Leydig Cells in the Fallopian Tube and Walthard Cell Nests in the Ovary: Heterotopia or Eutopia?
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: ONLINE ARTICLE: LETTER TO THE EDITOR Source Type: research

Indolent T-Cell Lymphoproliferative Disorder of the Uterine Corpus: A Case Report
We present the case of a 31-yr old in whom an Indolent T-cell lymphoproliferative disorder (iTCLPD) was identified in resection chippings for a suspected fibroid, following presentation with menorrhagia. Laboratory investigations revealed an oligoclonal T-cell infiltrate with the immunophenotype of nonactivated cytotoxic T cells, and a proliferative fraction of 10% to 15%. There was no clinical or radiologic evidence of systemic disease, and the patient remained well with no indication of relapse 1 yr from resection and diagnosis. iTCLPD of the uterine corpus has features in common with the recently described iTCLPD...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Low-grade Appendiceal Mucinous Neoplasm and Endometriosis: Incidental Coincident Pathologies at Cesarean Section
Incidental pathologic findings at the time of Cesarean section are exceedingly uncommon. Similarly, occult low-grade appendiceal mucinous neoplasms and other noninflammatory, non-neoplastic appendiceal pathologies are rare, although appendiceal neoplasia, most commonly well-differentiated neuroendocrine tumors, may be found during evaluation of acute appendicitis. Here we report the first case of incidental coincident low-grade appendiceal mucinous tumor and endometriosis involving the appendix at the time of Cesarean section. We highlight pitfalls in the histopathologic evaluation of these processes, particularly given th...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Expression of SMAD4 is Retained in Most Gynecologic Tumors with Mucinous Differentiation
SMAD4 is a tumor suppressor gene that plays a role in cancer initiation and progression. A few studies have explored the value of immunohistochemistry for SMAD4 in gynecologic neoplasms, mainly in the ovary. However, literature is sparse when it comes to other sites such as endometrium and cervix, as well as in benign and borderline ovarian mucinous neoplasms. The aim of this study was to assess the expression of SMAD4 in various gynecologic tumors. We selected primary gynecologic tumors comprising a spectrum of neoplasms showing mucinous differentiation. Few cases of metastatic tumors were also included. A total of 103 ca...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Sarcomatous Transformation in Undifferentiated/Dedifferentiated Endometrial Carcinoma: An Underrecognized Phenomenon and Diagnostic Pitfall
We describe 3 cases in which the undifferentiated component was associated with sarcomatous differentiation, characterized by spindled cells in 2 cases and heterologous malignant cartilage in 1 case. Two of the 3 cases demonstrated mismatch repair deficiency by immunohistochemistry. This phenomenon has not previously been formally reported and increases the likelihood of misdiagnosis, especially within biopsy samples; differential diagnoses may include endometrial stromal sarcoma and grade 3 endometrioid adenocarcinoma with spindled morphology. We review the current literature and provide strategies for resolving the diffe...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Primary Ovarian High-grade Neuroendocrine Carcinoma With Merkel Cell–like Immunophenotype Arising in a Teratoma
We report a case of an 19-yr-old female with bilateral ovarian teratomas with a high-grade NEC (immunohistochemically positive with chromogranin, synaptophysin, and CD56 and MIB1 proliferation index in excess of 90%) arising within one of these. Although CK20 was negative, the NEC exhibited an immunophenotype suggestive of a Merkel cell carcinoma with diffuse positive staining with FLI-1, SATB2 and neurofilament, markers which are preferentially expressed in Merkel cell carcinoma compared with other NECs. There was also diffuse staining for SALL4. Immunohistochemistry and molecular studies for Merkel cell polyomavirus were...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: CASE REPORTS Source Type: research

Ovarian Steroid Cell Tumor in an Adolescent With Von Hippel-Lindau Syndrome: A Case Report and Review of the Literature
We describe the case of a 16-yr-old girl with a previous diagnosis of bilateral pheochromocytoma and several pancreatic neuroendocrine tumors in VHL syndrome context. Follow-up abdominal-pelvic magnetic resonance imaging revealed a 33 mm, well-circumscribed nodule in the right ovary. The patient was submitted to laparoscopic right salpingo-oophorectomy. Microscopically, the tumor consisted of polygonal cells with abundant microvacuolized clear cytoplasm arranged in a solid pattern. The neoplastic cells were immunohistochemically positive for inhibin and calretinin. A diagnosis of ovarian steroid cell tumor was made....
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: CASE REPORTS Source Type: research

Xanthogranulomatous Salpingitis
There are approximately a dozen cases of xanthogranulomatous salpingitis reported in the literature, mostly as case reports. Thirteen such cases were identified from 2003 to 2018 at our institution. Patient’s ages ranged from 21 to 75 yr old (median and mean, 49 yr). Clinical presentations and surgical indications included pelvic inflammatory disease (5 cases), endometrial carcinoma (4 cases), suspicion of ovarian malignancy (1 case), symptomatic fibroids (1 case), endometriosis (1 case), and infertility (1 case). Surgical-pathologic correlation resulted in diagnoses of tubo-ovarian abscess (4 cases), o...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

High-grade Pelvic Serous Carcinoma Within the Fallopian Tube Lumen: Real or Artifact?
Tumor cells are occasionally observed in the lumen in histologic sections of the fallopian tube from women with gynecologic cancer. There is some evidence that this finding may be important in endometrial cancer, but its significance is unknown in women with extrauterine pelvic serous carcinomas (tubo-ovarian high-grade serous carcinoma). Fallopian tube sections from 213 women with extrauterine pelvic serous carcinoma were reviewed, and luminal tumor cells were correlated with clinical and pathologic features. Intraluminal tumor cells were found in 84 patients (39%). The presence or absence of luminal tumor cells correlate...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

Vulvar Silicone Granuloma
We report a case of vulvar silicone granulomas following injection of liquid silicone into the labia. The patient is a 51-yr-old female who presented with vulvar pain and enlarged, indurated labia majora. In the past, she had undergone bilateral labial cosmetic augmentation with a silicone-based filler injected directly into the labia and into the gluteal regions. This had been performed in a nonmedical setting. At surgery, oblong firm soft tissue masses were removed from both labia. Microscopically, the lesions demonstrated replacement of the subcutaneous adipose tissue by fibrous tissue containing innumerable round empty...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

Cervical Mesonephric Adenocarcinoma With Novel FGFR2 Mutation
Mesonephric adenocarcinoma is a rare tumor, accounting for (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

Vaginal Low-Grade Endometrial Stromal Sarcoma: An Extremely Rare Case Report and Review of the Literature
Endometrial stromal sarcoma (ESS) is a malignant tumor of the uterus that has been described as the second most common malignant uterine mesenchymal tumor. Primary extrauterine ESS (EESS) is an extremely uncommon occurrence. We hereby report a new bona fide case of low-grade EESS in a 74-yr-old woman arising in the vagina, presenting as a polypoid mass associated with irregular vaginal bleeding. On examination, a 6×2×2 cm polypoid mass was found in the left vaginal wall. Consequently, the patient underwent partial vaginectomy and repair. No ESS or endometriotic lesion was found in the endometrium and bil...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

Intralymphatic Rosai-Dorfman Disease Associated With Vulvar Lymphedema: A Case Report of an Extremely Rare Phenomenon
We report a 16-yr-old female who presented with vaginal swelling and mass-like enlargement of the right labia. The mass had been present for nearly a year without pain or tenderness. Clinically, the lesion was thought to be a Bartholin gland cyst. Following surgical resection, histologic examination demonstrated a hypocellular myxedematous stroma with a mixture of ectatic thin and thick-walled vessels within which there were numerous collections of histiocytes, lymphocytes, and plasma cells. The histopathologic differential diagnosis included localized vulvar lymphedema, a specialized genital tract neoplasm, and childhood ...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

Clinicopathologic Association and Prognostic Value of MELF Pattern in Invasive Endocervical Adenocarcinoma (ECA) as Classified by IECC
Microcystic, elongated, and fragmented (MELF) pattern of myometrial invasion is correlated with lymphovascular invasion (LVI) and lymph node metastases in uterine endometrioid carcinoma but has not been described in endocervical adenocarcinoma (ECA). A total of 457 ECAs were collected, and clinical/morphologic parameters correlated with follow-up data. Potential associations between MELF pattern and age, human papillomavirus status, tumor size/grade, LVI, lymph node metastases, Silva pattern were analyzed. Statistical analyses of overall survival (OS), disease-free survival, progression-free survival (PFS) were conducted u...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

PD-L1 Expression Correlates With Young Age and CD8+ TIL Density in Poorly Differentiated Cervical Squamous Cell Carcinoma
Management options are limited in advanced or recurrent cervical carcinoma. The Food and Drug Administration has recently approved programed cell death-1 (PD-1)/PD-ligand-1 (PD-L1) inhibitors for the treatment of advanced PD-L1 positive cervical cancer. We studied PD-L1 expression in cervical squamous cell carcinoma (CSCC) samples initially on a The tissue microarray and then in full-tissue sections from poorly differentiated (grade 3) cancers. Tissue microarray was composed of 45 grade 3 and 2 (moderately differentiated) tumors. PD-L1 expression was evaluated as categorical data and by obtaining combined positive score of...
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer
Surgical resection with free surgical margins is the cornerstone of successful primary treatment of vulvar squamous cell carcinoma (VSCC). In general reexcision is recommended when the minimum peripheral surgical margin (MPSM) is (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

Philip B. Clement, M.D. Reflections on a Rewarding 50 Year Career in Gynecologic Pathology: An Interview With Robert H. Young
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 19, 2020 Category: Pathology Tags: HISTORY OF GYNECOLOGICAL PATHOLOGY Source Type: research

Update on the ISGyP Endocervical Adenocarcinoma Project
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: Society page Source Type: research

A Case of Recurrent Vulvar Carcinoma With Cardiac Metastasis: Case Report and Review of the Literature
A 67-yr-old female patient was diagnosed with squamous cell vulvar carcinoma and treated with a radical vulvectomy and bilateral sentinel lymphadenectomy. Three months after the surgery, the patient presented with local recurrence and underwent surgical excision of the mass, followed by chemotherapy. Eight months later, the patient was admitted due to weakness and pleural effusion. The patient underwent a chest computed tomography and echocardiogram, which revealed a large mass in the right ventricle penetrating into the pericardium and an additional mass residing on the tricuspid valve. She underwent a pericardial biopsy,...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORT Source Type: research

HPV-independent Vulvar Squamous Cell Carcinoma is Associated With Significantly Worse Prognosis Compared With HPV-associated Tumors
In conclusion, a subset of VSCC is associated with HPV, which correlates with better outcome. Relatively inexpensive tests such as histomorphologic evaluation, p16 immunohistochemistry, and HPV RNA ISH can be used to predict outcome in VSCC. Therefore, routine reporting of HPV status in VSCC is recommended. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

Correlation Between p16/Ki-67 Expression and the Grade of Cervical Intraepithelial Neoplasias
Interpretation of histopathology of cervical premalignant lesions suffers from marked interobserver variability due to its subjective nature. We aimed to evaluate the usefulness of the biomarkers p16 and Ki-67 in improving the diagnostic accuracy of cervical histopathology and assess the correlation between p16 expression and human papillomavirus test in different grades of cervical intraepithelial neoplasia (CIN). Cervical tissue specimens with a diagnosis of CIN 1 or worse (CIN 1+) on hematoxylin and eosin staining were selected for immunohistochemistry (IHC) staining for p16 and Ki-67. The IHC slides were examined by a ...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

White Adipocytes of the Uterine Cervix Tend to Appear in Women of Older Age, Postmenopause Status, and Higher Body Mass Index
The human uterine cervix consists mainly of epithelium and stroma, including smooth muscle cells and fibrovascular tissues. Fat cells in the uterine cervix have been rarely reported, and the only previous research article has shown that intracervical adipocytes are unrelated to clinical factors. The aim of this study was to investigate the frequency of fat cells in the uterine cervix, as well as to evaluate the relationship between intracervical adipocytes and clinicopathologic factors. We retrospectively selected 405 cases in Japanese women who received cervical conization at our hospital between 2003 and 2017. Cervical c...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

Synchronous Well-differentiated Endometrioid Adenocarcinoma and Leiomyosarcoma of the Uterus With Pulmonary Metastasis in a 50-Yr-Old Woman: A Case Report and Review of Literature
We report the case of a 50-yr-old woman who was diagnosed with concomitant endometrial adenocarcinoma and uterine leiomyosarcoma. The sarcomatous neoplasm was positive for anti-smooth muscle actin and CD10, and focally positive for Cytokeratin AE1/AE3 and Cytokeratin Cam 5.2. She underwent total abdominal hysterectomy with bilateral salpingoopherectomy followed by radiation, brachytherapy, and chemotherapy. Three years later, she presented with cough and dyspnea and was found to have pulmonary metastasis. These tumor cells were positive for anti-smooth muscle actin, Cytokeratin AE1/AE3, Cytokeratin Cam 5.2, and epithelial ...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Genetically Related Choriocarcinoma Developing 5 Yr After a Complete Hydatidiform Mole and Simulating a Cornual Ectopic Pregnancy
Persistent gestational trophoblastic disease can arise from any type of antecedent pregnancy, including molar and tubal pregnancies. While most cases of persistent gestational trophoblastic disease present within the first year following initial diagnosis, recurrence has rarely been reported many years after initial diagnosis. Distinguishing recurrence from a new independent lesion is clinically important. A 25-yr-old woman presented with a mass in the right uterine cornu that was discontiguous with the endometrial cavity and was associated with an elevated serum human chorionic gonadotropin level. She had a history of an ...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Pleomorphic Undifferentiated Uterine Sarcoma in a Young Patient Presenting With Elevated Beta-hCG and Rare Variants of Benign Leiomyoma: A Case Report and Review of the Literature
Leiomyosarcoma (LMS) is a malignant mesenchymal neoplasm showing smooth muscle differentiation. Uterine LMS is more frequent that nonuterine LMS, and represents 1% of all malignant neoplasms of the uterus. Pleomorphic undifferentiated uterine sarcoma is a rare entity, and is defined by high-grade sarcoma histology with loss of muscular markers. Several cases of pleomorphic undifferentiated uterine sarcoma have been reported in the literature, with worse clinical outcome when compared with conventional LMS. Here we report the first case of a pleomorphic undifferentiated uterine sarcoma in association with LMS in a 33 yr old...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Combination of MCM2 With Ki67 and p16 Immunohistochemistry Can Distinguish Uterine Leiomyosarcomas
Our objective was to evaluate the diagnostic utility of 2 new proliferation markers, cyclin D1 and minichromosome maintenance complex component 2 (MCM2), in comparison with p16, p53, and Ki67 in differentiating the spectrum of smooth muscle tumors. An institutional database search from 2009 to 2017 identified 10 cases of uterine leiomyoma with bizarre nuclei (LBN), 12 smooth muscle tumors of uncertain malignant potential, and 13 leiomyosarcomas (LMS). Ten resected leiomyomas (LM) were included as controls. Immunohistochemistry was performed on the befitting representative block from each case. Ki67 was 10% in all LMSs. Alt...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Use of Immunohistochemical Markers (HNF-1β, Napsin A, ER, CTH, and ASS1) to Distinguish Endometrial Clear Cell Carcinoma From Its Morphologic Mimics Including Arias-Stella Reaction
In this study, classic CC immunohistochemical markers (Napsin A, HNF-1β, and ER) and 2 recent novel markers, cystathionine gamma-lyase (CTH) and arginosuccinate synthase (ASS1), are assessed for their utility in distinguishing CC from its morphologic mimics. Tissue microarrays containing 64 CC, 128 EC, 5 EC with clear cell change, 16 SC, 5 mixed carcinomas, and 11 whole ASR sections were stained, with 12 additional examples of ASR stained subsequently. A cutoff of 70% and moderate intensity were used for HNF-1β, 80% of cells and strong intensity were used for CTH, and any staining was considered positive for the ...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

A New Classification of Benign, Premalignant, and Malignant Endometrial Tissues Using Machine Learning Applied to 1413 Candidate Variables
Benign normal (NL), premalignant (endometrial intraepithelial neoplasia, EIN) and malignant (cancer, EMCA) endometria must be precisely distinguished for optimal management. EIN was objectively defined previously as a regression model incorporating manually traced histologic variables to predict clonal growth and cancer outcomes. Results from this early computational study were used to revise subjective endometrial precancer diagnostic criteria currently in use. We here use automated feature segmentation and updated machine learning algorithms to develop a new classification algorithm. Endometrial tissue from 148 patients ...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Primary Peritoneal Low-grade Serous Carcinoma in a Patient With Lynch Syndrome: A Case Report
Lynch syndrome (LS) is an autosomal dominant disease caused by a germline mutation in DNA mismatch repair genes which increases the risk of several cancers such as endometrial and colorectal cancers. However, there are only a few reports of peritoneal malignancies in patients with LS. Herein, we report the first case of a primary peritoneal low-grade serous carcinoma in a woman with LS and provide a literature review of peritoneal malignancies in patients with LS. The patient was a 72-yr-old gravid 2 para 2 Japanese woman with a germline mutation in MLH1. She had a history of colon cancer and endometrial cancer and was tre...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: CASE REPORTS Source Type: research

BRAF Wild-type, PTEN Mutant Malignant Uveal Melanoma Arising Within a Mature Ovarian Teratoma: A Case Report and Review of the Literature
We present a case of primary malignant melanoma arising within a mature cystic teratoma in a young patient, who ultimately developed widespread metastasis necessitating systemic therapy. Our case highlights the role of molecular medicine not only in forming an understanding the origin of the melanoma, but also guiding targeted systemic therapies. Alongside the case we present a review of the literature describing the incidence of molecular aberrations within melanoma as well as the established and emerging techniques and cytotoxic agents for malignant melanoma. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: CASE REPORTS Source Type: research

Prophylactic Risk-reducing Hysterectomies and Bilateral Salpingo-oophorectomies in Patients With Lynch Syndrome: A Clinicopathologic Study of 29 Cases and Review of the Literature
In this study, we present the clinicopathologic findings of 29 cases of LS patients that underwent risk-reducing gynecologic surgery at our institution over a period of 13 yr. Clinical-pathologic information was obtained from the patients’ charts and pathology reports. Significant pathologic abnormalities were identified in 17% (5/29) of cases, all showing endometrial hyperplasia. Four of them with atypical and 1 without atypical. All of our cases with endometrial pathology had significant findings on preoperative endometrial sampling. To further study the recommendation of in toto submission of the endometriu...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

Mutational and Immunophenotypic Profiling of a Series of 8 Tubo-ovarian Carcinosarcomas Revealed a Monoclonal Origin of the Disease
Carcinosarcomas are rare, highly aggressive neoplasms composed of a combination of carcinomatous and sarcomatous elements. These tumors represent a paradigmatic field for the study of intratumor heterogeneity. A series of 8 tubo-ovarian carcinosarcomas was characterized for the following: (i) immunohistochemical expression of MNF116, epithelial membrane antigen, vimentin, S100, chromogranin, synaptophysin, desmin, myogenin (MYF4), and p53; (ii) mutational profiling of KRAS, BRAF, PIK3CA, NRAS, TP53, and DICER1 genes. Heterologous differentiation was present in 6 of 8 tumors. Cytokeratin MNF116 and epithelial membrane antig...
Source: International Journal of Gynecological Pathology - June 13, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

Gynecological Pathology Fellowship Training Programs World-wide Results of an ISGyP Membership Survey
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: Society page: PDF Only Source Type: research

Case Study: Schistosomiasis of the Endocervical Canal, A Rarely Reported Localization
We report the asymptomatic case of endocervical schistosomiasis without visible exocervical lesions in a 41-yr-old Malagasy woman with human papillomavirus-positive status detected during a cervical cancer screening campaign in Andilampanahy, Madagascar. Schistosomiasis involving only the endocervical canal is rarely reported and can be diagnosed histologically with endocervical brushing, which therefore represents a minimally invasive and well-tolerated tool for disease detection. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

Transtubal Spread of a Superficially Invasive Cervical Adenocarcinoma to the Ovaries After 11 Years
We report a 55-yr-old woman who presented with bilateral ovarian masses, 11 yr after hysterectomy for superficially invasive stage IA1 cervical adenocarcinoma of usual (human papillomavirus–associated) type. The bilateral ovarian tumors were composed of glands lined by malignant mucinous epithelium and these tumors were metastases from her previous cervical adenocarcinoma, based on morphology, immunophenotype, and positive in situ hybridization for human papillomavirus. In addition, there was extensive involvement of the mucosa of the left fallopian tube by malignant mucinous epithelium. The patient is alive a...
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

Expression and Clinical Significance of Nicotinamide N-Methyltransferase in Cervical Squamous Cell Carcinoma
Nicotinamide N-methyltransferase (NNMT) is a cytosolic enzyme, overexpressed in various human malignancies. It is associated with cancer progression and resistance to treatment. The role of NNMT in cervical cancer has not been studied thus far. We aimed to evaluate expression of NNMT in cervical squamous cell carcinoma (SCC) and investigate its clinical significance. NNMT expression was assayed by use of immunohistochemistry in 61 cases of SCC, 11 cases of high-grade squamous intraepithelial lesion, 17 cases of low-grade squamous intraepithelial lesion, and 51 benign cervical tissues. NNMT immunoreactivity was scored based...
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

HPV-negative Tumors in a Swedish Cohort of Cervical Cancer
Despite the common perception that the human papilloma virus (HPV) is a requirement for the development of cervical cancer (CC), a considerable number of CCs test HPV negative. Presently, many countries are shifting to HPV primary CC screening, and it is of importance to increase the knowledge about the group of CCs that test HPV negative. The aim of this study was to reinvestigate a proportion of cervical tumors with a primary negative or invalid test result. Reinvestigation with repeated genotyping (targeting L1) was followed by analysis with an alternative target method (targeting E6/E7) on existing or additional tumor ...
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

Low-grade Serous Carcinoma Arising in Inguinal Nodal Endosalpingiosis: Report of 2 Cases and Literature Review
We report 2 cases of low-grade serous carcinoma probably arising from endosalpingiosis within inguinal lymph nodes. The neoplasms occurred in 51- and 58-yr old women in the absence of tumor within the adnexa, peritoneum or elsewhere. These represent the first reported examples of low-grade serous carcinoma arising within and confined to inguinal nodes. We review the pertinent literature regarding primary nodal low-grade serous carcinoma. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

Tumor-to-Tumor Metastasis of Colorectal Adenocarcinoma to Ovarian Cystadenofibroma: A Case Report and Review of the Literature
In this report, we descried an incidental histopathologic finding of metastatic adenocarcinoma to an ovarian cystadenofibroma and review cases published previously in the literature. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: CASE REPORT Source Type: research

An Alternate Diagnostic Algorithm for the Diagnosis of Intraepithelial Fallopian Tube Lesions
In this study, 2 gynecologic pathologists independently evaluated sections of fallopian tubes from a sample of women (N=198, 623 slides) undergoing salpingectomy. A total of 101 (54%) women were undergoing risk-reducing salpingo-oophorectomy. Pathologists were blinded to patient histories and prior diagnoses. Pathologists rendered one of three diagnoses for each slide: “negative for fallopian tube intraepithelial neoplasia (FTIN),” “indeterminate for FTIN,” or “definite for FTIN.” Cases that were considered by histology definite for FTIN or suspicious for FTIN were stained with p53 and K...
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

A Clinicopathologic Study and Descriptive Analysis of “Atypical Endosalpingiosis”
We report a series of 10 cases classified as AE, in attempt to further characterize this lesion. The patients ranged in age from 24 to 72 yr (mean, 39.7 yr) and the commonest presenting complaint was abdominal pain. Operative findings usually comprised small peritoneal nodules and/or fibrous adhesions, predominantly involving the pelvis. The lesions were either mesothelial or submesothelial in location and typically exhibited mixed tubular and papillary architecture, sometimes with minor components of solid, cribriform or single cell growth. Epithelial multilayering was present in all cases but usually involv...
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

Extragonadal Yolk Sac Tumor Limited to the Myometrium: Report of a Case With Potential Fertility Preservation and Molecular Analysis Suggesting Germ Cell Origin
Extragonadal pelvic yolk sac tumor (YST) in postpubertal female patients is a rare malignant neoplasm with potentially 2 distinct histogenetic pathways, and no clear treatment algorithm, especially in young patients desiring future fertility. Here we report a case of extragonadal YST arising within the myometrium in a 30-yr-old nulligravid woman. The patient presented with heavy and irregular bleeding, and imaging studies showed an 8.2 cm uterine mass, most consistent with a degenerating uterine leiomyoma. The patient underwent abdominal myomectomy, and intraoperative frozen section evaluation revealed a high-grade ...
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

A Rare Case of Atypical Placental Site Nodule With an Emerging Intermediate Trophoblastic Tumor
We report a case of a 39-yr-old woman who developed abnormal uterine bleeding 44 mo after her last recognized pregnancy. An endometrial curettage specimen demonstrated an APSN with some features concerning for an intermediate trophoblastic tumor. A hysterectomy specimen demonstrated residual APSN with foci consistent with emerging PSTT and ETT. This case illustrates the earliest form of PSTT and ETT arising in association with an APSN and supports interpretation of APSN as an intermediary lesion between typical PSN and intermediate trophoblastic tumors. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Interpretation of Mismatch Repair Protein Immunohistochemistry in Endometrial Carcinoma Should Consider Both Lynch Syndrome Screening and Immunotherapy Susceptibility: An Illustrative Case Report
We present an instructive case of FIGO grade 1 endometrioid endometrial carcinoma with a biphasic morphology, corresponding to subclonal loss of mismatch repair proteins (MMRP) MLH1 and PMS2 by immunohistochemistry and subclonal microsatellite instability. A pulmonary metastasis represented only the tumor component with retention of MMRPs. This case illustrates the need for pathologists to recognize and report heterogenous expression of MMRPs in endometrial carcinoma, to consider tumor heterogeneity when selecting foci for molecular studies, and to re-evaluate MMRP expression in tumor metastases, when clinically indicated....
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Lymphangioleiomyoma of the Uterus and Pelvic Lymph Nodes: A Report of 3 Cases, Including the Potentially Earliest Manifestation of Extrapulmonary Lymphangioleiomyomatosis
We present 3 cases of extrapulmonary lymphangioleiomyomatosis (LAM) identified incidentally in the uterine corpus and pelvic nodes resected for other reasons. One patient, a 47-yr-old female with corpus cancer, underwent a total hysterectomy and nodal dissection; the other 2 patients, aged 44 and 49 yr, underwent simple hysterectomy for corpus leiomyomas. None of the patients had evidence of tuberous sclerosis complex or any significant lesions in other organs. An area of spindle cell proliferation, intimately associated with dilated and tortuous lymphatic vessels, was found in the myometrium of all 3 patients, and ...
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Uterine Endometrial Stromal Tumors With Limited Infiltration: First Report of a Case Series Indicating Potential for Malignant Behavior
The distinction between a uterine endometrial stromal nodule (ESN) and low-grade endometrial stromal sarcoma (LGESS) is based on the nature of the interface between the lesion and the surrounding myometrium and the presence or absence of vascular invasion. Most LGESS exhibit widespread irregular myometrial invasion with or without vascular invasion, whereas ESNs are well-circumscribed without vascular invasion. Tavassoli and Norris proposed that minor marginal irregularity (up to 3 protrusions, each (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Is It Possible to Develop a Prediction Model for Lymphovascular Space Invasion in Endometrioid Endometrial Cancer?
Conclusions It seems possible to predict the presence of LVSI in women with endometrioid EC when the “risk of LVSI index” is calculated. However, external validation of this model is warranted. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

LAG-3 and GAL-3 in Endometrial Carcinoma: Emerging Candidates for Immunotherapy
LAG-3 is an immunosuppressive checkpoint molecule expressed on T cells. One of its ligands, GAL-3, can promote the progression of malignancy and has been identified on tumor cells. Both LAG-3 and GAL-3 are the targets of emerging immunotherapies, but have not been well-studied in endometrial carcinomas. LAG-3, CD3, and GAL-3 immunohistochemistry was performed on 75 endometrial cancers (25 nonmethylated mismatch repair-deficient, 25 MLH1-hypermethylated mismatch repair-deficient, and 25 mismatch repair-intact). LAG-3+ and CD3+ lymphocytes were averaged per high-power field. Tumoral GAL-3 expression was semiquantitatively sc...
Source: International Journal of Gynecological Pathology - April 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Ovarian Sclerosing Stromal Tumor and Müllerian Cyst in an 11-yr-old Girl: A Case Report and Review of the Literature
Sclerosing stromal tumor (SST) is an extremely rare ovarian neoplasm that primarily affects young female individuals. Patients with SST often present with pelvic pain and menstrual irregularities. Herein, we report a case of SST of the ovary in an 11-yr-old girl with symptoms of abdominal pain and menstrual irregularities. A preoperative diagnosis of tumors in the left adnexa and right ovary was made by pelvic ultrasonography and magnetic resonance imaging, and the patient underwent exploratory laparotomy and laparoscopic cystectomy. The ovarian masses were removed and proven to be SST in the left ovary and Müllerian ...
Source: International Journal of Gynecological Pathology - February 12, 2020 Category: Pathology Tags: Online Article: Case Report Source Type: research

Incidental Microscopic Granulosa Cell Proliferations: Tumorlet or Non-neoplastic?
We report a case of a 22-yr-old nulliparous woman with incidental microscopic granulosa cell proliferation in the wall of an endometriotic cyst. Excision of the cyst revealed extensive endometriosis and incidental microscopic nests and cords of granulosa cells measuring 1.5 mm and positive for inhibin A and calretinin. A rare Call-Exner body was noted. An extensive literature review of both ovarian and extraovarian granulosa cell proliferations were performed to determine their possible origin, variable morphologic features and differential diagnosis. Forty-seven cases were identified occurring in pregnant (26%) and...
Source: International Journal of Gynecological Pathology - February 12, 2020 Category: Pathology Tags: Pathology of the Upper Tract: Case Reports Source Type: research