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International Journal of Gynecological Pathology

Bevan Tandon, Ian S Hagemann, Horacio M Maluf, John D Pfeifer, Hussam Al-Kateb
Small cell carcinoma of the ovary, hypercalcemic type (SCCOHT), is a rare, highly lethal malignancy predominantly affecting young adult females. We report a patient with widely metastatic SCCOHT and concurrent uterine cervical pleomorphic liposarcoma. Clinical targeted next-generation sequencing was performed on both neoplasms and demonstrated hemizygous stop-gain TP53 mutations (p.R196*), and wild-type SMARCA4 in both tumors. Microarray analyses of both tumors revealed similar but not identical widespread loss of heterozygosity over most chromosomes associated with loss of chromosomal copy number in the SCCOHT and pleomorphic liposarcoma tumors, amplification of FGFR1 in both tumors, and amplification of MYC in the SCCOHT...
February 7, 2017: International Journal of Gynecological Pathology
Isabel Alvarado-Cabrero, Andres A Roma, Kay J Park, Joanne K L Rutgers, Elvio G Silva
A pattern-based classification system has recently been proposed for invasive endocervical adenocarcinoma (EAC), which is predictive of the risk for lymph node metastases (LNM). The main utility of the system lies in separating cases with very low risk for LNM (pattern A) from those with higher risk (pattern B and C). Different growth patterns (GPs) are found in pattern C cases. The aim of the study was to evaluate the effect of GP on the behavior of pattern C EAC. By reevaluating 189 pattern C EACs, we documented 6 architectural GPs: diffuse destructive (DD), confluent (CON), extensive linear destructive (ELD), band-like lymphocytic infiltrate (BLL), solid (SOL), and micropapillary (MP)...
January 27, 2017: International Journal of Gynecological Pathology
Taylan Şenol, Mesut Polat, Enis Özkaya, Ateş Karateke
The aim of this study was to assess whether misinterpretation of frozen sections in endometrial cancer cases is associated with survival and determine the factors leading to mismatch. One hundred fifty endometrial cancer cases treated in Zeynep Kamil Maternity and Children's Health Training and Research Hospital between January 2010 and December 2014 were included in the study. Frozen sections and final histopathologic reports were screened from a prospectively collected database and analyzed on whether mismatch between the initial and the final reports has any impact on disease-free survival...
January 27, 2017: International Journal of Gynecological Pathology
Emily Han-Chung Hsiue, Chiun Hsu, Li-Hui Tseng, Tzu-Pin Lu, Kuan-Ting Kuo
Epithelioid trophoblastic tumor (ETT) is a rare chemoresistant gestational trophoblastic neoplasm that typically presents as an intrauterine lesion. To our knowledge, no isolated abdominal wall ETT around a Cesarean scar has been reported. Here we describe a 54-yr-old woman with a complex obstetric history who presented with a solitary abdominal wall tumor adjacent to the abdominal Cesarean section scar. The tumor demonstrated typical morphologic and immunophenotypic features of ETT. The gestational origin of the tumor was confirmed by microsatellite genotyping...
January 27, 2017: International Journal of Gynecological Pathology
Martin Köbel, Basile Tessier-Cloutier, Joyce Leo, Lien N Hoang, C Blake Gilks, Robert A Soslow, Deborah Delair, Colin J R Stewart, Cheng-Han Lee
Mixed endometrioid and clear cell carcinoma of the endometrium refers to a scenario in which the tumor exhibits histologic features of both endometrioid and clear cell carcinoma. We observed a tendency for these tumors to occur in a mismatch repair (MMR) protein-deficient molecular background in a prior study that examined a small cohort of mixed-type endometrial carcinomas. The aim of this study was to determine the rate of MMR protein deficiency in a larger series of endometrial mixed endometrioid and clear cell carcinomas, through a retrospective survey of MLH1, PMS2, MSH2, and MSH6 expression in such tumors at 5 tertiary centers...
January 20, 2017: International Journal of Gynecological Pathology
Tariq Rashid, Jennifer L Young-Pierce, Elizabeth Garrett-Mayer, Whitney Graybill, Shelby Neal, Laura S Spruill
African American (AA) females with endometrial carcinoma have a significantly worse prognosis with regard to disease-free survival and overall survival than their European American (EA) counterparts and this finding is true across all stages and grades. The presence of tumor-infiltrating lymphocytes (TILs) has been demonstrated to be of prognostic significance in a variety of malignancies, including endometrial cancers. This study aims to determine whether clinically significant differences in levels of CD8+ cytotoxic T lymphocytes, FoxP3+ regulatory T lymphocytes, and CD45RO+ memory T lymphocytes exist between races and to document the clinical impact of TILs...
January 20, 2017: International Journal of Gynecological Pathology
Maitrayee Roy, Sunesh Kumar, Neerja Bhatla, Mukurdipi D Ray, Lalit Kumar, Deepali Jain, Ravi Phulware, Sandeep R Mathur
Endometrial stromal sarcoma (ESS) is a rare neoplasm comprising only 0.2% to 1% of all uterine malignancies and afflicts women between 42 and 59 yr of age. ESSs frequently express estrogen receptor (ER) and progesterone receptor (PR). However, the published literature contains scant data on the expression and therapeutic/prognostic role of androgen receptor (AR) in ESSs. We undertook this study to characterize the expression of AR along with ER and PR in ESSs and correlate it with clinicopathologic features...
January 20, 2017: International Journal of Gynecological Pathology
Pinias Mukonoweshuro, W Glenn McCluggage
The presence of trophoblastic differentiation or nongestational choriocarcinoma in a carcinoma is rare but has been described in various organs, including in the female genital tract. We report a cervical clear cell carcinoma admixed with a component of choriocarcinoma in a 52-year-old woman, only the second report of this combination in the literature. Immunohistochemically, the tumor exhibited isolated loss of staining with the mismatch repair protein MSH6. We review the literature on trophoblastic differentiation in cervical carcinoma...
December 12, 2016: International Journal of Gynecological Pathology
Esther Oliva, W Glenn McCluggage
No abstract text is available yet for this article.
March 2017: International Journal of Gynecological Pathology
Jaclyn C Watkins, Eric J Yang, Michael G Muto, Colleen M Feltmate, Ross S Berkowitz, Neil S Horowitz, Sapna Syngal, Matthew B Yurgelun, Anu Chittenden, Jason L Hornick, Christopher P Crum, Lynette M Sholl, Brooke E Howitt
Although consensus has yet to be reached on universal mismatch-repair (MMR) protein immunohistochemical (IHC) screening for Lynch syndrome (LS) in endometrial cancer (EC), an increasing number of institutions have adopted universal screening protocols similar to those used for colorectal carcinoma. Here we describe our institution's experience with a prospective universal screening protocol in which all ECs resected over a period of 19 months (n=242) were screened for MLH1, PMS2, MSH2, and MSH6 deficiencies using IHC, followed by MLH1 promoter methylation testing when appropriate...
March 2017: International Journal of Gynecological Pathology
Lisa Barbera, Lilian T Gien, Rinku Sutradhar, Gillian Thomas, Al Covens, Laurie Elit, Anthony Fyles, Eileen Rakovitch, Ying Liu, Mahmoud Khalifa
We conducted a population-based patterns of care study of vulvar carcinoma. This paper describes the changes in reporting based on pathology review. This is a retrospective population-based cohort study. We obtained all pathology records available from the provincial cancer registry for primary invasive squamous cell carcinoma of the vulva diagnosed between 1998 and 2007. Pathology reviews were conducted centrally by a group of gynecologic pathologists and were identified during abstraction. Corresponding original reports were matched to pathology review reports based on accession numbers...
March 2017: International Journal of Gynecological Pathology
Serena Wong, Wei Hong, Pei Hui, Natalia Buza
Immunohistochemistry for transcription factor PAX8 (paired box gene 8) has recently emerged as a powerful tool in the differential diagnosis of gynecologic malignancies, especially when encountered at a metastatic site. Previous studies have shown PAX8 expression in the majority of ovarian and endometrial carcinomas; however, data regarding PAX8 expression in cervical tumors are limited. In this study PAX8 expression was evaluated in 136 epithelial malignancies of the uterine cervix-including 103 squamous cell carcinomas (SCC), 20 adenocarcinomas of usual type, 6 endometrioid adenocarcinomas, and 7 adenosquamous carcinomas-on tissue microarray slides...
March 2017: International Journal of Gynecological Pathology
Emanuela Veras, Robert J Kurman, Tian-Li Wang, Ie-Ming Shih
One of the major immune checkpoints responsible for immune evasion in cancer cells is the interaction between programmed cell death-1 (PD-1) and its ligand (PD-L1). As human trophoblastic cells display many of the features of malignant cells such as the ability to invade normal tissue including blood vessels and are apparently not eradicated by the host immune system, we undertook the present study to determine whether PD-L1 was upregulated in different types of trophoblastic cells during normal pregnancy and in gestational trophoblastic diseases...
March 2017: International Journal of Gynecological Pathology
Ian Said, Steffen Böhm, Joanne Beasley, Peter Ellery, Asma Z Faruqi, Raji Ganesan, Lynn Hirschowitz, Sharanpal Jeetle, Sarah Lam Shang Leen, W Glenn McCluggage, Jacqueline McDermott, Reena Merard, Thomas O Millner, Giorgia Trevisan, Jo Vella, C Blake Gilks, Naveena Singh
A 3-tier histopathologic scoring system, the chemotherapy response score (CRS), was previously devised for reporting the histologic response to neoadjuvant chemotherapy in interval debulking surgery specimens of stage IIIc/IV tuboovarian high-grade serous carcinoma. This has been shown to predict the outcome and offer additional information to other methods of assessing the treatment response. In the present study, the reproducibility of this scoring system was assessed by determining the interobserver agreement among reporting pathologists...
March 2017: International Journal of Gynecological Pathology
Claire L Newton, Elly Brockbank, Naveena Singh, Asma Faruqi
Ovarian mucinous borderline tumors are traditionally divided into 2 morphologic groups: endocervical type, also known as seromucinous, and intestinal type. We present a case of stage 4B seromucinous ovarian borderline tumor with endometriosis and review the literature. At the time of writing, this is believed to be the first case of a seromucinous borderline tumor reported at such an advanced stage.
March 2017: International Journal of Gynecological Pathology
Mette Hjortkjær, Marianne Waldstrøm, Anders Jakobsen, Hanne Kanstrup, Erik Søgaard-Andersen, Karina Dahl Steffensen
BRCA1/2 mutation status in epithelial ovarian cancer (EOC) presently relies on genetic testing which is resource consuming. Immunohistochemistry is cheap, fairly reproducible, and may identify gene product alterations due to both germline and somatic mutations and other defects along the BRCA gene pathway (BRCAness phenomenon), which is important when treatment with poly (adenosine-diphosphate-ribose) polymerase (PARP) inhibitors is considered. The aim of this study was to investigate immunohistochemical detection of BRCA1 and PARP expression in EOC and their possible prognostic relevance...
March 2017: International Journal of Gynecological Pathology
Abhijit Chougule, Pranab Dey
No abstract text is available yet for this article.
March 2017: International Journal of Gynecological Pathology
Tamara Zudaire, Rosa Guarch, Ana Valcayo, Kelly García, Miguel Ángel Resano, Diego Requena, Mercedes Rodríguez
Langerhans cell histiocytosis (LCH) of the vulva is rare and even moreso in postmenopausal women. Twenty-six cases of primary vulvar LCH have been described in the current literature, and only 8 cases are in postmenopausal women. We report an additional case of primary vulvar LCH in a 59-yr-old woman with subsequent multiorgan involvement. In this article, we briefly describe the clinical presentation, histopathological findings, and immunohistochemistry results of vulvar LCH. We want to emphasize the importance of recognizing this entity in a woman with vulvar lesions both for the clinician and the pathologist...
March 2017: International Journal of Gynecological Pathology
Ankur R Sangoi, Malti Kshirsagar, Andrew E Horvai, Andres A Roma
The novel marker special AT-rich sequence binding protein (SATB2) is highly sensitive for mesenchymal tumors with osteoblastic differentiation. However, SATB2 expression in gynecologic tract carcinosarcoma has not been previously explored. Given the potential prognostic and therapeutic implications of heterologous carcinosarcoma in the gynecologic tract, this study investigates the utility of SATB2 in identifying osteosarcomatous elements. A multi-institution database review identified consecutive cases of gynecologic tract carcinosarcoma including both heterologous and homologous types...
March 2017: International Journal of Gynecological Pathology
Ayoma D Attygalle, Katherine Vroobel, Dorte Wren, Desmond P J Barton, Stephen J Hazell, Paola Dal Cin, Konrad Koelble, W Glenn McCluggage
Endometrial stromal sarcoma (ESS) characterized by YWHAE-NUTM2A/B genetic fusion is a recently recognized entity that is classified as a high-grade (HG) ESS in the 2014 World Health Organization Classification. These are myoinvasive neoplasms and typically contain a monomorphous HG round-cell cyclinD1-positive component with or without an accompanying low-grade (LG) component that is only focally positive/negative for cyclinD1. We report a case of YWHAE-NUTM2A/B ESS in a 46-yr-old woman that showed a number of unusual histologic features, including being entirely confined to the endometrium with no myoinvasion or lymphovascular space invasion...
March 2017: International Journal of Gynecological Pathology
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