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 ...
Read More
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.
Gynecologic Pathology
Soheila Sarmadi; Narges Izadi-Mood; Nazanin Mansourzadeh; Dorna Motevalli
Abstract
Background & Objective: Endometrial carcinoma (EC) has been traditionally classified into two distinct categories of low-grade and high-grade. Type I (low grade) EC, which constitutes the majority of cases, is linked to estrogen-related molecular pathways. But type II (high-grade) EC accounts for ...
Read More
Background & Objective: Endometrial carcinoma (EC) has been traditionally classified into two distinct categories of low-grade and high-grade. Type I (low grade) EC, which constitutes the majority of cases, is linked to estrogen-related molecular pathways. But type II (high-grade) EC accounts for 10-20% of cases and behaves in an aggressive way. Pathologic and biological features of type II EC have not been fully elucidated yet. Several investigations have demonstrated HER2/neu expression and amplification in type II EC, especially papillary serous carcinoma (PSC). This study assessed HER2/neu expression in high-grade EC as well as its association with other clinical and histopathological prognostic factors. Methods: In this cross-sectional study, we performed HER2/neu immunohistochemical (IHC) staining in 37 high-grade EC cases with histological diagnostic categories of PSC (n=23), clear cell carcinoma (CCC) (n=9), and carcinosarcoma with high-grade carcinomatous component (PSC, CCC, grade 3 endometrioid carcinoma, or unclassified high-grade adenocarcinoma) (n=5). All patients were followed for 2-9 years in order to evaluate their disease-free survival (DFS) and overall survival (OS) during study period (2005-2014). Result: HER2/neu IHC staining was positive in 12 patients (32.4%) including 8/23 (34.8%) PSC, 2/9 (22.2%) CCC, and 2/5 (40%) carcinosarcoma cases. There was no statistically significant difference between HER2/neu expression and DFS or OS of the patients (P>0.05). Conclusion: We observed that HER2/neu is expressed in one-third of high-grade ECs. This ancillary test is supportive in follow-up of patients with high-grade ECs.
Narges Izadi-Mood; Soheila Sarmadi; Hossein Sadidi
Volume 9, Issue 4 , October 2014, , Pages 263-267
Abstract
Background & Objectives: Tumor diathesis (TD) is defined as granular proteinaceous precipitates on slide surface of cytologic smears. It is found in the background of smears of invasive carcinoma but not in all cases. The aim of present study was to determine the prevalence of TD in cervicovaginal ...
Read More
Background & Objectives: Tumor diathesis (TD) is defined as granular proteinaceous precipitates on slide surface of cytologic smears. It is found in the background of smears of invasive carcinoma but not in all cases. The aim of present study was to determine the prevalence of TD in cervicovaginal smears from patients with uterine cervix carcinoma.
Methods: Cytological smears and histological slides from the Department of Pathology, Women Hospital, Tehran, Iran, of forty six patients histologically confirmed carcinoma of uterine cervix from 1995 to 2003 were reviewed for presence of TD, red blood cells, and neutrophils on cytological smears as well as depth of invasion, histologic types and grade of differentiation of tumor.
Results: TD was detected in 28 of the 46 smears (60.9%); in 18 patients with squamous cell carcinoma (62.1%), 7 adenocarcinoma (58.3%), 2 adenosquamous carcinoma (66.7%) and one endometrial carcinoma which involved uterine cervix. TD was seen in 4 (33.3%) uterine cervix carcinoma with 5mm depth of invasion and 17 (65.4%) uterine cervix carcinoma with ≥ 5mm depth of invasion. There was a positive correlation between the presence of TD and the depth of invasion. Although an important criterion of malignancy, TD, was absent in some cases of carcinoma, particularly those that had < 5mm depth of invasion.
Conclusion: Increasing in depth of invasion and decreasing in differentiation of the tumor were associated with increasing in frequency of TD in cytological smears. A definite distinction between an intraepithelial lesion and a shallow invasive cancer may not be possible on cervicovaginal smears.