Awards
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Awards: PDF Only Source Type: research

Announcement
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Announcement: PDF Only Source Type: research

Tubulovillous Adenoma of Vagina With Both KRAS and APC Mutations: Case Report
We report a case of a 74-yr-old women with a tubulovillous adenoma occurring in the vagina, and a second one occurring later in the vulva. Tumor cells in both lesions were CK7−, CK20+, CDX-2+, and showed intact mismatch-repair proteins. A G13D (c.38G>A, p.Gly13Asp) mutation in the KRAS gene was identified in both masses. As well, a novel frameshift truncating mutation (c.4320delA, p.Pro1441fsTer32) in the APC gene was detected only in the vaginal mass, ruling out the possibility that the vulvar mass was a local recurrence of the vaginal mass. This is the first identification of KRAS and APC gene mutations in adeno...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Lower Genital Tract: Case Report Source Type: research

HPV 6-associated HSIL/Squamous Carcinoma in the Anogenital Tract
We report 4 cases of low risk anogenital HPV infections—3 cervical (immature low-grade squamous intraepithelial lesion with metaplastic phenotype) and one anal (exophytic condyloma) lesion—that manifested with high-grade squamous intraepithelial lesion/squamous cell carcinoma. Two were associated with invasion one of which metastasized to a regional node. Two cases exhibited strong p53 positivity in the high-grade squamous intraepithelial lesion/squamous cell carcinoma component analogous to that seen in HPV-negative differentiated intraepithelial lesions of the external genitalia. This series of cases adds to ...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Lower Genital Tract: Original Article Source Type: research

GATA3 Expression in Common Gynecologic Carcinomas: A Potential Pitfall
GATA binding protein 3 (GATA3) immunohistochemistry is primarily used as a marker of breast and urothelial differentiation, particularly in metastatic settings. In the gynecologic tract it also serves a robust marker for mesonephric and trophoblastic tumors. However, expression has also been described in more common malignancies of gynecologic tract including ovarian, endometrial, and cervical carcinomas. Data on the distribution of GATA3 expression in gynecologic malignancies is somewhat limited, particularly across different histologic subtypes of ovarian, endometrial, and cervical carcinomas. To assess the rates of GATA...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Lower Genital Tract: Original Article Source Type: research

Pericytoma With t(7;12): The First Ovarian Case Reported and a Review of the Literature
We report the first case of an ovarian pericytoma with t(7;12). An 11-year-old child presented with abdominal pain and distension. A suprapubic mass was detected on examination and radiological investigations revealed a 16.5 cm solid-cystic ovarian mass. Histologically, the tumor was composed of spindle cells with S100-protein, Bcl-2, and CD10 reactivity on immunohistochemistry. Alpha fetoprotein, calretinin, alpha-inhibin, WT1, smooth muscle actin, caldesmon, desmin, cytokeratins, chromogranin, synaptophysin, EMA, Sox10, CD117, CD31, CD34, and CD68 were all negative. Molecular tests showed t(7;12)(p22;q13), resulting in t...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Upper Genital Tract: Case Reports Source Type: research

Next-generation Sequencing of an Ovarian Spindle Cell Tumor Identified an Ovarian Low-grade Endometrial Stromal Sarcoma: A Rare Entity
Ovarian spindle cell tumors comprise a heterogeneous group of ovarian neoplasms from benign to malignant. Since this morphologic finding describes a broad category of ovarian neoplasms, it is not easy to determine an accurate diagnosis. Low-grade endometrial stromal sarcoma (LG-ESS) is a rare gynecological malignancy that presents with spindle cell lesions. To identify ovarian LG-ESS, we performed whole-exome sequencing and transcriptome sequencing of a spindle cell tumor. The tumor harbored JAZF1-SUZ12, a well-known gene fusion commonly found in uterine LG-ESS. Moreover, 28 non-silent somatic mutations (13 frameshift, 12 ...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Upper Genital Tract: Case Reports Source Type: research

Primary Ewing Family of Tumor Arising in the Ovary: A Case Report
In conclusion, primary EFT in the ovary is extremely rare with highly aggressive behavior and poor outcome for metastatic disease. Demonstration of EWSR1 rearrangement, observed in a variety of soft tissue tumors, is very helpful in the diagnosis of EFT when interpreted on the basis morphology and immunohistochemistry. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Upper Genital Tract: Case Reports Source Type: research

An Epithelioid Smooth Muscle Neoplasm Mimicking a Signet Ring Cell Carcinoma in the Ovary
A 53-yr-old woman who presented with elevated renal indices was discovered to have a 4.5 cm right renal mass and an incidental 9.7 cm left ovarian mass on imaging studies. She underwent a partial nephrectomy and bilateral salpingo-oophorectomy, revealing a chromophobe renal cell carcinoma and an unusual ovarian neoplasm with epithelioid cells displaying prominent signet ring cell-like morphology. Immunohistochemical analysis of the ovarian neoplasm demonstrated that the tumor cells were diffusely immunoreactive for smooth muscle markers and negative for all tested cytokeratins and epithelial membrane antigen....
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Upper Genital Tract: Case Reports Source Type: research

Papilloma of the Fallopian Tube: A Rare Gynecologic Neoplasm Harboring a BRAF (c.1799T>A) Mutation (V600E)
Papillomas of the fallopian tube are exceedingly rare benign tumors, and only very few cases have been reported in the literature. Clinically, they may present as a mass lesion or occur without symptoms. Histomorphologically, they are papillary tumors covered by nonatypical epithelium with occasional ciliated or goblet cells growing in the lumen, and they are most frequently located in the infundibular region of the fallopian tube. They require a number of differential diagnostic evaluations and can be mistaken for either other benign tumors or malignant neoplasms. Because of their rare occurrence, molecular data about thi...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Upper Genital Tract: Case Reports Source Type: research

A Cell Line–based Immunohistochemical p53 Expression Pattern Control Panel
This study suggests the addition of a p53 cell line expression pattern control panel could potentially increase p53 interpretation accuracy for ovarian cancer subtypes. We developed a cell line–based p53 control panel that has the potential to increase individual interrater reliability for p53 immunohistochemical expression pattern determination, support immunohistochemical optimization, and direct submission of difficult to interpret p53 staining cases to next-generation sequencing. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Upper Genital Tract: Original Articles Source Type: research

Evidence of a Monoclonal Origin for Bilateral Serous Tubal Intraepithelial Neoplasia
This study complements others addressing the multiple origins of STIN in the setting of existing HGSC. It further underscores the fact that potential overlap in biologic behavior between STILs and STICs as well as timing and direction of metastatic spread has yet to be resolved. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Upper Genital Tract: Original Articles Source Type: research

Endometriosis-associated Ovarian Cancer is a Subset With a More Favorable Outcome and Distinct Clinical-pathologic Characteristics
This study investigated the clinical-pathologic characteristics and outcome of EAOC compared with other ovarian carcinomas that are not associated with endometriosis (non-EAOC) in a large cohort. Seven hundred two patients meeting the inclusion criteria were further subclassified as group I when patients had ovarian carcinoma associated with or arising within endometriosis (EAOC) and group II when patients had non-EAOC. Age, gross features, histologic type, International Federation of Gynecology and Obstetrics stage, and disease-free survival (DFS) were compared between the groups. One hundred sixty-eight (23.9%) patients ...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Upper Genital Tract: Original Articles Source Type: research

Acute Pancreatitis Caused by Isolated Pancreatic Metastasis From Uterine Choriocarcinoma
Choriocarcinoma is an aggressive gestational trophoblastic neoplasia known for its widely metastatic potential. However, isolated pancreatic metastasis is an extremely rare occurrence and has not been documented in the English literature to the best of our knowledge. The metastatic deposits in the index case led to widespread hemorrhage and necrosis of the pancreatic parenchyma, causing severe acute pancreatitis. The patient succumbed to her illness before chemotherapy was administered. Thus, we present an autopsy case of a uterine choriocarcinoma with isolated pancreatic metastasis presenting as severe acute pancreatitis ...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Corpus: Case Reports Source Type: research

Ectopic Fetal Hepatic Tissue in the Placenta
In this report, we summarize the previous literature regarding intraplacental ectopic liver, and we propose a sensitive approach to suspected ectopic liver of the placenta that may be sufficient to capture both the fetal and mature hepatocyte immunophenotypes. This approach may extend to other related pathologies including assessment of suspected intraumbilical hepatocytes. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Corpus: Case Reports Source Type: research

ZC3H7B-BCOR-Rearranged Endometrial Stromal Sarcomas: A Distinct Subset Merits its Own Classification?
This report supports emerging evidence that ESS with ZC3H7B-BCOR gene fusion may have an aggressive clinical course in spite of its low-grade histology. This report further expands the morphologic spectrum of ZC3H7B-BCOR fusion ESS to include nonmyxoid histology. Finally, this report underlines the value of molecular analysis in the proper classification of this aggressive tumor with deceptive low-grade histology. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Corpus: Case Reports Source Type: research

Clinicopathologic Features and Genetic Alterations of a Primary Osteosarcoma of the Uterine Corpus
We report a case of primary uterine OS with pulmonary metastasis in a 74-yr-old woman. Histopathologic features of the uterine tumor were in keeping with a pure chondroblastic OS composed of neoplastic cells with osteoblastic/chondroblastic differentiation and neoplastic bone formation. Despite treatment with Doxorubicin and Olaratumab and later with palliative radiation therapy, the patient died 7 mo after hysterectomy due to multiple distant metastases. A targeted next-generation sequencing assay based on a 637-gene panel was performed to analyze genetic alterations in this highly aggressive tumor, but no somatic ...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Corpus: Case Reports Source Type: research

Expression of Immunomodulatory Molecules PD-1, PD-L1, and PD-L2, and their Relationship With Clinicopathologic Characteristics in Endometrial Cancer
This study comprised 127 patients with EC. Anti PD-1, PD-L1, and PD-L2 antibodies were examined immunohistochemically on sections obtained from tissue microarray paraffin blocks. No staining with PD-1 in tumor cells was seen; however, we found positive staining in tumor cells at 36.2% with PD-L1 and 64.4% with PD-L2, and at 61.6% with PD-1, 36.2% with PD-L1, and 93.2% with PD-L2 in immune cells. When comparing staining and clinicopathologic findings, most of the PD-L1 negative tumors (both in tumor and immune cells) were FIGO Stage I, which was significantly higher than stage II-III-IV tumors (P (Source: International Jour...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Corpus: Original Articles Source Type: research

SATB2 is Consistently Expressed in Squamous Morules Associated With Endometrioid Proliferative Lesions and in the Stroma of Atypical Polypoid Adenomyoma
We report the previously undescribed occurrence of consistent SATB2 nuclear positivity within morules. Nuclear positivity was present in 38/43 (88%) cases of morules (24 focal; 14 diffuse) while all cases of nonmorular squamous metaplasia in endometrioid proliferative lesions (n=13) were SATB2 negative, except for occasional positive nuclei in 1 case. We also observed that the stromal cells of atypical polypoid adenomyoma typically exhibited diffuse nuclear immunoreactivity with SATB2 while the stromal cells of other endometrial polypoid lesions (endometrial polyp, adenomyoma, adenosarcoma) were usually negative, although ...
Source: International Journal of Gynecological Pathology - August 7, 2019 Category: Pathology Tags: Pathology of the Corpus: Original Articles Source Type: research

Endometrioid Adenocarcinoma With Solitary Metastasis to the Appendix, Mimicking Primary Appendiceal Adenocarcinoma: A Case Report and Literature Review
Metastatic tumors of the appendix are rare. Endometrial cancer tends to metastasize by directly invading neighboring structures; the lung, liver, bones, and brain are common sites of distant metastasis. Herein, we present a case of a solitary endometrial metastatic tumor in the appendiceal mucosa without serosal involvement that mimicked a primary adenocarcinoma of the appendix. The patient who had undergone a radical hysterectomy for an endometrioid adenocarcinoma 3 years earlier presented to the hospital with a history of persistent right-lower abdominal pain. Physical examination showed tension of the abdominal muscles,...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE UPPER GENITAL TRACT: CASE REPORTS Source Type: research

Coexistence of BRAF V600E and TERT Promoter Mutations in Low-grade Serous Carcinoma of Ovary Recurring as Carcinosarcoma in a Lymph Node: Report of a Case
We present a case of low-grade serous carcinoma with transformation to carcinosarcoma on recurrence in the lymph node. Identical BRAF V600E and telomerase reverse transcriptase promoter mutations were identified in both the original and recurrent tumor. Given that telomerase reverse transcriptase promotor mutations are thought to play a role in progression of other tumor types, the function of telomerase reverse transcriptase mutations in BRAF mutated low-grade serous carcinoma deserves investigation. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE UPPER GENITAL TRACT: CASE REPORTS Source Type: research

Fascin as a Useful Marker for Identifying Neural Components in Immature Teratomas of Human Ovary and Those Derived From Murine Embryonic Stem Cells
Immature teratoma of the human ovary is a rare disease, and its diagnosis and grading are currently based on histologic evaluation of the presence and amount of immature neural components in the tumor. Despite the importance of tumor grading, immature neural components especially without rosette formation are difficult to identify, partly because useful biomarkers for them are not yet available. Toward this goal, we investigated 16 immature teratomas from human ovaries as well as 10 of those derived from murine embryonic stem cells transplanted into immunodeficient mice. Immunohistochemistry was performed for cytokeratin, ...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE UPPER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Immunohistochemical Analysis of Somatostatin Receptors in Endometriosis Tissue Samples: A Retrospective Study
Three types of endometriosis are described: superficial peritoneal endometriosis (SPE), ovarian endometrioma (OMA), and deep infiltrating endometriosis (DIE). The expression of somatostatin receptors (SSTR1, 2, and 5) in human endometrial tissue and its ectopic form has been previously studied and may be different in each type of endometriosis. The aim of this study was to assess the immunohistochemical expression of SSTR1, 2, and 5 in tissue samples of SPE, OMA, and DIE. We performed a retrospective analysis in the pathology department database. Patients aged 50% of the cells showed immunostaining. Seventy-six patients we...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE UPPER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Secondary Tumors of the Gynecologic Tract: A Clinicopathologic Analysis
Although the spread of extragenital tumors to individual female genital tract organs, particularly the ovary, has been much studied, histologic data with regard to secondary tumors involving the whole gynecologic tract are largely lacking. Thus, the aim of the study was to investigate the pathologic and clinical features of these tumors in order to better understand their features. This is a retrospective study of 196 secondary lesions involving the gynecologic tract. The parameters studied were the primary site, its histologic type and grade, the presence of mucous production, the type of secondary involvement, defined as...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE UPPER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Ovarian Carcinoma Histotype: Strengths and Limitations of Integrating Morphology With Immunohistochemical Predictions
Ovarian carcinoma histotypes are critical for research and patient management and currently assigned by a combination of histomorphology +/− ancillary immunohistochemistry (IHC). We aimed to validate the previously described IHC algorithm (Calculator of Ovarian carcinoma Subtype/histotype Probability version 3, COSPv3) in an independent population-based cohort, and to identify problem areas for IHC predictions. Histotype was abstracted from cancer registries for eligible ovarian carcinoma cases diagnosed from 2002 to 2011 in Alberta and British Columbia, Canada. Slides were reviewed according to World Health Organiza...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE UPPER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Mucolipidosis Type II Affecting 1 Fetus and Placental Disk of a Dichorionic-Diamnionic Twin Gestation: A Case Report and Review of the Literature
Mucolipidosis type II, also known as I-cell disease, is an autosomal recessive inborn error of metabolism, resulting from loss-of-function mutations in GNPTAB. Affected infants exhibit multiple physical anomalies and developmental delay, and death from disease follows in early childhood. Here we present an instructive case of mucolipidosis type II affecting 1 fetus and placental disk in a dichorionic-diamnionic twin pregnancy delivered at 36-wk gestation. The second twin and placental disk showed no abnormality. On microscopic examination, the affected placenta displayed marked vacuolization of the syncytiotrophoblast and ...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Endometrial Carcinoma With an Unusual Morphology in a Patient With Cornelia de Lange Syndrome: A Case Study
Cornelia de Lange syndrome (CdLS) is a cohesinopathy, which is characterized by multiple structural anomalies as well as mental and growth retardation. A 36-yr-old nulliparous woman with oligomenorrhea was referred to us due to a mass in the uterine corpus. She had been clinically diagnosed with CdLS during infancy based on her specific facial features as well as growth and intellectual retardation. Imaging examinations and an endometrial biopsy revealed endometrial endometrioid carcinoma and polycystic ovary syndrome (PCOS). She underwent a hysterectomy and bilateral salpingo-oophorectomy. The tumor was mainly located at ...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Wilms Tumor of the Uterus
We present the case of an adult female diagnosed with uterine WT. Following hysterectomy due to a uterine mass, histopathologic examination demonstrated a triphasic malignancy composed of epithelial, stromal, and blastemal elements. The characteristic morphologic features, which were supported by immunohistochemical analysis, were diagnostic of WT of the uterus. A summary of the main clinicopathologic parameters, along with a review of all previously reported cases, are described. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: CASE REPORTS Source Type: research

Expression of Laminin Receptor 1 in Normal, Hyperplastic, and Malignant Endometrium
Laminin receptor 1 may have a role in the progression from endometrial hyperplasia with or without atypia to endometrial cancer. Therefore, we aimed to investigate the pattern, percentage, and intensity of laminin receptor 1 expression in normal, hyperplastic, and neoplastic endometrium. Paraffin blocks of 131 specimens with the diagnoses of normal endometrium (n=25), endometrial hyperplasia with atypia (n=21) or without atypia (n=55), and endometrial cancer (n=30) were immunostained with laminin receptor 1 antibody, and its expression percentage, pattern, and intensity in the epithelial cytoplasm, basement membrane, and e...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Serum Prolactin Contributes to Enhancing Prolactin Receptor and pJAK2 in Type I Endometrial Cancer Cells in Young Women Without Insulin Resistance
Elevated levels of serum prolactin and a high expression of prolactin receptor (PRLR) in cancer cells was recently identified in patients with endometrial cancer (EC). However, the impact of prolactin on EC remains unknown. The aim of this study was to elucidate the clinical and immunohistochemical characteristics of hyperprolactinemic patients with EC according to the pathogenetic types, type I and type II. EC patients were retrospectively divided into a high prolactin (HP) group and a low prolactin (LP) group by a serum prolactin level of 20 ng/mL and were compared between 2 groups. The expression of PRLR, phospho...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Thickened Endometrium in Postmenopausal Women With an Initial Biopsy of Limited, Benign, Surface Endometrium: Clinical Outcome and Subsequent Pathologic Diagnosis
In conclusion, a slight majority of women with postmenopausal bleeding and/or thickened endometrium had an initial limited surface endometrial sample. Most had no subsequent endometrial sampling. Among those with subsequent follow-up, the majority had benign findings. The study highlights the inconsistencies in adequacy criteria for endometrial sampling and the lack of standardization of subsequent management. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Aberrant Nuclear Localization of aPKCλ/ι is Associated With Poorer Prognosis in Uterine Cervical Cancer
This study aimed to investigate aPKCλ/ι expression patterns in cervical squamous cell carcinoma (SCC) and its association with disease progression. We immunohistochemically assessed aPKCλ/ι expression in 168 SCC samples and 13 normal uterine cervix samples. In 69.0% of SCC cases, aPKCλ/ι was expressed more abundantly than in normal epithelium, but there was no significant association between aPKCλ/ι intensity and disease progression (P=0.087, Cochran-Mantel-Haenszel test). aPKCλ/ι in normal cervical epithelium was confined to the cytoplasm or intercellular junctio...
Source: International Journal of Gynecological Pathology - June 12, 2019 Category: Pathology Tags: PATHOLOGY OF THE LOWER GENITAL TRACT: ORIGINAL ARTICLE Source Type: research

The Schiller-Duval Body
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: EPONYMS AND ENTITIES: ORIGINAL ARTICLE Source Type: research

Primary Mammary Analog Secretory Carcinoma (MASC) of the Vulva With ETV6-NTRK3 Fusion: A Case Report
We report, to our knowledge, the first example of a primary vulvar neoplasm with pathologic features identical to secretory carcinoma of the breast and an ETV6-NTRK3 fusion. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: CASE REPORT Source Type: research

Expression of Markers of Müllerian Clear Cell Carcinoma in Primary Cervical and Vaginal Gastric-type Adenocarcinomas
The incidence of cervical adenocarcinoma, both absolute and relative to squamous cell carcinoma, is increasing. Most cervical adenocarcinomas are human papillomavirus associated, although non–human papillomavirus-associated neoplasms exist; the latter include gastric-type adenocarcinoma (GAS) and clear cell carcinoma (CCC). Histologically, these 2 tumors may superficially resemble one other and although morphologic evaluation usually permits a correct diagnosis, immunohistochemistry may be required to resolve diagnostic uncertainty, especially in a small biopsy specimen. Markers of CCC include hepatocyte nuclear fact...
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: PATHOLOGY OF THE LOWER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Morphologic Features of Gastric-type Cervical Adenocarcinoma in Small Surgical and Cytology Specimens
Gastric-type cervical adenocarcinoma (GCA) is a human papillomavirus-unassociated, aggressive, chemorefractory tumor. Well-differentiated examples may exhibit bland morphologic appearances, which could potentially lead to misdiagnosis, particularly in limited material. We sought to characterize the morphologic features of GCA in surgical biopsy and cytology specimens. We identified patients with histologic diagnoses of GCA or minimal-deviation adenocarcinoma between 2004 and 2017. Available slides from biopsy, curettage, and cytology specimens were reviewed. Fifty-nine specimens (37 histology, 22 cytology) were reviewed fr...
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: PATHOLOGY OF THE LOWER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Radiation-associated Angiosarcoma Mimicking Fallopian Tube High-grade Serous Carcinoma in a Woman With De Novo Li-Fraumeni Syndrome
We present a case study of a woman with history of rectal adenocarcinoma, and a new diagnosis of radiation-associated angiosarcoma mimicking fallopian tube high-grade serous carcinoma who was subsequently found to have de novo Li-Fraumeni syndrome. Our objective is to highlight angiosarcoma as a potential pitfall in the diagnosis of high-grade serous carcinoma. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: CASE REPORTS Source Type: research

Inflammatory Myofibroblastic Tumor Arising in the Cul-De-Sac, Mimicking Ectopic Decidua
Extra-ovarian neoplasms incidentally discovered during cesarean section are very rare. Here we report a case of inflammatory myofibroblastic tumor found during cesarean section of a 30-year-old, full-term woman, forming a mass in her cul-de-sac. Histology revealed an extensively decidualized spindle cell process, positive for anaplastic large cell lymphoma kinase (ALK) through immunohistochemistry and fluorescent in situ hybridization (FISH). To the best of our knowledge, this is the first presentation of inflammatory myofibroblastic tumor in this location without concurrent intrauterine component, that additionally demons...
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: CASE REPORTS Source Type: research

Ovarian Sertoli-Leydig Cell Tumor With Heterologous Hepatocytes and a Hepatocellular Carcinomatous Element
We describe the case of a 68-yr-old woman who presented with abdominal distention. A computed tomographic scan revealed a large right adnexal mass without evidence of intrahepatic tumors, and a complete cytoreductive surgery was performed. Pathologic examination revealed a moderately differentiated Sertoli-Leydig cell tumor with various heterologous elements, including gastrointestinal-type glands, insular carcinoid, and aggregations of hepatocytes without significant cytologic atypia. Moreover, adjacent to these hepatocytes, extensive overgrowth of highly atypical hepatocyte-like cells, providing a striking morphologic si...
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: CASE REPORTS Source Type: research

Comprehensive Surgical Staging in Stage 1 Clear Cell and Endometrioid Ovarian Carcinomas: Is it Necessary?
The objective of this article was to evaluate the presence of occult metastasis after comprehensive surgical staging of clear cell ovarian carcinoma (CCC) and endometrioid ovarian carcinoma (EMCA) that appeared to be confined to the ovary at time of surgery. Between 1998 to 2016, 85 patients with CCC and EMCA were identified who were comprehensively staged and felt to be stage 1 intraoperatively. Of the 85 patients who underwent surgical staging, 4 (4.7%) had omental and dense pelvic side-wall tumor adhesions. On final pathology, 67 (79%) patients were diagnosed as stage 1A of which 29 (43%) patients were upstaged to 1C1 d...
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: PATHOLOGY OF THE UPPER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Assessment of a Chemotherapy Response Score (CRS) System for Tubo-Ovarian High-Grade Serous Carcinoma (HGSC)
A chemotherapy response score (CRS) system was recently described to assess the histopathologic response and prognosis of patients with tubo-ovarian high-grade serous carcinoma (HGSC) receiving neoadjuvant chemotherapy. The current study was performed as an independent assessment of this CRS system. We retrospectively identified advanced stage HGSC patients who received neoadjuvant chemotherapy and underwent interval debulking. If available, a hemotoxylin and eosin slide from the omentum and the adnexa was selected for the study. Slides were independently scored by 13 pathologists using the 3-tiered CRS system. Reviewers t...
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: PATHOLOGY OF THE UPPER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Mesonephric Adenocarcinoma of the Uterine Corpus: Report of 2 Cases and Review of the Literature
In this study, we report 2 cases of MNA of uterine corpus. One case involved the inner half of myometrium with endometrial involvement; the second case involved the outer half of myometrium without endometrial involvement. We also reviewed the clinical and pathologic presentations of this rare entity, and discussed the histogenesis of uterine corpus MNA based on recent molecular findings. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: CASE REPORT Source Type: research

Insufficient and Scant Endometrial Samples: Determining Clinicopathologic Outcomes and Consistency in Reporting
There are no widely accepted pathologic criteria for reporting endometrial samples with limited tissue and no consensus on the clinical follow-up of patients with these samples. Our study compares clinicopathologic outcomes and determines reporting consistency for these samples. This was done in 3 parts: (1) retrospective chart review of all patients with reported insufficient or scant endometrial samples from 2010 to 2013 at our center to determine repeat sampling and final pathologic diagnosis; (2) survey of gynecologists about their practice for managing patients with these samples; (3) blind review of 99 cases of previ...
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Predictive Histologic Factors in Carcinosarcomas of the Uterus: A Multi-institutional Study
In this study, we evaluated the clinical and histopathologic features of 196 uterine carcinosarcomas to identify potential prognostic factors. Patients’ ages ranged from 34 to 95 yr (median, 68 yr). Seventy-three (38%) patients experienced tumor recurrence during follow-up. Tumors ≥5 cm, outer half myometrial invasion, lymphovascular invasion, lymph node metastasis, advanced stage (International Federation of Gynecology and Obstetrics stages III–IV), sarcomatous component on recurrence, sarcoma dominance, and positive cytology were significantly associated with shorter disease-free inter...
Source: International Journal of Gynecological Pathology - April 17, 2019 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Actinomycotic Endometritis
Seven cases of actinomycotic endometritis were identified among 28,906 endometrial biopsies performed in the last 10 yr. The patients’ ages ranged from 44 to 85 yr old. An intrauterine device was in place from 7 to 44 yr. The reasons to perform the biopsies included abnormal uterine bleeding, malodor, prolapse, pelvic inflammatory disease, and suspicion of metastatic uterine sarcoma. Definitive identification of Actinomyces israelii by culture was obtained in 1 case only. Gram, Gomori methenamine silver, and Fite stains were useful in the differential diagnosis with pseudoactinomycotic granules, ...
Source: International Journal of Gynecological Pathology - March 1, 2019 Category: Pathology Tags: PATHOLOGY OF THE CORPUS: ORIGINAL ARTICLES Source Type: research

Lipoblastoma-like Tumor of the Vulva, an Important Benign Mimic of Myxoid Liposarcoma
No abstract available (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - February 7, 2019 Category: Pathology Tags: LETTER TO THE EDITOR Source Type: research

Primary Cervical Malignant Melanoma: 2 Cases and a Literature Review
Primary cervical malignant melanoma (MM) is an extremely rare tumor, and we are only aware of 44 reported cases. Further information is needed with regard to this disease’s clinicopathologic features. Two patients (55 and 81 yr old) with postmenopausal vaginal bleeding were diagnosed with primary cervical MM on the basis of hematoxylin-eosin staining and immunohistochemistry findings. Our literature review revealed that the average age in cases of primary cervical MM was 59 yr (range, 34–81 yr); 93% of patients presented with vaginal bleeding, and 82% of patients were diagnosed at an early ...
Source: International Journal of Gynecological Pathology - February 7, 2019 Category: Pathology Tags: CASE REPORT Source Type: research

Bartholin Gland Carcinoma: Clinicopathologic Features, Including p16 Expression and Clinical Outcome
Bartholin gland carcinomas are rare forms of vulvar malignancy and it is unclear what proportion is associated with high-risk human papilloma virus (HPV) infection. Our hospital archives were searched for all cases of Bartholin gland carcinoma from 1984 to 2017 (n=16). We excluded 3 adenoid cystic carcinomas, which were the subject of a previous study, leaving 13 cases. We reviewed all slides and performed immunostains for p16 as a surrogate biomarker for high-risk HPV. There were 12 squamous cell carcinomas (SCCs), including 1 SCC with transitional-like morphology and 1 papillary SCC, and 1 adenocarcinoma. All SCCs showed...
Source: International Journal of Gynecological Pathology - February 7, 2019 Category: Pathology Tags: PATHOLOGY OF THE LOWER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Human Papillomavirus (HPV)-associated Lymphoepithelioma-like Carcinoma of the Vagina and Anal Canal: A Rare Variant of Squamous Cell Carcinoma
We report 2 LELCs of the vagina and 1 of the anal canal, the first report of LELC at the latter site. All 3 neoplasms were diffusely positive with p16 (block-type immunoreactivity) and the anal canal lesion contained high-risk human papillomavirus type 16; the 2 vaginal neoplasms underwent human papillomavirus testing but were unsuitable for analysis. All cases were Epstein-Barr virus negative. In reporting these cases, we highlight the potential for misdiagnosis and suggest an association with human papillomavirus infection similar to LELCs in the uterine cervix. (Source: International Journal of Gynecological Pathology)
Source: International Journal of Gynecological Pathology - February 7, 2019 Category: Pathology Tags: PATHOLOGY OF THE LOWER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research

Classic Vulvar Intraepithelial Neoplasia With Superimposed Lichen Simplex Chronicus: A Unique Variant Mimicking Differentiated Vulvar Intraepithelial Neoplasia
High-grade vulvar intraepithelial neoplasia, a precursor lesion to vulvar squamous cell carcinoma, is subdivided into 2 types, classic or usual vulvar intraepithelial neoplasia (CVIN) and differentiated vulvar intraepithelial neoplasia (DVIN). CVIN, which is a human papilloma virus (HPV)-dependent lesion, is typically distinguished from DVIN, a p53 mutation-dependent process, by its distinct histomorphologic and immunohistochemical characteristics. However, distinguishing between the 2 entities becomes challenging in cases of CVIN with superimposed inflammatory changes, especially lichen simplex chronicus (LSC). Twelve cas...
Source: International Journal of Gynecological Pathology - February 7, 2019 Category: Pathology Tags: PATHOLOGY OF THE LOWER GENITAL TRACT: ORIGINAL ARTICLES Source Type: research