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Perceptions of Controversies and Unresolved Issues in the 2014 FIGO Staging System for Endometrial Cancer: Survey Results From Members of the International Society of Gynecological Pathologists and International Gynecologic Cancer Society. 对 2014 FIGO 子宫内膜癌分期系统中存在的争议和未决问题的看法:国际妇科病理学家协会和国际妇科癌症协会会员调查结果。
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-05-01 Epub Date: 2023-08-18 DOI: 10.1097/PGP.0000000000000977
Neslihan Kayraklioglu, Levon Katsakhyan, Paul A Cohen, Naveena Singh, Joseph T Rabban, Xavier Matias-Guiu

Long-standing controversial and unresolved issues in the current "International Federation of Gynecology and Obstetrics" staging system for endometrial cancer are well-recognized by pathologists and clinicians alike and exist primarily as a result of limitations to the existing literature. To guide the design of future outcome-based studies specifically aimed at resolving such gaps, the International Society of Gynecologic Pathologists developed a survey of the current perceptions of pathologists (n = 172) and clinicians (n= 135) from the International Society of Gynecological Pathologists and from the International Gynecologic Cancer Society on areas for potential refinement of the current International Federation of Gynecology and Obstetrics staging system. The highest priority issues for pathologists and clinicians alike were the need to determine whether stage IIIA patients (ovarian/fallopian tube involvement) can be reliably separated into favorable versus unfavorable outcome groups to avoid over-treatment of the former group and to determine whether stage IIIC patients (lymph node metastases) can be separated into favorable versus unfavorable outcome groups based on the size of lymph node metastases. The majority of pathologists and clinicians viewed lymphovascular space invasion as an independent prognostic variable and favored incorporating lymphovascular space invasion into staging, though the level of support did not meet the threshold of 75% in support that we used to define a formal consensus. While pathologists did agree on the prognostic value of reporting the extent of lymphovascular space invasion, there was no consensus on the diagnostic criteria to distinguish focal versus substantial involvement. The majority of pathologists and clinicians viewed that a universally accepted protocol for sentinel lymph node ultra-staging is lacking. Both survey groups conveyed a slight preference for incorporating tumor histotype and molecular classification into staging but the support was short of the 75% threshold for formal consensus. Collectively, this survey permits the International Society of Gynecological Pathologists to develop a pathologist and clinician-driven long-term strategy for prioritizing and designing outcome-based studies specifically targeted to resolving controversial and unresolved issues in the International Federation of Gynecology and Obstetrics staging of endometrial cancer.

病理学家和临床医生都清楚地认识到,目前 "国际妇产科联盟 "子宫内膜癌分期系统中长期存在的争议和未解决的问题,这主要是由于现有文献的局限性造成的。为了指导设计未来以结果为基础的研究,专门解决这些差距,国际妇科病理学家协会对国际妇科病理学家协会和国际妇科癌症协会的病理学家(n=172)和临床医生(n=135)目前对当前国际妇产科联合会分期系统可能改进的领域的看法进行了调查。病理学家和临床医生最优先考虑的问题是,需要确定是否能可靠地将 IIIA 期患者(卵巢/输卵管受累)分为预后良好组和预后不良组,以避免对前者进行过度治疗,以及确定是否能根据淋巴结转移的大小将 IIIC 期患者(淋巴结转移)分为预后良好组和预后不良组。大多数病理学家和临床医生认为淋巴管间隙侵犯是一个独立的预后变量,并赞成将淋巴管间隙侵犯纳入分期,尽管支持率未达到我们用来定义正式共识的 75% 的支持率阈值。虽然病理学家对报告淋巴管间隙受侵程度的预后价值达成了一致,但对区分局灶性和实质性受累的诊断标准却没有达成共识。大多数病理学家和临床医生认为,前哨淋巴结超分期缺乏普遍接受的方案。两个调查组都表示略微倾向于将肿瘤组织型和分子分类纳入分期,但支持率未达到达成正式共识的 75% 临界值。总之,这项调查使国际妇科病理学家协会能够制定一项由病理学家和临床医生主导的长期战略,优先考虑和设计基于结果的研究,专门解决国际妇产科联盟子宫内膜癌分期中存在的争议和未决问题。
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引用次数: 0
Comprehensive Immunohistochemical Analysis of Mesonephric Marker Expression in Low-grade Endometrial Endometrioid Carcinoma. 低级别子宫内膜样癌中中肾标记物表达的全面免疫组化分析
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-05-01 Epub Date: 2023-08-11 DOI: 10.1097/PGP.0000000000000976
Yurimi Lee, Sangjoon Choi, Hyun-Soo Kim

Immunohistochemical markers shown to be useful in identifying/confirming mesonephric/mesonephric-like differentiation (MLD markers) include thyroid transcription factor (TTF1), GATA-binding protein 3 (GATA3), and cluster of differentiation 10 (CD10). Only a few studies have examined the expression levels of MLD markers in endometrial endometrioid carcinomas (EECs). This study aimed to analyze the frequency and pattern of MLD marker expression in low-grade EECs. We performed immunostaining for the detection of TTF1, GATA3, and CD10 expression in 50 low-grade EEC tissue samples and evaluated their staining proportion and intensity. Nine tumors (18.0%) expressed at least one MLD marker in varying proportions and intensities, and 2 of these tumors were positive for 2 MLD markers (TTF1/GATA3 and GATA3/CD10, respectively). Three (6.0%) tumors showed moderate-to-strong nuclear TTF1 immunoreactivity in ≤5% of the tumor cells. Five tumors (10.0%) had at least moderate nuclear GATA3 staining, and three of them displayed a staining proportion of ≥15%. Three tumors (6.0%) were focal (mean proportion, 15%) but strongly positive for CD10. Our findings indicate that a subset of EEC can express one or more MLD markers with varying staining proportions and intensities. Given that a diagnosis of uterine mesonephric-like adenocarcinoma should be established based on a combination of characteristic histologic features, unique immunophenotypes, and confirmed molecular findings, pathologists should not exclude EEC based only on the presence of focal immunoreactivity for MLD markers. Awareness of the atypical expression patterns of MLD markers in EEC helps pathologists avoid misdiagnosing EEC as a uterine mesonephric-like adenocarcinoma.

免疫组化标记物被证明有助于识别/确认间肾/中肾样分化(MLD标记物),包括甲状腺转录因子(TTF1)、GATA结合蛋白3(GATA3)和分化簇10(CD10)。只有少数研究检测了子宫内膜样癌(EECs)中MLD标记物的表达水平。本研究旨在分析 MLD 标记在低级别 EECs 中的表达频率和模式。我们对50个低分化EEC组织样本进行了免疫染色,检测TTF1、GATA3和CD10的表达,并评估了它们的染色比例和强度。九个肿瘤(18.0%)以不同的比例和强度表达了至少一种 MLD 标记,其中两个肿瘤的两种 MLD 标记(分别为 TTF1/GATA3 和 GATA3/CD10)均呈阳性。3个肿瘤(6.0%)在≤5%的肿瘤细胞中显示出中等至强的核TTF1免疫反应。5个肿瘤(10.0%)至少有中度的核GATA3染色,其中3个肿瘤的染色比例≥15%。三个肿瘤(6.0%)为局灶性(平均比例为 15%),但 CD10 强阳性。我们的研究结果表明,EEC 的一部分可表达一种或多种 MLD 标记,染色比例和强度各不相同。鉴于子宫系膜样腺癌的诊断应根据特征性组织学特征、独特的免疫表型和确证的分子研究结果综合确定,病理学家不应仅根据 MLD 标记的局灶性免疫反应来排除 EEC。认识到 MLD 标记物在 EEC 中的非典型表达模式有助于病理学家避免将 EEC 误诊为子宫间质样腺癌。
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引用次数: 0
Erythrasma of the Vulva: An Invisible Dermatosis. 外阴红斑:一种隐形皮肤病。
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-09 DOI: 10.1097/PGP.0000000000001031
Soma Jobbagy, Alvaro C Laga, Jaclyn C Watkins

Erythrasma is a prevalent superficial bacterial infection typically caused by Corynebacteria species and preferentially affecting intertriginous sites including axillary, interdigital, and inguinal skin folds. However, erythrasma of the vulva is uncommon, with only 2 cases previously reported. Although erythrasma can be diagnosed clinically using Woods lamp examination, it may not always be considered in the differential diagnosis for patients presenting with persistent vulvar pruritus. We report 12 cases of vulvar erythrasma identified by histopathology, with a review of clinical and histologic features. The mean patient age was 60.1 yr and the mean patient BMI was 30.5. Five of 12 patients presented with pruritic rash. The time from symptom onset to diagnosis was 9 mo in 1 case, >18 mo in 4 cases, and unknown in the remaining cases. The characteristic histologic features were compact orthokeratosis and mild perivascular chronic inflammation. In all 12 cases, Periodic Acid-Schiff-diastase (PAS-D) staining highlighted intracorneal filamentous rods which were not readily appreciable on H&E. After the diagnosis of erythrasma, 4 patients were treated with topical lincomycin, of whom 3 had clinical improvement in symptoms. One patient was treated with topical macrolide antibiotic and also reported improvement in symptoms. Consideration of erythrasma on the differential for patients presenting with vulvar rash and pruritus may shorten the time to diagnosis and treatment, minimize patient discomfort, and reduce the scope and cost of diagnostic testing.

红斑痤疮是一种常见的浅表细菌感染,通常由棒状杆菌引起,好发于三叉神经间部位,包括腋窝、趾间和腹股沟皮肤皱褶。然而,外阴红斑并不常见,此前仅有 2 例报道。虽然红斑可通过伍德灯检查进行临床诊断,但对于出现持续性外阴瘙痒的患者,可能并不总是将其考虑在鉴别诊断中。我们报告了 12 例经组织病理学鉴定的外阴红斑病例,并回顾了临床和组织学特征。患者的平均年龄为 60.1 岁,平均体重指数为 30.5。12 名患者中有 5 人出现瘙痒性皮疹。从症状出现到确诊的时间,1 例为 9 个月,4 例超过 18 个月,其余病例时间不明。组织学特征为角化不全和轻度血管周围慢性炎症。在所有 12 个病例中,PAS-D 染色可显示角膜内丝状棒状物,但在 H&E 染色中不易观察到。确诊为红斑痤疮后,4 名患者接受了局部林可霉素治疗,其中 3 人的临床症状有所改善。一名患者接受了局部大环内酯类抗生素治疗,症状也有所改善。对于出现外阴皮疹和瘙痒的患者,考虑将红斑病原体列入鉴别诊断,可以缩短诊断和治疗的时间,最大限度地减少患者的不适感,并减少诊断检测的范围和费用。
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引用次数: 0
Human Papillomavirus-Associated Multiphenotypic Carcinoma: First Description of a Vulval Case. 人类乳头瘤病毒相关多型性癌:外阴病例的首次描述。
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-04-09 DOI: 10.1097/PGP.0000000000001034
Charlotte C Currie, Darren Leaning, W Glenn McCluggage, Emma Spoor

Human papillomavirus (HPV)-associated multiphenotypic sinonasal carcinoma is a rare and recently described epithelial neoplasm exhibiting myoepithelial differentiation and morphological overlap with salivary gland neoplasms, especially adenoid cystic carcinoma; it is commonly associated with HPV, especially type 33. It has mainly been reported in the nasal cavity and paranasal sinuses with a single case reported in the breast. Herein, we report the first vulval example in a 47-year-old patient who presented with a large craggy mass in the region of the Bartholin gland. The histologic features were of a high-grade carcinoma composed of basaloid cells arranged in sheets and nests, with occasional ductal formations, surrounded by densely hyalinised basement membrane-type material. There was diffuse block-type immunoreactivity with p16 and HPV genotyping revealed high-risk HPV type 16. In reporting this case, we highlight the propensity for "salivary gland-type" neoplasms to arise in the vulva, especially in the Bartholin gland, and stress that pathologists should consider salivary-type neoplasms when faced with a morphologically unusual vulval tumor.

人乳头状瘤病毒(HPV)相关多型鼻窦癌是一种罕见的上皮性肿瘤,最近才被描述出来,表现为肌上皮分化,形态上与唾液腺肿瘤重叠,尤其是腺样囊性癌;它通常与人乳头状瘤病毒(尤其是 33 型)相关。它主要发生在鼻腔和副鼻窦,乳房也有一例报道。在此,我们报告了第一例外阴癌,患者 47 岁,巴氏腺区域有一个巨大的峭壁状肿块。组织学特征为高级别癌,由成片和成巢排列的类基底细胞组成,偶有导管形成,周围为致密透明的基底膜样物质。p16呈弥漫块状免疫反应,HPV基因分型显示为高危HPV16型。在报告该病例时,我们强调了 "唾液腺型 "肿瘤在外阴,尤其是巴氏腺中出现的倾向,并强调病理学家在遇到形态异常的外阴肿瘤时应考虑唾液腺型肿瘤。
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引用次数: 0
Well-differentiated Squamous Cell Carcinoma With Sarcomatous Differentiation in Patient With a History of Recurrent Verrucous Carcinoma. 有复发性疣状癌病史的患者体内分化良好的鳞状细胞癌伴有肉瘤。
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2023-11-13 DOI: 10.1097/PGP.0000000000000999
Komal Ijaz, Eric Johannesen, Van Nguyen T

Human papillomavirus-independent vulvar squamous cell carcinoma has a peak incidence in about the eighth decade of life. A variable portion of the vulvar squamous cell carcinoma are human papillomavirus-independent comprising 20% to 80% of all cases. Verrucous carcinoma (VC) is part of the spectrum of human papillomavirus-independent carcinomas and its combination with well-differentiated squamous cell carcinoma with sarcomatous differentiation is an extremely unusual neoplasm. The available literature on VC is currently limited to case reports and small single-institution studies. Here, we present a case concerning an 81-year-old woman with a history of chronic itching, swelling, and lichen sclerosis with variable-sized multiple white-pink plaques of the vulva. The pathologic diagnosis of VC was made. The patient later on developed multiple lesions of biopsy proved VC and most recent biopsy shows well-differentiated squamous cell carcinoma with abrupt sarcomatous differentiation. A review of the literature shows the rarity of this lesion of the female genital tract. Clinicians and patients should be aware of the aggressive behavior of cancers and adjust their surgical management together with the follow-up strategy. To the best of our knowledge, this is the first description of a VC and well-differentiated squamous cell carcinoma with abrupt sarcomatous differentiation occurring in the vulva.

人类乳头瘤病毒独立型外阴鳞状细胞癌的发病高峰期大约在人的第八个十年。外阴鳞状细胞癌中有一部分与人类乳头状瘤病毒无关,占所有病例的20%至80%。疣状癌(VC)是人类乳头瘤病毒不依赖性癌谱的一部分,它与肉瘤样分化的分化良好的鳞状细胞癌相结合,是一种极为罕见的肿瘤。目前,关于VC的文献仅限于病例报告和单个机构的小型研究。在此,我们介绍一例病例,患者是一名 81 岁的妇女,有慢性瘙痒、肿胀和苔藓样硬化病史,外阴有大小不等的多发性白色粉红色斑块。病理诊断为外阴癌。后来,患者又出现了活组织检查证实的多发性外阴阴道炎病变,最近的活组织检查结果显示为分化良好的鳞状细胞癌,并伴有肉瘤样分化。文献综述显示,这种女性生殖道病变非常罕见。临床医生和患者应认识到癌症的侵袭性,并调整手术治疗和随访策略。据我们所知,这是首次描述发生在外阴的VC和分化良好的鳞状细胞癌伴有突发性肉瘤分化。
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引用次数: 0
Neuroendocrine Marker Expression in Primary Non-neuroendocrine Epithelial Tumors of the Ovary: A Study of 551 Cases. 卵巢原发性非神经内分泌上皮肿瘤中的神经内分泌标记物表达:对 551 例病例的研究。
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2023-06-14 DOI: 10.1097/PGP.0000000000000962
Michaela Kendall Bártů, Kristýna Němejcová, Romana Michálková, Quang Hiep Bui, Jana Drozenová, Pavel Fabian, Oluwole Fadare, Jitka Hausnerová, Jan Laco, Radoslav Matěj, Gábor Méhes, Adam Šafanda, Naveena Singh, Petr Škapa, Zuzana Špůrková, Simona Stolnicu, Marián Švajdler, Sigurd F Lax, W Glenn McCluggage, Pavel Dundr

Expression of neuroendocrine (NE) markers in primary ovarian non-NE epithelial tumors has rarely been evaluated. The aim of our study was to evaluate the expression of the most widely used NE markers in these neoplasms and to determine any prognostic significance of NE marker expression. The cohort consisted of 551 primary ovarian tumors, including serous borderline tumors, low-grade serous carcinomas, high-grade serous carcinomas (HGSC), clear cell carcinomas, endometroid carcinomas, mucinous borderline tumors, and mucinous carcinomas. Immunohistochemical analysis was performed using antibodies against INSM1, synaptophysin, chromogranin, and CD56 on tissue microarray. Positivity for INSM1, synaptophysin, chromogranin, and CD56 was most frequently observed in mucinous tumors (48.7%, 26.0%, 41.5%, and 100%, respectively). The positivity for these NE markers was mostly restricted to nonmucinous elements distributed throughout the tumor. The mucinous borderline tumor and mucinous carcinomas groups had similar proportions of positivity (mucinous borderline tumor: 53%, mucinous carcinomas: 39%). In the other tumor types, except for HGSC, there was only focal expression (5%-10%) or negativity for NE markers. HGSC showed high CD56 expression (in 26% of cases). Survival analysis was only performed for CD56 in HGSC as this was the only group with sufficient positive cases, and it showed no prognostic significance. Except for mucinous tumors, expression of NE markers in non-NE ovarian epithelial tumors is low. CD56 expression in HGSC occurs frequently but is without diagnostic or prognostic value.

神经内分泌(NE)标记物在原发性卵巢非NE上皮性肿瘤中的表达很少得到评估。我们的研究旨在评估这些肿瘤中最广泛使用的神经内分泌标记物的表达情况,并确定神经内分泌标记物表达的预后意义。研究对象包括 551 例原发性卵巢肿瘤,包括浆液性边界瘤、低级别浆液性癌、高级别浆液性癌(HGSC)、透明细胞癌、子宫内膜癌、粘液性边界瘤和粘液腺癌。在组织芯片上使用 INSM1、突触素、嗜铬粒蛋白和 CD56 抗体进行免疫组化分析。INSM1、突触素、嗜铬粒蛋白和CD56的阳性率在粘液腺癌中最高(分别为48.7%、26.0%、41.5%和100%)。这些 NE 标记物的阳性大多局限于分布在肿瘤各处的非黏液成分。粘液性边界瘤和粘液腺癌组的阳性比例相似(粘液性边界瘤:53%;粘液腺癌:39%)。在其他类型的肿瘤中,除间皮瘤外,NE标记物仅有局灶性表达(5%-10%)或阴性。HGSC表现出较高的CD56表达(26%的病例)。只对 HGSC 中的 CD56 进行了生存分析,因为只有这一组有足够多的阳性病例,而且没有显示出预后意义。除粘液性肿瘤外,非 NE 卵巢上皮肿瘤中 NE 标记物的表达量较低。CD56 在 HGSC 中经常表达,但没有诊断或预后价值。
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引用次数: 0
Prevalence and Prognostic Significance of PIK3CA Mutation and CNV Status and Phosphorylated AKT Expression in Patients With Cervical Cancer Treated With Primary Surgery. 宫颈癌初治手术患者中 PIK3CA 突变和 CNV 状态以及磷酸化 AKT 表达的发生率和预后意义
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2023-08-25 DOI: 10.1097/PGP.0000000000000978
Kevin Martell, John B McIntyre, Tasnima Abedin, Elizabeth N Kornaga, Angela M Y Chan, Emeka Enwere, Martin Köbel, Michelle L Dean, Tien Phan, Prafull Ghatage, Susan P Lees-Miller, Corinne M Doll

Currently, there are limited and conflicting reports on the prognostic utility of PIK3CA and associated pathway markers for cervical cancers treated with primary surgical management. Moreover, current studies are lacking complete characterization of adjuvant treatment with RT and/or chemotherapy. We aimed to document the prevalence, clinicopathologic, adjuvant treatment details, and prognostic value of PI3K/AKT pathway mutations and copy number variation and phosphorylated AKT status in patients with cervical cancers treated with primary surgery. A clinicopathologic review was performed on a retrospective cohort of 185 patients with cervical cancer, treated with primary surgery at a single tertiary institution. Next-generation sequencing and digital PCR was used to determine PI3K/AKT pathway mutational status and PIK3CA copy number variation, respectively, and fluorescent immunohistochemistry measured phosphorylated AKT expression. In all, 179 of 185 (96.8%) of tumors were successfully sequenced; 48 (26.8%) were positive for PI3K/AKT pathway mutations-the majority (n=37, 77.1%) PIK3CA mutations. PIK3CA mutation was associated with pathologically positive lymph nodes [12 (32%) vs. 22 (16%); P =0.022] and indication for postoperative chemoradiotherapy [17 (45.9%) vs. 32 (22.5%); P =0.004]. On multivariable analysis, PIK3CA status was not associated with overall survival ( P =0.103) or progression-free survival ( P =0.240) at 5 yrs, nor was PIK3CA copy number variation status. phosphorylated AKT ≤ median significantly predicted for progression-free survival [multivariable hazard ratio 0.39 (0.17-0.89; P =0.025)] but not overall survival ( P =0.087). The correlation of PIK3CA with pathologic positive lymph node status yet lack of association with survival outcomes may be due to the use of adjuvant postoperative therapy. PIK3CA assessment before radical hysterectomy may help identify patients with a higher risk of node-positive disease.

目前,关于 PIK3CA 和相关通路标记物对初治手术治疗的宫颈癌的预后作用的报道有限且相互矛盾。此外,目前的研究还缺乏对 RT 和/或化疗辅助治疗的完整描述。我们旨在记录宫颈癌初治手术患者中 PI3K/AKT 通路突变、拷贝数变异和磷酸化 AKT 状态的发生率、临床病理、辅助治疗细节和预后价值。我们对在一家三级医疗机构接受初次手术治疗的 185 例宫颈癌患者进行了临床病理学回顾。下一代测序和数字 PCR 分别用于确定 PI3K/AKT 通路突变状态和 PIK3CA 拷贝数变异,荧光免疫组化则用于测量磷酸化 AKT 的表达。185例肿瘤中有179例(96.8%)成功测序;48例(26.8%)PI3K/AKT通路突变阳性,其中大多数(37例,77.1%)为PIK3CA突变。PIK3CA突变与病理淋巴结阳性[12(32%)vs 22(16%);P =0.022]和术后化放疗指征[17(45.9%)vs 32(22.5%);P =0.004]有关。在多变量分析中,PIK3CA状态与5年的总生存期(P =0.103)或无进展生存期(P =0.240)无关,PIK3CA拷贝数变异状态也与无进展生存期无关。磷酸化AKT≤中位数可显著预测无进展生存期[多变量危险比0.39 (0.17-0.89; P =0.025)],但与总生存期无关(P =0.087)。PIK3CA与病理淋巴结阳性状态相关,但与生存结果无关,这可能与术后辅助治疗的使用有关。在根治性子宫切除术前对PIK3CA进行评估可能有助于识别出结节阳性疾病风险较高的患者。
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引用次数: 0
Uterine Leiomyosarcoma With Osteoclast-like Giant Cells: Report of 2 Cases and Review of Literature. 伴有破骨细胞样巨细胞的子宫纵隔肉瘤:2例病例报告及文献综述。
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2023-06-15 DOI: 10.1097/PGP.0000000000000965
Zhengshan Chen, Jianling Ji, Evan Yung, Sue Ellen Martin, Saloni Walia

Leiomyosarcoma (LMS) with osteoclast-like giant cells (OLGCs) is a rare entity with only 18 reported cases thus far. It is not known whether these OLGCs are a reactive or malignant component of LMS. Herein we describe the clinical, histologic, and molecular characteristics of 2 cases of LMS with OLGCs and perform a brief literature review. In 2 of our cases, the OLGCs, marked with CD68, had a low proliferation index with Ki67 and did not show diffuse positivity for smooth muscle markers by immunohistochemistry. By next-generation sequencing, one case harbored a clinically significant TP53 mutation, which has been reported in a significant subset of conventional LMSs. In this case, based on immunohistochemistry, OLGCs showed different molecular alterations as compared with LMS. Although we did not show a distinct immunophenotype or molecular profile for LMS with OLGCs, this study provides additional data on this rare entity.

伴有破骨细胞样巨细胞(OLGCs)的骨髓肉瘤(LMS)是一种罕见病,迄今仅有18例报道。目前尚不清楚这些破骨细胞样巨细胞是LMS的反应性成分还是恶性成分。在此,我们描述了2例伴有OLGCs的LMS的临床、组织学和分子特征,并对文献进行了简要回顾。在我们的2例病例中,OLGCs以CD68为标记,Ki67增殖指数较低,免疫组化结果显示平滑肌标记物未呈弥漫阳性。通过下一代测序,一个病例发现了具有临床意义的TP53基因突变,据报道,相当一部分传统的LMS都存在这种突变。在该病例中,根据免疫组化结果,OLGCs与LMS相比表现出不同的分子改变。虽然我们没有发现伴有OLGCs的LMS有独特的免疫表型或分子特征,但这项研究为这一罕见病例提供了更多数据。
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引用次数: 0
The Relationship Between Melatonin 1-2 Receptor Expression in Patients With Epithelial Ovarian Cancer and Survival. 癌症患者褪黑素1-2受体表达与生存的关系。
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2023-10-04 DOI: 10.1097/PGP.0000000000000968
Elifnur Bicer, Tugan Bese, Deniz Dilan Tuzun, Sennur Ilvan, Basak Ozge Kayan, Fuat Demirkiran

Melatonin has antiproliferative, antiangiogenic, apoptotic, and immunomodulatory properties in ovarian cancer. Considering those, we evaluated the relationship between melatonin 1 (MT1) and melatonin 2 receptor (MT2) expression in tumor tissues of patients with epithelial ovarian cancer, disease-free survival (DFS), and overall survival (OS). Patients who received primary surgical treatment for epithelial ovarian cancer in our clinic between 2000 and 2019 were retrospectively scanned through patient files, electronic databases, and telephone calls. One hundred forty-two eligible patients were included in the study, their tumoral tissues were examined to determine MT1 and MT2 expression by immunohistochemical methods. The percentage of receptor-positive cells and intensity of staining were determined. MT1 receptor expression ( P = 0.002 for DFS and P = 0.002 for OS) showed a significant effect on DFS and OS. MT2 expression had no effect on survival ( P = 0.593 for DFS and P = 0.209 for OS). The results showed that the higher the MT1 receptor expression, the longer the DFS and OS. It is suggested that melatonin should be considered as adjuvant therapy for ovarian cancer patients in addition to standard treatment, and clinical progress should be observed.

褪黑激素在卵巢癌症中具有抗增殖、抗血管生成、凋亡和免疫调节的特性。考虑到这些,我们评估了上皮性卵巢癌症患者肿瘤组织中褪黑素1(MT1)和褪黑素2受体(MT2)表达、无病生存率(DFS)和总生存率(OS)之间的关系。通过患者档案、电子数据库和电话,对2000年至2019年间在我们诊所接受上皮性卵巢癌症初级手术治疗的患者进行了回顾性扫描。142名符合条件的患者被纳入该研究,通过免疫组织化学方法检测他们的肿瘤组织以确定MT1和MT2的表达。测定受体阳性细胞的百分比和染色强度。MT1受体表达(DFS P=0.002,OS P=0.002)对DFS和OS表现出显著影响。MT2表达对生存率没有影响(DFS为0.593,OS为0.209)。结果表明,MT1受体表达越高,DFS和OS越长。建议除标准治疗外,还应考虑将褪黑素作为卵巢癌症患者的辅助治疗,并观察临床进展。
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引用次数: 0
"Deciduoid" Change in Uterine Leiomyomas in Pregnancy: Aberrant Expression of Sex Cord Markers Inhibin and Calretinin. 妊娠期子宫肌瘤的 "蝶形 "变化:性索标志物抑制素和钙凝蛋白的异常表达
IF 2.4 4区 医学 Q3 OBSTETRICS & GYNECOLOGY Pub Date : 2024-03-01 Epub Date: 2023-07-10 DOI: 10.1097/PGP.0000000000000969
Jesús Machuca-Aguado, W Glenn McCluggage

Leiomyomas are common hormone-responsive uterine neoplasms which can exhibit a variety of morphologic changes secondary to hormonal agents such as progestogens. They may increase in size during pregnancy as a result of hormonal stimulation but surprisingly the morphologic features of leiomyomas in pregnancy are not well described in the literature. In this report, we describe the morphologic features of a series of 29 uterine leiomyomas in pregnancy. The features include in decreasing order of frequency infarct-type necrosis, decidualization of the serosal surface, hyalinization, myxoid alteration of the stroma, edema (sometimes with cyst formation), and dystrophic calcification. We also report a feature which we term "deciduoid" change (seen in 10 of 29 leiomyomas) which takes the form of altered smooth muscle cells with an epithelioid morphology with abundant eosinophilic or clear cytoplasm. Furthermore, we show that the "deciduoid" cells commonly exhibit expression of sex cord markers inhibin and calretinin. We speculate on the pathogenesis of the "deciduoid" change which together with its "aberrant" immunophenotype may result in diagnostic problems and consideration of other neoplasms.

子宫纵隔肌瘤是常见的激素反应性子宫肿瘤,在孕激素等激素类药物的作用下会出现各种形态变化。在妊娠期间,由于激素的刺激,它们的体积可能会增大,但令人惊讶的是,文献中对妊娠期子宫左肌瘤的形态特征并没有很好的描述。在本报告中,我们描述了一系列 29 例妊娠期子宫纵膈肌瘤的形态特征。这些特征按频率递减顺序包括梗死型坏死、浆膜表面蜕膜化、透明化、基质肌样改变、水肿(有时伴有囊肿形成)和萎缩性钙化。我们还报告了一种被称为 "蜕膜 "变化的特征(见于 29 个子宫肌瘤中的 10 个),这种变化表现为平滑肌细胞的上皮样形态改变,具有丰富的嗜酸性或透明胞质。此外,我们还发现 "蝶形 "细胞通常表达性索标志物抑制素和钙黄绿素。我们推测了 "蝶形细胞 "变化的发病机制,其 "反常 "的免疫表型可能会导致诊断上的问题,并考虑其他肿瘤。
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引用次数: 0
期刊
International Journal of Gynecological Pathology
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