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Article: Napsin A, Hepatocyte Nuclear Factor-1-Beta (HNF-1β), Estrogen and Progesterone Receptors Expression in Arias-Stella Reaction

TitleNapsin A, Hepatocyte Nuclear Factor-1-Beta (HNF-1β), Estrogen and Progesterone Receptors Expression in Arias-Stella Reaction
Authors
KeywordsArias-Stella reactionclear
cell carcinoma
estrogen receptors
HNF-1β
napsin A
Issue Date2019
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.ajsp.com
Citation
American Journal of Surgical Pathology, 2019, v. 43 n. 3, p. 325-333 How to Cite?
AbstractBackground: The Arias-Stella reaction (ASR) can mimic endometrial clear cell carcinoma (ECCC) in small biopsies, especially when drug or pregnancy history is unknown. A panel of immunohistochemical markers comprising napsin A, hepatocyte nuclear factor-1-beta (HNF-1β), estrogen and progesterone receptors (ER, PR) has been found useful in confirming a diagnosis of ECCC. However, the detailed characterization of how expression of this combination of markers in the ECCC mimics ASR has yet to be thoroughly evaluated. Design: The frequency and extent of napsin A, HNF-1β, ER, and PR expression in ASR were assessed in a large series. For napsin A, any cytoplasmic staining was considered positive while only nuclear staining was deemed to be positive for HNF-1β, ER, and PR. Immunohistochemical histoscores based on the intensity and extent of staining were calculated. Results: Forty cases were gestational and 10 were nongestational ASR. In 19 (38%), the reaction was extensive and involved >50% of the glands. A stromal decidual change was found in 31 (77.5%) of the gestational and 3 (30%) of the nongestational cases. Napsin A was positive in all gestational and 8 of 10 (80%) nongestational ASR. All ASR showed HNF-1β expression. ER expression was reduced in 37 (92.5%) and lost in 3 (7.5%) gestational ASR, and reduced in 9 (90%) and lost in 1 (10%) of nongestational ASR. None of the ASR in our series expressed PR. Conclusions: Naspin A and HNF-1β were frequently expressed in both gestational and nongestational ASR, and ER expression was usually either reduced or loss. Interpretation of these markers in small biopsies containing atypical clear cells should be made with caution.
Persistent Identifierhttp://hdl.handle.net/10722/271318
ISSN
2017 Impact Factor: 5.878
2015 SCImago Journal Rankings: 2.393

 

DC FieldValueLanguage
dc.contributor.authorIp, P-
dc.contributor.authorWang, SY-
dc.contributor.authorWong, O-
dc.contributor.authorChow, KL-
dc.contributor.authorLee, H-
dc.contributor.authorCheung, A-
dc.contributor.authorTse, KY-
dc.date.accessioned2019-06-24T01:07:32Z-
dc.date.available2019-06-24T01:07:32Z-
dc.date.issued2019-
dc.identifier.citationAmerican Journal of Surgical Pathology, 2019, v. 43 n. 3, p. 325-333-
dc.identifier.issn0147-5185-
dc.identifier.urihttp://hdl.handle.net/10722/271318-
dc.description.abstractBackground: The Arias-Stella reaction (ASR) can mimic endometrial clear cell carcinoma (ECCC) in small biopsies, especially when drug or pregnancy history is unknown. A panel of immunohistochemical markers comprising napsin A, hepatocyte nuclear factor-1-beta (HNF-1β), estrogen and progesterone receptors (ER, PR) has been found useful in confirming a diagnosis of ECCC. However, the detailed characterization of how expression of this combination of markers in the ECCC mimics ASR has yet to be thoroughly evaluated. Design: The frequency and extent of napsin A, HNF-1β, ER, and PR expression in ASR were assessed in a large series. For napsin A, any cytoplasmic staining was considered positive while only nuclear staining was deemed to be positive for HNF-1β, ER, and PR. Immunohistochemical histoscores based on the intensity and extent of staining were calculated. Results: Forty cases were gestational and 10 were nongestational ASR. In 19 (38%), the reaction was extensive and involved >50% of the glands. A stromal decidual change was found in 31 (77.5%) of the gestational and 3 (30%) of the nongestational cases. Napsin A was positive in all gestational and 8 of 10 (80%) nongestational ASR. All ASR showed HNF-1β expression. ER expression was reduced in 37 (92.5%) and lost in 3 (7.5%) gestational ASR, and reduced in 9 (90%) and lost in 1 (10%) of nongestational ASR. None of the ASR in our series expressed PR. Conclusions: Naspin A and HNF-1β were frequently expressed in both gestational and nongestational ASR, and ER expression was usually either reduced or loss. Interpretation of these markers in small biopsies containing atypical clear cells should be made with caution.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.ajsp.com-
dc.relation.ispartofAmerican Journal of Surgical Pathology-
dc.rightsThis is a non-final version of an article published in final form in (provide complete journal citation)-
dc.subjectArias-Stella reactionclear-
dc.subjectcell carcinoma-
dc.subjectestrogen receptors-
dc.subjectHNF-1β-
dc.subjectnapsin A-
dc.titleNapsin A, Hepatocyte Nuclear Factor-1-Beta (HNF-1β), Estrogen and Progesterone Receptors Expression in Arias-Stella Reaction-
dc.typeArticle-
dc.identifier.emailIp, P: philipip@hku.hk-
dc.identifier.emailWong, O: wonggw@hkucc.hku.hk-
dc.identifier.emailChow, KL: cklpatho@pathology.hku.hk-
dc.identifier.emailLee, H: horlee@hku.hk-
dc.identifier.emailCheung, A: anycheun@hkucc.hku.hk-
dc.identifier.emailTse, KY: tseky@hku.hk-
dc.identifier.authorityIp, P=rp01890-
dc.identifier.authorityCheung, A=rp00542-
dc.identifier.authorityTse, KY=rp02391-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/PAS.0000000000001212-
dc.identifier.pmid30608233-
dc.identifier.scopuseid_2-s2.0-85059614049-
dc.identifier.hkuros298248-
dc.identifier.volume43-
dc.identifier.issue3-
dc.identifier.spage325-
dc.identifier.epage333-
dc.publisher.placeUnited States-

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