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

Case Report and Review of the Literature of a Rare Entity of a Uterine Fibroid: A Genital Rhabdomyoma
Extracardiac rhabdomyomas are rare benign tumors. According to histopathologic and clinical characteristics, they are divided into 3 subgroups: adult, fetal, and genital rhabdomyomas. Various adult extracardiac rhabdomyomas have been reported in the head and neck region, whereas genital rhabdomyomas are uncommon. Here, we report on a uterine genital rhabdomyoma in a 32-yr-old woman with secondary sterility. After myomectomy, the histopathologic analysis showed a slow cycling tumor with striated muscle differentiation and without any evidence of malignancy. Immunohistochemical staining proved coexpression of actin, caldesmo...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Plexiform Neurofibroma of the Uterus: A Case Report
We describe a case of plexiform neurofibromas involving the uterine cervix in a patient with known NF1 that presented with chronic pelvic pain and heavy menstrual bleeding. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Immunohistochemical Markers With Potential Diagnostic, Prognostic, and Therapeutic Significance in Uterine Carcinosarcoma: A Clinicopathologic Study of 43 Cases
Uterine carcinosarcomas (UCS) are rare and highly aggressive tumors. Although it is currently accepted that the majority of UCS are metaplastic carcinomas, their aggressive behavior is unparalleled to that of any other high-grade endometrial neoplasms. Therefore, the search for the distinct immunohistochemical and molecular features that could help in the development of new treatment strategies continues. We evaluated the expression of PDL-1, growth hormone releasing hormone receptor, p53, WT1, PAX-8, estrogen receptor, HNF-1, and mismatch repair proteins in 43 UCS. Tumors were selected from the archives of the Magee-Women...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLE Source Type: research

Cervical Superficially Invasive Squamous Cell Carcinoma With Supraclavicular Lymph Node Metastasis: A Case Report
Typically, local spread and lymph-vascular space invasion (LVSI) occur before lymph node (LN) and distant metastases during the progression of uterine cervical cancer. The prognostic value of LVSI in cervical superficially invasive squamous cell carcinoma (SISCC) is still debated. We encountered a rare case of cervical SISCC without LVSI presenting with multiple LN metastases, including pelvic, para-aortic, and left supraclavicular LNs. Immunohistochemical analysis of p16INK4a and in situ hybridization of human papillomavirus confirmed the relationship of the cervical SISCC and pelvic LN metastases. Aspiration cytology of ...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

NTRK-rearranged Cervical Sarcoma: Expanding the Clinicopathologic Spectrum
The NTRK genes (NTRK1, NTRK2, and NTRK3) encode for TrkA, TrkB, and TrkC, neurotrophic tyrosine receptor kinases which serve a variety of functions including in the regulation of pathways involved in carcinogenesis. A number of reports have described NTRK gene fusions in a variety of adult and pediatric tumor types from various organ systems including the central nervous system, thyroid gland, breast, and soft tissue. NTRK-rearranged uterine sarcomas are a recently described group of tumors which occur in both the uterine corpus and cervix, tend to morphologically resemble fibrosarcoma, and may behave aggressively, althoug...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

Trefoil Factor 2 (TFF2) as a Surrogate Marker for Endocervical Gastric-type Carcinoma
This study was carried out to investigate whether TFF2 could be a surrogate marker to separate GAS from other types of ECA. ECAs from 9 international institutions were reviewed for consensus histotype. Of them, expression of TFF2 was immunohistochemically examined compared with that of HIK1083, using whole sections of 50 ECAs (10 GASs and 40 non-GASs) and 179 ECAs (24 GASs and 155 non-GASs) with tissue microarrays (TMAs). TMAs were assessed to simulate assessment of immunohistochemical stains in small biopsies. Both markers were similarly scored, and any cytoplasmic/membranous staining of>5% of tumor cells was considere...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLE Source Type: research

Bilateral Ovarian Malakoplakia: Case Report and Review of the Literature With Clinical and Diagnostic Considerations
Malakoplakia is a rare condition in which histiocytic cells accumulate within different organs and tissues, sometimes mimicking neoplasia. Gynecologic involvement is extremely rare and therefore may cause relevant diagnostic confusion for both clinicians and pathologists. In this paper, we described the seventh case of ovarian malakoplakia, and we reviewed the literature to compare it with the previously reported ones. Moreover, we investigated the histologic and molecular differential diagnosis of malakoplakia, with special attention to other histiocytic disorders of gynecologic interest. Finally, we discussed the most re...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: CASE REPORTS Source Type: research

Stromal Endocrine Cell Micronests Associated With an Ovarian Mucinous Cystadenoma: Endocrine Cell Preservation (Pseudohyperplasia) Potentially Mimicking Stromal Sex Cord Proliferation or Tumor Microinvasion
We report a 31-yr-old patient with a mucinous cystadenoma in which ECMs were distributed in the stroma surrounding degenerate glandular elements. Immunohistochemistry demonstrated only sparse endocrine cells within the neoplastic glands. We postulate that the ECMs in this case reflected relative preservation of endocrine elements in the context of epithelial atrophy, a process more commonly encountered in gastrointestinal pathology. Ovarian ECMs should also be distinguished from stromal sex cord proliferations and tumor microinvasion. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: CASE REPORTS Source Type: research

Expression of HER2 and EGFR Proteins in Advanced Stage High-grade Serous Ovarian Tumors Show Mutual Exclusivity
In conclusion, HER2 and EGFR are expressed in a small percentage of tumors and the mutual exclusivity of these markers precludes the possibility of dual targeting with anti-HER2 and anti-EGFR therapy in advanced stage high-grade serous ovarian carcinoma. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

Late Development of Metastatic Ovarian Mucinous Adenocarcinoma From Primary Gallblader Adenocarcinoma and High-grade Dysplasia
We report 2 cases of metastatic gallbladder adenocarcinoma involving the ovaries of women aged 65 and 59 after long time periods of 8 and 5 yr following diagnosis of high-grade dysplasia or early adenocarcinoma of the gallbladder, respectively. In both cases, a review of the original operative notes suggested the possibility of intraoperative gallbladder rupture or bile leakage suggesting that the metastatic disease may have developed secondary to “seeding.” In both cases, p53 immunohistochemistry revealed identical null mutation-type immunoreactivity within the gallbladder and ovarian neoplasms, assisti...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

The Many Uses of p53 Immunohistochemistry in Gynecological Pathology: Proceedings of the ISGyP Companion Society Session at the 2020 USCAP Annual9 Meeting
Ancillary immunohistochemistry (IHC) has become a reliable adjunct for subclassification of gynecological neoplasms. An important recent development was optimization and validation of p53 IHC, where 3 abnormal IHC patterns (nuclear overexpression, complete absence, cytoplasmic) were shown to predict underlying TP53 mutations with high accuracy in ovarian carcinomas. p53 IHC now helps in distinguishing high-grade serous from low-grade serous carcinomas. Thereafter, the new interpretation of p53 IHC was quickly adapted for other purposes and similar accuracies were shown in endometrial carcinomas, vulvar squamous cell carcin...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PROCEEDINGS OF THE ISGYP COMPANION SOCIETY SESSION AT THE USCAP 2020 ANNUAL MEETING: REVIEW ARTICLES Source Type: research

ALK Immunohistochemistry and Molecular Analysis in Uterine Inflammatory Myofibroblastic Tumor: Proceedings of the ISGyP Companion Society Session at the 2020 USCAP Annual Meeting
Inflammatory myofibroblastic tumor of the uterus (uIMT) is rare. However, it has been increasingly recognized in recent years, largely due to more awareness of its occurrence in the gynecologic tract and the characterization of features that help distinguish it from more common lesions in the differential diagnosis, particularly smooth muscle neoplasms. One of these features is expression of anaplastic lymphoma kinase (ALK, also known as CD246), which has been documented in most uIMTs described in the literature. This review concentrates on the role of ALK testing in the diagnosis and management of uIMT. In terms of immuno...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PROCEEDINGS OF THE ISGYP COMPANION SOCIETY SESSION AT THE USCAP 2020 ANNUAL MEETING: REVIEW ARTICLES Source Type: research

S100 and Pan-Trk Staining to Report NTRK Fusion-Positive Uterine Sarcoma: Proceedings of the ISGyP Companion Society Session at the 2020 USCAP Annual Meeting
NTRK fusion-positive uterine sarcoma is a recently recognized mesenchymal tumor that is defined by its morphologic resemblance to soft tissue fibrosarcoma, NTRK gene rearrangements, and potential response to Trk inhibition. Reported lesions affect premenopausal women with a median age of 32 yr, and most arise in the uterine cervix. Haphazard, storiform, or herringbone patterns of spindle cells with mild to moderate nuclear atypia are characteristic. SMA, CD34, and S100 are variably positive, but tumors are negative for desmin, ER, PR, and SOX10 and retain H3K27me3 expression. While pan-Trk immunohistochemistry is po...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PROCEEDINGS OF THE ISGYP COMPANION SOCIETY SESSION AT THE USCAP 2020 ANNUAL MEETING: REVIEW ARTICLES Source Type: research

HER2 Testing and Reporting in Endometrial Serous Carcinoma: Practical Recommendations for HER2 Immunohistochemistry and Fluorescent In Situ Hybridization: Proceedings of the ISGyP Companion Society Session at the 2020 USCAP Annual Meeting
This article provides an overview of the unique characteristics of HER2 protein expression and gene amplification in endometrial serous carcinoma and summarizes the HER2 scoring criteria used for patient enrollment in the recent clinical trial. Following the experience of guideline-development in other tumor types, the trial criteria should serve as the basis for future endometrial carcinoma-specific HER2 testing and scoring recommendations, to ensure therapeutic response in new patient cohorts. Thus, based on the clinical trial, the author proposes a specific HER2 testing algorithm for endometrial serous carcinoma to guid...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PROCEEDINGS OF THE ISGYP COMPANION SOCIETY SESSION AT THE USCAP 2020 ANNUAL MEETING: REVIEW ARTICLES Source Type: research

POLE, MMR, and MSI Testing in Endometrial Cancer: Proceedings of the ISGyP Companion Society Session at the USCAP 2020 Annual Meeting
Subclassification of endometrial carcinoma (EC) based on morphologic features alone has been shown to have suboptimal reproducibility, both in regard to biopsy versus hysterectomy findings, as well as interobserver agreement. This restricts the role of morphologic classification of EC as a tool for risk prediction and therefore treatment planning. A diagnostic algorithm based on The Cancer Genome Atlas (TCGA) classification of EC holds promise for improving accuracy in risk prediction. This classifies EC into 4 groups: those harbouring mutations in the exonuclease domain of DNA polymerase epsilon, POLE (POLEmut), those sho...
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PROCEEDINGS OF THE ISGYP COMPANION SOCIETY SESSION AT THE USCAP 2020 ANNUAL MEETING: REVIEW ARTICLES Source Type: research

PD-L1 Interpretation in Cervical Carcinomas: Proceedings of the ISGyP Companion Society Session at the 2020 USCAP Annual Meeting
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - December 15, 2020 Category: Pathology Tags: PROCEEDINGS OF THE ISGYP COMPANION SOCIETY SESSION AT THE USCAP 2020 ANNUAL MEETING: REVIEW ARTICLES Source Type: research

Endometrial Polyp of the Placental Fetal Membranes: Report of a Case
Endometrial polyps embedded in the fetal membranes have only rarely been described. A review of the English literature showed only one abstract describing this occurrence and to the best of our knowledge, there have been no other publications of this entity. Herein we present a case of a 37-yr-old woman with a history prior abortion and complicated pregnancy (type 2 diabetes mellitus and preeclampsia) who delivered by cesarean section. Although the placenta did not show hypertensive vasculopathic changes or other pathologic findings, an endometrial polyp embedded within the fetal membranes was present. Recognition of this ...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: ONLINE ARTICLE: CASE REPORT Source Type: research

Paraganglioma of the Vagina Associated With Germline SDHB Mutation: Report of a Case With Review of the Literature
We report a case of vaginal paraganglioma in a 15-yr-old adolescent girl who presented with irregular heavy menses and anemic symptoms. Examination under anesthesia revealed a polypoid mass of 3 cm size in the left anterior vaginal wall, which was resected piecemeal. Histology showed a circumscribed nodular tumor with typical nested morphology of paraganglioma and no significant nuclear atypia. Immunohistochemically the tumor cells were diffusely positive for synaptophysin and chromogranin while being negative for cytokeratin, accompanied by S100-positive sustentacular cells. SDHB immunohistochemistry demonstrated t...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

Telangiectatic Squamous Cell Carcinoma of Uterine Cervix: A Previously Undescribed Variant of Squamous Cell Carcinoma
We describe an unusual telangiectatic variant of squamous cell carcinoma in a 53 yr old woman. The tumor showed the usual morphologic features of a poorly differentiated keratinizing squamous cell carcinoma with>75% tumor area showing cavernous hemangioma like ectatic spaces filled with blood. The blood-filled spaces lacked an endothelial lining as evidenced by negativity for CD31 and CD34. This unusual variant has not been reported previously. Awareness of this entity is necessary for avoiding confusion with vascular tumors such as hemangiomas and angiosarcoma. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: CASE REPORTS Source Type: research

Mutational Profile in Vulvar, Vaginal, and Urethral Melanomas: Review of 37 Cases With Focus on Primary Tumor Site
Melanomas of female genital tract are rare tumors with poor prognosis. While BRAF-V600E is the most common pathogenic mutation seen in cutaneous sun-exposed melanomas, mucosal and anogenital melanomas usually lack BRAF mutations and instead they harbor KIT alterations. The American Joint Committee on Cancer staging guideline (AJCC eighth edition) recommends using cutaneous melanoma guidelines for vulvar melanoma staging and does not provide any recommendations for vaginal melanoma staging. The aim of this study is to investigate the mutational status of invasive melanomas arising from different anatomic sites in lower fema...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

Genomic Characterization of HPV-related and Gastric-type Endocervical Adenocarcinoma: Correlation With Subtype and Clinical Behavior
The majority of endocervical adenocarcinomas (EAs) are caused by human papillomavirus (HPV). Gastric-type EA, the second most common EA and unrelated to HPV, is biologically different with a more aggressive clinical course. Our knowledge of the molecular fingerprint of these important EA types and its role in diagnosis, prognosis and management is still evolving. Thus, we sought to evaluate the genomic profile of HPV-related and gastric EA. Clinical information including patient outcome was gathered for 56 tumors (45 HPV-associated and 11 gastric-type) surveying evaluated by a targeted massively parallel sequencing assay (...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE LOWER TRACT: ORIGINAL ARTICLES Source Type: research

KRAS-mutated Uterine Endometrioid Carcinoma With Extensive Surface Changes Resulting in Striking Morphologic Mimicry of an Ovarian Serous Borderline Tumor
We report an endometrioid carcinoma of the uterine corpus with striking morphologic mimicking of an ovarian serous borderline tumor with only a minimal amount of conventional endometrioid carcinoma. The tumor was diffusely positive for estrogen receptor, negative for WT1, and showed wild-type immunoreactivity with p53. Targeted sequencing revealed a KRAS mutation (G12V/D/A), but no BRAF mutation. This close mimicry of a serous borderline tumor by a uterine endometrioid carcinoma has not been emphasized in the literature and this case is unique because the features involved almost the entire neoplasm. In reporting this case...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: CASE REPORTS Source Type: research

Malignant Sex Cord-Stromal Tumor, Not Otherwise Specified, Harboring FOXL2, p53, and TERT Promoter Mutations: Report of a Case
Rare sex cord-stromal tumors of the ovary cannot be further subclassified and are therefore designated “sex cord-stromal tumor-not otherwise specified.” These tumors have highly varied morphology, and the literature describing them is limited. Herein, we report the pathology and clinical course of a 46-yr-old woman diagnosed with sex cord-stromal tumor-not otherwise specified. The tumor was composed predominantly of juvenile granulosa cell tumor histology, with elements of thecoma, adult granulosa, Sertoli, as well as poorly differentiated epithelioid and sarcomatoid components. Next-generation sequencing revea...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: CASE REPORTS Source Type: research

Expression of the Immune Checkpoints LAG-3 and PD-L1 in High-grade Serous Ovarian Carcinoma: Relationship to Tumor-associated Lymphocytes and Germline BRCA Status
Ovarian high-grade serous carcinomas (HGSC) have shown lackluster responses to immunotherapies targeting the PD-1/PD-L1 axis, perhaps due to the coexistence of other mechanisms of immune evasion in this tumor type. Lymphocyte activation gene-3 (LAG-3) is another inhibitory immune checkpoint often expressed on tumor-associated lymphocytes which is targeted by drugs currently in clinical trials. Forty-eight HGSC with known germline BRCA mutation status were immunohistochemically stained for LAG-3, CD8, and FOXP3. Positive tumor-associated lymphocytes were enumerated and averaged over 10 high-power fields (HPF). PD-L1 immunos...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

Endometrioid Tubal Intraepithelial Neoplasia (E-TIN) of the Fallopian Tube: A Case Series
We report 4 cases of endometrioid tubal intraepithelial neoplasia with clinical correlation and morphologic differential diagnosis. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE UPPER TRACT: ORIGINAL ARTICLES Source Type: research

Mesonephric Adenocarcinoma of the Uterine Corpus: A Report on 2 Cases With Comparison to Its Cervical Counterpart
Mesonephric adenocarcinoma (MA) is a rare tumor of the female genital tract that develops in the uterine cervix. Recently, a few cases of MA arising from the uterine body have been reported, whereas the differences between these 2 entities remain unknown. Two uterine MAs and 1 cervical MA were included in this study. In uterine MA, there was an admixture of various growth patterns with tubular, glandular, slit-like, papillary, and solid architectures. Both tumors extensively involved the endometrium, while no mesonephric remnants were noted. Immunostaining was diffusely positive for TTF-1, while there was only focal staini...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORT Source Type: research

Interlaboratory Concordance of ProMisE Molecular Classification of Endometrial Carcinoma Based on Endometrial Biopsy Specimens
Molecular classifiers improve the consistency of categorization of endometrial carcinoma and provide valuable prognostic information. We aimed to evaluate the interlaboratory agreement in ProMisE assignment across 3 dedicated Canadian gynecologic oncology centers. Fifty cases of endometrial carcinoma diagnosed on biopsy were collected from 3 centers and 3 unstained sections were provided to each participating site so that immunohistochemistry for MSH6, PMS2, and p53 could be performed and interpreted at each center, blinded to the original diagnoses and the results from other centers. A core was taken for DNA extraction an...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

PNL2: A Useful Adjunct Biomarker to HMB45 in the Diagnosis of Uterine Perivascular Epithelioid Cell Tumor (PEComa)
The objective of this study was to determine PNL2 utility in diagnosing uterine PEComas as well as distinguishing PEComas from uterine smooth muscle tumors (SMTs). Twenty-one uterine PEComas and 45 SMTs were analyzed for PNL2; a subset was also stained for HMB45, Melan-A, Cathepsin-K, Desmin, and h-Caldesmon. Cases were scored as negative (0), focal (10% of tumor cells). PEComas were positive for PNL2, HMB45, and Melan-A in 86%, 100%, and 57% of cases, respectively. In PEComas, PNL2 was patchy to diffusely positive more frequently (10/18, 56%) than Melan-A (4/12, 33%). In contrast, 2 of 45 (4%) SMTs were focally PNL2 posit...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Presence of Glandular Cells at the Preoperative Cervical Cytology and Local Recurrence in Endometrial Cancer
We investigated the correlation between glandular cells (GC) detected at preoperative cervical-smear and the histologic findings and oncologic outcomes in patients undergoing surgery for endometrial cancer (EC). We retrospectively analyzed data of all consecutive EC patients who underwent surgery between January 1, 1990 and December 31, 2012 with preoperative cervical smear performed within 3 mo from the EC diagnosis. Basic descriptive, logistic regression and artificial neural network analyses were used. Five-year disease-free survival and overall survival were assessed using Kaplan-Meier and Cox hazard models. The...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Diagnostic Variation in p53 Usage for Endometrial Carcinoma Diagnosis: Implications for Molecular Subtyping
Immunostaining for p53 is widely but variably used when diagnosing endometrial carcinoma (EC). Mutant-pattern p53 staining can support a diagnosis of serous carcinoma, and also serve as a surrogate test for identifying the “serous-like” subset of aggressive EC identified by The Cancer Genome Atlas characterized by high numbers of somatic copy number abnormalities. We, retrospectively, assessed WHO histotype, usage of p53 immunostaining, and p53 status in a consecutive series of biopsies showing EC from a single hospital. Of 79 ECs, 59 (75%) were low-grade EC (LGEC), 13 (16%) high-grade EC (HGEC), and 7 (9%) wer...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Variable Expression of MSH6 in Endometrial Carcinomas With Intact Mismatch Repair and With MLH1 Loss Due to MLH1 Methylation
Immunohistochemistry for mismatch repair proteins MLH1, MSH2, MSH6, and PMS2 is an effective screen to detect individuals at risk for Lynch syndrome. College of American Pathologists guidelines stipulate that protein expression should be reported as present versus absent, as most patients with germline mutations in a mismatch repair gene have complete loss of protein expression in tumor cells. A similar approach is employed to screen for cancer patients eligible for immune checkpoint blockade. This “all or none” interpretive approach ignores substantial evidence that mismatch repair may be more finely regulated...
Source: International Journal of Gynecological Pathology - October 8, 2020 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

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