Mixed tumors of the vagina: an immunohistochemical study of 13 cases with emphasis on the cell of origin and potential aid in differential diagnosis

Oliva, Esther; González, Lucía M.; Dionigi, Adriana; Young, Robert H.

doi:10.1038/modpathol.3800173

Cited by 42 publications

(24 citation statements)

References 45 publications

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“…Antibodies to Fli-1 (1:160 dilution, Santa Cruz Biotechnology, CA), CD99 (1:100 dilution; Novocastra, CA), synaptophysin (predilute, Ventana Medical Systems, Inc., AZ) , chromogranin A (predilute, Ventana Medical Systems, AZ), CD10 (predilute, Ventana Medical Systems, AZ), CD56 (predilute, Cell Marque, CA), glial fibrillary acidic protein (GFAP) (predilute, Ventana Medical Systems, AZ), neuron specific enolase (NSE) (1:150 dilution, Dako, CA; antigen retrieval not applied), S100 (predilute, Ventana Medical Systems, AZ), vimentin (predilute, Ventana Medical Systems, AZ), and cytokeratins CAM5.2 (1:80 dilution, Becton & Dickinson, CA) and AE1/AE3, (1:160, Signet Laboratories, MA; Protease1 was used for antigen retrieval), were used for immunohistochemical staining with appropriate controls. Staining was done on a BenchMark XT automated tissue staining system (Ventana Medical Systems, AZ) using validated protocols as described previously (44). Endogenous peroxidase activity was blocked by H 2 O 2 before antibody incubation.…”

Section: Methodsmentioning

confidence: 99%

Primitive Neuroectodermal Tumors of the Female Genital Tract

Chiang

Snuderl

Kojiro-Sanada

et al. 2017

American Journal of Surgical Pathology

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Primary primitive neuroectodermal tumor (PNET) of the female genital tract is rare, and its proper classification remains unclear. The clinical, histologic, and immunophenotypic features as well as EWSR1 rearrangement status of 19 gynecologic PNETs, including 10 ovarian, 8 uterine, and 1 vulvar tumors, are herein reported. Patient age ranged from 12 to 68 years, with a median age of 20 and 51 years among those with ovarian and uterine PNETs, respectively. Morphologic features of central nervous system (CNS) tumors were seen in 15 PNETs, including 9 medulloblastomas, 3 ependymomas, 2 medulloepitheliomas, and 1 glioblastoma, consistent with central PNET. The remaining 4 PNETs were composed entirely of undifferentiated small round blue cells and were classified as Ewing sarcoma/peripheral PNET. Eight PNETs were associated with another tumor type, including 5 ovarian mature cystic teratomas, 2 endometrial low-grade endometrioid carcinomas and a uterine carcinosarcoma. By immunohistochemistry, 17 PNETs expressed at least 1 marker of neuronal differentiation, including synaptophysin, NSE, CD56, S100, and chromogranin in 10, 8, 14, 8, and 1 tumors, respectively. GFAP was positive in 4 PNETs, all of which were of central type. Membranous CD99 and nuclear Fli-1 staining was seen in 10 and 16 tumors, respectively, and concurrent expression of both markers was seen in both central and Ewing sarcoma/peripheral PNETs. All tumors expressed vimentin; while keratin cocktail (CAM5.2, AE1/AE3) staining was only focally present in 4 PNETs. Fluorescence in situ hybridization was successful in all cases and confirmed EWSR1 rearrangement in 2 of 4 tumors demonstrating morphologic features of Ewing sarcoma/peripheral PNET and concurrent CD99 and Fli-1 expression. In conclusion, central and Ewing sarcoma/peripheral PNETs may be encountered in the female genital tract with central PNETs being more common. Central PNETs show a spectrum of morphologic features that overlaps with CNS tumors but lack EWSR1 rearrangements. GFAP expression supports a morphologic impression of central PNET and is absent in Ewing sarcoma/peripheral PNET. Ewing sarcoma/peripheral PNETs lack morphologic features of CNS tumors.

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Section: Methodsmentioning

confidence: 99%

Primitive Neuroectodermal Tumors of the Female Genital Tract

Chiang

Snuderl

Kojiro-Sanada

et al. 2017

American Journal of Surgical Pathology

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“…Exophytic benign and malignant epithelial neoplasms may also occur, and mesenchymal tumors including angiomyofibroblastoma, superficial myofibroblastoma, and leiomyoma can form intravaginal polypoid masses. Rarer entities include the benign mixed tumor (spindle cell epithelioma), which usually arises within the lower third of the vagina related to the hymenal ring (3,4). Recently, McCluggage and Young (5) described 10 cases of an additional distinctive vaginal lesion, which they termed tubulosquamous polyp (TSP).…”

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confidence: 99%

Tubulo-squamous Vaginal Polyp With Basaloid Epithelial Differentiation

Stewart¹

2009

International Journal of Gynecological Pathology

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Tubulo-squamous polyp is a recently described and apparently benign lesion that most frequently involves the upper vagina of postmenopausal patients. Histologically, it is characterized by the presence of cysts, squamous epithelial nests, and small tubular structures that are surrounded by a hypocellular fibrous stroma. Some lesions show focal immunoreactivity for prostatic acid phosphatise and/or prostate-specific antigen raising the possibility of derivation from Skene's glands. In this report, an additional case of tubulo-squamous polyp is presented in which there was prominent basaloid epithelial differentiation, mainly in the form of elongated cords of cells around the peripheral and deep aspect of the lesion. This feature has not been recorded previously in tubulo-squamous polyp and potentially could create diagnostic difficulty with other lesions such as basal cell/adenoid basal carcinoma or small-cell neuroendocrine carcinoma.

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“…It is thought that many of these salivary type neoplasms arise from Bartholin's glands. Mixed tumors of salivary gland type should be distinguished from so-called mixed tumor of the vagina (spindle cell epithelioma), which is a biphasic neoplasm composed of epithelial and mesenchymal elements and thought to be of epithelial derivation [26]. The latter usually arises close to the hymen and has an epithelial component, usually glandular in type (sometimes with squamous metaplasia), as well as a mesenchymal component.…”

Section: Discussionmentioning

confidence: 99%