scholarly journals Clear cell endometrial carcinoma precursors: presentation of two cases and diagnostic issues

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Angela Santoro ◽  
Antonio Travaglino ◽  
Frediano Inzani ◽  
Damiano Arciuolo ◽  
Giuseppe Angelico ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Clear Cell ◽  
Correct Diagnosis ◽  
Relevant Literature ◽  
Intraepithelial Neoplasia ◽  
Molecular Study ◽  
Invasive Disease ◽  
Low Grade ◽  
Endometrial Intraepithelial Neoplasia ◽  
Putative Precursor

Abstract Background The precursors of clear cell endometrial carcinoma (CC-EC) are still undefined. Here, we deal with the diagnostic issues related to CC-EC precursors by presenting a morphological, immunophenotypical and molecular study of two representative cases and discussing the relevant literature. Case presentation Our and previous cases suggest that clear cell endometrial intraepithelial carcinoma (CC-EIC) is a real entity, which may be distinguished from metaplastic/reactive changes and from its serous counterpart. CC-EIC appears associated with atrophic polyps and may be diagnosed based on morphological and immunophenotypical features of CC-EC in the absence of invasive disease. We described a p53-mutant putative precursor characterized by high-grade nuclei in the absence of other distinctive features. Two putative low-grade precursors resembled atypical tubal metaplasia and endometrial intraepithelial neoplasia, although immunohistochemistry could not support their relationship with CC-EC. Conclusions In conclusion, pathologists should be aware of the existence of CC-EIC, since its correct diagnosis may be crucial for a correct patient management. Although several putative earlier precursors have been described, they does not show univocal features that allow their recognition in the common practice. Further studies are necessary in this field.

scholarly journals Chronic gastritis and precancerous diseases of the stomach: Is there a chance of a correct diagnosis?

2021 ◽  
Vol 13 (1) ◽  
pp. 85-102
Author(s):  
Aleksandr V. Tryapitsyn ◽  
Vladimir A. Malkov ◽  
Emil M. Gasanov ◽  
Ilya Belyakov
Keyword(s):  
Gastric Mucosa ◽  
Intestinal Metaplasia ◽  
Chronic Gastritis ◽  
Correct Diagnosis ◽  
Intraepithelial Neoplasia ◽  
Autoimmune Gastritis ◽  
Low Grade ◽  
Adequate Treatment ◽  
H Pylori ◽  
Almost All

AIM: The purpose of the study is to investigate the occurrence of the main forms of chronic gastritis, metaplastic and dysplastic changes in the gastric mucosa, the degree of their severity, and to assess their potential risk for the development of gastric cancer. MATERIALS AND METHODS: The study involved 2982 patients who underwent esophagogastroduodenoscopy with a standard biopsy of the gastric mucosa for morphological assessment and bacterioscopy. If autoimmune gastritis was suspected, an additional serological diagnosis was performed. When detecting intestinal metaplasia of the gastric mucosa as well as neoplastic changes according to the histological report, the description of this report was analyzed in order to identify possible equivalents in the macroscopic description of the mucous membrane. RESULTS: Out of 2982 histological studies of gastric mucosa biopsies, 1273 cases (42.7%) were found to contain H. pylori contamination. In 726 cases (24.3%), intestinal metaplasia. 66 biopsies (2.21%) showed the presence of low-grade intraepithelial neoplasia of the mucosa, 2 biopsies showed indeterminate neoplasia and 4 biopsies showed high-grade neoplasia. In 3 out of the total number of the samples, intravascular gastric adenocarcinoma was detected. In 168 cases (5.6%), gastritis was detected with predominant inflammation of the fundal region characteristic of autoimmune gastritis. In 286 biopsies (10.6%), inflammatory and/or atrophic changes and/or metaplastic changes were preserved, which, as a rule, did not have high activity and pronounced inflammation. In the remaining 1279 cases (42.9%), there was no significant inflammation or atrophic changes. The analysis of endoscopic findings showed that the detectability of intestinal metaplasia of the gastric mucosa without a biopsy study was 13.3%. DISCUSSION OF THE RESULTS: According to the results of the conducted research and analysis, it can be stated that at present, the correct diagnosis of chronic gastritis with the establishment of the etiological factor, prognosis and risks of stomach cancer development is practically not feasible within the modern health care system. This not only deprives a doctor of the opportunity to make a correct diagnosis and prescribe adequate treatment to a patient, but also makes almost all cascades of carcinogenesis, including early cancer, invisible.

scholarly journals Prediction of endometrial carcinoma by subjective endometrial intraepithelial neoplasia diagnosis

2004 ◽  
Vol 18 (3) ◽  
pp. 324-330 ◽  
Author(s):  
Jonathan L Hecht ◽  
Tan A Ince ◽  
Jan P A Baak ◽  
Heather E Baker ◽  
Maryann W Ogden ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Intraepithelial Neoplasia ◽  
Endometrial Intraepithelial Neoplasia

Endometrial carcinoma: controversies in histopathological assessment of grade and tumour cell type

2010 ◽  
Vol 63 (5) ◽  
pp. 410-415 ◽  
Author(s):  
Blaise A Clarke ◽  
C Blake Gilks
Keyword(s):  
Endometrial Carcinoma ◽  
Clear Cell ◽  
Adjuvant Radiation ◽  
Low Grade ◽  
High Grade ◽  
Cell Type ◽  
Type Assignment ◽  
Grading Systems ◽  
Extent Of Surgery ◽  
Worse Prognosis

Histopathological assessment of tumour grade and cell type is central to the management of endometrial carcinoma, guiding the extent of surgery and the use of adjuvant radiation therapy and chemotherapy. Endometrioid carcinomas are usually low grade but high-grade examples are encountered, and they have a significantly worse prognosis, similar to that of high-grade subtypes such as serous and clear cell carcinoma. This article reviews the various grading systems that have been proposed for use with endometrioid endometrial carcinoma, and discusses the recent progress in cell type assignment, including the use of immunohistochemistry as a diagnostic adjunct.

scholarly journals Risk of subsequent endometrial carcinoma associated with endometrial intraepithelial neoplasia classification of endometrial biopsies

Cancer ◽  
2008 ◽  
Vol 113 (8) ◽  
pp. 2073-2081 ◽  
Author(s):  
James V. Lacey ◽  
George L. Mutter ◽  
Marisa R. Nucci ◽  
Brigitte M. Ronnett ◽  
Olga B. Ioffe ◽  
...  
Keyword(s):  
Endometrial Carcinoma ◽  
Intraepithelial Neoplasia ◽  
Endometrial Intraepithelial Neoplasia

scholarly journals Rare Case of Multilocular Cystic Renal Neoplasm of Low Malignant Potential with Chronic Pyelonephritis

2021 ◽  
Author(s):  
Mrunal Kesari ◽  
Shweta Agrawal ◽  
Yoganand Patil ◽  
Indranil Bhattacharya ◽  
Monica Dholpure
Keyword(s):  
Clear Cell ◽  
Correct Diagnosis ◽  
Malignant Potential ◽  
Low Grade ◽  
Renal Neoplasm ◽  
Cell Renal Cell Carcinoma ◽  
Clear Cells ◽  
Ca Ix ◽  
Renal Tumours ◽  
Low Malignant Potential

Multilocular Cystic Renal Neoplasm of Low Malignant Potential (MCRNLMP) represents a rare variant of clear cell (conventional) renal carcinoma. They constitute between 3-6% of clear cell Renal Cell Carcinoma (RCC). The RCC constitutes less than 1% of all renal tumours. The MCRNLMP has an excellent prognosis with no reports of recurrence or metastasis. Authors reported a case of 67-year-old male patient on account of its rarity, co-existing pyelonephritis and incidental detection of MCRNLMP. Differentiation between MCRNLMP, RCC variants and other cystic lesions with clear cells is important as prognosis, treatment differ markedly. Radiological Bosnaik classification of complex cysts in category IIF and III is challenging and requires microscopic examination for correct diagnosis. Histopathology shows cysts separated and fibrous septae having groups of clear cells with low grade nuclei. Immunohistochemistry with Carbonic Anhydrase-IX (CA-IX), Epithelial Membrane Antigen (EMA), Cytokeratin (CK7) and CD10 is confirmatory. Diagnosis requires detailed imaging studies, meticulous grossing of nephrectomy specimens, extensive sampling of cystic tissue to find clear cells and immunohistochemistry (IHC).

Sign in / Sign up

Export Citation Format

Share Document