Gynecologic Tumor Invasion
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Diagnostic Immunochemistry in Gynaecological Neoplasia Guide to Diagnosis
International Journal of Scientific and Research Publications, Volume 9, Issue 9, September 2019 356 ISSN 2250-3153 Diagnostic Immunochemistry in Gynaecological Neoplasia Guide to Diagnosis S.S Pattnaik, J.Parija,S.K Giri, L.Sarangi, Niranjan Rout, S. Samantray, N. Panda,B.L Nayak, J.J Mohapatra, M.R Mohapatra, A.K Padhy Presently Working As Senior Resident In Dept Of Gynaecology Oncology, At Ahrcc ,M.B.B.S , M.D (O&G) DOI: 10.29322/IJSRP.9.09.2019.p9346 http://dx.doi.org/10.29322/IJSRP.9.09.2019.p9346 Abstract- AIM AND OBJECTIVE - This short review provides an updated overview of the essential immunochemical markers currently used in the diagnostics of gynaecological malignancies along with their molecular rationale. The new molecular markers has revolutionized the field of IHC MATERIAL METHODS -We have reviewed the recent ihc markers according to literature revision and our experiencewe, have discussed the the use of ihc , CONCLUSION- The above facts will help reach at a diagnosis in morphologically equivocal cases of gynaecology oncology pathology, and guide us to use a specific the panel of ihc ,which will help us reach accurate diagnosis. I. INTRODUCTION HC combines microscopic morphology with accurate molecular identification and allows in situ visualisation of specific protein I antigen . IHC has definite role in guiding cancer therapy.The role of pathologist is increasing beside tissue diagnoses , to perfoming IHC biomarker analyse ,assisting the development of novel markers. Ihc markers are being in used in new perspective , in guiding anticancer therapy.ihc represents a solid adjunct for the classification of gynaecological malignancies that improves intraobserver reproducibility and has potential of revealing unexpected features(1) OVARIAN IHC: • PAX -8 is the most specific marker, emerging to diagnose primary ovarian cancer,but it lacks sensibility as it is also expressed in metastasis from endocervix ,kidney and thyroid. -
"General Pathology"
,, ., 1312.. CALIFORNIA TUMOR TISSUE REGISTRY "GENERAL PATHOLOGY" Study Cases, Subscription B October 1998 California Tumor Tissue Registry c/o: Department of l'nthology and Ruman Anatomy Loma Lindn Universily School'oflV.lcdicine 11021 Campus Avenue, AH 335 Lomn Linda, California 92350 (909) 824-4788 FAX: (909) 478-4188 E-mail: cU [email protected] CONTRIBUTOR: Philip G. R obinson, M.D. CASE NO. 1 - OcrOBER 1998 Boynton Beach, FL TISSUE FROM: Stomach ACCESSION #28434 CLINICAL ABSTRACT: This 67-year-old female was thought to have a pancreatic mass, but at surgery was found to have a nodule within the gastric wall. GROSS PATHOLOGY: The specimen consisted of a 5.0 x 5.5 x 4.5 em fragment of gray tissue. The cut surface was pale tan, coarsely lobular with cystic degeneration. SPECIAL STUDIES: Keratin negative Desmin negative Actin negative S-100 negative CD-34 trace to 1+ positive in stromal cells (background vasculature positive throughout) CONTRIBUTOR: Mar k J anssen, M.D. CASE NO. 2 - ocrOBER 1998 Anaheim, CA TISSUE FROM: Bladder ACCESSION #28350 CLINICAL ABSTRACT: This 54-year-old male was found to have a large rumor in his bladder. GROSS PATHOLOGY: The specimen consisted of a TUR of urinary bladder tissue, forming a 7.5 x 7. 5 x 1.5 em aggregate. SPECIAL STUDfES: C)1okeratin focally positive Vimentin highly positive MSA,Desmin faint positivity CONTRIBUTOR: Howard Otto, M.D. CASE NO.3 - OCTOBER 1998 Cheboygan, Ml TISSUE FROM: Appendix ACCESSION #28447 CLINICAL ABSTRACT: This 73-year-old female presented with acute appendicitis and at surgery was felt to have a periappendiceal abscess. -
Endometrioid Carcinoma
Ovarian Cancer Endometrioid Carcinoma What is an Ovarian What characterizes Endometrioid Tumor? Ovarian Endometrioid Endometrioid tumors make up Carcinoma? about 2 to 4 percent of all ovar- Ovarian cancer often does not Definition of ian tumors and most of them present clear physical symptoms. Terms (about 80 percent) are malignant, Some signs of ovarian cancer representing 10 to 20 percent of include persistent (more than two Endometrial: all ovarian carcinomas. In some weeks) pelvic or abdominal pain Excessive growth of cases, endometrioid carcinomas of or discomfort; bloatedness, gas, cells in the endome- the ovary appear synchronously nausea and indigestion; vaginal trium, the tissue that with an endometrial carcinoma bleeding; frequent or urgent uri- lines the uterus. (epithelial cancer of the uterus) nation with and/or endometriosis (presence of no infection; Epithelial: Relating endometrial tissue outside unexplained to the epithelium, the uterus). weight gain tissue that lines the Ovarian Endometrioid Carcino- or loss; fa- internal surfaces of mas are the second most common tigue; and body cavities or ex- ternal body surfaces type of epithelial ovarian can- changes in of some organs, cer, which is the most common bowel habits. such as the ovary. ovarian cancer. According to the If you have American Cancer Society, ovar- a known his- ian cancer accounts for 6 percent tory of endo- Ovarian Endometri- Malignant: Cancer- of all cancers among women. The metriosis involving the ovary and oid Carcinoma often ous and capable of fi ve-year survival rate for women there is a change in the intensity does not present spreading. with advanced ovarian cancer is or type of symptoms that you are clear symptoms. -
Tumors of the Uterus and Ovaries
CALIFORNIA TUMOR TISSUE REGISTRY 104th SEMI-ANNUAL CANCER SEMINAR ON TUMORS OF THE UTERUS AND OVARIES CASE HISTORIES PRELECTOR: Fattaneh A. Tavassoll, M.D. Chairperson, GYN and Breast Pathology Armed Forces Institute of Pathology Washington, D.C. June 7, 1998 Westin South Coast Plaza Costa Mesa, California CHAIRMAN: Mark Janssen, M.D. Professor of Pathology Kaiser Pennanente Medical Center Anaheim, California CASE HISTORIES 104ru SEMI-ANNUAL SEMINAR CASE #t- ACC. 2S232 A 48-year-old, gravida 3, P.ilra 3, female on oral contraceptives presented with dysmenorrhea and amenorrhea of three months duration. Initial treatment included Provera and oral contraceptives. Pelvic ultrasound lev~aled a 7 x 5 em right ovarian cyst and a possible small uterine fibroid. Six months later, she returned with a large malodorous mass protruQing through the cervix <;>fan enlarged uterus. The 550 gram uterine specimen was 13 x 13 x 6 em. The myometrium was 4 em thick. A 8 x 6 em polypoid, pedunculated mass protruded through the cervix. The cut surface of the mass was partially hemorrhagic, surrounded by light tan soft tissue. (Contributed by David Seligson, M.D.) CASE #2- ACC. 24934 A 70-year-old female presented with vaginal bleeding of recent onset. A total abdominal hysterectomy and bilaterl!] salpingo-oophorectomx were performed. The 8 x 9 x 4 em uterus was symmetrically enlarged. The ·endometrial cavity was dilated by a 4.5 x 3.0 x4.0 em polypoid mass composed of loculated, somewhat mucoid tissue. Sections through the broad stalk revealed only superficial attachment to the myometrium, without obvious invasion. -
Aderomyoma of the Common Bile Duct --Report of a Case
Yamanashl Med. J. 4 (2), 83"v87, 1989 Case Report AdeRomyoma of the Common Bile Duct --Report of a Case Yoshiro MATsuMoTe, Masatoshi MoGAKi, Hidehisa AoyAMA, Takayoshi SEKmAwA, Katsnhiko SuGAHARA, Koichi SuDAi), and Masayuki FuJiNo2) DePa,rt・ment of Surge7pu. i)DePartment of Pathology, 2)DePartment of lnte7"nal Medicine, YamanasJzi Medical Coglege, Tamaho, Nakakoma, Ya?nanashi 409-38, JaPan Abstract: Adenomyomas in the extrahepatic biie duc£ are extremely rare. In a 75-year- old male with acute cholangitis due to adenomyoma £erming a protruding lesion iR the terminal bile duct, pamacreatoduodenectomy was carried out, resulting complete cure, Key words: Adenomyoma of the common bile duct, Early bile dact cancer, Obstructive jaundice formed, aRd £rom the histologic examina- INTRODUCTION tion of the surgical specimen, adenomyoma Adenomyoma in the biliary ductal system of the common bile duct was confirmed. is most freguently fouRd in the gallbladder. Although beRign neoplasma o£ the bile The gallbiadder wall is more abuRdant in duct system are uncommon, the tumors are muscle fibers than is the wall o£ the bile clinically very important because they can duct. Adenomyoma in the gallbladder is cause obstructive jaundice4) and require knowlt to be closely re}ated to the forma- differentiation £rom eary cancer of the bile tion of gallstones. In other parts of the duct. biliary ductal system, kex4xeve]-, adeno- We report here the surgical results and myoma is very rarei)・2), although a few pathologic findings in a case of adeno- cases of a tumor arising from the papil}a myoma of the terminal bile duct. of Vater3) have beelt reported. -
Brief Communication No Evidence of Endometriosis Within Serous and Mucinous Tumors of the Ovary
Int J Clin Exp Pathol 2012;5(2):140-142 www.ijcep.com /ISSN: 1936-2625/IJCEP1111013 Brief Communication No evidence of endometriosis within serous and mucinous tumors of the ovary Tadashi Terada Department of Pathology, Shizuoka City Shimizu Hospital, Shizuoka, Japan Received November 25, 2011; accepted January 31, 2012; Epub February 12, 2012; Published February 28, 2012 Abstract: Ovarian endometriosis can transform into malignant tumors. The author retrospectively examined HE slides of 112 serous tumors and 75 mucinous tumors for the existence of ovarian endometriosis. When endometriosis is present within the tumors, the term “endometriosis-derived tumor” was applied. When endometriosis is recognized adjacent to the tumor, the term “endometriosis-associated tumor” was used. Of the 112 serous tumors (46 benign, 18 borderline, and 50 malignant), 4 (3.5%) (2 benign and 2 malignant) were endometriosis-associated tumors. None was endometriosis-derived tumor. Of the 75 mucinous tumors (30 benign, 26 borderline, and 19 malignant), 4 (5%) (1 borderline and 3 benign) were endometriosis-associated tumors. No tumors showed endometriosis-derived tu- mors. The data suggest that endometriosis does not transform into serous and mucous tumors. The author felt the limitation of retrospective survey, because the limited numbers of slides (5 to 15) were obtained from each tumor. The author also felt that endometriosis can be difficult to discern because of degenerative changes and other similar lesions such as fallopian tube, fimbria, inclusion cysts, rete ovarii, paraovarian cyst, and Müllerian ducts remnants. Prospective study using whole ovarian examination is required. Keywords: Ovary tumor, endometriosis, ovary serous tumor, ovary mucinous tumor, endometriosis-derived tumor Introduction Yoshikawa et al [4] reported that malignancies in endometriosis are clear cell (39.2%), endo- It is well recognized that malignant transforma- metrioid (21.2%), serous (3.3%), and mucinous tion can occur in ovarian endometriosis [1, 2]. -
Histopathology of Gynaecological Cancers
1 Histopathology of gynaecological cancers Ovarian tumours Ovarian tumours are classified based on cell types, Classification of Tumours of the Ovary patterns of growth and, whenever possible, on Epithelial tumours (ET) histogenesis (WHO Classification 2014). Sex cord–stromal tumours (SCST) There are 3 major categories of primary ovarian tumour: Germ cell tumours (GCT) epithelial tumours (ETs), sex cord–stromal tumours Monodermal teratoma and somatic type tumours arising from dermoid cyst (SCSTs) and germ cell tumours (GCTs). Secondary Germ cell–sex cord stromal tumours tumours are not infrequent. Mesenchymal and mixed epithelial and mesenchymal tumours The incidence of malignant forms varies with age. Other rare tumours, tumour-like conditions Carcinomas, accounting for over 80%, peak at the 6th Lymphoid and myeloid tumours decade; SCSTs peak in the perimenopausal period; GCTs Secondary tumours peak in the first three decades. Prognosis is worse for WHO, 2014 carcinomas. Stage I: Tumour confined to ovaries or Fallopian tube(s) IA: Tumour limited to 1 ovary (capsule intact) or Fallopian tube; no tumour on ovarian or Fallopian tube surface; no malignant cells in the ascites or peritoneal The staging classification has been recently revised washings (FIGO 2013 Classification) and ovarian, Fallopian tube IB: Tumour limited to both ovaries (capsules intact) or Fallopian tubes; no and peritoneal cancer are classified together. tumour on ovarian or Fallopian tube surface; no malignant cells in the ascites or peritoneal washings Stage I cancer is confined to the ovaries or Fallopian IC: Tumour limited to 1 or both ovaries or Fallopian tubes, with any of the following: • IC1: Surgical spill tubes. -
Prognostic Factors for Patients with Early-Stage Uterine Serous Carcinoma Without Adjuvant Therapy
J Gynecol Oncol. 2018 May;29(3):e34 https://doi.org/10.3802/jgo.2018.29.e34 pISSN 2005-0380·eISSN 2005-0399 Original Article Prognostic factors for patients with early-stage uterine serous carcinoma without adjuvant therapy Keisei Tate ,1 Hiroshi Yoshida ,2 Mitsuya Ishikawa ,1 Takashi Uehara ,1 Shun-ichi Ikeda ,1 Nobuyoshi Hiraoka ,2 Tomoyasu Kato 1 1Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan 2Department of Pathology and Clinical Laboratories, National Cancer Center Hospital, Tokyo, Japan Received: Nov 29, 2017 ABSTRACT Revised: Jan 15, 2018 Accepted: Jan 26, 2018 Objective: Uterine serous carcinoma (USC) is an aggressive type 2 endometrial cancer. Data Correspondence to on prognostic factors for patients with early-stage USC without adjuvant therapy are limited. Keisei Tate This study aims to assess the baseline recurrence risk of early-stage USC patients without Department of Gynecology, National Cancer adjuvant treatment and to identify prognostic factors and patients who need adjuvant therapy. Center Hospital, 5 Chome-1-1 Tsukiji, Chuo-ku, Methods: Sixty-eight patients with International Federation of Gynecology and Obstetrics Tokyo 104-0045, Japan. (FIGO) stage I–II USC between 1997 and 2016 were included. All the cases did not undergo E-mail: [email protected] adjuvant treatment as institutional practice. Clinicopathological features, recurrence Copyright © 2018. Asian Society of patterns, and survival outcomes were analyzed to determine prognostic factors. Gynecologic Oncology, Korean Society of Results: FIGO stages IA, IB, and II were observed in 42, 7, and 19 cases, respectively. Median Gynecologic Oncology follow-up time was 60 months. Five-year disease-free survival (DFS) and overall survival This is an Open Access article distributed under the terms of the Creative Commons (OS) rates for all cases were 73.9% and 78.0%, respectively. -
A Case of Ovarian Endometrioid Adenocarcinoma with Yolk Sac
Gynecologic Oncology Reports 27 (2019) 60–64 Contents lists available at ScienceDirect Gynecologic Oncology Reports journal homepage: www.elsevier.com/locate/gynor Case report A case of ovarian endometrioid adenocarcinoma with yolk sac differentiation and Lynch syndrome T ⁎ Janhvi Sookrama, , Brooke Levinb, Julieta Barroetac, Kathy Kenleyd, Pallav Mehtab, Lauren S. Krilla a Department of Obstetrics and Gynecology, Division of Gynecologic Oncology, MD Anderson Cancer Center at Cooper, Cooper University Health System, Camden, NJ, USA b Division of Hematology/Medical Oncology, MD Anderson Cancer Center at Cooper, Cooper University Health System, Camden, NJ, USA c Department of Pathology, Cooper University Health System, Camden, NJ, USA d Cooper University Health System, Camden, NJ, USA ARTICLE INFO ABSTRACT Keywords: Ovarian endometrioid adenocarcinoma with yolk sac component has been reported in fewer than twenty cases in Ovarian endometrioid adenocarcinoma the literature. A majority of the diagnoses are described in postmenopausal women without specific reference to Yolk sac tumor germline genetic testing. We describe, to our knowledge, the first case in the English literature of a pre- Germ cell tumor menopausal woman that presented with an ovarian endometrioid adenocarcinoma with focal yolk sac compo- Lynch syndrome nent and was subsequently found to have a germline MSH2 mutation confirming a diagnosis of Lynch syndrome. Ovarian cancer Concurrent diagnosis of ovarian endometrioid adenocarcinoma with yolk sac tumor and Lynch syndrome is an extremely rare finding in a young patient and requires careful follow-up. Genetics evaluation and testing may be reasonable for individuals with this rare or mixed tumor pathology at young age of onset and can have clinical utility in guiding future cancer treatment or surveillance. -
HIV-1: Cancer Evaluation 8/1/16
Report on Carcinogens Monograph on Human Immunodeficiency Virus Type 1 August 2016 Report on Carcinogens Monograph on Human Immunodeficiency Virus Type 1 August 1, 2016 Office of the Report on Carcinogens Division of the National Toxicology Program National Institute of Environmental Health Sciences U.S. Department of Health and Human Services This Page Intentionally Left Blank RoC Monograph on HIV-1: Cancer Evaluation 8/1/16 Foreword The National Toxicology Program (NTP) is an interagency program within the Public Health Service (PHS) of the Department of Health and Human Services (HHS) and is headquartered at the National Institute of Environmental Health Sciences of the National Institutes of Health (NIEHS/NIH). Three agencies contribute resources to the program: NIEHS/NIH, the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention (NIOSH/CDC), and the National Center for Toxicological Research of the Food and Drug Administration (NCTR/FDA). Established in 1978, the NTP is charged with coordinating toxicological testing activities, strengthening the science base in toxicology, developing and validating improved testing methods, and providing information about potentially toxic substances to health regulatory and research agencies, scientific and medical communities, and the public. The Report on Carcinogens (RoC) is prepared in response to Section 301 of the Public Health Service Act as amended. The RoC contains a list of identified substances (i) that either are known to be human carcinogens or are reasonably anticipated to be human carcinogens and (ii) to which a significant number of persons residing in the United States are exposed. The NTP, with assistance from other Federal health and regulatory agencies and nongovernmental institutions, prepares the report for the Secretary, Department of HHS. -
Mixed Epithelial Carcinoma of the Endometrium: Recommendations for Diagnosis from the Isgyp Endometrial Carcinoma Project
Mixed Epithelial Carcinoma of the Endometrium: Recommendations for Diagnosis from the ISGyP Endometrial Carcinoma Project Joseph Rabban MD MPH Pathology Department University of California San Francisco March 2017 Introduction The 2014 edition of the World Health Organization (WHO) Classification of Tumors of the Female Reproductive Organs recognizes mixed carcinoma (also called mixed cell adenocarcinoma by WHO) as a specific histologic category of epithelial endometrial cancer.(1) The 2014 WHO defines it as a tumor composed of “two or more different histological types of endometrial carcinoma, at least one of which is of the type II category.” The term “type II” category refers to non-endometrioid, non-mucinous types (e.g. serous carcinoma, clear cell carcinoma, carcinosarcoma). The rationale for recognizing this category stems largely from the adverse behavior of tumors that contain as little as 5% of a component of serous carcinoma admixed with endometrioid adenocarcinoma, with the implication that the type II tumor component should drive patient management. The International Society of Gynecologic Pathologists (ISGyP) Endometrial Carcinoma Project has reviewed this definition and identified areas that merit clarification and areas that remain controversial. This lecture will address practical recommendations for the diagnosis of mixed epithelial carcinoma of the endometrium and review the key entities in the differential diagnosis. Clinical Significance The literature on mixed epithelial carcinoma of the endometrium is composed of three kinds of studies: 1.) studies of endometrial serous carcinoma in which some of the cases are pure serous carcinoma and some are mixed with endometrioid adenocarcinoma; 2.) studies of endometrial clear cell carcinoma in which some cases are pure and some are mixed with other cancer types; 3.) studies specifically of mixed endometrial cancers. -
SNOMED CT Codes for Gynaecological Neoplasms
SNOMED CT codes for gynaecological neoplasms Authors: Brian Rous1 and Naveena Singh2 1Cambridge University Hospitals NHS Trust and 2Barts Health NHS Trusts Background (summarised from NHS Digital): • SNOMED CT is a structured clinical vocabulary for use in an electronic health record. It forms an integral part of the electronic care record, and serves to represent care information in a clear, consistent, and comprehensive manner. • The move to a single terminology, SNOMED CT, for the direct management of care of an individual, across all care settings in England, is recommended by the National Information Board (NIB), in “Personalised Health and Care 2020: A Framework for Action”. • SNOMED CT is owned, managed and licensed by SNOMED International. NHS Digital is the UK Member's National Release Centre for the creation of, and delegated authority to licence the SNOMED CT Edition and derivatives. • The benefits of using SNOMED CT in electronic care records are that it: • enables sharing of vital information consistently within and across health and care settings • allows comprehensive coverage and greater depth of details and content for all clinical specialities and professionals • includes diagnosis and procedures, symptoms, family history, allergies, assessment tools, observations, devices • supports clinical decision making • facilitates analysis to support clinical audit and research • reduces risk of misinterpretations of the record in different care settings • Implementation plans for England: • SNOMED CT must be implemented across primary care and deployed to GP practices in a phased approach from April 2018. • Secondary care, acute care, mental health, community systems, dentistry and other systems used in direct patient care must use SNOMED CT as the clinical terminology, before 1 April 2020.