Gynecologic Pathology
Fatemeh Samiee Rad; Mehdi Ghaebi; Arezoo Bajelan
Abstract
Pure ovarian neuroendocrine tumors are very rare. Herein, we present a young Iranian woman with a pure primary ovarian neuroendocrine tumor.A 26-year-old female presented with chronic abdominal pain and progressive constipation and was referred to the emergency room. Imaging findings confirmed a mass ...
Read More
Pure ovarian neuroendocrine tumors are very rare. Herein, we present a young Iranian woman with a pure primary ovarian neuroendocrine tumor.A 26-year-old female presented with chronic abdominal pain and progressive constipation and was referred to the emergency room. Imaging findings confirmed a mass in the right adnexa. Following the resectional surgery of the ovarian mass, histopathological and immunohistochemistry results disclosed a mixed type of primary ovarian neuroendocrine tumor. The patient did not experience tumor recurrence afterward.Due to the rarity and low prevalence of primary pure ovarian neuroendocrine tumors, the histopathologic diagnosis should be confirmed by an immunohistochemistry study.
Gynecologic Pathology
Maryam Entezarian; Fereshteh Ameli; Noraidah Masir; Tan Geok Chin
Abstract
Background & Objective: Ovarian cancer is associated with the highest mortality rate among gynecologic malignancies. Despite new therapeutic strategies, ovarian cancer still has a high risk of metastasis and mortality. Endocan is a newly identified endothelial cell activation marker, which is responsible ...
Read More
Background & Objective: Ovarian cancer is associated with the highest mortality rate among gynecologic malignancies. Despite new therapeutic strategies, ovarian cancer still has a high risk of metastasis and mortality. Endocan is a newly identified endothelial cell activation marker, which is responsible for angiogenesis, tumor invasion, and aggressive behavior of tumors. The aim of this study was to assess Endocan expression in different types of ovarian tumors and to identify its relationship with clinicopathologic characteristics of ovarian tumors.Methods: This cross-sectional study was conducted on 183 tissue samples, including benign, borderline, and malignant ovarian tumors collected from the University Kebangsaan Malaysia Medical Center archive of Pathology during 2005-2015. Mouse monoclonal anti-human Endocan/ESM-1 Clone MEP08 was used at a dilution of 1:400 for immunohistochemical (IHC) staining. All the information was collected by a checklist, and the association between clinicopathological features and high or low levels of Endocan -MVD was evaluated using Pearson chi-square, Fischer's exact, or Monte Carlo tests.Results: The prevalence of Endocan positivity was significantly higher in malignant compared to borderline and benign ovarian tumors (P<0.001). There was also a significant association between type of tumor and Endocan status in malignant ovarian tumors (P=0.02), indicating that Endocan positivity was more likely in serous malignant ovarian tumors compared to other ovarian tumor types. However, the tumor stage was not significantly associated with Endocan status (P=0.31).Conclusion: This study showed that Endocan positivity may show the highest prevalence among malignant tumors suggesting that high Endocan expression would be negatively associated with ovarian tumor behavior.
Gynecologic Pathology
Kavita Gaur; Shailaja Shukla; Shinjini Choudhury; Pankaj Raj; Sharda Patra
Abstract
Uterine leiomyoma with hepatic vasculopathy, specifically non-cirrhotic portal fibrosis (NCPF), has hitherto been undescribed. NCPF is characterized by elevated portal pressure sans cirrhosis and has previously not been described in association with a gynecological pathology. We report the case of a ...
Read More
Uterine leiomyoma with hepatic vasculopathy, specifically non-cirrhotic portal fibrosis (NCPF), has hitherto been undescribed. NCPF is characterized by elevated portal pressure sans cirrhosis and has previously not been described in association with a gynecological pathology. We report the case of a female under evaluation for a heterogeneously enhancing intrauterine mass with multiple hepatic lesions with increased uptake of fluorodeoxyglucose on positron emission analysis. Fibroscan values were increased. Histopathologic evaluations revealed a leiomyoma with liver tissue showing tubercular granulomas, thin wispy fibrotic strands, and rounded portal tracts pointed to NCPF. No evidence of malignancy was seen. Metabolic imaging may be unreliable to distinguish between benign and malignant uterine pathology and granulomatous and malignant hepatic lesions. Elastography may also be ineffective in diagnosing the etiology of liver fibrosis. Histopathological analysis hence remains essential despite noninvasive tests. Further research is required on females afflicted with NCPF to exclude a hormonal link.
Gynecologic Pathology
Azar Daneshpajooh; Mahboubeh Mirzaei; Maryam Iranpour
Abstract
Fibroepithelial polyps of the vagina (FEPV) are rare entities which normally manifest as one or more painless polyps sometimes with symptoms such as bleeding, vaginal discharge, and discomfort regarding the size of the mass. Despite their benign nature, they can be confused with other vaginal tumors ...
Read More
Fibroepithelial polyps of the vagina (FEPV) are rare entities which normally manifest as one or more painless polyps sometimes with symptoms such as bleeding, vaginal discharge, and discomfort regarding the size of the mass. Despite their benign nature, they can be confused with other vaginal tumors due to their abnormal histology. In this report, we present a case of a 44-year-old woman with a giant pedunculated and symptomatic polyp of the vagina with anterior vaginal wall prolapse. The treatment method included a simple local excision of the polyp and anterior vaginal compartment repair. Histopathological examination revealed a polypoid lesion covered by squamous epithelium containing a central fibrovascular core without atypia. The patient experienced an uneventful postoperative recovery, with no complication, which implies that surgery is the most effective modality for managing such tumors.
Gynecologic Pathology
Neda Nasirian; Khadigeh Elmizadeh
Abstract
Chemotherapy of ovarian tumors has some effects on morphology of stromal cells also residual tumoral cells which can cause problems in diagnosis of tumor type and staging of it .In some cases ,it can makes problem in diagnosis of residual epithelial tumor from other differential diagnosis such as spindle ...
Read More
Chemotherapy of ovarian tumors has some effects on morphology of stromal cells also residual tumoral cells which can cause problems in diagnosis of tumor type and staging of it .In some cases ,it can makes problem in diagnosis of residual epithelial tumor from other differential diagnosis such as spindle cell tumors like sarcoma.We had a case which had previouse chemotherapy. Her ovarian tumor had plump spindle cells with pleomorphism similar to spindle cell tumors.Finally ,in these cases ,Immuno histochemisteric study can differentiate correct diagnosis from differential diagnosis.
Gynecologic Pathology
Lila Siavoshinia; Mostafa Jamalan; Majid Zeinali; Aminollah Pourshohod; Mahdie Koushki; Bahman Moradipoodeh; Ghorban Mohammadzadeh
Abstract
Background & objectives: Overexpression of human epidermal growth factor receptor 2 (HER2) causes cell transformation and development of various types of malignancies. Idarubicin is an effective anti-neoplastic drug but specific delivery of it to the targeted cells is still a great challenge. Affibody ...
Read More
Background & objectives: Overexpression of human epidermal growth factor receptor 2 (HER2) causes cell transformation and development of various types of malignancies. Idarubicin is an effective anti-neoplastic drug but specific delivery of it to the targeted cells is still a great challenge. Affibody as a cost-effective peptide molecule with low molecular weight has a high affinity for HER2 receptors. Breast and ovarian cancers as wide speared types of malignancies are associated with high expression of HER2. In the current study, we assessed the cytotoxic effects of idarubicin-ZHER2 affibody conjugate on the positive-HER2 cancer cell lines. Methods: The cytotoxic effects of constructed idarubicin-ZHER2 affibody conjugate on the SK-BR-3, SK-OV-3, and MCF-7 cells with various levels of HER2 expression were evaluated by MTT assay after 48 hours of incubation time. Results: Idarubicin showed a potent and dose-dependent cytotoxic effect against all treated cell lines while the SK-OV-3 cells were significantly more sensitive. The dimeric form of the ZHER2 affibody molecule showed a mild effect on the cell viability of all treated cells at its optimum concentration. The constructed Idarubicin-ZHER2 affibody conjugate decreased the viability of SK-OV-3 cells at its optimal concentration, more efficiently and specifically than other treated cells. Conclusion: The ZHER2-affibody conjugate of idarubicin has a more specific cytotoxic effect compared with idarubicin alone against HER2-overexpressing ovarian cancerous cells. It appears the ZHER2-affibody conjugate of idarubicin has great potential to be implicated as an innovative anti-cancer agent in future clinical trials in patients with HER2-overexpressing ovarian cancer.
Gynecologic Pathology
Fatemeh Nili; Samaneh Salarvand; Hana Saffar; Bita Kalaghchi; Reza Ghalehtaki
Abstract
Mesonephric adenocarcinoma of the uterine cervix, an extremely rare tumor of the female genital tract, derives from the remnants of embryonic mesonephric ducts and its prognosis, diagnosis and treatment is rather challenging. We report a case of a 46-year-old woman with history of abnormal uterine bleeding ...
Read More
Mesonephric adenocarcinoma of the uterine cervix, an extremely rare tumor of the female genital tract, derives from the remnants of embryonic mesonephric ducts and its prognosis, diagnosis and treatment is rather challenging. We report a case of a 46-year-old woman with history of abnormal uterine bleeding and an enlarged uterine cervix on physical examination without obvious mass lesion. She was clinically underdiagnosed with cervical myoma and mesonephric hyperplasia. After simple hysterectomy, stage IB2 mesonephric adenocarcinoma was diagnosed. Despite adjuvant chemoradiation, she presented with peritoneal and locoregional recurrence in less than a year. In the presence of abnormal bleeding and cervical mass, mesonephric hyperplasia in cervical biopsy specimen should be suspected for adenocarcinoma. Radical hysterectomy and complete staging with or without salpingo-oophorectomy is the mainstay of treatment. Despite all ambiguities, due to small number of the reported cases, the overall prognosis seems to be less favorable than conventional cervical adenocarcinoma.
Gynecologic Pathology
Mohammad Reza Shokouh; Akbar Safaie; Afagh Moattari; Jamal Sarvari
Abstract
Background & Objective: Ovarian cancer is one of the most common cancers amongst women. The association of Human papillomavirus (HPV) and Epstein-Barr virus (EBV) with ovarian cancer is inconclusive; therefore, the aims of this study were to evaluate the frequency of HPV and EBV in malignant, ...
Read More
Background & Objective: Ovarian cancer is one of the most common cancers amongst women. The association of Human papillomavirus (HPV) and Epstein-Barr virus (EBV) with ovarian cancer is inconclusive; therefore, the aims of this study were to evaluate the frequency of HPV and EBV in malignant, borderline, benign and normal ovarian tissues. Methods: In this case-control study, 205 Paraffin-embedded ovarian tissue specimens including 68 malignant, 27 borderline, 65 benign, and 45 normal tissues were included from December 2014 to January 2018 and subjected to DNA extraction. The β-globin gene was amplified using PCR to confirm the quality of the extracted DNA. The genomes of HPV (genotypes 16 and 18) and EBV were identified, using specific primers by PCR. Results: The mean age of participants was 43.42 ± 15.4 years. The frequency of HPV was statistically significant between malignant versus benign (p =0.02) and control groups (p =0.002), but not with borderline tumor group (p =0.78). Amongst HPV infected samples, 1 (4.5%) and 14 (63.6%) samples were infected with types 16 and 18, respectively. Also 4 (18.2 %) samples were infected with both genotypes. Eleven samples including 7(10.3%) malignant, 1 (3.7%) borderline, 3 (4.6%) benign and none (0%) of normal control groups were infected with EBV, which was statistically different between malignant and the normal control group (p =0.03). Conclusion: The results of our study showed the possible role of high risk HPVs as well as EBV in pathogenesis of ovarian cancer, and further studies are recommended to confirm these findings.
Gynecologic Pathology
Farzaneh Nazari; Zahra Dehghani
Abstract
Ovarian cancer is the most lethal gynecologic malignancy. The surface epithelial tumor is the most common type of ovarian cancer. Among these, the mucinous tumors account for 10-15% of ovarian tumors. Mucinous ovarian tumors are among the most difficult ovarian neoplasms for surgical pathologists to ...
Read More
Ovarian cancer is the most lethal gynecologic malignancy. The surface epithelial tumor is the most common type of ovarian cancer. Among these, the mucinous tumors account for 10-15% of ovarian tumors. Mucinous ovarian tumors are among the most difficult ovarian neoplasms for surgical pathologists to interpret. Mucinous tumors sometimes coexist with other surface epithelial tumors. Therefore, making the accurate diagnosis of the mucinous tumors is essential. On the other hand, association of Brenner tumors with other neoplasms is rare. Ovarian Brenner tumor has always been discussed by pathologists as an enigmatic tumor, because of its rarity and disputed histogenesis. Here, we reported a case of large mucinous cystadenoma with Brenner component.
Gynecologic Pathology
Mohammad Hashemi-Bahremani; Abdolali Ebrahimi; Mohaddese Fallahi
Abstract
Background & Objective: The her2 amplification plays an important role in breast cancer management. Therefore, there is a need for using supplementary molecular methods in IHC equivocal cases. Present study has been conducted to determine the effects of clinicopathological variables on her2 gene ...
Read More
Background & Objective: The her2 amplification plays an important role in breast cancer management. Therefore, there is a need for using supplementary molecular methods in IHC equivocal cases. Present study has been conducted to determine the effects of clinicopathological variables on her2 gene amplification by chromogenic in situ hybridization (CISH) in IHC Her2 (2+) breast cancer individuals. Methods: A cross-sectional study was conducted in Zaferanyeh Laboratory collaborated with Shahid Beheshti University of Medical Sciences (Tehran-Iran; 2015-2018). All pathological data related invasive breast cancer patients with equivocal IHC results were included. CISH method was performed as a supplementary technique. The associations between histopathologic variables, status of Ki-67 index, progesterone and estrogen receptors (PR & ER) with her2 amplification by CISH were investigated and analyzed. The level of significance was considered as P-value < 0.05. Result: Totally, 239 patients with mean age of 53.2 years were studied. CISH identified her2 gene amplification in 51 subjects (21.3%). The type of tumor (invasive ductal carcinoma), the tumor grade, and the value of Ki-67 index were directly correlated with her2 amplification. Significant negative associations were also observed between CISH results and ER and PR expression. Conclusion: As her2 gene amplification was identified in 21.3% of invasive breast cancer patients with equivocal IHC results, it is supposed that applying CISH method may consider as a potentially valuable supplementary method. Results have also shown that higher grades of tumor, invasive ductal carcinoma, absences of hormone receptors and high Ki-67 index significantly correlated with the her2 amplification.
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
Fatemeh Samiee Rad; Sohayla Farajee
Abstract
Extramammary Paget’s disease and vulvar intraepithelial neoplasia are common lesions of vulve, but synchronous occurrence is rare in a same location. Herein we describe a concurrence of primary cutaneous extra mammary Paget’s disease and squamous cell carcinoma in situ of vulva in an Iranian ...
Read More
Extramammary Paget’s disease and vulvar intraepithelial neoplasia are common lesions of vulve, but synchronous occurrence is rare in a same location. Herein we describe a concurrence of primary cutaneous extra mammary Paget’s disease and squamous cell carcinoma in situ of vulva in an Iranian women. A 59 year old woman, initially presented to Kosar teaching hospital gynecology clinic April 2017 with a single, well defined, scaly, white ulcerated mass, 2 cm in diameter on right minor labia, but other examinations were normal. She had no urinary or gastrointestinal symptoms. Incisional biopsies from the mass represented concurrence extramammary Paget’s disease and VIN3. She underwent radical vulvectomy .No evidence of disease recurrence was noted after 16 months follow up. Participant consent was obtained before patient was enrolled in this study. There are lot of diseases that involve genitalia and lead to vulvar lesions. But in this rare case, we diagnosed concurrence of extramammary Paget’s disease and vulvar intraepithelial neoplasia in a same location. Additionally, the clinical presentation as a vulvar mass was found unusual. Therefore, we report the case to sensitize gynecologists and pathologists for uncommon pathologies and their manifestations in vulva.
Gynecologic Pathology
Maryam Kazemi Aghdam; Seyed Alireza Nadji; Azadeh Alvandimanesh; Maliheh Khoddami; Yassaman Khademi
Abstract
Background & Objective: Malignant breast tumors, which are one of the most important deadly cancers in women, like many other cancers, are proposed to be related to viruses etiologically. Proper management of breast carcinoma necessitates an identification of the etiological factors. Human Papilomavirus is ...
Read More
Background & Objective: Malignant breast tumors, which are one of the most important deadly cancers in women, like many other cancers, are proposed to be related to viruses etiologically. Proper management of breast carcinoma necessitates an identification of the etiological factors. Human Papilomavirus is considered to have an etiological role in breast carcinoma. We carried out this study to find out if Human Papilomavirus-DNA is present in the malignant and benign breast tissue in our patients. Methods: Seventy five paraffin-embedded breast cancer tissues and 75 normal breast tissues and benign breast lesions were examined in this study (case-control) to look for Human Papilomavirus-DNA employing Nested Polymerase Chain reaction. The tissues were examined over a period of ten years in the pathology department of the Pathobiology Laboratory Center of Tehran. Result: No Human Papilomavirus-DNA was found in any of the malignant or control group specimens. Conclusion: Our results showed no evidence of Human Papilomavirus in cancerous and benign tissues, which is consistent with some other studies in English medical literature. More investigations using more specimens from different parts of the country are required to confirm the presence or absence of any connection between Human Papilomavirus and development of breast carcinoma in Iran.
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.
Gynecologic Pathology
Mihir A Gudi; Yiu Yi Chung; Nohadani Mahrokh
Abstract
Background and Objective: Anti-CK5/6 monoclonal antibodies have an established role in breast disease diagnosis. Anti-CK5 monoclonal antibodies have recently become commercially available. There has been growing interest in the staining characteristics of anti-CK5 and its potential diagnostic role in ...
Read More
Background and Objective: Anti-CK5/6 monoclonal antibodies have an established role in breast disease diagnosis. Anti-CK5 monoclonal antibodies have recently become commercially available. There has been growing interest in the staining characteristics of anti-CK5 and its potential diagnostic role in place of anti-CK5/6. We aim to compare and contrast the staining characteristics of anti-CK5/6 vs anti-CK5. Material and Methods: 58 tissue blocks containing 122 different lesions were selected from tissue archives. Two specimens (groups) were taken from each lesion One (group) was stained with anti-CK5 and the other (group) with anti-CK5/6 monoclonal antibodies, using the Streptavidin-biotin immuno-peroxidase method. The two groups of slides were compared and contrasted for lesion staining pattern and for intensity, using light microscopy. Results: Results showed that the diagnostic staining pattern was exactly the same in both anti-CK5 and anti-CK5/6 groups, and also showed that anti-CK5, stained most of the lesions more intensely than anti-CK5/6. Conclusion: Anti-CK5 performed at least as well (for lesion-pattern staining), and better (for lesion staining intensity) than did anti-CK5/6 in the diagnosis of a wide range of breast tissues and lesions. It may be justified to safely replace anti-CK5/6 with anti-CK5 in future routine clinical use, with resultant diagnostic and economic benefits.
Gynecologic Pathology
Fatemeh Nili; Azadeh Sedighi moghadam pour; Hedieh Moradi Tabriz; Parisa Sedighi Moghadam Pour; Hana Saffar
Volume 13, Issue 4 , October 2018, , Pages 467-470
Abstract
Peripheral primitive neuroectodermal tumor (pPNET) is a highly aggressive small round cell tumor belonging to PNET/Ewing sarcoma family. Ovarian tumors composed of primitive neuroectodermal elements are extremely rare. Herein we reported two cases of peripheral primitive neuroectodermal tumors of ovary ...
Read More
Peripheral primitive neuroectodermal tumor (pPNET) is a highly aggressive small round cell tumor belonging to PNET/Ewing sarcoma family. Ovarian tumors composed of primitive neuroectodermal elements are extremely rare. Herein we reported two cases of peripheral primitive neuroectodermal tumors of ovary in two patients with different clinical presentations. Definite diagnoses were made based on the histomorphology and immunohistochemistry results. With respect to different clinical behaviors, treatment modalities and prognosis of peripheral primitive neuroectodermal tumors compared to other known ovarian neoplasms, it is essential to consider this entity as a differential diagnosis in ovarian tumors especially in young patients.
Gynecologic Pathology
Nilay Nishith; Vidya Monappa; Ranjini Kudva
Volume 13, Issue 3 , July 2018, , Pages 363-367
Abstract
Background and Objective: Primary fallopian tube carcinomas (PFTC) are rare tumors with non-specific clinical presentations. The current case was unique since the tumor was first detected on endometrial curettage and clinicoradiologically was misdiagnosed as endometrial carcinoma.Case Report: A 48-year-old, ...
Read More
Background and Objective: Primary fallopian tube carcinomas (PFTC) are rare tumors with non-specific clinical presentations. The current case was unique since the tumor was first detected on endometrial curettage and clinicoradiologically was misdiagnosed as endometrial carcinoma.Case Report: A 48-year-old, post-menopausal female presented with one episode of vaginal bleeding. Endometrial curettage showed poorly differentiated carcinoma, while cervico-vaginal Papanicolaou (Pap) smear was negative for malignant cells. Right sided fallopian tube carcinoma in-situ was diagnosed on histopathological examination of surgical hysterectomy with B/L salpingo-oophorectomy specimen. Conclusion: As observed in the current case, unusual tumor histology with broad papillary fronds lined by pleomorphic cells showing nuclear stratification and focal involvement of endometrial curettage specimen may be considered a useful pointer for tubal malignancy.
Gynecologic Pathology
Kaneeka Bhatnagar; Vikram Narang; Bhavna Garg; Neena Sood
Volume 13, Issue 3 , July 2018, , Pages 372-376
Abstract
Background and Objective: Xanthogranulomatous oophritis is an uncommon, non-neoplastic, chronic process in which the affected organ is destroyed by massive cellular infiltration of foamy histiocytes admixed with multinucleated giant cells, plasma cells, fibroblasts, neutrophils, and foci of necrosis. ...
Read More
Background and Objective: Xanthogranulomatous oophritis is an uncommon, non-neoplastic, chronic process in which the affected organ is destroyed by massive cellular infiltration of foamy histiocytes admixed with multinucleated giant cells, plasma cells, fibroblasts, neutrophils, and foci of necrosis. The etiology of this entity is unknown, but it shares histopathological findings similar to those of xanthogranulomatous change occurring in various organs, including the gallbladder and kidney.Case Report: The current case was a 20-year-old female presenting with a tubo-ovarian mass with suspicion of malignancy on clinicoradiological findings and final diagnosis of xanthogranulomatous oophritis established on histopathology.Conclusion: Clinically and radiologically, xanthogranulomatous oophritis mimics tumor of the ovary and fallopian tube, thereby making it an important entity. A vigilant histopathological evaluation is important to diagnose the disease.
Gynecologic Pathology
Srilatha Parampalli Srinivas; Archana Shivamurthy; Lakshmi Rao; Rajeshwari Gurumoorthy Bhat
Abstract
Hepatoid variant of yolk sac tumor of ovary is an unusual tumor with an aggressive behavior. It is usually observed in young females, presents with abdominal complaints and is associated with raised α-fetoprotein (AFP) levels. It should be differentiated from other hepatoid tumors involving the ...
Read More
Hepatoid variant of yolk sac tumor of ovary is an unusual tumor with an aggressive behavior. It is usually observed in young females, presents with abdominal complaints and is associated with raised α-fetoprotein (AFP) levels. It should be differentiated from other hepatoid tumors involving the ovary. A complete patient evaluation with gross, microscopy, and immunohistochemistry can identify the site of origin to administer appropriate treatment. The current study reported the case of a 30-year-old married parous female presenting with abdominal distention and pain of two months duration. She had regular menstrual cycles. Based on lab investigations her serum AFP level was markedly raised to 34,244 ng/mL (normal range: 0-9 ng/mL). Computerized tomography (CT) scan showed large lobulated heterogeneous mass in both ovaries and omental, gall bladder, and lung metastasis. A CT guided biopsy of the ovarian mass was done. On histopathology, a differential diagnosis of hepatoid variant of yolk sac tumor, hepatoid carcinoma of ovary and hepatoid tumor arising from gall bladder metastasizing to the ovary were observed. Patient underwent surgery. Per operatively gross ascites with bilateral ovarian mass, extensive omental, pelvic, and gall bladder deposits were observed. Bilateral salpingo-oophorectomy with omental deposit biopsy was conducted. Histopathology along with immunohistochemistry confirmed a diagnosis of hepatoid variant of yolk sac tumor in both ovaries with widespread intra-abdominal metastasis.
Gynecologic Pathology
Fatemeh Nili; Niusha Noubari; Alireza Abdollahi
Abstract
ysgerminoma is one of the two most common types of ovarian germ cell tumors. Providing accurate pathologic diagnosis and treatment planning, the prognosis is good even in advanced stages. Pathologic diagnosis is generally straightforward. In microscopic examination, the usual known growth patterns in ...
Read More
ysgerminoma is one of the two most common types of ovarian germ cell tumors. Providing accurate pathologic diagnosis and treatment planning, the prognosis is good even in advanced stages. Pathologic diagnosis is generally straightforward. In microscopic examination, the usual known growth patterns in tumor cells are solid, trabecular, insular and rarely pseudoglandular. In this paper, we reported an advanced ovarian dysgerminoma with different microscopic patterns of growth, including pseudopapillary and macrofollicular structures, in an 18-year-old woman. The patient underwent staging laparotomy and is currently receiving chemotherapy.
Gynecologic Pathology
Savita Agarwal; Megha Ralli; Pinki Pandey; Shruti Singh
Abstract
Ovarian small cell carcinoma is a rare and highly malignant tumor with poor prognosis. It usually presents in younger females with features of hypercalcemia. The exact histogenesis of the tumor is unclear and it may present as an undifferentiated tumor. In such cases, immunohistochemistry (IHC) plays ...
Read More
Ovarian small cell carcinoma is a rare and highly malignant tumor with poor prognosis. It usually presents in younger females with features of hypercalcemia. The exact histogenesis of the tumor is unclear and it may present as an undifferentiated tumor. In such cases, immunohistochemistry (IHC) plays an important role to confirm the diagnosis. Limited treatment options are available and mainly include radical surgery followed by adjuvant therapy in advanced stages. The current report was a rare case of small cell carcinoma of ovary presenting no symptoms of hypercalcemia diagnosed on histopathological examination and IHC findings.
Gynecologic Pathology
Subrata Pal; Kingshuk Bose; Palash Ch Mondal; Srabani Chakrabarti; Mrinal Sikder
Abstract
Placental mesenchymal dysplasia (PMD) is a rare benign placental abnormality. It is characterized by hydropic degeneration of stem villi, placentomegaly, and increased maternal serum alpha-fetoprotein(AFP). It can be associated with different congenital abnormalities, karyotype abnormalities, and feto-maternal ...
Read More
Placental mesenchymal dysplasia (PMD) is a rare benign placental abnormality. It is characterized by hydropic degeneration of stem villi, placentomegaly, and increased maternal serum alpha-fetoprotein(AFP). It can be associated with different congenital abnormalities, karyotype abnormalities, and feto-maternal morbidities. It is difficult to differentiate PMDfrom partial mole, complete mole with twin pregnancy in ultrasound, and in macroscopic examination. The current paper presentsa rare case of placental mesenchymal dysplasia in a young primigravida mother who delivered a normal fetus withnormal karyotype.
Gynecologic Pathology
Mahdi Ahadi; Vahid Naseh; Masoud Salehipour
Abstract
Background & objective: The HER-2 gene is an important on co protein overexpressed in many types of cancers. The current study hypothesized that curcumin downregulates HER-2 and inhibits the signal transduction pathway of PI3K/Akt, MAPK, and activation of NFκB, which could be useful to treat ...
Read More
Background & objective: The HER-2 gene is an important on co protein overexpressed in many types of cancers. The current study hypothesized that curcumin downregulates HER-2 and inhibits the signal transduction pathway of PI3K/Akt, MAPK, and activation of NFκB, which could be useful to treat overexpressed-HER-2 hepatocellular carcinoma (HCC). Methods: In the current study, 40 male NMRI (Naval Medical Research Institute) mice were divided into 4 groups of 10 as follow: Group1 (control group) only received 5 mL/kg corn oil, group 2 (poisoned group) received 30 mg/L arsenic (As2O3) dissolved in water, group3 (curcumin treated), and group 4 (curcumin and arsenic treated) received 10 to 20mg/5mL/kg for 60 days. Once experimental period was completed, liver samples were collected. The analysis of the gene expression was performed by real-time polymerase chain reaction (PCR) technique. Results: Gene expression analysis showed that curcumin had significantly downregulated the activity of HER-2, in poisoned mice. Conclusion: According to the current study results, it could be concluded that curcumin has the inhibitory potential toward HER-2-overexpressed HCC.
Gynecologic Pathology
Fatemeh Bagheri; Somayyeh Rahmani; Somayyeh Azimi; Jamileh Bigom Taheri
Abstract
Giant Cell Fibroma (GCF) was described as a new entity of fibrous hyperplastic soft tissue. It seems that stimulus from an unexplained origin can have a role in its etiology. Histopathologically GCF is consisted of multinucleated fibroblasts that have oval shape nuclei within the eosinophilic cytoplasm. ...
Read More
Giant Cell Fibroma (GCF) was described as a new entity of fibrous hyperplastic soft tissue. It seems that stimulus from an unexplained origin can have a role in its etiology. Histopathologically GCF is consisted of multinucleated fibroblasts that have oval shape nuclei within the eosinophilic cytoplasm. Surgical excision is the treatment of choice and recurrence is very rare. Here we report a case of relatively large GCF in a 54-year-old man. Gingiva is the common location of GCF. As in our case, it may be mistaken as irritation fibroma especially if it is on the buccal mucosa, the most common location for fibroma. Correct diagnosis is based on biopsy and clinical examination to see surface texture roughness. To minimize bleeding because of its large size an excisional biopsy with Diod laser was performed under local anesthesia for this patient.
