1
|
Kitamura SI, Yoshida H, Kobayashi-Kato M, Kikkawa N, Tanase Y, Uno M, Ishikawa M, Kato T. Adenoid Basal Carcinoma with Adenoid Cystic Carcinoma Component of the Uterine Cervix: A Case Report and Literature Review. Int J Surg Pathol 2022:10668969221134691. [DOI: 10.1177/10668969221134691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Adenoid basal carcinoma (ABC) is rare cancer with a favorable prognosis. However, some ABCs are associated with other histological types, such as squamous cell carcinoma. Here, we present a case of a mixed tumor of ABC and adenoid cystic carcinoma (ACC) of the cervix, with a detailed immunohistochemical study and literature review. We describe a case of a 66-year-old woman who underwent cervical cancer screening that led to the detection of a 0.7 cm nodular lesion. Cervical punch biopsies revealed a high-grade squamous intraepithelial lesion. Cervical conization revealed a mixed carcinoma composed of ABC and ACC, showing stromal invasion, lymphovascular invasion, and positive resection margins. Immunohistochemically, the ACC components were positive for KIT and αSMA and negative for NKX3.1. The tumor presented with proficient mismatch repair (MMR) and was negative for HER2, PD-L1, and TRKA (NTRK1). Subsequent radical hysterectomy with pelvic lymph node dissection revealed the presence of residual tumor cells in the cervix. Our literature review identified six similar cases, including one patient who died of disease recurrence. We report a rare tumor comprising both ABC and ACC. Prognostic data on mixed tumors are scarce; however, given the aggressive nature of ACC, attention should be paid to the detection of mixed tumors. Since ABC and ACC histology may overlap, adequate sampling and IHC for detecting ACC would be helpful.
Collapse
Affiliation(s)
- Sho-ichi Kitamura
- Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Hiroshi Yoshida
- Department of Diagnostic Pathology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Mayumi Kobayashi-Kato
- Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Nao Kikkawa
- Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Yasuhito Tanase
- Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Masaya Uno
- Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Mitsuya Ishikawa
- Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| | - Tomoyasu Kato
- Department of Gynecology, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo 104-0045, Japan
| |
Collapse
|
2
|
Robles Díaz J, Salvador Reyes F. Carcinoma adenoide quístico de cuello uterino: una rara entidad. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2021. [DOI: 10.1016/j.gine.2020.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
3
|
Griesinger LM, Szczepanski JM, McMullen ER, Skala SL. Uncommon Cervical Lesions: A Review and Discussion of the Differential Diagnosis. Arch Pathol Lab Med 2020; 145:891-902. [PMID: 33091926 DOI: 10.5858/arpa.2020-0327-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— While the vast majority of cervical tumors consist of human papillomavirus (HPV)-related squamous cell carcinoma or adenocarcinoma, a subset of rare tumor types, frequently unrelated to HPV, does occur in this location. These tumors vary widely in prognostic and therapeutic implications, and accurate recognition is crucial to providing appropriate treatment. Some are benign or portend a favorable prognosis (adenoid basal carcinoma, ectopic prostate tissue), while others are frankly malignant lesions with a less favorable prognosis (adenoid cystic carcinoma, HPV-negative endocervical adenocarcinoma, mesonephric adenocarcinoma, clear cell carcinoma, small cell carcinoma, and adenosquamous carcinoma). OBJECTIVE.— To review the morphologic features of uncommon cervical lesions, the utility of immunohistochemistry for distinction between these entities, and the clinical and prognostic implications of accurate diagnosis. DATA SOURCES.— University of Michigan cases and review of the pertinent literature regarding the entities described. CONCLUSIONS.— Key morphologic and immunohistochemical features detailed herein will allow for the accurate distinction between these uncommon cervical lesions. Morphology is most useful in discriminating between the entities, as there is frequent immunohistochemical overlap between them; however, in rare instances immunohistochemistry can be useful in resolving the diagnosis.
Collapse
Affiliation(s)
- Laurie M Griesinger
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor
| | | | - Emily R McMullen
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Stephanie L Skala
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor
| |
Collapse
|
4
|
Stewart CJR, Moses J. NKX3.1 expression in cervical 'adenoid basal cell carcinoma': another gynaecological lesion with prostatic differentiation? Pathology 2020; 53:193-198. [PMID: 33032811 DOI: 10.1016/j.pathol.2020.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/07/2020] [Accepted: 07/20/2020] [Indexed: 10/23/2022]
Abstract
Adenoid basal cell carcinoma (ABC) is considered a rare cervical neoplasm which when present in 'pure' form, uniquely amongst apparently malignant cervical tumours, has never been reported to metastasise or lead to fatal patient outcome. We recently encountered a case of ABC that was morphologically reminiscent of prostatic differentiation, more specifically basal cell hyperplasia of the prostate. Immunohistochemistry was strongly positive for the prostate related marker NKX3.1 in the glandular cells, but there was no expression of prostate specific antigen (PSA) or prostatic acid phosphatase (PAP). However, subsequent review of five additional cervical ABCs demonstrated focal PAP expression in two of four tested cases, and all were NKX3.1 positive. NKX3.1 expression was also demonstrated in the glandular epithelium of 10 additional gynaecological lesions considered to show prostatic differentiation including five cases of cervical ectopic prostatic tissue, three ovarian teratomas with prostatic differentiation, and two vaginal tubulosquamous polyps. We suggest that some lesions traditionally classified as ABC may in fact represent a variant of prostatic differentiation within the cervix, possibly analogous to basal cell hyperplasia of the prostate.
Collapse
Affiliation(s)
- Colin J R Stewart
- Department of Pathology, King Edward Memorial Hospital, Perth, WA, Australia; School of Women's and Infants' Health, University of Western Australia, WA, Australia.
| | - Joanne Moses
- LabPlus, Auckland City Hospital, Auckland, New Zealand
| |
Collapse
|
5
|
Shi H, Shao Y, Liu Q, Wang S, Lu W, Lu B. A clinicopathological and molecular analysis of cervical carcinomas with basaloid features. Histopathology 2019; 76:283-295. [PMID: 31393622 DOI: 10.1111/his.13968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/08/2019] [Accepted: 08/05/2019] [Indexed: 12/24/2022]
Abstract
AIMS To investigate the relationship between adenoid basal carcinoma (ABC), adenoid cystic carcinoma (ACC) and squamous cell carcinoma (SCC) in the uterine cervix. METHODS AND RESULTS We analysed the clinicopathological and molecular features in two pure ABCs, 15 SCCs with ABC-/ACC-like features and seven basaloid SCCs (BSCCs) by chart review, immunohistochemistry, human papillomavirus (HPV) RNA in-situ hybridisation and fluorescence in-situ hybridisation. All patients were alive with no evidence of disease, except for one patient with ACC-like features who died of disease at 18 months post diagnosis. The mixed carcinomas comprised variable SCCs and ABC-/ACC-like components displaying vague transitional zones. All components consistently showed diffuse p16, p63 and SOX2, variable cytokeratin (CK)7 and CK17 and rare Ber-EP4 and MYB expression; there was a substantially lower Ki67 index in pure ABCs and the ABC-like components. The ACC-like components showed no myoepithelial differentiation (SMA, calponin and S100) and MYB gene fusions. CK7, CK17 and Ber-EP4 were characteristically stronger in BSCCs than in the mixed carcinomas (P < 0.01). High-risk HPV (HR-HPV) E6/E7 mRNA was detected in 12 mixed carcinomas and seven BSCCs, but not in pure ABCs. The HR-HPV mRNA expression was higher in the SCC components and BSCCs than in the ABC-like components of mixed carcinomas (P < 0.05). CONCLUSIONS The ACC-like components in mixed carcinomas probably represent the morphological mimics of salivary ACCs. ABC-like components may be the potential precursor of the ACC-like and SCC components. HR-HPV oncogenes may play a role in the pathogenesis of SCCs with ABC-/ACC-like features.
Collapse
Affiliation(s)
- Haiyan Shi
- Department of Surgical Pathology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Ying Shao
- Department of Surgical Pathology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Qin Liu
- Department of Surgical Pathology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Su Wang
- Department of Surgical Pathology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Weiguo Lu
- Center for Uterine Cancer Diagnosis and Therapy Research of Zhejiang Province, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China.,Department of Gynecological Oncology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| | - Bingjian Lu
- Department of Surgical Pathology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China.,Center for Uterine Cancer Diagnosis and Therapy Research of Zhejiang Province, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China
| |
Collapse
|
6
|
Xing D, Lu J. Distinctive clinicopathological features and disease‑specific survival of adenoid cystic carcinoma and adenoid basal carcinoma in the lower female genital tract. Oncol Rep 2018; 41:1769-1778. [PMID: 30569173 DOI: 10.3892/or.2018.6927] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 10/09/2018] [Indexed: 11/06/2022] Open
Abstract
Adenoid cystic carcinomas (ACCs) and adenoid basal carcinomas (ABCs) in the lower female genital tract are very rare. Data on the clinicopathologic features and survival outcomes of ACCs and ABCs in the lower female genital tract are limited to case reports and small case series studies. The present study systemically analyzed 233 cases, including 84 cervical ACCs, 78 cervical ABCs and 71 vulvar ACCs, to identify clinicopathologic features and survival factors in a population‑based Surveillance, Epidemiology and End Results (SEER) study. Whereas cervical ACCs and ABCs tend to occur in the elderly (median, 72 and 69 years, respectively), vulvar ACCs commonly occurred in patients a decade younger (median, 59 years). The majority of patients with cervical ABC had localized disease and almost all received surgery. In contrast, cervical and vulvar ACC patients tended to have higher stage disease, and a significant proportion of these patients received radiotherapy, with or without surgery. The 5‑year cause‑specific survival (CSS) rates for patients with cervical ACC were 69.3%, vulvar ACC 87.7% and cervical ABC 96.6%. The 5‑year overall survival (OS) rate for patients with cervical ACC was 59.2%, significantly worse than that of cervical ABC (88.3%; P=0.002) and vulvar ACC (81.2%; P=0.01). Increased age and high stage were significantly associated with a worse prognosis in patients with cervical and vulvar ACCs by univariate and multivariate analysis (P<0.05). Tumor stage was the only significant factor associated with 5‑year overall survival in patients with cervical ABC (P<0.05). The present data demonstrated that the distinctive clinicopathologic features and survival outcomes differed significantly among ACCs and ABCs in the lower female genital tract, thus providing a rationale for location/pathologic type‑based treatment modalities.
Collapse
Affiliation(s)
- Deyin Xing
- Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD 21231, USA
| | - Jiayun Lu
- Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| |
Collapse
|
7
|
Cervical Adenoid Basal Carcinoma: Clinicopathologic Features of 9 Cases With Reference to CK17 and Ki-67 Expression. J Low Genit Tract Dis 2018; 23:77-81. [PMID: 30106815 DOI: 10.1097/lgt.0000000000000428] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aims of this study were to clarify the histological features of adenoid basal carcinoma (ABC) and determine whether cytokeratin 17 (CK17) and Ki-67 can facilitate the differential diagnosis of ABC from squamous cell carcinoma (SCC). MATERIALS AND METHODS Nine cases of pure ABC were collected from the files of the Division of Pathology at the Zhejiang University Hospital Women's School of Medicine. For comparison, 20 cases of moderately to poorly differentiated cervical SCC, including 2 of basaloid SCC, were also retrieved from the same period. Blocks were recut, reread, and immunostained for CK17 and Ki-67. RESULTS Morphologically, ABCs were mainly composed of small basaloid cell nests and variable squamous differentiation foci. For immunohistochemical staining, 1 of 9 cases showed diffuse CK17 staining, 5 of 9 showed focal positive staining, and 3 of 9 showed negative staining in the basaloid cell area of ABC, whereas no CK17 expression was found in ABC squamous foci. Eighteen of the 20 invasive SCCs showed diffuse CK17 staining, and 2 showed focal staining. The Ki-67 proliferative index varied in different ABC areas, with a relatively high index in squamous differentiation foci and a low index in basaloid cell areas. In contrast, Ki-67 staining was unevenly intense in SCC. CONCLUSIONS Adenoid basal carcinoma had characteristic morphological features, and the differential diagnosis of ABC from SCC is usually simple, based on morphology. In select cases, when histological findings are equivocal, the loss of CK17 expression in the squamous differentiation area, and a lower Ki-67 index in basal cell foci support ABC diagnosis.
Collapse
|
8
|
Sharma P, Jha V, Mandal AK. Clinicopathological Correlation of Adenoid Cystic Carcinoma: A Notorious Masquerader and Clinical Paradox. Indian J Med Paediatr Oncol 2018. [DOI: 10.4103/ijmpo.ijmpo_141_16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Abstract
Background: Adenoid cystic carcinoma (ACC) is an uncommon tumor with nonspecific clinicoradiological features thereby masquerading other nonneoplastic and neoplastic entities. Materials and Methods: Cases of ACC were retrospectively reviewed over a period of 4 years. The clinical details of these patients including fine-needle aspiration cytology (FNAC) and imaging findings were retrieved. Diagnosis was confirmed on histomorphology and supplemented with immunohistochemistry (IHC). Results:: Thirty cases of ACC were included in the study. Mean patient age was 55.5 years with a slight female preponderance. Among the 30 ACCs, 10 (33.4%) were located in submandibular gland, 7 (23.4%) in parotid gland, 6 (20%) in sublingual gland, 2 (6.7%) in lung and one each (3.33%) in nasal cavity, breast, cervix, lip, and skin of face. Preoperative imaging was suggestive of malignancy in 29 cases while a single case of parotid gland ACC was misdiagnosed as benign salivary gland neoplasm. FNAC was performed in 29 cases with a diagnostic accuracy of 82.7%. Histopathological examination showed characteristic features of ACC in all cases with perineural invasion seen in 7 cases. On IHC, positivity for cytokeratin was seen in all cases, cluster of differentiation 117 in 24 cases, thyroid transcription factor-1 in two cases and human epidermal growth factor receptor/neu in two cases. All cases were negative for estrogen receptor and progesterone receptor IHC. Mean Ki-67 score was 47.8%. Conclusion: ACCs are notorious tumors showing slow growth kinetics with propensity for perineural invasion, late recurrences, and distant metastasis. It should be kept in mind as a differential diagnosis at unusual sites other than salivary glands.
Collapse
Affiliation(s)
- Preeti Sharma
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Vidya Jha
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | - Ashish Kumar Mandal
- Department of Pathology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| |
Collapse
|
9
|
Frequent NFIB-associated Gene Rearrangement in Adenoid Cystic Carcinoma of the Vulva. Int J Gynecol Pathol 2018; 36:289-293. [PMID: 27662035 DOI: 10.1097/pgp.0000000000000324] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Adenoid cystic carcinoma is a rare malignant tumor that usually arises in the major and minor salivary glands and other locations containing secretory glands, including the lower female genital tract. Lower female genital tract carcinomas with adenoid cystic differentiation can be subclassified into 2 distinct groups based on the presence or absence of high-risk HPV. Cervical mixed carcinomas with some adenoid cystic differentiation are high-risk HPV-related but pure adenoid cystic carcinomas of vulvar and cervical origin appear to be unrelated to high-risk HPV. Mechanisms by which normal cells give rise to an HPV-unrelated adenoid cystic carcinoma remain largely unknown. Studies demonstrate that chromosomal translocation involving the genes encoding the transcription factors MYB and NFIB functions as a driving force of adenoid cystic carcinomas development regardless of anatomic site. The current study used fluorescence in situ hybridization with 3 different probes including MYB break-apart probe, NFIB break-apart probe, and MYB-NFIB fusion probe to assess for the presence of gene rearrangements in adenoid cystic carcinomas of the vulva. Six (66.7%) of 9 vulvar adenoid cystic carcinomas demonstrated NFIB rearrangement. Of these 6 cases with a disturbed NFIB, only 2 cases (33.3%) were positive for a MYB rearrangement that was also confirmed by a positive MYB-NFIB fusion pattern. NFIB-associated gene rearrangement is a frequent genetic event in vulvar adenoid cystic carcinomas. Chromosome translocations involving NFIB but with an intact MYB indicate the presence of novel oncogenic mechanisms for the development of adenoid cystic carcinomas of the vulva.
Collapse
|
10
|
Hang JF, Hsieh MS, Li WY, Chen JY, Lin SY, Liu SH, Pan CC, Kuo YJ. Human papillomavirus-related carcinoma with adenoid cystic-like features: a series of five cases expanding the pathological spectrum. Histopathology 2017; 71:887-896. [DOI: 10.1111/his.13301] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 06/26/2017] [Indexed: 02/05/2023]
Affiliation(s)
- Jen-Fan Hang
- Department of Pathology and Laboratory Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- School of Medicine; National Yang-Ming University; Taipei Taiwan
| | - Min-Shu Hsieh
- Department of Pathology; National Taiwan University Hospital and National Taiwan University College of Medicine; Taipei Taiwan
- Graduate Institute of Pathology; National Taiwan University College of Medicine; Taipei Taiwan
| | - Wing-Yin Li
- Department of Pathology and Laboratory Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- School of Medicine; National Yang-Ming University; Taipei Taiwan
| | - Jo-Yu Chen
- Department of Pathology; En Chu Kong Hospital; New Taipei Taiwan
| | - Shih-Yao Lin
- Department of Anatomical Pathology; Far Eastern Memorial Hospital; New Taipei Taiwan
| | - Shih-Hao Liu
- Department of Pathology; En Chu Kong Hospital; New Taipei Taiwan
| | - Chin-Chen Pan
- Department of Pathology and Laboratory Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- School of Medicine; National Yang-Ming University; Taipei Taiwan
| | - Ying-Ju Kuo
- Department of Pathology and Laboratory Medicine; Taipei Veterans General Hospital; Taipei Taiwan
- School of Medicine; National Yang-Ming University; Taipei Taiwan
| |
Collapse
|
11
|
Application of p16 Immunohistochemistry and RNA In Situ Hybridization in the Classification of Adenoid Basal Tumors of the Cervix. Int J Gynecol Pathol 2017; 35:82-91. [PMID: 26352551 DOI: 10.1097/pgp.0000000000000221] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our understanding of adenoid basal tumors of the cervix has evolved over time. Most of the proliferations referred to as adenoid basal carcinoma have a clinically benign course--leading some to suggest the term "adenoid basal epithelioma." However, rarely, these may be associated with invasive carcinomas. These tumors have been etiologically linked with high-risk human papillomavirus (HR-HPV) infection. Here, we investigate the use of p16 immunohistochemistry and HR-HPV RNA in situ hybridization (ISH) in the classification of adenoid basal tumors of the cervix. Seventeen cases of adenoid basal tumors of the cervix were included. The patients' age ranged from 19 to 79 yr (average, 59 yr). p16 immunostain was performed on all cases and RNA ISH was performed in 4 cases with available formalin-fixed paraffin-embedded tissue. There were 11 low-grade tumors, 5 frankly invasive carcinomas, and 1 with histologic features that were intermediate between the former 2 categories. p16 immunostain was negative or showed patchy cytoplasmic staining in the low-grade tumors and was strongly and diffusely positive in the invasive carcinomas. HR-HPV RNA ISH was negative in the 3 low-grade tumors and was positive in 1 case of invasive carcinoma including the adenoid basal component. Distinct p16 immunostaining and HR-HPV RNA ISH patterns exist between low-grade adenoid basal tumors and invasive adenoid basal carcinomas. Our study indicates that p16 immunostaining and HR-HPV RNA ISH can be employed as useful ancillary tools in differentiating between noninvasive and invasive adenoid basal tumors along with careful histopathologic evaluation.
Collapse
|
12
|
Adenoid Cystic Carcinoma of the Uterine Cervix: A Report of 2 Cases. Case Rep Pathol 2017; 2017:8401741. [PMID: 28348909 PMCID: PMC5350325 DOI: 10.1155/2017/8401741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 02/19/2017] [Indexed: 11/24/2022] Open
Abstract
Adenoid cystic carcinoma is malignant tumor that exceptionally occurs in the uterine cervix. It is mostly seen in postmenopausal women and has an aggressive clinical course. We report two cases of an adenoid cystic carcinoma associated with a high grade squamous intraepithelial lesion and invasive squamous cell carcinoma of the uterine cervix and discuss briefly its clinical and pathological characteristics.
Collapse
|
13
|
Lower Female Genital Tract Tumors With Adenoid Cystic Differentiation: P16 Expression and High-risk HPV Detection. Am J Surg Pathol 2016; 40:529-36. [PMID: 26645728 DOI: 10.1097/pas.0000000000000565] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Lower female genital tract tumors with adenoid cystic differentiation are rare, and data on their relationship with high-risk human papillomavirus (HPV) are limited. Here we report the clinicopathologic features from a case series. Tumors with adenoid cystic differentiation, either pure or as part of a carcinoma with mixed differentiation, arising in the lower female genital tract were evaluated by means of immunohistochemical analysis for p16 expression and in situ hybridization using 1 or more probes for high-risk HPV (a high-risk probe covering multiple types, a wide-spectrum probe, and separate type-specific probes for HPV16 and HPV18) and when possible by polymerase chain reaction for high-risk HPV. Six cervical carcinomas with adenoid cystic differentiation admixed with various combinations of at least 1 other pattern of differentiation, including adenoid basal tumor (epithelioma and/or carcinoma), squamous cell carcinoma (basaloid or keratinizing), and small cell carcinoma were identified in patients ranging in age from 50 to 86 years (mean, 73 y; median, 76 y). All of these tumors were characterized by diffuse p16 expression. High-risk HPV was detected in 5 of 6 tested cases: 4 cases by in situ hybridization (all positive for HPV-wide-spectrum and HPV16) and 1 by polymerase chain reaction (HPV45). Seven pure adenoid cystic carcinomas (6 vulvar and 1 cervical) were identified in patients ranging in age from 27 to 74 years (mean, 48 y; median, 48 y). All of these tumors were characterized by variable p16 expression ranging from very limited to more extensive but never diffuse. No high-risk HPV was detected in any of these pure tumors. Lower female genital tract carcinomas with adenoid cystic differentiation appear to comprise 2 pathogenetically distinct groups. Cervical carcinomas with mixed differentiation, including adenoid cystic, adenoid basal, squamous, and small cell components, are etiologically related to high-risk HPV and can be identified by diffuse p16 expression. Pure vulvar and cervical adenoid cystic carcinomas appear to be unrelated to high-risk HPV and are distinguished from the mixed carcinomas by nondiffuse p16 expression.
Collapse
|
14
|
Nakai T, Ichihara S, Kada A, Ito N, Moritani S, Kawasaki T, Uchiyama T, Itami H, Morita K, Takano M, Takeda M, Hatakeyama K, Ohbayashi C. The unique luminal staining pattern of cytokeratin 5/6 in adenoid cystic carcinoma of the breast may aid in differentiating it from its mimickers. Virchows Arch 2016; 469:213-22. [PMID: 27240462 DOI: 10.1007/s00428-016-1963-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 04/14/2016] [Accepted: 05/17/2016] [Indexed: 12/12/2022]
Abstract
Adenoid cystic carcinoma (AdCC) of the breast is an uncommon but distinct neoplasm composed of a dual cell population polarized around true glandular (luminal) spaces and pseudolumina. The aim of this study was to clarify whether various immunohistochemical markers (CK7, EMA, CD117, p63, calponin, CD10, S100, CK5/6, CK14, vimentin, and type IV collagen) can distinguish between the two cell types in classical AdCC (n = 14) and in collagenous spherulosis (n = 5). The sensitivity and specificity of these 11 markers to distinguish luminal from abluminal cells were evaluated using a curve created by plotting the true-positive rate (sensitivity) against the false-positive rate (1 - specificity) at threshold settings of 0, 10, 50, and 70 %. The most sensitive and specific markers for luminal cells in AdCC were CK7 and EMA; those for abluminal cells were type IV collagen, p63, and vimentin. CD10 and S100 did not act as abluminal markers in AdCC. CK5/6, one of the basal/myoepithelial markers, was expressed more frequently in luminal than in abluminal cells of AdCC. Thus, CK5/6 immunostaining resulted in a reverse expression pattern, analogous to what we recently documented in clear cells in mammary adenomyoepithelioma. In conclusion, compared with myoepithelial/abluminal cells of normal breast or collagenous spherulosis, the neoplastic abluminal cells of classical AdCC are characterized by enhanced vimentin and attenuated CD10 and S100. Furthermore, the luminal cells of AdCC show a unique aberrant staining pattern for CK5/6 that may aid in the differential diagnosis.
Collapse
Affiliation(s)
- Tokiko Nakai
- Department of Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Shu Ichihara
- Department of Pathology, Clinical Research Center, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, Aichi, Japan.
| | - Akiko Kada
- Department of Clinical Trials and Research, Clinical Research Center, Nagoya Medical Center, Nagoya, Aichi, Japan
| | - Noriko Ito
- Department of Clinical Research Management, Clinical Research Center, Nagoya Medical Center, Nagoya, Aichi, Japan
| | - Suzuko Moritani
- Department of Pathology, Shiga Medical University, Otsu, Shiga, Japan
| | - Tomonori Kawasaki
- Department of Molecular Diagnostic Pathology, Iwate Medical University School of Medicine, Morioka, Japan
| | - Tomoko Uchiyama
- Department of Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Hiroe Itami
- Department of Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Kouhei Morita
- Department of Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Masato Takano
- Department of Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Maiko Takeda
- Department of Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Kinta Hatakeyama
- Department of Pathology, Nara Medical University, Kashihara, Nara, Japan
| | - Chiho Ohbayashi
- Department of Pathology, Nara Medical University, Kashihara, Nara, Japan
| |
Collapse
|
15
|
Penault-Llorca F, Devouassoux-Shisheboran M. [Glandular lesions of the uterine cervix: Case 8]. Ann Pathol 2016; 36:207-9. [PMID: 27236351 DOI: 10.1016/j.annpat.2016.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 03/20/2016] [Indexed: 11/18/2022]
Affiliation(s)
- Frédérique Penault-Llorca
- Departement de pathologie, centre Jean-Perrin, 58, rue Montalembert, BP 392, 63011 Clermont-Ferrand cedex 1, France.
| | | |
Collapse
|
16
|
Co-existing of adenoid cystic carcinoma and invasive squamous cell carcinoma of the uterine cervix: a report of 3 cases with immunohistochemical study and evaluation of human papillomavirus status. Diagn Pathol 2015; 10:145. [PMID: 26285694 PMCID: PMC4545692 DOI: 10.1186/s13000-015-0376-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 07/29/2015] [Indexed: 11/10/2022] Open
Abstract
Backgrounds The aim of this study was to describe the clinicopathological characteristics and high-risk human papillomavirus (HPV) infection status in patients diagnosed with co-existing of adenoid cystic carcinoma (ACC) and invasive squamous cell carcinoma (SCC) of the uterine cervix. Methods Three patients were identified from the pathology databank of Peking Union Medical College Hospital from year 2000 to 2014. Immunohistochemistry and in situ hybridization (ISH) were employed in this study. Results The patients were aged 64, 77 and 63 years (average, 68 years old). All the patients were postmenopausal women who presented with bloody or watery vaginal discharge. The cervical cytology screening results were all suspicious for high-grade squamous intraepithelial lesion (HSIL). The subsequent cervical colposcopy biopsies all showed cervical intraepithelial neoplasia III (CINIII). One patient received only a cervical conization, whereas the other two patients underwent hysterectomy. The immunohistochemical results showed that the ACC compartments were positive for CK7 and CD117; the cases of SCC were negative for CK7 and CD117. P63 staining was strongly positive and diffuse throughout the SCC compartments, whereas only patchy positive areas were observed in the ACC. MYB exhibited strong nuclear staining in the ACC and SCC compartments but negative staining in the endocervical gland. In situ hybridization (ISH) signals for high-risk HPV DNA and mRNA were present in the two compartments of all three patients. The patients had no evidence of disease at an average follow-up time of 21.6 months. Conclusion High-risk HPV was present in both the ACC and SCC compartments in all three patients.
Collapse
|
17
|
Jeong J, Ha SY, Cho HY, Chung DH, An J. Comparison of Cytologic Characteristics between Adenoid Cystic Carcinoma and Adenoid Basal Carcinoma in the Uterine Cervix. J Pathol Transl Med 2015; 49:396-402. [PMID: 26278519 PMCID: PMC4579280 DOI: 10.4132/jptm.2015.07.08] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 06/26/2015] [Accepted: 07/08/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adenoid cystic carcinoma (ACC) and adenoid basal carcinoma (ABC) are rare in the uterine cervix. ACC is more aggressive than ABC, thus accurate differential diagnosis is important. In this study, we identified cytologic features useful in distinguishing these two tumors for diagnosis. METHODS Three cases of ACC and five cases of ABC were selected for this study. Cervicovaginal smear slides were reviewed retrospectively, and the area, circumference, major axis, and minor axis of nuclei were measured using an image analyzer. RESULTS ACC displayed three-dimensional clusters with a small acini pattern. ABC displayed peripheral palisading without an acini pattern. The nuclei of ACC were more irregular and angulated than those of ABC, and the former showed a coarsely granular chromatin pattern. The nucleic area, circumference, major axis, and minor axis were 18.556±8.665 µm(2), 23.320±11.412 µm, 5.664±1.537 µm, and 4.127±1.107 µm in ACC and 11.017±4.440 µm(2), 15.920±5.664 µm, 4.612±1.025 µm, and 3.088±0.762 µm in the cases of ABC. All measured values showed statistically significant difference (p < .001). CONCLUSIONS Although the nuclei of both of these tumor types were oval shaped, inferred from the ratio of minor axis to major axis (0.728 in ACC and 0.669 in ABC), the area of nuclei was approximately 1.7 times larger in ACC than in ABC. Distinguishing nucleic features, including area, morphology, and chromatin pattern, may be helpful in making a correct diagnosis.
Collapse
Affiliation(s)
- Juhyeon Jeong
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Seung Yeon Ha
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Hyun Yee Cho
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Dong Hae Chung
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| | - Jungsuk An
- Department of Pathology, Gachon University Gil Medical Center, Incheon, Korea
| |
Collapse
|
18
|
Nayak SP, Kowe BD, Kumbhalkar DT. Adenoid Cystic Carcinoma of the Cervix: Unusual Presentation of a Rare Condition. JOURNAL OF MEDICAL SCIENCES AND HEALTH 2015. [DOI: 10.46347/jmsh.2015.v01i01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
19
|
Benhayoune K, El Fatemi H, Bannani A, Melhouf A, Harmouch T. Adenoid cystic carcinoma of cervix: two cases report and review of the literature. Pan Afr Med J 2015; 20:77. [PMID: 26090035 PMCID: PMC4450047 DOI: 10.11604/pamj.2015.20.77.5720] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 01/05/2015] [Indexed: 11/30/2022] Open
Abstract
Adenoid cystic carcinoma of the cervix is a rare and aggressive tumor with fatal outcome. In this paper we report two cases of primary adenoid cystic carcinoma and a review of literature. A 80 years old woman, admitted to our hospital with postmenopausal bleeding and hydrorrhea. Gynealogical examination showed a cervical stenotic with the presence of a tumor processus. Biopsy of cervical growth was done. 80-year-old woman presented with vaginal bleeding with pelvic pain. Physical examination revealed a friable mass in the cervix. Incisional biopsy was performed. In the both cases the diagnosis of adenoid cystic carcinoma of the cercix was confirmed. Adenoid cystic carcinoma of the cervix is clinically and radiologically similar to other tumors of the cervix but the diagnosis can only be made by histological examination.
Collapse
Affiliation(s)
| | - Hinde El Fatemi
- Laboratory of Surgical Pathology, CHU Hassan II of Fez, Fez, Morocco
| | | | | | - Toufik Harmouch
- Laboratory of Surgical Pathology, CHU Hassan II of Fez, Fez, Morocco
| |
Collapse
|
20
|
Kim HG, Song YJ, Na YJ, Choi OH. A case of adenoid Basal carcinoma of the uterine cervix. J Menopausal Med 2014; 19:154-7. [PMID: 25371884 PMCID: PMC4217559 DOI: 10.6118/jmm.2013.19.3.154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2013] [Revised: 05/27/2013] [Accepted: 05/27/2013] [Indexed: 11/05/2022] Open
Abstract
Adenoid basal carcinoma of the uterine cervix is uncommon neoplasia mostly occurring in postmenopausal women. It has excellent prognosis and a favorable clinical course. In addition, adenoid basal carcinoma is differentiated from adenoid cystic carcinoma by histologic and cellular morphologies, and immunohistochemistry. In this paper, we present the case of a 22 year old Korean female. She initially had a high-grade squamous intraepithelial lesion (HSIL) on Pap smear and a subsequent cervical loop electrosurgical excision procedure (LEEP) specimen revealing adenoid basal carcinoma. The lesion showed the histologic characteristics of adenoid basal carcinoma. Because of the lesion's low potential for recurrence and metastasis, the young primipara had a conization procedure performed and has been under close observation.
Collapse
Affiliation(s)
- Hwi-Gon Kim
- Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Yangsan, Korea
| | - Yong Jung Song
- Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Yangsan, Korea
| | - Yong Jin Na
- Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Yangsan, Korea
| | - Ook-Hwan Choi
- Department of Obstetrics and Gynecology, Pusan National University School of Medicine, Yangsan, Korea
| |
Collapse
|
21
|
Lin YC, Perng CL, Chang YM, Li YF, Tsai YM, Wu GJ, Lin CK. Coexistent squamous cell carcinoma and adenoid basal carcinoma in the uterine cervix and infection with human papillomavirus (HPV 31). Taiwan J Obstet Gynecol 2014; 52:407-10. [PMID: 24075382 DOI: 10.1016/j.tjog.2012.04.040] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2012] [Indexed: 10/26/2022] Open
Abstract
OBJECTIVE Adenoid basal carcinoma (ABC) is an uncommon neoplasm of the uterine cervix. ABC can be accompanied by carcinoma in situ or invasive carcinoma. Most cases are discovered accidentally during radical hysterectomy. ABC is associated with a high risk of human papillomavirus infection (HPV), most often HPV 16 infection. CASE REPORT We present a rare case of an 86-year-old Taiwanese married woman who suffered from bloody vaginal discharge and occasional lower abdominal pain and received cervical biopsy. The pathological report revealed squamous cell carcinoma (SCC) of the uterine cervix. After radical hysterectomy, bilateral salpingo-oophorectomy, and bilateral pelvic and para-aortic lymph node dissection, the final pathological report revealed SCC coexisting with ABC, and both of the components were infected by HPV 31. After receiving radiotherapy, she maintained outpatient department follow-up. CONCLUSION A literature review revealed that this was a rare case of combined ABC-SCC associated with HPV 31 infection. In this case, the ABC component did not affect the tumor stage because it was confined to the cervix. However, we must avoid overestimating the clinical stage because the ABC component is thought to be a benign lesion.
Collapse
Affiliation(s)
- Yu-Chieh Lin
- Department of Pathology, National Defense Medical Center and Tri-Service General Hospital, Taipei, Taiwan; Department of Pathology, Taoyuan Armed Forces General Hospital, Taoyuan, Taiwan
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
A wide variety of neoplasms of varying histogenesis occur within the ovary. We report the first case of a primary ovarian myoepithelioma, a diagnosis made on the basis of the morphologic features coupled with immunoreactivity with epithelial and myoid markers. The tumor had a lobulated appearance with variable architectural patterns including anastomosing cords, trabeculae, and nests of epithelioid to spindled tumor cells within a hyalinised and focally myxoid stroma. Fluorescence in situ hybridization for EWS gene rearrangement and reverse transcriptase polymerase chain reaction for EWSR1-POU5F1 and EWSR1-PBX1, molecular abnormalities which are found in some extrasalivary myoepitheliomas, were negative. In reporting this unique neoplasm, we discuss the wide differential diagnosis generated by the case.
Collapse
|
23
|
Ordóñez NG. Broad-spectrum immunohistochemical epithelial markers: a review. Hum Pathol 2013; 44:1195-215. [DOI: 10.1016/j.humpath.2012.11.016] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2012] [Revised: 11/21/2012] [Accepted: 11/28/2012] [Indexed: 02/06/2023]
|
24
|
Adenoid basal hyperplasia of the uterine cervix: a lesion of reserve cell type, distinct from adenoid basal carcinoma. Hum Pathol 2012; 43:2255-65. [DOI: 10.1016/j.humpath.2012.03.023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Revised: 03/03/2012] [Accepted: 03/06/2012] [Indexed: 01/08/2023]
|
25
|
Nagy PS, Tóth Z, Gocze P, Adám L. [Adenoid cystic carcinoma of the uterine cervix]. Orv Hetil 2012; 153:435-7. [PMID: 22390868 DOI: 10.1556/oh.2012.29149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This report presents the history of a 35-year-old patient with adenoid cystic cervical cancer stage IIIB. Adenoid cystic carcinoma of the uterine cervix is a rare disease with poor prognosis. Following irradiation therapy, the patient was declared tumor free, and 20 years after diagnosis and treatment, she has no pathological signs or symptoms.
Collapse
|
26
|
Viriyapak B, Park ST, Lee AW, Park JS, Lee CW, Song MJ, Hur SY. Cervical adenoid basal carcinoma associated with invasive squamous cell carcinoma: a report of rare co-existence and review of literature. World J Surg Oncol 2011; 9:132. [PMID: 22004883 PMCID: PMC3217854 DOI: 10.1186/1477-7819-9-132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Accepted: 10/18/2011] [Indexed: 11/10/2022] Open
Abstract
Cervical adenoid basal carcinoma (ABC) rarely can harbor associated malignancies like adenoid cystic carcinoma or squamous cell carcinoma (SCC), which express markedly different prognosis from a pure ABC, making an appropriate biopsy essential to provide a clear diagnosis and therapeutic plan. We report a 64-year-old asymptomatic lady with an abnormal cervical cytology, who underwent a conization to reveal an ABC with overlying microinvasive SCC. Doubtful resection margins led us to perform radical hysterectomy with lymph node dissection. Subsequent pathological examination showed a true invasive SCC co-existing with ABC, with invasion of the parametrium. Unlike the indolent course of many pure ABC patients, the prognosis of 11 previously reported co-existing invasive SCC with ABC patients appears to depend on the SCC component. Our case reiterates the importance of adequate biopsy with careful interpretation to cover the possibility of a co-existent malignancy. Besides, it presents an argument in favor of radical surgery for the primary treatment of suspicious associated malignancy, and supports adjuvant treatment according to the unfavorable extent of the co-existent invasive carcinoma.
Collapse
Affiliation(s)
- Boonlert Viriyapak
- Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | | | | | | | | | | |
Collapse
|
27
|
Park KJ. Neoplastic Lesions of the Cervix. Surg Pathol Clin 2011; 4:17-86. [PMID: 26837288 DOI: 10.1016/j.path.2010.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This review presents a discussion of the gross and microscopic features, diagnosis, differential diagnosis, and prognosis of neoplastic lesions of the cervix. Biomarkers are discussed for each entity presented - cervical intraepithelial neoplasia, squamous carcinoma, glandular neoplasms, adenocarcinoma in situ, adenosquamous carcinoma, and others.
Collapse
Affiliation(s)
- Kay J Park
- Department of Pathology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA.
| |
Collapse
|
28
|
Carcinome adénoïde kystique du vagin : troisième cas dans la littérature. IMAGERIE DE LA FEMME 2010. [DOI: 10.1016/j.femme.2010.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
29
|
Thymic basaloid carcinoma: a clinicopathologic study of 12 cases, with a general discussion of basaloid carcinoma and its relationship with adenoid cystic carcinoma. Am J Surg Pathol 2009; 33:1113-24. [PMID: 19461509 DOI: 10.1097/pas.0b013e3181a2443b] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Thymic carcinoma (primary carcinoma of the thymic epithelium; type C thymoma) is a rare malignancy. It usually presents in middle-aged to elderly patients and can exhibit a wide variety of morphologic appearances. Thymic basaloid carcinoma (thymic BC) is a particularly rare subtype, with less than 20 cases published in the English literature, mostly in the form of individual case reports. In this study, we present the clinicopathologic and immunohistochemical features of 12 new cases of thymic BC. There were 10 (83%) men and 2 (17%) women. Ages at the time of initial diagnosis ranged from 34 to 77 years (mean 55 y). The 2 most common manners of presentation were dyspnea on exertion (3 patients) and as an incidental finding on radiographic imaging (2 patients). Tumors ranged in size from 4.4 to 17 cm (mean 10.1 cm). One of 12 cases (8.3%) was associated with a multilocular thymic cyst. Immunohistochemistry was performed in 8 cases. Pan-cytokeratin was positive in all cases. CD117 (c-kit) was positive in 6 of 8 cases (75%), p63 was positive in 7 of 8 cases (88%), p53 was positive in 7 of 8 cases (88%), ranging from <10% to 90%, CD5 was focally positive in 3 of 8 cases (38%), collagen type IV was positive in 4 of 8 cases (50%), and proliferative index, as estimated by Ki67, ranged from <1% to approximately 15%. In 1 of 2 cases with sarcomatoid differentiation, Ki67 was greater than 80% in the sarcomatoid area. Cases were negative for thyroid transcription factor-1 (0 of 8), S-100 (0 of 7), and synaptophysin (0 of 7). Long-term data was available in 8 patients with an average follow-up of 30 months. Five patients died of their disease at an average of 34 months from the time of diagnosis. Of the remaining 3 patients, 1 had a stable recurrence and died at 4 years from unrelated causes, and 2 were alive without the evidence of disease at 12 and 7 months, respectively. Thymic BC, although previously regarded as a low-grade neoplasm, has shown that it is capable of aggressive behavior and significant mortality. In this paper, we review the pertinent literature and discuss the possible relationship of thymic BC with thymic adenoid cystic carcinoma, as well as BCs and adenoid cystic carcinomas at other sites.
Collapse
|
30
|
Advanced adenoid cystic carcinoma of the cervix: a case report and review of the literature. CASES JOURNAL 2009; 2:6634. [PMID: 19829837 PMCID: PMC2740204 DOI: 10.4076/1757-1626-2-6634] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 02/24/2009] [Indexed: 11/19/2022]
Abstract
Introduction Adenoid cystic carcinoma is a malignant epithelial neoplasm derived from the salivary glands. Primary adenoid cystic carcinoma of the cervix is extremely rare, accounting for less than 1% of all cervical carcinomas. In this paper we report a case of primary adenoid cystic carcinoma and a review of the related literature. Case presentation A 68 year-old woman was admitted with signs and symptoms suggestive of a cervical cancer. The radiological and pathological investigations confirmed the diagnostic of primary adenoid cystic carcinoma of the cervix at Stage IIIB according to the International Federation of Gynaecology and Obstetrics classification. The patient was managed successfully by concurrent chemo-radiotherapy. Conclusion The optimal management of adenoid cystic carcinoma cannot be established for certain. From our case and from the literature, it appears that combined treatment (surgery, radiotherapy, and chemotherapy) is necessary for achieving a long-term remission. Concurrent chemo-radiotherapy appears to be a logical option for locally advanced disease.
Collapse
|
31
|
Winters R, Naud S, Evans MF, Trotman W, Kasznica P, Elhosseiny A. Ber-EP4, CK1, CK7 and CK14 are useful markers for basaloid squamous carcinoma: a study of 45 cases. Head Neck Pathol 2008; 2:265-71. [PMID: 20614292 PMCID: PMC2807584 DOI: 10.1007/s12105-008-0089-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
Abstract
Diagnosis of basaloid squamous carcinoma (BSCC) currently relies mainly on histological criteria, with variable immunohistochemical results reported in small series. We explored the use of a battery of immunohistochemical stains to elucidate this diagnosis on 45 cases of BSCC. To further elucidate the immunohistochemical profile of BSCC, to explore potential genetic pathways of malignant transformation using proliferation markers, and to investigate a possible link with Human Papillomavirus (HPV). Forty-five cases of BSCC and 34 site-matched cases of squamous cell carcinoma (SCC) were obtained from the archives of the pathology department at our institution. Extensive literature review was undertaken utilizing Medline. Ber-EP4 is a useful diagnostic marker for BSCC, positive in 82% (37/45) of the cases and in 68% (23/34) of SCC. An alternative is the combination of cytokeratins CK14 and CK7, known to be negative, and CK1, known to be positive, which achieves an accuracy of 73% (33/45) in BSCC and 88% (30/34) in SCC. The two diagnostic approaches were in agreement in 66% of the cases; both methods were equally accurate in the divergent cases. Increased expression of the proliferation markers supports the concept that BSCC is a rapidly growing tumor. Results of p16 stains support an etiological link between BSCC and HPV; interestingly, HPV was present significantly more in BSCC (71% (32/45)), than in SCC (59% (20/34)) in this study (P=0.02).
Collapse
|
32
|
Abstract
We report 10 cases of a morphologically distinct vaginal polyp which has hitherto not been characterized. The polyps occurred in women aged 39 to 78 years (most were postmenopausal) and were from 1.0 to 3.0 cm. Most of whose location is known to us were in the upper vagina. Histologically, all the polyps were remarkably similar and composed of well-circumscribed expansile nests of epithelial cells embedded in a hypocellular fibrous stroma. The epithelial elements, which were morphologically bland, were predominantly glycogenated or nonglycogenated squamous in type but small tubules were present at the periphery of some of the nests in all cases. Some of the squamous nests exhibited central necrosis with or without calcification and, in 3 cases, some contained keratin pearls. In 3 cases, a few tubules unassociated with squamous elements were present. In 3 of 4 cases tested, the cells lining the tubules were positive with prostatic acid phosphatase and in 2 of 4 with prostate-specific antigen. The epithelial elements reacted with broad-spectrum cytokeratins and cytokeratin 7 but the mesenchymal component was negative. The squamous elements were estrogen receptor positive and the mesenchymal component estrogen and progesterone receptor positive. The histologic features of this polyp, which we term "tubulo-squamous polyp of the vagina," are constant and distinctive and differ from other polyps and from mixed tumor of the vagina. Several cases reported in the literature as vaginal mixed tumor or Brenner tumor are likely examples of this entity. Possible theories of histogenesis include a Mullerian origin, derivation from mesonephric remnants or derivation from urogenital sinus-derived epithelium. Positive staining in some cases with prostatic acid phosphatase and prostate-specific antigen raises the possibility of ectopic prostatic tissue, although the overall appearance is different from that entity, or derivation from paraurethral Skene glands, the female equivalent of prostatic glands in the male.
Collapse
Affiliation(s)
- W Glenn McCluggage
- Department of Pathology, Royal Group of Hospitals Trust, Belfast, Northern Ireland.
| | | |
Collapse
|
33
|
Kuroda N, Hirano K, Ohara M, Hirouchi T, Mizuno K, Kubo A, Enzan H. Adenoid basal carcinoma arising in the cervical polyp: an immunohistochemical study of stromal cells. Med Mol Morphol 2007; 40:112-4. [PMID: 17572848 DOI: 10.1007/s00795-006-0343-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2006] [Accepted: 09/04/2006] [Indexed: 01/12/2023]
Abstract
Adenoid basal carcinomas of the uterine cervix are uncommon neoplasms and generally run a favorable clinical course. Although it is well known that these tumors do not evoke the stromal reaction, we immunohistochemically examined a stromal reaction in a case of adenoid basal carcinoma. A 40-year-old woman was found to have a cervical polyp during a medical checkup and underwent polypectomy. Histological examination revealed the finding of adenoid basal carcinoma. Immunohistochemically, a smaller number of CD34-positive and CD31-negative stromal cells, namely fibroblasts, in the stroma of tumor center than in normal cervical stroma were observed. On the other hand, alpha-smooth muscle actin-positive and h-caldesmon-negative stromal cells, namely myofibroblasts, were completely absent in the stroma of tumor center. Finally, our preliminary report suggests that the decrease of CD34-positive fibroblasts in adenoid basal carcinoma may show an early stromal reaction to tumor invasion. Gynecologists and pathologists should bear in mind that adenoid basal carcinoma may arise in a cervical polyp.
Collapse
Affiliation(s)
- Naoto Kuroda
- Department of Pathology, Kochi Red Cross Hospital, Kochi, Japan.
| | | | | | | | | | | | | |
Collapse
|
34
|
Al-Nafussi A. Histopathological challenges in assessing invasion in squamous, glandular neoplasia of the cervix. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.cdip.2006.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
35
|
DePond WD, Flauta VS, Lingamfelter DC, Schnee DM, Menendez KP. Adenoid basal carcinoma of the cervix in a 20-year-old female: a case report. Diagn Pathol 2006; 1:20. [PMID: 16914043 PMCID: PMC1560395 DOI: 10.1186/1746-1596-1-20] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2006] [Accepted: 08/16/2006] [Indexed: 11/26/2022] Open
Abstract
Background Adenoid basal carcinoma of the cervix is a rare condition mostly occurring among postmenopausal women. Although it can be confused with adenoid cystic carcinoma of the cervix, adenoid basal carcinoma has several clinicopathologic features that will allow distinction from adenoid cystic carcinoma. Case presentation This is the case of a twenty-year old African-American female who initially presented with a high-grade squamous intraepithelial lesion on Pap smear, with a subsequent cervical LEEP specimen revealing adenoid basal carcinoma. The lesion showed the characteristic histologic features of adenoid basal carcinoma and was positive for the immunohistochemical marker EMA and negative for collagen IV, further defining the tumor while helping to rule out the possibility of adenoid cystic carcinoma. As far as the authors are aware, this is the youngest reported case of adenoid basal carcinoma to date. Conclusion This case shows that adenoid basal carcinoma can deviate markedly from its typical postmenopausal demographics to affect women as young as 20 years of age. In addition, adenoid basal carcinoma has several identifiable features that will differentiate it from adenoid cystic carcinoma including histologic and cellular morphologies, as well as immunohistochemistry. Treatment for most patients involves hysterectomy, LEEP, or a conization procedure which provides a favorable prognosis because of this lesion's low potential for recurrence and metastasis.
Collapse
Affiliation(s)
- William David DePond
- Department of Pathology, University of Missouri-Kansas City School of Medicine and Truman Medical Centers, Kansas City, Missouri, USA
| | - Victor Santos Flauta
- Department of Pathology, University of Missouri-Kansas City School of Medicine and Truman Medical Centers, Kansas City, Missouri, USA
| | - Daniel Christian Lingamfelter
- Department of Pathology, University of Missouri-Kansas City School of Medicine and Truman Medical Centers, Kansas City, Missouri, USA
| | - David Mark Schnee
- Department of Obstetrics and Gynecology, University of Missouri-Kansas City School of Medicine and Truman Medical Centers, Kansas City, Missouri, USA
| | - Kristyn Poncy Menendez
- Department of Obstetrics and Gynecology, University of Missouri-Kansas City School of Medicine and Truman Medical Centers, Kansas City, Missouri, USA
| |
Collapse
|
36
|
Russell MJ, Fadare O. Adenoid basal lesions of the uterine cervix: evolving terminology and clinicopathological concepts. Diagn Pathol 2006; 1:18. [PMID: 16911774 PMCID: PMC1564042 DOI: 10.1186/1746-1596-1-18] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Accepted: 08/15/2006] [Indexed: 11/10/2022] Open
Abstract
The epithelial proliferations that are designated adenoid basal carcinoma (ABC) in the current classification from the World Health Organization represent <1% of all cervical malignancies. These lesions may be associated, and occasionally show morphologic transitions with, conventional cervical malignancies. The determination of the precise frequency with which these so-called ABCs show this association is hampered by the inherent selection bias in the reported cases. However, this frequency appears to be substantial (>15%). The biologic course of ABCs that are associated with separate malignancies is largely dependent on the clinicopathologic parameters of the associated malignancies. Morphologically pure lesions, in contrast, have largely been associated with favorable patient outcomes, as none of the 66 reported patients have experienced tumor recurrence, metastases or tumor-associated death, irrespective of the modality of treatment. Although the finding of genome integrated high-risk human papillomavirus (HPV) types and p53 alterations in adenoid basal lesions (ABL) argue in support of their neoplastic nature, we identified no lines evidence that suggest an inherent malignancy for morphologically pure lesions. The finding of morphologic transitions between ABLs and conventional malignancies and shared HPV types in these areas, suggest that ABLs have some malignant potential. However, the precise magnitude of this potential is not readily quantifiable and should not dictate the management of morphologically pure lesions that are entirely evaluable. ABLs continue to occupy a unique position in human oncology in which the term carcinoma (without an in-situ suffix) is applied to a tumor that has not been shown to recur, metastasize or cause death. We concur with a previous proposal that the term ABC should be discarded and replaced with Adenoid Basal Epithelioma (ABE). In our opinion, there is insufficient evidence at present time to expose patients with morphologically pure lesions to the ominous implications--social, psychological, medical, financial--of a "carcinoma" diagnosis. Morphologically impure lesions should not be designated ABC or ABE. Furthermore, given the uncertainties regarding the frequency with which ABE are associated with separate malignancies, we suggest that the ABE designation only be applied when the tumor in question is entirely evaluable e.g in a hysterectomy specimen or in an excisional biopsy with negative margins. Otherwise, the generic designation Adenoid Basal Tumor is preferable. This approach strikes an appropriate balance between the need to prevent over-treatment of pure lesions on one hand, and the need to ensure that the lesions are indeed pure on the other.
Collapse
Affiliation(s)
- Michael J Russell
- Department of Pathology, Wilford Hall Medical Center, Lackland AFB, TX, USA
- San Antonio Uniformed Services Health Education Consortium Residency Program in Pathology, San Antonio, TX, USA
| | - Oluwole Fadare
- Department of Pathology, Wilford Hall Medical Center, Lackland AFB, TX, USA
- Department of Pathology, University of Texas Health Sciences Center at San Antonio, San Antonio, TX, USA
| |
Collapse
|
37
|
Koyfman SA, Abidi A, Ravichandran P, Higgins SA, Azodi M. Adenoid cystic carcinoma of the cervix. Gynecol Oncol 2005; 99:477-80. [PMID: 16139349 DOI: 10.1016/j.ygyno.2005.06.063] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2005] [Revised: 05/30/2005] [Accepted: 06/03/2005] [Indexed: 11/21/2022]
Abstract
BACKGROUND Adenoid cystic carcinoma of the cervix is a rare and aggressive neoplasm for which there are no standardized treatment protocols. CASE A 38-year-old G3P3 Asian female diagnosed with a stage Ib adenoid cystic carcinoma of the cervix with intermediate risk histologic features received a type III hysterectomy in July 2004. She refused external beam radiotherapy, but agreed to be treated with adjuvant vaginal cuff radiation. She has been closely followed and has no evidence of disease to date. CONCLUSION Patients with stage Ib adenoid cystic carcinoma of the cervix, especially those with histologic features associated with a higher risk of recurrence, should receive aggressive local therapy, following the guidelines established for similarly staged patients with squamous cell carcinoma of the cervix.
Collapse
Affiliation(s)
- Shlomo A Koyfman
- Department of Obstetrics and Gynecology, Bridgeport Hospital, Bridgeport, CT 06610, USA.
| | | | | | | | | |
Collapse
|
38
|
Teramoto N, Nishimura R, Saeki T, Nogawa T, Hiura M. Adenoid basal carcinoma of the uterine cervix: report of two cases with reference to adenosquamous carcinoma. Pathol Int 2005; 55:445-52. [PMID: 15982222 DOI: 10.1111/j.1440-1827.2005.01852.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Adenoid basal carcinoma (ABC) of the uterine cervix is a rare neoplasm with excellent prognosis. Differential diagnosis between ABC and an ABC-like lesion of adenosquamous cell carcinoma (ASC) of the cervix is important due to their contrasting prognosis. Reported herein are two cases of ABC that have been compared with seven ASC exhibiting ABC-like lesions from approximately 2600 resected uterine cervical malignancies diagnosed at Shikoku Cancer Center. The two ABC were incidentally found in the uterine cervix of 69-year-old and 59-year-old Japanese women due to cervical intraepithelial neoplasia grade 3 and to squamous cell carcinoma, respectively. The ABC consisted of infiltrating nests of basaloid cells with low nuclear atypia. The patients remained alive without recurrence for 9 years and 18 months, respectively. An ABC-like lesion was defined as basaloid cell nests simulating ABC, but with some features indicating malignant potential. However, the differential diagnosis was sometimes difficult because two of seven ABC-like lesions were originally diagnosed as ABC. Immunohistochemically, cytokeratin 7 was negative for the basaloid cells of two ABC, but positive for six of six ABC-like lesions of ASC, while cytokeratin 8 was positive for both ABC and ASC. This cytokeratin pattern might provide a good tool for distinguishing between ABC and an ABC-like lesion of ASC when the histological findings are equivocal.
Collapse
Affiliation(s)
- Norihiro Teramoto
- Department of Clinical Research, National Hospital Organization Shikoku Cancer Center, Matsuyama, Japan.
| | | | | | | | | |
Collapse
|
39
|
Nishida M, Nasu K, Takai N, Miyakawa I, Kashima K. Adenoid cystic carcinoma of the uterine cervix. Int J Clin Oncol 2005; 10:198-200. [PMID: 15990970 DOI: 10.1007/s10147-004-0466-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2004] [Accepted: 11/26/2004] [Indexed: 12/20/2022]
Abstract
Adenoid cystic carcinoma of the uterine cervix is a rare and peculiar variant of adenocarcinoma. This tumor represents 3% of all primary cervical adenocarcinomas, and it is locally aggressive and capable of metastasis to other organs even in its early stage. We report a case of adenoid cystic carcinoma stage IIIb that was successfully treated with radiotherapy. The patient shows no evidence of recurrent tumor at 5 years after radiotherapy. Generally, radiotherapy and chemotherapy are chosen as the first treatment, because this cancer is seen most commonly in the elderly.
Collapse
Affiliation(s)
- Masakazu Nishida
- Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Hasama-machi, Oita 879-5593, Japan.
| | | | | | | | | |
Collapse
|
40
|
Abstract
Carcinomas of the cervix may be categorized on morphological grounds into four main groups: squamous carcinomas; adenocarcinomas; neuro-endocrine tumours; and others including adenosquamous carcinomas. Each group contains several morphological subvariants. Invasive squamous carcinomas and adenocarcinomas are preceded by cervical intra-epithelial neoplasia and cervical glandular intra-epithelial neoplasia, respectively. Each is graded into low and high grade. Micro-invasive carcinomas with stromal invasion less than 3mm in depth have a minimal chance of lymph node metastasis. When there is lymph node involvement, the obturator node may be the most common. Presence or absence of lymph node involvement, tumour size and depth of invasion are the important independent histopathological indicators of prognosis. The presence or absence of vascular space invasion is a valuable prognostic indicator. Small cell carcinomas, large cell neuro-endocrine carcinomas and possibly adenoid cystic carcinomas are aggressive. With these exceptions, it is doubtful whether tumour type is of much clinical significance. Tumour grade, as currently assessed, is of no significant value.
Collapse
Affiliation(s)
- A J Tiltman
- Whittaker & Associates, Private Bag X11, Rondebosch 7701, South Africa.
| |
Collapse
|
41
|
Parwani AV, Smith Sehdev AE, Kurman RJ, Ronnett BM. Cervical adenoid basal tumors comprised of adenoid basal epithelioma associated with various types of invasive carcinoma: Clinicopathologic features, human papillomavirus DNA detection, and P16 expression. Hum Pathol 2005; 36:82-90. [PMID: 15712186 DOI: 10.1016/j.humpath.2004.08.015] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Adenoid basal tumors are uncommon cervical lesions that some pathologists consider invasive carcinomas but others consider "epitheliomas" due to their low-grade histological appearance and rarely documented malignant behavior. We report the clinicopathologic features of 10 tumors comprised of both typical low-grade adenoid basal tumors (epitheliomas) intimately associated with invasive carcinomas having infiltrative growth, increased cytological atypia and mitotic activity, and various types of differentiation, including adenoid basal/squamous, pure squamous, adenoid cystic, and small cell neuroendocrine. Tumors were evaluated for the presence of human papillomavirus (HPV) DNA and immunohistochemical p16 expression. The patients in the study group ranged in age from 45 to 81 years (mean, 65 years). Most of the patients presented with abnormal cervicovaginal smears. The initial diagnosis was made on specimens obtained by cervical biopsy, laser electrocautery excision procedure (LEEP), or cone biopsy in 8 patients. Two 2 patients were incidentally diagnosed in hysterectomy specimens. All 10 patients had squamous intraepithelial lesions (9 high-grade, 1 low-grade). In all cases diagnosed in LEEP or cone biopsy specimens, the invasive carcinoma component was present in the excisional specimen and extended to the margins. Seven patients diagnosed on excisional or biopsy specimens who underwent hysterectomy had residual tumor in the cervix, ranging from microscopic foci to deeply invasive. No lymph node metastases were identified in 4 patients who were staged. Seven patients with follow-up were alive without evidence of disease after follow-up intervals of 8 to 84 months (mean, 45 months; median, 29 months). One patient with a component of small cell carcinoma died of other causes without evidence of disease at 18 months. HPV 16 DNA was detected in both the adenoid basal epithelioma and invasive carcinoma components in 9 tumors by in situ hybridization, and HPV 33 was detected by polymerase chain reaction in 1 tumor. All tumors expressed p16 diffusely. Adenoid basal tumors are high-risk HPV-related tumors that can be comprised of both a low-grade adenoid basal tumor, which can be designated as epithelioma, and invasive carcinomas of various types. The invasive component is usually evident in the excisional biopsy specimen, allowing for recognition of a tumor that needs further management.
Collapse
Affiliation(s)
- Anil V Parwani
- Department of Pathology, The Johns Hopkins University School of Medicine and Hospital, Baltimore, MD 21231, USA
| | | | | | | |
Collapse
|
42
|
Kaku A, Kiyosue H, Matsumoto S, Mori H, Kashima K, Miyakawa I. Radiological features of adenoid cystic carcinoma of the uterine cervix. Eur Radiol 2004; 15:975-7. [PMID: 15480694 DOI: 10.1007/s00330-004-2382-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2003] [Revised: 04/23/2004] [Accepted: 05/17/2004] [Indexed: 11/26/2022]
Abstract
Adenoid cystic carcinoma (ACC) of the uterine cervix is a rare primary neoplasm of the uterus that occurs in post-menopausal women; its radiological findings have not been described previously. We present the MR findings of a case of ACC. The mass exhibited homogeneous low-signal intensity on T1-weighted images. On T2-weighted images, the mass showed high-signal intensity with a lobulated contour and multiple septum-like internal architectures. It also contained spots of very high-signal intensity, which would represent the mucin in the glandular lumen. The multiple septum-like internal architectures probably represented interglandular fibrous stroma. These MRI findings may be helpful for future diagnoses of ACC of the uterine cervix.
Collapse
Affiliation(s)
- Ayumi Kaku
- Department of Academic Radiology, Oita University Faculty of Medicine, Japan.
| | | | | | | | | | | |
Collapse
|
43
|
Dimashkieh HH, Khazai L, Novak GD, Casey MB. Pathologic quiz case: an 83-year-old woman with a uterine cervical mass. Adenoid cystic carcinoma. Arch Pathol Lab Med 2004; 128:817-8. [PMID: 15214839 DOI: 10.5858/2004-128-817-pqcayw] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Haytham H Dimashkieh
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minn, USA
| | | | | | | |
Collapse
|
44
|
Khoury T, Lele S, Tan D. Pathologic quiz case: an asymptomatic 79-year-old woman with an abnormal Papanicolaou test. Adenoid basal carcinoma of the cervix. Arch Pathol Lab Med 2004; 128:485-6. [PMID: 15043480 DOI: 10.5858/2004-128-485-pqcaay] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Thaer Khoury
- Department of Pathology, Buffalo General Hospital, State University of New York, Buffalo 14263, USA
| | | | | |
Collapse
|
45
|
Daponte A, Grayson W, Moisuc D, Ebrahim S, Guidozzi F. Adenoid cystic carcinoma stage Ib1 treated with radical surgery displaying human papilloma virus 33 (HPV 33): immunoelectron microscopy and review. Gynecol Oncol 2003; 90:673-6. [PMID: 13678745 DOI: 10.1016/s0090-8258(03)00403-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND The presence of human papilloma virus (HPV) 33 and possible myoepithelial differentiation in an adenoid cystic carcinoma of the cervix (ACC) Ib1 and the clinical outcome are reported. CASE The case is an ACC, stage Ib1 harboring HPV 33, which was treated by radical hysterectomy and lymphadenectomy only. Human papilloma virus analysis of the tumor was done by means of nonisotopic in situ hybridization and polymerase chain reaction. Additionally immunoelectron microscopy was performed. CONCLUSION Our patient had a vault recurrence 12 months after class III (Meigs) hysterectomy. The cancer tissue was totally excised, the lymphnodes (n = 31) were negative, and there was no lympho-vascular invasion and no perineural infiltration. The primary tumor displayed HPV 33 integration and features suggesting myoepithelial differentiation. We would recommend a low threshold for the use of radiotherapy in the management of similar findings.
Collapse
Affiliation(s)
- A Daponte
- Department of Obstetrics and Gynaecology, University of Thessaly, Greece.
| | | | | | | | | |
Collapse
|
46
|
Abstract
Squamous cell carcinoma is the most common malignant cervical tumor, but the incidence of adenocarcinomas has been rising during the past few decades. This article discusses the epidemiology and pathogenesis of the squamous cell carcinoma, its clinical and histologic features, including microinvasive carcinoma, its histologic grade, and variant tumors. The prognostic impact of these features and the differential diagnosis are also covered. The second portion of this article is devoted to the glandular tumors of the cervix, including adenocarcinoma in situ and invasive adenocarcinoma and its variants. The differential diagnosis of these tumors with tumor like glandular lesions is given special attention. Finally, less common malignant cervical tumors are covered, with an emphasis being placed on their significance.
Collapse
Affiliation(s)
- Steven G Silverberg
- Department of Anatomic Pathology, University of Maryland School of Medicine, Baltimore, Maryland 21201, USA
| | | |
Collapse
|
47
|
Endo H, Hirokawa M, Takahashi H, Mikami Y, Sano T. Cervical polyp with eccrine syringofibroadenoma-like features. Histopathology 2003; 42:301-4. [PMID: 12605651 DOI: 10.1046/j.1365-2559.2003.15312.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
48
|
|
49
|
Application of immunohistochemistry in the evaluation of neoplastic epithelial lesions of the uterine cervix and endometrium. ACTA ACUST UNITED AC 2003. [DOI: 10.1054/cdip.2002.0152] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
|
50
|
Abstract
This report provides a comprehensive review of several special types of adenocarcinoma of the uterine cervix. The clinicopathologic features of three tumors that may cause difficulties in diagnosis are detailed: adenoid basal carcinoma (epithelioma), adenoma malignum (minimal deviation adenocarcinoma), and mesonephric adenocarcinoma. Updated information on classification and clinical behavior are presented, as is data on their histochemical, immunohistochemical, and molecular profiles.
Collapse
Affiliation(s)
- William R Hart
- Division of Pathology and Laboratory Medicine, The Cleveland Clinic Foundation, Ohio 44195, USA
| |
Collapse
|