Gynecologic Pathology
Fatemeh Nili; Soheib Fathi; Mansoureh Tavakoli; Elham Mirzaian; Maryam Lotfi
Abstract
Background & Objective: Clear cell carcinoma (CCC) is an uncommon histopathologic subtype of ovarian and endometrial carcinoma. Due to the morphologic overlapping with other subtypes of ovarian and endometrial carcinomas, an accurate diagnosis is crucial.Methods: In this study, 31 cases of ovarian ...
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Background & Objective: Clear cell carcinoma (CCC) is an uncommon histopathologic subtype of ovarian and endometrial carcinoma. Due to the morphologic overlapping with other subtypes of ovarian and endometrial carcinomas, an accurate diagnosis is crucial.Methods: In this study, 31 cases of ovarian clear cell carcinoma (OCCC), 28 endometrial clear cell carcinoma (ECCC), and 80 non-CCC subtypes (33 high-grade serous carcinomas of the ovary, 2 low-grade serous carcinomas, 10 ovarian endometrioid, 3 serous carcinomas and 29 endometrioid carcinomas of the endometrium) were investigated for immunohistochemical expression of AMACR. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the distinction of OCCC and ECCC from other histopathologic subtypes were calculated.Results: Positive AMACR staining was seen in 18 OCCCs (58%) and 10 ECCCs (35.7%). In the non-clear cell group, 44 cases of ovarian (98%) and 25 cases of endometrial carcinoma (78%) showed negative results. Only one case of ovarian endometrioid carcinoma and 7 cases (22%) of endometrial endometrioid carcinomas revealed a positive reaction (P<0.05). Collectively, sensitivity, specificity, PPV, and NPV of AMACR expression, for the diagnosis of OCCC were calculated as 58%, 98%, 94.7%, and 77.2%, respectively. The sensitivity, specificity, PPV, and NPV were shown to be as 35.7%, 78.1%, 58.8%, and 58.1%, respectively in the endometrium.Conclusion: AMACR may be a highly specific immunohistochemical marker for the distinction of serous and clear cell carcinoma. A small percentage of endometrioid carcinoma may show positive staining. The sensitivity of this marker may not be higher than the other well-known Napsin-A IHC marker.
Gynecologic Pathology
Fatemeh Nili; Mansoureh Tavakoli; Narges Izadi-Mood; Hana Saffar; Soheila Sarmadi
Abstract
Background & Objective: Clear cell carcinomas (CCC) differ from other types of ovarian and endometrial carcinomas in biology, behavior and response to chemotherapy. Histopathologic diagnosis may be challenging in some situations which necessitates immunohistochemistary (IHC) assessment. In this study ...
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Background & Objective: Clear cell carcinomas (CCC) differ from other types of ovarian and endometrial carcinomas in biology, behavior and response to chemotherapy. Histopathologic diagnosis may be challenging in some situations which necessitates immunohistochemistary (IHC) assessment. In this study we investigated the diagnostic utility of Napsin-A in diagnosis of ovarian and endometrial CCCs. Methods: Ovarian and endometrial CCC samples from 2013 to 2018 in 3 general and women’s hospital in Tehran were re-evaluated by 2 expert pathologists. Forty-two samples were included as case and 42 non-clear cell carcinomas (Non-CCC) of ovary and endometrium were selected as control group. Based on IHC study tumors with sum intensity and percentage score ≥2 (at least 1+ staining in more than 1% of tumor cells) were considered positive. Result: The prevalence of endometrial and ovarian CCC in the case group were 15 and 27 respectively. The tumors in the control group included 22 cases of endometrioid, 2 high grade papillary serous carcinoma (HGSC) of endometrium, 6 endometrioid and 12 HGSC of ovary. Napsin-A positivity was observed in 35 (83%) of CCCs while 7 (17%) samples including 3 out of 15 endometrial and 4 out of 27 ovarian CCCs were Napsin-A negative. No positive reaction was seen in control group. The overall accuracy, specifity and sensitivity of Napsin-A for diagnosis of ovarian and endometrial CCCs were 83%, 100% and 83%, respectively. Sensitivity for ovarian and endometrial CCCs were 85% and 80%, orderly. Conclusion: Napsin-A is an accurate and reliable marker for distinction of CCCs from non-CCCs in ovary and endometrium. A panel of antibodies may yield the highest diagnostic accuracy.
Sabina Khan; Mohammad Jaseem Hassan; Sujata Jetley; Zeeba S Jairajpuri; Ayesha Ahmad
Volume 8, Issue 2 , April 2013, , Pages 127-130
Abstract
Endometrial calcification along with ossification is an uncommon clinical entity. Most of the cases are asymptomatic or present with secondary infertility. Endometrial ossification associated with repeated abortions has been reported very infrequently. Here we report a case of endometrial calcification ...
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Endometrial calcification along with ossification is an uncommon clinical entity. Most of the cases are asymptomatic or present with secondary infertility. Endometrial ossification associated with repeated abortions has been reported very infrequently. Here we report a case of endometrial calcification with ossification due to retained fetal bony tissue in a 38 year old symptomatic female having previous history of two abortions. This case highlights the importance of detailed clinical history, ultrasonographic and endometrial evaluation along with histopathological examination in a patient having repeated abortions. It also emphasizes the need to consider endometrial tuberculosis in the differential diagnosis of endometrial calcification and subsequent ossification especially in areas where tuberculosis is rampant.
Aditi Bhattacharyya; Sonia Gon; Goutam Bandyopadhyay; Bipasa Majumdar; Prosenjit Gayen
Volume 7, Issue 3 , July 2012, , Pages 197-202
Abstract
Giant cell carcinoma of the endometrium is a rare and an aggressive tumor that should be distinguished from other endometrial tumors with a prominent giant cell component, including trophoblastic tumors, certain primary sarcomas, and malignant mixed müllerian tumors. At present, cumulative data ...
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Giant cell carcinoma of the endometrium is a rare and an aggressive tumor that should be distinguished from other endometrial tumors with a prominent giant cell component, including trophoblastic tumors, certain primary sarcomas, and malignant mixed müllerian tumors. At present, cumulative data on this rare histological variant is limited and the prognostic significance of the presence and the extent of a giant cell component in endometrial carcinoma remain uncertain. We report giant cell carcinoma of endometrium in an Indian female, which according to our best knowledge, is the first case being reported from Indian Subcontinent.
