Distant Metastasis Development in Breast Cancer

PLoS ONE ◽  
2012 ◽  
Vol 7 (12) ◽  
pp. e52796 ◽  
Author(s):  
Noemí Eiró ◽  
Iván Pidal ◽  
Belen Fernandez-Garcia ◽  
Sara Junquera ◽  
Maria L. Lamelas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Distant Metastasis ◽  
Invasive Front ◽  
Primary Tumors ◽  
Metastasis Development
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