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Query: UMLS:C0476089 (endometrial cancer)
 11,379 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The distinction of involvement of adenomyosis by endometrial carcinoma from endometrial carcinoma invading the myometrium can at times be difficult. This distinction, however, is important from the standpoint of staging, treatment, and prognosis because the outcome of carcinoma invading the myometrium as compared with involving adenomyosis is significantly worse. CD10 has been recently reported to be expressed by normal and neoplastic endometrial stromal cells. We therefore hypothesized that CD10 may be helpful in distinguishing carcinoma within adenomyosis from endometrial carcinoma directly invading the myometrium. Twenty-two cases of invasive endometrioid adenocarcinoma were identified from the surgical pathology files of the Johns Hopkins Hospital and consultation files of one of the authors (R.J.K.) and immunostained for CD10, desmin, and caldesmon. The pattern of staining was compared with five cases in which carcinoma was confined to adenomyosis. As a control, 14 cases of adenomyosis unassociated with carcinoma were included in the analysis. All 22 endometrial carcinomas that invaded the myometrium expressed CD10 to some extent in cells immediately surrounding the neoplastic glands. In 18, all of the invasive nests displayed CD10 in surrounding cells, but in four cases the staining was patchier, involving the surrounding cells of approximately 50-75% of the invasive nests. In four cases of myoinvasive carcinoma, the CD10-positive cells surrounding the nests of invasive carcinoma were also positive for desmin and caldesmon. In the remaining 18 cases with myoinvasive carcinoma, the cells surrounding the carcinomas failed to react with desmin and caldesmon. All five endometrial carcinomas involving adenomyosis displayed CD10 positivity in what appeared to be endometrial stromal cells surrounding the neoplastic glands. The stromal cells were negative for desmin and caldesmon. The control cases of adenomyosis were all positive for CD10, although in four cases the staining was patchy compared with 10 cases in which it was diffuse. Desmin and caldesmon were negative in all of these cases. Although CD10 identifies endometrial stromal cells in the endometrium and in adenomyosis and endometriosis, this study demonstrates that CD10 does not aid in distinguishing myometrial invasion of endometrial carcinoma from involvement of adenomyosis by endometrial carcinoma because the cells surrounding the tumor in the myoinvasive group express CD10.
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PMID:CD10 imunostaining does not distinguish endometrial carcinoma invading myometrium from carcinoma involving adenomyosis. 1276 82

In recent years there have been a plethora of publications regarding the value of immunohistochemical studies in diagnosis in gynecological pathology. In many instances, papers are published initially that suggest that a certain antibody or panel of antibodies is of value in the diagnosis of a particular neoplasm and in the distinction of this from mimics. However, this is usually quickly followed by other studies that somewhat contradict these findings. The aim of this review is to present a critical appraisal of the value of immunohistochemical studies in the diagnosis of uterine neoplasms with emphasis on the recent literature. It is stressed that immunohistochemistry is necessary in relatively few cases and a knowledge of the potential immunoreactivity of utilized antibodies is required. With regard to endometrial carcinoma, topics discussed in this review include antibodies of value in the distinction between type 1 and type 2 carcinoma, in the characterization of focal serous proliferations in endometrial polyps and non-polypoid endometrium, in the sometimes problematic distinction between an endometrial and an endocervical adenocarcinoma, and in the distinction between a uterine and ovarian serous carcinoma. The value of CD10 as a proposed marker of mesonephric adenocarcinoma is also discussed. With regard to uterine mesenchymal neoplasms, a critical appraisal of the value of relatively new antibodies, including CD10 and h-caldesmon, in distinguishing between a smooth muscle and an endometrial stromal neoplasm is discussed as is the immunophenotype of two rare uterine mesenchymal neoplasms, uterine tumor resembling ovarian sex cord tumor (UTROSCT) and perivascular epithelioid cell tumor (PEComa).
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PMID:A critical appraisal of the value of immunohistochemistry in diagnosis of uterine neoplasms. 1509 30

To evaluate and compare the immunophenotype of endocervical and endometrial stromal cells and to asses its potential application in tumor localization. Paraffin sections of benign endocervix (n = 24), benign endometrium (n = 33), endocervical adenocarcinoma (n = 9), endometrial carcinoma (n = 13), and endometrial hyperplasia (n = 16) were stained with antibodies to CD10, Wilms Tumor-1, CD34, smooth muscle actin, and factor XIIIa by immunohistochemistry. In 16 cases, lower uterine segment was also available. Immunoreactivity of stromal cells was recorded as positive (>/=50% staining), focally positive (>/=5%-<50%) or negative (<5%). Endocervical stromal cells (ECSC) in either benign or malignant cervical epithelial lesions were predominantly CD34/CD10 (CD34 dominant immunophenotype). Endometrial stromal cells (EMSCs) in either benign or malignant epithelial lesions were primarily CD34/CD10 (CD10 dominant immunophenotype). Expression of Wilms Tumor-1 was decreased in EMSC of the EMCA when compared to their counterpart in endometrial hyperplasia. There was no differential expression of smooth muscle actin and factor XIIIa identified between ECSC and EMSC. The immunophenotypes of the ECSC and EMSC overlapped in the lower uterine segment. The functional status of the endometrium had no effect on the immunoprofile. The pattern of CD34 and CD10 immunostaining in stromal cells might be helpful in determining tumor involvement in uterine and cervical sites.
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PMID:Immunoprofile of endocervical and endometrial stromal cells and its potential application in localization of tumor involvement. 1719 1

We report a rare case of sertoliform endometrioid carcinoma of the endometrium in a 71-year-old African American woman who presented with postmenopausal bleeding. Her medical condition was remarkable for hypertension, diabetes, and obesity. She underwent total hysterectomy, right salpingo-oophorectomy and lymph node sampling. The endometrium was occupied by a 4.5-cm solid polypoid tumor, which grossly invaded into the myometrium. Microscopically, the tumor consisted of small hollow tubules, anastomosing cords and trabeculae, and tightly packed nests. Microglandular areas mimicking adult granulosa cell tumors were also present. But true Call-Exner bodies were absent. Component of typical endometrioid carcinoma was noted only focally. The uninvolved endometrium demonstrated atypical complex hyperplasia. The tumor cells were diffusely immunoreactive for epithelial membrane antigen, estrogen receptor, and progesterone receptor (PR), and focally for vimentin. The tumor cells were also diffusely positive for inhibin alpha and CD99. Immunostains for other sex cord markers (calretinin, WT-1, and Melan-A) were also positive in approximately 30% to 40% of the tumor cells. Immunostains for CD10, smooth muscle actin, desmin, or HHF35 were negative. Two ovarian sertoliform endometrioid carcinomas from our archived tissue were, however, immunoreactive for epithelial membrane antigen but negative for inhibin alpha. Despite the prominent sertoliform features, both histologically and immunohistochemically, the tumor was of a high-grade endometrial carcinoma and will likely behave as such. As of today, dual differentiation of epithelium and sex cord by immunohistochemical staining has not been demonstrated in sertoliform endometrioid carcinomas of either endometrial or ovarian origin. Our case is the first documentation of such example and suggests that endometrial carcinoma can undergo true sex cord differentiation.
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PMID:Sertoliform endometrioid carcinoma of the endometrium with dual immunophenotypes for epithelial membrane antigen and inhibin alpha: case report and literature review. 1758 14

The major differential diagnostic problem presented by atypical polypoid adenomyofibroma (atypical polypoid adenomyoma) (APA), which usually affects young women, is the exclusion of well-differentiated endometrial carcinoma invading the myometrium. This distinction, however, is of great clinical importance from the standpoint of treatment because reproductive conservation is feasible for patients with APA. Recently, CD10, known to be a marker of endometrial stromal cells, was reported to be also expressed in cells immediately surrounding the neoplastic glands invading the myometrium [Am J Surg Pathol 27 (2003) 786-789; Mod Pathol 16(1) (2003) 22-27]. However, CD10 expression in the myofibromatous component of APA has not been previously examined in the literature. We therefore decided to examine whether the CD10-immunostaining pattern in APA is different from that in myoinvasive carcinoma. Furthermore, we also attempted to obtain any histopathologic findings that may offer some insight regarding the histogenesis of APA. Seven cases of APA were immunostained for CD10 using curettage or polypectomy specimens, in addition to hysterectomy specimens in 1 case. Areas with more fibrotic rather than muscular stroma were focally observed in 4 cases. The pattern of staining was compared with hysterectomy specimens taken from 19 cases in which well- to moderately differentiated endometrioid adenocarcinoma had deeply invaded the myometrium (outer two thirds of the myometrium) but was not associated with adenomyosis. In 6 of 7 cases of APA, CD10 was never expressed in the myofibromatous stromal components. In 1 case of APA, the fascicles of fibrotic and muscular mesenchymal cells in the interglandular areas were focally and weakly positive for CD10. All 19 myoinvasive carcinomas expressed CD10 to some extent in cells immediately surrounding the neoplastic myoinvasive glands (fringe-like staining pattern). The proportion of the myoinvasive nests immediately surrounded by CD10-positive mesenchymal cells was as follows: mean, 74%; median, 80%; minimum, 5%; maximum, 100%. The fringe-like CD10-staining pattern was not observed in APA. Furthermore, we identified a gradual transformation from preexisting endometrial stromal cells (CD10 positive) into the typical myofibromatous stromal component (CD10 negative) of APA in 1 case. In conclusion, this study demonstrated differences in the CD10 immunoreactivity or immunostaining pattern between the stromal components of APA and myoinvasive endometrial carcinoma. This difference should lead to a more accurate diagnosis of APA (pseudo-myoinvasive lesion). Furthermore, the histogenesis of APA may perhaps be explained by "myofibromatous metaplasia" of the endometrial stromal cells.
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PMID:CD10 immunostaining distinguishes atypical polypoid adenomyofibroma (atypical polypoid adenomyoma) from endometrial carcinoma invading the myometrium. 1861 43

Mucinous and microglandular adenocarcinomas of the endometrium (MUC-AD and MIGL-AD, respectively) are uncommon types of endometrial cancer. When present in endometrial biopsy or curettage, these tumors may display a unique microglandular architectural pattern mimicking benign microglandular hyperplasia (MGH) of the endocervix. We compared the immunoprofile of MUC-AD and MIGL-AD with that of MGH and benign endocervical glands to identify the markers that would reliably separate these malignancies from benign endocervical tissue. A total of 10 MIGL-AD and 30 MUC-AD cases were collected for the study. Fifteen consecutive cases of benign endocervical glands and MGH were used as a control group. All cases were stained for vimentin, p16, Ki-67, BCL-2, survivin, CD10, and CD34. p16 was the only marker that showed a significantly different staining pattern between the benign and malignant cases, whereas the staining for vimentin, Ki-67, BCL-2, and survivin demonstrated marked overlaps. All but 1 MUC-AD and MIGL-AD cases were positive for p16, whereas none of the cases of benign mucinous endocervical epithelium and MGH showed p16 positivity. Furthermore, the stromal cells of endocervix demonstrated weak to moderate positivity for CD10 and strong positivity for CD34, whereas endometrial tumors showed a reverse pattern, with strong stromal positivity for CD10 and either no, or only weak, staining for CD34. In conclusion, epithelial p16 and stromal CD10/CD34 immunostaining can be useful in distinguishing MUC-AD and MIGL-AD from benign endocervical epithelium in endometrial sampling.
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PMID:Immunohistochemical differences between mucinous and microglandular adenocarcinomas of the endometrium and benign endocervical epithelium. 2056 57

Canine endometrial carcinomas are rare, and mostly occur in geriatric bitches. In this work, the uterus of a 10-year-old female Boxer evidencing an endometrial carcinoma on the body of the uterus was used to describe the histopathological features of the tumour and to study its immunophenotype. In this work, a panel of immunomarkers (cytokeratins AE1/AE3 and 14, vimentin, CD10 and Ki-67) was applied to the endometrial carcinoma to establish the staining patterns indicative of the tumour agressiveness and cellular differentiation. Additionally DNA ploidy was also performed. In this case, the tumour showed papillar pattern, with large pleomorphic, anaplastic cells and also some aberrant multinucleated and giant cells. In some areas of the tumour, it was also observed cytotrophoblastic-like cells outlining the papillae. Cytokeratin AE1/AE3 expression was detected in the luminal neoplasic cells. Cytokeratin 14 positivity was sporadic and irregular, and was observed mainly in the luminal epithelium. Only stromal and aberrant cells showed a positive staining to vimentin. Positive membranous staining to CD10 was evidenced by clear epithelial, cytotrophoblastic-like cells at the tumour surface but not by the stromal cells. The mitotic and Ki-67 indices were low, suggestive of a weak aggressiveness of the tumour. The multinucleated and giant cells evidenced a positive immunostaining to CK AE1/AE3, and CD 10; its positivity to vimentin was sporadic. This study aims to contribute to the advancement of the knowledge in canine endometrial carcinoma immunophenotype.
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PMID:Histopathologic and immunohistochemical exam in one case of canine endometrial adenocarcinoma. 1914 37

Atypical polypoid adenomyoma (APA) is a rare, benign lesion. The tumor occurs in nulliparous women aged 22-48 years (average 33 years) and it has been suggested as being related to prolonged estrogenic stimulation. We describe a case of a 72-year-old woman who presented at our hospital with persistent, worsening urinary incontinence and pelvic pain. Physical examination and pelvic ultrasound disclosed uterine enlargement, a mass in the endometrial cavity and multiple small myomas. Total hysterectomy with bilateral salpingo-oophorectomy was performed. The histological diagnosis for the mass of the endometrial cavity was atypical polypoid adenomyoma. APA should be distinguished from endometrial carcinoma and other malignant uterine neoplasms such as adenofibroma, adenosarcoma and malignant mixed mullerian tumor. The immunohistochemical panel which usually includes alpha smooth muscle actin, desmin, Ki67 and recently CD10 is often helpful in establishing the diagnosis. The treatment may vary depending on the patient's age, her desire to preserve fertility, and the severity of her symptoms.
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PMID:Atypical polypoid adenomyoma of the uterus. A case report and a review of the literature. 2243 20

A clearcut definition of the transition from the cervix to the lower uterine segment is lacking. We therefore evaluated the location of the anatomic border between the cervix and the uterine corpus. Using both morphometry and immunohistochemisty, we examined the epithelial and stromal cell types in this transition zone. In 26 patients, longitudinal sections from the cervix uteri up to the fundus uteri were paraffin embedded and immunohistochemically stained for BCL2, keratin 5, Ki-67, CD10, and CD34. Examination of the slides resulted in the identification of a junctional zone in the cranial portion of the cervix, which is characterized by a usually abrupt morphologic and immunohistochemical transition from an endocervical-type mucinous epithelium to a ciliated tubal-like epithelium and a slow transition in stromal marker expression patterns. This epithelial transition was characterized by its intense keratin 5 and BCL2 staining with accompanying Ki-67 expression in the tubal-like epithelium, whereas the endocervical epithelium was largely negative for these markers. CD10 expression was usually quite intense directly around endocervical invaginations, but the remaining stroma was negative. Toward the endometrial cavity, expression increased and endometrial stroma displayed full thickness expression for CD10. CD34 showed a reverse pattern to CD10, with moderate expression in the endocervical stroma, which disappeared in the endometrial stoma. The immunohistochemical identification of this transition may allow a more objective determination of the extension of endometrial carcinoma into the cervix in cases that are morphologically problematic. Furthermore, as ciliated tubal-like epithelium is invariably found cranial to the uterine-cervix-isthmus junction, a diagnosis of tubal metaplasia should not be made in this region and tubal-like epithelium is not indicative of a metaplastic process.
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PMID:BCL2 and keratin 5 define the uterine-cervix-isthmus junction, a transition between endocervical and tubal-like epithelium. 2320 80

Mesonephric carcinoma of the uterine corpus is an extremely rare malignancy that originates from the mesonephric remnant of the female reproductive tract. There have been no previous reports of mesonephric carcinoma accompanied by a sarcomatous component. The current study presents two cases of uterine corpus mesonephric carcinoma with sarcomatous components that occurred in postmenopausal women. Immunohistochemically, the tumour cells were positive for vimentin and CD10. The tumours of these patients were located in the uterine myometrium; therefore, treatment was similar to that for endometrial cancer. Although the follow-up period was short in the current cases, no metastatic disease was identified in the second case and thus, this may increase clinical knowledge with regard to the biological behavior of these rare malignancies.
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PMID:Mesonephric carcinoma of the uterine corpus: A report of two cases. 2687 Feb 13


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