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Article: Oncocytic metaplasia and carcinoma of the endometrium: An immunohistochemical and ultrastructural study

TitleOncocytic metaplasia and carcinoma of the endometrium: An immunohistochemical and ultrastructural study
Authors
Issue Date1999
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.intjgynpathology.com
Citation
International Journal Of Gynecological Pathology, 1999, v. 18 n. 1, p. 12-19 How to Cite?
AbstractEndometrial oncocytic carcinoma is an unusual neoplasm, with few cases reported. Endometrial curettage specimens coded as prominent oxyphilic metaplasia (N = 5) and oxyphilic or oncocytic carcinoma (N = 4) were reviewed, and hysterectomy slides from the four carcinomas were also examined. Immunohistochemical and ultrastructural analyses were performed in three of five metaplasias and in all four carcinomas. Most patients (89%) with oncocytic metaplasia and carcinoma had vaginal bleeding. Oncocytic metaplasia was characterized by a single layer of cells with abundant eosinophilic, granular cytoplasm, minimal pleomorphism, and rare mitotic activity. Carcinoma was diagnosed on the basis of an altered stroma (n = 2) and/or a confluent growth pattern (n = 4) and had a papillary (n = 4), glandular (n = 2), or solid (n = 1) morphology. Carcinomas showed a similar population of oncocytic cells as metaplasias, but with occasional nuclear stratification and greater pleomorphism and mitotic activity. Tumors were International Federation of Gynecology and Obstetrics (FIGO) grade 1 (n = 2) or 2 (n = 2) and FIGO stage Ib, Ic, IIb, and IIIc. Omental metastases developed in the patient with the stage III tumor at 13 months; the two patients with stage I tumors were alive with no evidence of disease at a mean of 29 months. All carcinomas expressed p53 and 75% and 100% were estrogen receptor (ER)and progesterone receptor (PR)-negative, respectively, whereas all metaplasias were p53 negative-and ER- and PR-positive. Ki-67 labeling index was 1 to 3% in metaplasias and 14 to 33% in carcinomas. Oncocytic metaplasias and carcinomas contained abundant mitochondria and free ribosomes, accounting for the oncocytic appearance. Because oncocytic carcinomas frequently show deep myometrial invasion and require surgical staging, it is important to distinguish oncocytic metaplasia from carcinoma on biopsy material. Ki-67, p53, and ER and PR immunostains may assist in this potentially difficult differential.
Persistent Identifierhttp://hdl.handle.net/10722/88632
ISSN
2015 Impact Factor: 1.437
2015 SCImago Journal Rankings: 0.723
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorSilver, SAen_HK
dc.contributor.authorCheung, ANYen_HK
dc.contributor.authorTavassoli, FAen_HK
dc.date.accessioned2010-09-06T09:45:55Z-
dc.date.available2010-09-06T09:45:55Z-
dc.date.issued1999en_HK
dc.identifier.citationInternational Journal Of Gynecological Pathology, 1999, v. 18 n. 1, p. 12-19en_HK
dc.identifier.issn0277-1691en_HK
dc.identifier.urihttp://hdl.handle.net/10722/88632-
dc.description.abstractEndometrial oncocytic carcinoma is an unusual neoplasm, with few cases reported. Endometrial curettage specimens coded as prominent oxyphilic metaplasia (N = 5) and oxyphilic or oncocytic carcinoma (N = 4) were reviewed, and hysterectomy slides from the four carcinomas were also examined. Immunohistochemical and ultrastructural analyses were performed in three of five metaplasias and in all four carcinomas. Most patients (89%) with oncocytic metaplasia and carcinoma had vaginal bleeding. Oncocytic metaplasia was characterized by a single layer of cells with abundant eosinophilic, granular cytoplasm, minimal pleomorphism, and rare mitotic activity. Carcinoma was diagnosed on the basis of an altered stroma (n = 2) and/or a confluent growth pattern (n = 4) and had a papillary (n = 4), glandular (n = 2), or solid (n = 1) morphology. Carcinomas showed a similar population of oncocytic cells as metaplasias, but with occasional nuclear stratification and greater pleomorphism and mitotic activity. Tumors were International Federation of Gynecology and Obstetrics (FIGO) grade 1 (n = 2) or 2 (n = 2) and FIGO stage Ib, Ic, IIb, and IIIc. Omental metastases developed in the patient with the stage III tumor at 13 months; the two patients with stage I tumors were alive with no evidence of disease at a mean of 29 months. All carcinomas expressed p53 and 75% and 100% were estrogen receptor (ER)and progesterone receptor (PR)-negative, respectively, whereas all metaplasias were p53 negative-and ER- and PR-positive. Ki-67 labeling index was 1 to 3% in metaplasias and 14 to 33% in carcinomas. Oncocytic metaplasias and carcinomas contained abundant mitochondria and free ribosomes, accounting for the oncocytic appearance. Because oncocytic carcinomas frequently show deep myometrial invasion and require surgical staging, it is important to distinguish oncocytic metaplasia from carcinoma on biopsy material. Ki-67, p53, and ER and PR immunostains may assist in this potentially difficult differential.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.intjgynpathology.comen_HK
dc.relation.ispartofInternational Journal of Gynecological Pathologyen_HK
dc.rightsInternational Journal of Gynecological Pathology. Copyright © Lippincott Williams & Wilkins.en_HK
dc.subject.meshAdenocarcinoma - chemistry - pathology - ultrastructureen_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshEndometrial Neoplasms - chemistry - pathology - ultrastructureen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHumansen_HK
dc.subject.meshImmunohistochemistryen_HK
dc.subject.meshMetaplasiaen_HK
dc.subject.meshMicroscopy, Electronen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshReceptors, Estrogen - analysisen_HK
dc.subject.meshReceptors, Progesterone - analysisen_HK
dc.titleOncocytic metaplasia and carcinoma of the endometrium: An immunohistochemical and ultrastructural studyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0277-1691&volume=18&spage=12&epage=19&date=1999&atitle=Oncocytic+metaplasia+and+carcinoma+of+the+endometrium:+an+immunohistochemical+and+ultrastructural+studyen_HK
dc.identifier.emailCheung, ANY:anycheun@hkucc.hku.hken_HK
dc.identifier.authorityCheung, ANY=rp00542en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid9891237-
dc.identifier.scopuseid_2-s2.0-0032911935en_HK
dc.identifier.hkuros44064en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0032911935&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume18en_HK
dc.identifier.issue1en_HK
dc.identifier.spage12en_HK
dc.identifier.epage19en_HK
dc.identifier.isiWOS:000077814200003-
dc.publisher.placeUnited Statesen_HK

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