The immunohistochemical discrimination of endometrioid adenocarcinomas

Dabbs, David J.; Sturtz, K. W.; Zaino, Richard J.

doi:10.1016/s0046-8177(96)90371-8

Cited by 81 publications

(37 citation statements)

References 14 publications

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“…The type of antibody used (polyclonal vs monoclonal) has some significance. According to Dabbs et al, 6 although endometrial adenocarcinomas were largely negative for CEA, the rate of CEA positivity varied in endocervical adenocarcinomas, with significantly higher rates observed with monoclonal CEA as compared to polyclonal CEA. In our study, the only endometrial carcinoma histologic subtypes that expressed CEA in any significant numbers were clear cell and serous carcinomas.…”

Section: Discussionmentioning

confidence: 98%

“…CEA has been touted as a good discriminatory marker for endometrial carcinoma vs histologic mimics, including endocervical carcinoma, [4][5][6][7]34 because endometrial carcinoma is usually CEA-negative and endocervical carcinoma is usually positive. Dallenbach-Hellweg et al, 5 however, reported that both endometrial and endocervical mucinous carcinomas expressed CEA; this was refuted by Kamoi et al, 9 who reported significantly more CEA expression in endocervical adenocarcinomas of the usual type compared to endometrioid adenocarcinomas of endometrium and endocervix and mucinous endometrial adenocarcinomas.…”

Section: Discussionmentioning

confidence: 99%

“…Morphologically similar carcinomas, such as endocervical adenocarcinomas, have been reported to express p16 [1][2][3] and carcinoembryonic antigen (CEA), [4][5][6] whereas endometrial adenocarcinomas frequently show estrogen receptor (ER), 7,8 progesterone receptor (PR), 7,8 and vimentin expression. 4,7,9 In practice, many pathologists have used immunohistochemical panels composed of markers against these antigens for determining site of origin.…”

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confidence: 99%

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Immunophenotypic diversity of endometrial adenocarcinomas: implications for differential diagnosis

et al. 2006

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Many endometrial adenocarcinomas, particularly those of endometrioid type, express estrogen receptors (ERs), progesterone receptors (PRs), and vimentin. This typical immunophenotype is frequently considered a standard against which others are compared when immunohistochemistry is used for differential diagnosis. We tested large numbers of endometrial cancers, enriched for high-grade tumors, to determine whether this reported immunophenotype was valid and whether expression differences between types of endometrial carcinoma could be exploited for diagnostic purposes. Immunohistochemical stains were performed on the following types of endometrial cancers using established methodology: International Federation of Gynecology and Obstetrics (FIGO) grades 1 and 2 endometrioid-42; FIGO grade 3 endometrioid-40; serous-24; clear cell-11; carcinosarcoma-9. In total, 92% of serous carcinomas expressed p16 strongly compared to weak-tomoderate expression of p16 in 7-67% of other tumors (FIGO grades 1 and 2 carcinoma and carcinosarcoma, respectively). A total of 84% of FIGO grades 1 and 2 carcinomas expressed ER compared to 9-54% of other tumors (clear cell and serous carcinomas respectively); 83% of FIGO grades 1 and 2 expressed PR compared to 11-54% of other carcinomas (carcinosarcoma and serous carcinoma, respectively). Most carcinomas were negative for monoclonal carcinoembryonic antigen (mCEA), and those that were positive showed mostly only focal membrane expression. Vimentin was expressed in nearly every tumor. Most tumors were diffusely vimentin positive, but a large range of expression patterns, from focal to diffuse and from weak to strong, was noted. Only 70% of FIGO grades 1 and 2 endometrioid carcinomas and 26% of grade 3 endometrioid carcinomas possessed the reportedly characteristic endometrial cancer immunophenotype p16 (À), ER ( þ ), PR ( þ ), mCEA (À), and vimentin ( þ ). Endometrial cancers demonstrate substantial immunophenotypic diversity that remained apparent even within groups of similar histologic subtype and grade. ER, PR, and p16 expression was more illustrative of tumor type and degree of differentiation than they were of endometrial origin. In contrast, the vimentin-positive/CEA-negative phenotype remained the most constant among all endometrial cancers.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Immunophenotypic diversity of endometrial adenocarcinomas: implications for differential diagnosis

et al. 2006

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“…Nevertheless, after taking into account the clinicopathologic findings and the results of the CK immunostains, negative stainings for vimentin, 27 CA125, gastric mucin gene MUC5AC 9 and human alveolar macrophage 56 (HAM56), 28 and strongly positive staining for carcinoembryonic antigen (CEA) 23,24 favor metastatic colorectal cancer over primary ovarian adenocarcinoma. Likewise, strong immunoreactivity for P53 supports the colonic origin of the neoplasm.…”

Section: Immunohistochemistrymentioning

confidence: 99%

Ovarian carcinomas, including secondary tumors: diagnostically challenging areas

Prat

2005

Mod Pathol

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The differential diagnosis of ovarian carcinomas, including secondary tumors, remains a challenging task. Mucinous carcinomas of the ovary are rare and can be easily confused with metastatic mucinous carcinomas that may present clinically as a primary ovarian tumor. Most of these originate in the gastrointestinal tract and pancreas. International Federation of Gynecology and Obstetrics (FIGO) stage is the single most important prognostic factor, and stage I carcinomas have an excellent prognosis; FIGO stage is largely related to the histologic features of the ovarian tumors. Infiltrative stromal invasion proved to be biologically more aggressive than expansile invasion. Metastatic colon cancer is frequent and often simulates ovarian endometrioid adenocarcinoma. Although immunostains for cytokeratins 7 and 20 can be helpful in the differential diagnosis, they should always be interpreted in the light of all clinical information. Occasionally, endometrioid carcinomas may exhibit a microglandular pattern simulating sex cord-stromal tumors. However, typical endometrioid glands, squamous differentiation, or an adenofibroma component are each present in 75% of these tumors whereas immunostains for calretinin and alpha-inhibin are negative. Endometrioid carcinoma of the ovary is associated in 15-20% of the cases with carcinoma of the endometrium. Most of these tumors have a favorable outcome and they most likely represent independent primary carcinomas arising as a result of a Mü llerian field effect. Although the criteria for distinguishing metastatic from independent primary carcinomas rely mainly upon conventional clinicopathologic findings, loss of heterozygosity and gene mutation analyses can be helpful. Transitional cell carcinomas are distinguished from undifferentiated carcinomas by the presence of thick, undulating papillae with smooth luminal borders, microspaces, and tumor cells with distinctive 'urothelial' appearance. Krukenberg tumors are metastatic adenocarcinomas traditionally perceived as composed of mucin-filled signet-ring cells associated with a striking proliferation of the ovarian stroma but many variations on this pattern occur.

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“…No mucin vacuoles are identifiable in hematoxylin and eosin-stained sections. The presence of vimentin in the neoplastic cells of more than 80% of endometrioid carcinomas of the endometrium helps to distinguish them from endometrioid carcinomas of the endocervix, only approximately 13% of which contain vimentin (41). The distinction is important because the therapy and prognosis differ based on the site of origin.…”

Section: Endometrioid Carcinomamentioning

confidence: 99%