A Novel Ciliated, Mucin-producing Variant of HPV-related Cervical Adenosquamous Carcinoma In Situ: A Case Report
Uterine cervical adenosquamous carcinoma in situ was originally defined as having either a uniform population of cells with features intermediate in appearance between glandular and squamous cells, or a mixture of distinct glandular and squamous components within a single lesion. The former type would likely be reclassified today as stratified mucin-producing intraepithelial lesion, while the latter type is vanishingly rare. Here, we report a novel case of bona fide adenosquamous carcinoma in situ, which exhibits 2 morphologically and immunophenotypically distinct components: (1) an inner glandular component composed of a ...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Case Report Source Type: research

Papillary Squamous Cell Carcinoma of the Uterine Cervix: Biopsy Samples Frequently Underrepresent the Presence of Stromal Invasion
Papillary squamous cell carcinoma is a rare variant of squamous cell carcinoma, histologically characterized by thin or broad papillae lined by epithelium showing the features of high-grade squamous intraepithelial lesion. Given the exophytic nature of these neoplasms, the diagnosis, assessment and quantification of invasion may be difficult in small biopsies. The goal of this study was to determine the presence and extent of cervical stromal invasion by comparing biopsy samples with excisional specimens in a cohort of patients diagnosed with papillary squamous cell carcinoma. Cases were identified from the surgical pathol...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Original Articles Source Type: research

Skene’s Gland Derivatives in the Female Genital Tract and Cervical Adenoid Basal Carcinoma are Consistently Positive With Prostatic Marker NKX3.1
Cervical ectopic prostatic tissue and vaginal tubulosquamous polyp are rare lesions which exhibit variable, and often focal, immunohistochemical expression with traditional prostatic markers [prostate-specific antigen and prostatic acid phosphatase (PSAP)]. These lesions are thought to arise from periurethral Skene’s glands, the female equivalent of prostatic glands in the male. Adenoid basal carcinoma is a rare and indolent cervical neoplasm. Expression of the prostatic marker NKX3.1 in ectopic prostatic tissue and tubulosquamous polyp has been reported but no studies have examined immunoreactivity with this marker ...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Original Articles Source Type: research

Targeted Molecular Sequencing of Recurrent and Multifocal Non–HPV-associated Squamous Cell Carcinoma of the Vulva
Recurrent vulvar squamous cell carcinomas (SCCs) are a poorly understood and aggressive group of treatment-resistant neoplasms. Currently, it remains unclear whether these are in fact recurrences of the same primary tumor, or the development of entirely new tumors. Here, to address this question, we examined the mutational profile of a series of patients with recurrent or multifocal non–human papilloma virus (HPV)-associated vulvar SCC. We performed a targeted 33-gene next-generation sequencing panel on a series of 14 patients with recurrent or multifocal non–HPV-associated vulvar SCC and precursor neoplasms. T...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Original Articles Source Type: research

Primary Ovarian Melanoma Arising From a Mature Teratoma With Melanoma In Situ Present in the Ciliated Columnar and Squamous Epithelium in a Patient With Synchronous Skin Basal Cell Carcinoma
We report a case of a 66-yr-old female who presented to emergency department with abdominal pain and bloating. Computed tomography scan showed a 21 cm complex pelvic mass. An urgent laparoscopic bilateral salpingo-oophorectomy was performed. Pathologically the mass was identified as a mature teratoma. Within the cystic teratoma, there was an area showing a sheet arrangement of atypical cells. Those atypical cells were positive for Melan A, Sox10, HMB45, and c-KIT, and negative for PD-L1. Melanoma in situ was present in both the squamous and ciliated columnar epithelium. The melanoma was negative for PD-L1, and no BR...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

A Rare Case of Castleman Disease Presenting as an Ovarian Tumor
We report a case of primary CD of the ovary, a rare localization with only 2 cases including the present case described in the world literature to date. A 58-yr-old woman who initially presented with abdominal pain underwent computed tomography scan which showed bilateral well-circumscribed solid adnexal masses. Because an ovarian bilateral tumor was suspected the patient was treated with a hysterectomy and bilateral salpingo-oophorectomy and the histopathologic examination confirmed the diagnosis of CD hyaline-vascular type of the right ovary associated with a contralateral fibroma. Three years after surgery the patient i...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

Benign Brenner Tumor in an Ectopic Ovary: A Case Report and Review of Literature
Supernumerary ectopic ovaries are very rare, with fewer than 40 cases of isolated supernumerary ovaries reported in the literature since their discovery in 1864. Tumors arising in ectopic ovaries are also extremely rare, with only a handful of reports in the literature. Given the rarity of this combination of findings, we report a case of a 68-yr-old woman incidentally found to have a 4.7 cm solid retroperitoneal mass adjacent to the liver, diagnosed as a benign Brenner tumor arising in a supernumerary ectopic ovary. To our knowledge, there has been only one previously reported case of Brenner tumor arising in this ...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

Intratubal Pseudopapillary Histiocytic Hyperplasia: A New Histologic Variant in the Spectrum of Histiocytic Lesions Involving the Fallopian Tube
Although histiocytic lesions of the fallopian tube are relatively rare compared to their epithelial counterparts, there exists a spectrum of histiocytic lesions involving the fallopian tube that are described under different terminologies dependent on the involved compartment of the fallopian tube. A common histologic denominator of all the hitherto reported tubal histiocytic lesions is the presence of sheets and clusters of histiocytes without any supportive connective tissue. The current study describes three cases of a heretofore-undescribed papillary histiocytic lesion in the lumen of the fallopian tube. All 3 lesions ...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Original Articles Source Type: research

Follicle Cysts of the Ovary: A Report of 30 Cases of a Common Benign Lesion Emphasizing its Unusual Clinical and Pathologic Aspects
The common ovarian follicle cyst is typically straightforward from both clinical and pathologic perspectives, but may have a variety of unusual features from both aspects at various stages of life. Lack of familiarity with these may lead to diagnostic quandaries, the most common of which is distinguishing between a follicle cyst and cystic granulosa cell tumor of either adult or juvenile type. We reviewed 30 cases of follicle cysts, all sent in consultation, to highlight unusual aspects of a common lesion. Patients ranged from 3 d to 47 yr old. Clinical presentations included precocious puberty, pelvic pain, ...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Original Articles Source Type: research

Immunoreactive Acellular Keratin in Sentinel Lymph Nodes From a Patient With Endometrioid Carcinoma of the Endometrium With Squamous Differentiation: A Case Report of a Potential Diagnostic Pitfall
We report a case of an 80-yr-old woman who underwent a right sentinel lymph node biopsy at the time of surgery for clinically and radiologically apparent stage I endometrial endometrioid adenocarcinoma. The immunostains for AE1/AE3 performed on the 2 right pelvic sentinel lymph nodes were positive, corresponding to subcapsular acellular keratin on hematoxylin and eosin; however, carcinoma cells could not be identified on the hematoxylin and eosin–stained slides. Immunomarkers for Ber-EP4 and EMA, both of which were strongly expressed in the endometrial carcinoma cells, were negative on the nodal tissue, and we conclu...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Case Reports Source Type: research

Uterine Cellular Blue Nevus Arising in Mullerian and Pelvic Dendritic Melanocytosis: Case Report of a Rare Phenomenon to Be Distinguished From Uterine Melanoma
A 37-yr-old woman presented to the gynecology clinic with abnormal uterine bleeding in the setting of known, large uterine fibroids. Preoperative endometrial biopsy identified atypical melanocytic cells concerning for uterine melanoma. Care was transferred to the gynecologic oncology service for hysterectomy. Intraoperative findings included macular, blue-black pigmentation of the peritoneum of the bladder and cervix, which was resected and sent for frozen section, confirming melanocytic neoplasia. The hysterectomy revealed multiple tan leiomyomas up to 12 cm, and a distinct 3 cm black, incompletely circumscr...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Case Reports Source Type: research

Uterine Adenosarcoma Originating in Adenomyosis: Report of an Extremely Rare Phenomenon and Review of Published Literature
We report a case of intramural uterine adenosarcoma arising in association with adenomyosis, in the absence of tumor involving the surface endometrium. This is an extremely rare phenomenon, with only 8 other published cases of uterine corpus adenosarcoma in the absence of surface endometrial involvement, 5 originating in adenomyosis and 3 in adenomyomas. We review these cases. The current FIGO staging system for uterine adenosarcoma assumes origin from the surface endometrium and does not address the rare occurrence of intramural tumors without a surface endometrial component. Such tumors are problematic to stage and could...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Case Reports Source Type: research

Loss of X Chromosome Inactivation in Androgenetic Complete Hydatidiform Moles With 46, XX Karyotype
Most complete hydatidiform moles (CHMs) showcase an androgenetic nature of the nuclear genome. In the normal female embryo, one of the 2 X chromosomes is inactive. However, the status of X chromosome inactivation (XCI) in androgenetic CHMs remains unknown. Seventy-one androgenetic CHM tissues with the 46, XX karyotype were collected. Seventy-four normal female villi and 74 normal male villi were collected as controls. The expression of XCI markers (XIST, TSIX, and XACT) and an X-linked gene (CDX4) was detected by real-time polymerase chain reaction. Other XCI-associated genes were also examined, including the methylation s...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

The O-Linked N-Acetylglucosamine Containing Epitope H (O-GlcNAcH) is Upregulated in the Trophoblastic and Downregulated in the Fibroblastic Cells in Missed Miscarriage Human Chorionic Villi With Simple Hydropic Degeneration
Epitope H contains an O-linked N-acetylglucosamine (O-GlcNAcH) residue in a specific conformation and/or environment recognized by the mouse monoclonal antibody H. O-GlcNAcH is present in several types of cells and in several polypeptides, including cytokeratin 8 and vimentin, on the latter in cells under stress. In the present work, we examined the expression of the O-GlcNAcH in 60 cases of endometrial curettings from missed miscarriage cases containing normal and simple hydropic degenerated chorionic villi in each case, using monoclonal antibody H and indirect immunoperoxidase and Western blot immunoblot. In all cases ex...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

CD56 is Expressed in Uterine Smooth Muscle Tumors
CD56 is used in gynecologic pathology, typically in the context of a neuroendocrine, sex cord or sex cord–like tumor. It has never been studied in uterine smooth muscle tumors, which can potentially enter their differential diagnosis, and thus CD56 positivity could potentially be a pitfall. Thus, the aim of this study was to explore its expression in this category of tumors. Seventy-eight uterine smooth muscle tumors, including 14 leiomyosarcomas, 46 leiomyomas and their variants, 14 smooth muscle tumors of uncertain malignant potential, and 4 intravenous leiomyomatoses were studied in regard to CD56 expression. Fift...
Source: International Journal of Gynecological Pathology - June 11, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

A Case Report of Incidental Primary Leiomyosarcoma of the Fallopian Tube and a Review of the Recent Literature
We present the case of a 46-yr-old woman with a history of renal transplantation in whom a primary leiomyosarcoma of the fallopian tube was identified incidentally following hysterectomy and bilateral salpingectomy undertaken for a uterine fibroid. The tumor demonstrated classic morphological and immunohistochemical features of a leiomyosarcoma. It appeared localized to the fallopian tube and was completely resected. Adjuvant therapy was not given but active surveillance initiated. After 14 mo of follow-up, there was no evidence of disease recurrence. We review cases from the past 20 yr with a focus on manage...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

Ovarian Mixed Epithelial Carcinoma With Extensive Bilateral Fallopian Tubes Metastases by the Low-grade Serous Carcinoma Component Mimicking Serous Tubal Intraepithelial Carcinoma: Case Presentation and Literature Review
Seromucinous carcinoma of the ovary was a newly defined category in the revised 2014 World Health Organization Classification of Tumors of Female Reproductive Organs. It was defined as a carcinoma composed of predominantly of serous and endocervical-type mucinous epithelium. Foci containing clear cells, and areas of endometrioid and squamous differentiation are not uncommon. It is a rare entity with morphologic and immunophenotypic features overlapping other types of ovarian carcinoma. There are different opinions as to whether it is a distinct entity or a histologic variant of well-established entities. Subsequent, to the...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

Pure Primary Ovarian Carcinoid Tumor
We report a case of a middle-aged woman who presented with abdominal distension. Computed tomography identified a 20 cm abdominopelvic mass. The patient underwent exploratory laparotomy, hysterectomy, and bilateral salpingo-oophorectomy. A large, solid, yellow-tan ovarian mass was resected and diagnosed as a PPOCT. Para-aortic lymph node metastases were identified. This case highlights the gross and microscopic findings characteristic of PPOCTs. In addition, the large number of differential considerations for an insular PPOCT at intraoperative evaluation are discussed. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

Somatically Derived Yolk Sac Tumor of the Ovary in a Young Woman
Ovarian carcinoma with a somatically derived yolk sac tumor component is a phenomenon known to mostly occur in postmenopausal women. Herein, we report an ovarian endometriosis-associated somatic yolk sac tumor arising in the background of a low-grade endometrioid adenocarcinoma in a young woman. A 27-yr-old woman presented with abdominal pain, subsequently recognized to be caused by a right ovarian mass undergoing torsion. Following operative management, microscopic examination of the salpingo-oophorectomy specimen showed endometriosis and a predominantly cystic ovarian neoplasm with 2 distinct phenotypic areas: (1) a yolk...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

Clear Cell Papillary Cystadenoma of the Ovary Masquerading as Metastatic Clear Cell Renal Cell Carcinoma: A Case Report and Review of the Literature
Clear cell papillary cystadenoma of the epididymis is an uncommon benign neoplasm, usually seen in patients with von Hippel-Lindau disease. Morphologic and immunohistochemical examination aid in distinguishing clear cell papillary cystadenoma from malignant histologic mimics including low-grade mesothelial proliferations and metastatic clear cell renal cell carcinomas. Analogous lesions have been described in the female genital tract, often posing diagnostic challenges due to their low incidence. Here, we present the difficult diagnostic aspects of the first case of clear cell papillary cystadenoma involving the ovary, inc...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

Ovarian Extravascular Papillary Endothelial Hyperplasia (Masson Tumor) Mimicking a Primary Gynecologic Malignancy
We describe the first 2 cases of this extravascular type to occur within the ovary, one of which mimicked malignancy radiologically. This condition is thought to represent a reactive phenomenon with reparative response secondary to thrombosis although with an unclear underlying pathogenesis. The prognosis is generally good, with complete surgical resection usually representing adequate treatment. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Original Articles Source Type: research

Impact of Ki-67 Labeling Index on Prognostic Significance of the Chemotherapy Response Score in Women With Tubo-ovarian Cancer Treated With Neoadjuvant Chemotherapy
The chemotherapy response score (CRS) proposed by Bohm and colleagues in 2015 has been validated as a reproducible method for determining histopathologic response of tubo-ovarian carcinoma to neoadjuvant chemotherapy and stratifies tumor response into 3 groups: CRS1 is defined as minimal/no response, CRS2 as moderate response, and CRS3 as marked response. Although described as a 3-tiered system, it essentially works as a 2-tiered system (CRS1/CRS2 vs. CRS3) for assessing prognosis. Here, we analyzed the prognostic value of CRS in a large cohort of tubo-ovarian carcinomas at a tertiary care center and evaluated the potentia...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Original Articles Source Type: research

Alveolar Soft Part Sarcoma of Uterine Corpus in a Young Female: A Case Report With Review of Literature
Alveolar soft part sarcoma (ASPS) is a rare soft tissue sarcoma, often occurs in adolescents and young adults with a particular predilection for the deep soft tissue of extremities. Occurrence of ASPS in the female genital tract is very uncommon and poses a significant diagnostic challenge. A case of ASPS of the uterine corpus is described in a young unmarried female, who presented to the out-patient clinic of our Institute with complaints of abnormal uterine bleeding for the past 9 mo. She was being treated with oral contraceptive pills, progesterone and tranexamic acid. Following radiological imaging and hysterosc...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Case Report Source Type: research

Does Specimen Type Have an Impact on HER2 Status in Endometrial Serous Carcinoma? Discordant HER2 Status of Paired Endometrial Biopsy and Hysterectomy Specimens in the Presence of Frequent Intratumoral Heterogeneity
A recent clinical trial showed prolonged progression-free survival in human epidermal growth factor receptor 2 (HER2)-positive advanced stage and recurrent endometrial serous carcinomas when trastuzumab was added to traditional chemotherapy. Approximately one third of these tumors are HER2-positive and have been described to show unique characteristics of HER2 protein expression and gene amplification, including significant intratumoral heterogeneity, in recent studies. However, currently, there are no standard protocols for the selection of optimal specimen type or algorithm for HER2 testing in endometrial serous carcinom...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

P16, Ki67, P53, and WT1 Expression in Uterine Smooth Muscle Tumors: An Adjunct in Confirming the Diagnosis of Malignancy in Ambiguous Cases
In this study, we aimed to find a panel of immunohistochemical stains that would be helpful in determining the correct diagnosis in ambiguous uterine smooth muscle tumors, with an emphasis on investigating the possible usefulness of the WT1 antibody. Uterine leiomyomas were found to be immunoreactive with WT1. Since a previous study reported on the lack of immunoreactivity of uterine leiomyosarcomas with WT1, we speculated that WT1 might be useful in this setting. We retrospectively reviewed the medical charts and slides of 91 patients: 22 with leiomyosarcoma, 15 with smooth muscle tumor of uncertain malignant potential, a...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

Adenomatoid Tumor of the Uterus: A Report of 6 Unusual Cases With Prominent Cysts Including 4 With Diffuse Myometrial Involvement, 4 With Uterine Serosal Involvement, and 2 Presenting in Curettage Specimens
We evaluated the clinicopathologic features of 6 adenomatoid tumors of the uterus with unusual features. All the tumors differed grossly from the usual adenomatoid tumor, typically being ill-defined and occupying>50% of the myometrium, essentially replacing it in 4. The neoplasm extended to the endometrium in 2 cases and in one of these it formed an intracavitary mass; in both the tumor was first diagnosed in a curettage. In the other 4 cases, the adenomatoid tumor was discovered in a hysterectomy specimen performed for irregular vaginal bleeding (3 patients), and the finding of a pelvic mass on a computed tomography sc...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

Nuclear Beta-Catenin Expression in Endometrioid Intraepithelial Neoplasia (Atypical Hyperplasia) Does Not Predict Carcinoma on Subsequent Hysterectomy
Beta-catenin (BC) mutations are associated with a high risk of recurrence in otherwise low-grade, early-stage uterine endometrioid adenocarcinomas. Recent literature suggests nuclear BC expression by immunohistochemistry is highly sensitive and specific for BC mutations. The significance of BC expression in endometrioid intraepithelial neoplasia (EIN/atypical hyperplasia) and its relationship to altered differentiation patterns in EIN has yet to be fully explored. Cases meeting current diagnostic criteria for EIN based on H&E examination were obtained from 2 institutions (years 1999–2014). Patterns of altered dif...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

Solitary Fibrous Tumor of the Vulva: Case Report of a Rare Entity and Review of Literature
Solitary fibrous tumor (SFT) is an uncommon mesenchymal tumor of fibroblastic origin, which shows a prominent hemangiopericytoma-like branching pattern. It may be found at any location and can rarely involve the female genital tract with the vulva being the most common site of involvement. This is a case report of vulvar SFT in a 47-yr-old female who presented with a slow growing vulvar mass for 3 yr. Histologic examination showed a neoplasm composed of ovoid to spindle shaped cells with hypocellular and hypercellular areas in a collagenous background. Prominent hemangiopericytoma-like vessels were identified. Immun...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Case Reports Source Type: research

Vulvar Primary Cutaneous CD8+ Aggressive Epidermotropic Cytotoxic T-Cell Lymphoma
Cutaneous T-cell lymphomas may present with a clinical course that is incongruent with the associated histologic findings. Primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma classically presents as an abrupt eruption of disseminated ulcerated annular plaques with aggressive behavior and a poor prognosis. Herein we describe a vulvar primary cutaneous CD8+ aggressive epidermotropic cytotoxic T-cell lymphoma with a locally aggressive clinical course that was strikingly responsive to radiation therapy. As aggressive therapy involving systemic chemotherapy is indicated for primary cutaneous CD8+ aggressi...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Case Reports Source Type: research

Atypical Microglandular Hyperplasia of Endocervix as the Presenting Feature of Plasminogen Deficiency
A 30-yr-old patient with no significant past medical history presented with postcoital bleeding and was found to have fibrinous pseudomembranous lesions overlying and partly in continuity with the endocervical mucosa. Histologically, these were characterized by an atypical microglandular proliferation that was associated with extensive fibrinous exudate and a prominent neutrophil polymorph infiltrate. Ligneous stromal alteration was not identified but the changes prompted hematologic review which confirmed plasminogen deficiency. A subsequent endometrial biopsy also demonstrated degenerate glands within a fibrin-rich matri...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Case Reports Source Type: research

The Combination of Transient Receptor Potential Vanilloid Type 1 (TRPV1) and Phosphatase and Tension Homolog (PTEN) is an Effective Prognostic Biomarker in Cervical Cancer
Transient receptor potential vanilloid type 1 (TRPV1) has been reported to play an important role in human cancers. However, the knowledge about TRPV1 in cervical cancer is sparse. Therefore, we evaluated the expression and clinical significance of TRPV1 in cervical cancer. Immunohistochemical analyses were performed for TRPV1 and phosphatase and tension homolog (PTEN) to delineate clinical significance using 150 cervical cancers, 230 cervical intraepithelial neoplasias, and 312 normal cervical epithelial tissues in a tissue microarray. Furthermore, the role of TRPV1 in cell growth was assessed in a cervical cancer cell li...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Original Articles Source Type: research

Expanding the Morphologic, Immunohistochemical, and HPV Genotypic Features of High-grade Squamous Intraepithelial Lesions of the Vulva With Morphology Mimicking Differentiated Vulvar Intraepithelial Neoplasia and/or Lichen Sclerosus
Squamous cell carcinoma of the vulva can arise through 2 pathways: human papillomavirus (HPV)-dependent high-grade squamous intraepithelial lesions (previously termed usual vulvar intraepithelial neoplasia) or HPV-independent (differentiated vulvar intraepithelial neoplasia, dVIN). Distinguishing between the 2 types can be clinically and histologically difficult. A subset of high-grade squamous intraepithelial lesions with superimposed chronic inflammation mimicking dVIN has recently been reported; p53 shows characteristic mid-epithelial staining (with basal sparing) in such cases. The pathology databases of 2 academic ins...
Source: International Journal of Gynecological Pathology - April 16, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Original Articles Source Type: research

Primary Synovial Sarcoma of the Uterine Cervix: First Case Report
We report a 42-yr-old woman with no prior history who presented to clinic with vaginal spotting for 3 mo and was found to have a large mass in the uterine cervix. The mass was evacuated from the vagina and sent for pathologic diagnosis. Sections showed proliferation of monotonous spindle cells with scant eosinophilic cytoplasm, round to slightly irregular nuclei, variable nucleoli and frequent mitosis in a background of delicate capillary and occasional thick-walled vessels. No malignant epithelium was identified in the entire specimen. On immunohistochemical workup tumor cells were negative for pan cytokeratin, OSC...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Case Reports Source Type: research

Enteric Type Bartholin Gland Adenocarcinoma: An Unusual Variant of a Rare Neoplasm
Vulval cancer is rare. With Bartholin gland carcinomas representing (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Case Reports Source Type: research

HMGA2 Is a Useful Marker of Vulvovaginal Aggressive Angiomyxoma But May Be Positive in Other Mesenchymal Lesions at This Site
Aggressive angiomyxoma (AA) is a rare mesenchymal neoplasm occurring almost exclusively in the vulvovaginal region and which has a wide differential diagnosis. It has previously been suggested that the nuclear transcription factor HMGA2 is a useful marker of AA, although the number of studies is limited. We investigated HMGA2 immunoreactivity in a large series (n=284) of vulvovaginal mesenchymal lesions. HMGA2 nuclear staining was classified as diffuse (≥50%), focal ( (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Original Articles Source Type: research

Atypical Non-neoplastic Changes in Anogenital Mammary-like Glands Accompanying Invasive Squamous Cell Carcinoma
In this report, we presented four cases of invasive squamous cell carcinoma accompanied by non-neoplastic atypical changes in ductal portions of AGMLG compatible with atypical ductal hyperplasia in breast adjacent to the carcinoma. This is a reactive phenomenon similar to that seen in apocrine/eccrine glands adjacent to squamous cell carcinoma. In a limited biopsy specimen, these areas should not be mistaken for adenocarcinoma. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: Original Articles Source Type: research

The “Far Left” of the Morphologic Spectrum of Ovarian High-grade Serous Carcinoma: Case Report of a Purely Noninvasive High-grade Serous Carcinoma Mimicking an Ovarian Serous Borderline Tumor
We report a case of a 71-yr-old woman with a unilateral 5.1 cm ovarian cyst with small papillary projections on contrast-enhanced magnetic resonance imaging of the pelvis. Histologic examination showed a noninvasive papillary neoplasm with hierarchical branching and epithelial proliferation, and thus, at low magnification, bearing a striking resemblance to a serous borderline tumor. However, a more careful examination demonstrated high-grade cytologic features, nuclear pleomorphism, and abundant mitotic activity, suggestive of high-grade serous carcinoma. The morphology and immunohistochemical profile of this lesion...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

PAX8-positive, Cytokeratin-positive Intra-abdominal Ewing Sarcoma Masquerading as a Mullerian Carcinoma in a Postmenopausal Female
We report a case of an intra-abdominal Ewing sarcoma in a postmenopausal female patient whose clinical and radiological presentation closely resembled that of peritoneal carcinomatosis. Biopsy of an omental nodule revealed numerous histologic features suggestive of a Mullerian carcinoma, including gland-like rosettes, strong, diffuse PAX8 immunoreactivity and cytokeratin expression. After excluding other differential diagnostic considerations, the possibility that this might represent an intra-abdominal Ewing sarcoma was entertained. Reverse transcriptase polymerase chain reaction testing demonstrated the presence of an EW...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

Misdiagnosis of High-grade Serous Ovarian Cancer With BRCA Mutation as Endometriotic Cyst Due to Its Unique Gross Morphology: A Case Report and Literature Review
It is believed that high-grade serous ovarian cancer (HGSOC) is a solid or multilocular-solid cancer. Here, we report the case of a 40-yr-old woman with a left ovarian unilocular cyst. Ultrasonography and computed tomographic examination confirmed that the cyst was thin-walled and homogenous in thickness without mural nodules. It was considered to be an endometriotic cyst. Left ovarian cyst excision specimens proved it to be HGSOC after pathologic examination. Therefore, the patient underwent radical surgery for HGSOC. Pathologic examination of radical resection specimens confirmed that the HGSOC was still in FIGO stage IA...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Case Reports Source Type: research

Evaluation of SWI/SNF Protein Expression by Immunohistochemistry in Ovarian Clear Cell Carcinoma
Ovarian clear cell carcinomas (OCCC) are known to harbor ARID1A mutations, and several recent studies have described immunohistochemical loss of SMARCA2, SMARCA4, and SMARCB1 in a subset of tumors. We performed ARID1A, SMARCA2, SMARCA4, and SMARCB1 immunohistochemistry on 105 OCCCs to identify possible associations with clinicopathologic features and assess their prognostic value in these tumors. ARID1A, SMARCA4, and SMARCB1 were considered retained if any tumor cell nucleus stained while for SMARCA2,>5% of tumor nuclei were required to be positive. Patients had a mean age of 56 yr and tumors averaged 13 c...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Original Articles Source Type: research

Diffuse Intratumoral Stromal Inflammation in Ovarian Clear Cell Carcinoma is Associated With Loss of Mismatch Repair Protein and High PD-L1 Expression
Ovarian clear cell carcinoma (OCCC) is an aggressive chemotherapy-resistant cancer with limited treatment options, and some OCCCs have mismatch repair (MMR) deficiency (MMRD). Emerging evidence has revealed that various cancers with MMRD are susceptible to anti-programmed death-1/programmed death ligand-1 (anti-PD-1/PD-L1) immunotherapy, and certain histologic features are associated with MMRD. However, few studies have addressed this in OCCC. We reviewed 76 OCCCs for tumor-associated inflammation (intratumoral stromal inflammation and peritumoral lymphocytes) and performed immunohistochemistry for 4 MMR proteins and PD-L1...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: Original Articles Source Type: research

Ciliated Carcinoma of the Endometrium
We report a case of ciliated carcinoma of the endometrium in a 55-yr-old woman with stromal hyperthecosis of the ovaries. The patient presented with postmenopausal uterine bleeding and an endometrial curetting revealed an atypical epithelial proliferation that met the criteria for endometrioid adenocarcinoma notwithstanding an abundance of ciliated cells. Cilia were present not only within typical endometrioid glands but also within microacini of quasi-solid areas as well as inside intracytoplasmic vacuoles. The subsequent hysterectomy specimen demonstrated a well-differentiated adenocarcinoma of the endometrium with a pre...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Case Reports Source Type: research

Coexistence of Conventional Leiomyoma, Fumarate Hydratase-deficient Atypical Leiomyoma, and Perivascular Epithelioid Cell Tumor in a Uterus: A Case Study
A 44-yr-old woman with menorrhagia and uterine fibroids underwent total laparoscopic hysterectomy, revealing several submucosal, intramural, and subserosal tan-white nodules in the uterus. Microscopic examination revealed tumors displaying 3 distinct morphologies: 1 tumor with features of conventional leiomyoma; 1 tumor with increased cellularity, staghorn/hemangiopericytoma-like vasculature, and occasional atypical cells with prominent red nucleoli and some perinucleolar halos suggesting a fumarate hydratase (FH)-deficient atypical leiomyoma; and 1 tumor with an admixture of epithelioid and spindled cells with the former ...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Case Reports Source Type: research

Evaluation of Apoptosis, Proliferation, and Adhesion Molecule Expression in Trophoblastic Tissue of Women With Recurrent Spontaneous Abortion and Infected With Toxoplasma gondii
Recurrent spontaneous abortion is an obstetric complication with undefined causes. Apoptosis, proliferation, and adhesion are considered important factors in the pathogenesis of abortion. This work aimed to determine Bax and Bcl-2 as a proapoptotic and antiapoptotic protein, Ki67 and P27kip as proliferative and antiproliferative proteins, and E-cadherin and CD44 as adhesion molecules in the trophoblastic tissues in cases with recurrent miscarriage. Immunohistochemistry and quantitative polymerase chain reaction analysis of Bax, Bcl-2, Ki67, P27kip, E-cadherin, and CD44 in paraffin-embedded sections of placental tissues obt...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

Equivalent Survival of p53 Mutated Endometrial Endometrioid Carcinoma Grade 3 and Endometrial Serous Carcinoma
TP53 status is the most important prognostic biomarker in endometrial carcinoma. We asked the question whether p53 mutated endometrial endometrioid carcinomas grade 3 (EEC3) or endometrial serous carcinomas (ESC), the latter ubiquitously harboring TP53 mutation, have different outcomes. TP53 mutation status was assessed by surrogate p53 immunohistochemistry on 326 EEC3 and ESC from 2 major cancer centers in Canada. Mutant-type p53 expression, including overexpression, complete absence, or cytoplasmic expression, was distinguished from the wild-type pattern. Statistical associations with clinico-pathological parameter, othe...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

Corded and Hyalinized Endometrioid Adenocarcinoma (CHEC) of the Uterine Corpus are Characterized by CTNNB1 Mutations and Can Show Adverse Clinical Outcomes
Corded and hyalinized endometrioid adenocarcinoma (CHEC) is a morphologic variant of endometrioid adenocarcinoma that is typically low-grade [International Federation of Gynecology and Obstetrics (FIGO) grade 1–2]. CHEC exhibits a biphasic appearance with gland forming adenocarcinoma merging with a diffuse component with corded growth often in a hyalinized matrix; squamous differentiation is frequent and osteoid production can be seen. This morphologic appearance can invoke a large differential diagnosis including carcinosarcoma. CHEC is thought to be associated with good clinical outcome although the available data ...
Source: International Journal of Gynecological Pathology - February 24, 2021 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: Original Articles Source Type: research

Upcoming Calendar of ISGyP LiVE Programming
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: Society page Source Type: research

Epidermolytic Acanthoma: Findings of a Large Retrospective Study
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: ONLINE ARTICLES: LETTERS TO THE EDITOR Source Type: research

Secretory Carcinoma (Mammary Analogue Secretory Carcinoma) of the Vulva With ETV6 Gene Rearrangement: A Brief Report With Follow-up
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: ONLINE ARTICLES: LETTERS TO THE EDITOR Source Type: research

Female Adnexal Tumor of Probable Wolffian Origin in the Setting of Peutz-Jeghers Syndrome
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: ONLINE ARTICLES: LETTERS TO THE EDITOR Source Type: research