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uterine endometrioid adenocarcinoma

Tuesday 11 April 2017

uterine endometrioid carcinoma

Definition: Endometrioid adenocarcinoma hasinvasive nests and sheets of endometrioid glands with cribriforming. Endometrioid adenocarcinoma is positive for vimentin, ER and PR.

Images

- uterine endometrioid adenocarcinoma / uterine endometrioid carcinoma

Types

- well-differentiated endometrioid adenocarcinoma

  • The glands of endometrioid adenocarcinoma are more atypical than these, and mitotic figures are more frequent.
  • Furthermore, there should be evidence of invasion, such as a desmoplastic response.
  • In addition, the stroma here is composed of sweeping fascicles of spindle cells.

Grade

- uterine endometrioid adenocarcinoma, FIGO grade 1

Differential diagnosis

- cervical adenocarcinoma

  • Most endometrioid adenocarcinomas stain positive for PTEN , and cervical adenocarcinomas stain positive for p53 / TP53 , but these two markers are not enough to make the distinction.
  • The combination of p53 and PTEN is of prognostic value for endometrial carcinoma.
  • Endocervical adenocarcinoma is more likely positive for CEA, p16 (or EBER for HPV) and p53, but can show some positivity for ER and PR, (although the strong majority, less than 5%, will stain with both). Endometrioid adenocarcinoma is more likely to be positive for vimentin, ER and PR.
  • CEA, p16, p53 IHC are more likely positive in endocervical adenocarcinoma, but other stains should be added for confirmation.

- uterine papillary serous carcinoma

  • IHC p16, ER, WT-1, IMP3, p53 panel. This panel is more likely positive in ovarian papillary serous carcinoma, particularly the combination of positivity for both WT-1 and ER, compared to uterine papillary serous carcinoma.
  • PTEN, p53 and IMP3 are more likely positive in uterine serous papillary carcinoma compared to endometrioid adenocarcinoma.

IHC

- p53 / TP53

  • Most serous adenocarcinomas, and high grade endometrioid adenocarcinomas are positive for p53 - p53 staining is correlated with worse prognosis.

- PTEN

  • PTEN is the opposite.
  • Loss of PTEN staining (linked to PTEN mutations) is associated with microsatellite instability ( MSI ) and a favorable prognosis.
  • PTEN is also more likely positive in serous carcinoma.

See also

- endometrioid carcinoma
- endometrioid tumors
- endometrial carcinomas