endometrial endometrioid adenocarcinoma

PO

Definition: Relatively indolent tumors that arise in background of endometrial hyperplasia.

Images

 Endometrioid adenocarcinoma with squamous metaplasia

• https://twitter.com/laherbefolle/status/741139234296369152

Immunochemistry

 p53

• Uterine papillary serous adenocarcinomas (UPSA) showed significantly higher p53 expression than did uterine endometrioid adenocarcinomas (UEA) (76.2% versus 35%), whereas both ER and PR are more often positive in endometrioid than in serous tumors.
• In endometrioid carcinoma, p53 overexpression is associated with high-grade and advanced-stage tumors (p =.0006 and.006), whereas ER and PR expression is associated with low-grade and early-stage tumors (p =.0006 and.0001; p =.003 and.0006).

 BCL2
* No significant difference was found in bcl-2 and bax expression between both histologic types. However, there is definite decrease in intensity of bcl-2 in UPSA compared with UEA.

• Bcl-2 immunopositivity is more common in low-grade, early-stage rather than in high-grade, advanced-stage adenocarcinomas, but the difference was not statistically significant (p =.24 and.07).

 BAX

• Bax immunopositivity is associated with well-differentiated (p =.04) and early-stage tumors. Furthermore, a significant inverse relationship between bax and p53 reactivity is defined (p =.05), especially in tumors of endometrioid type.
• Bax and PR immunoexpression correlated near the limit of statistical significance (p =.08), whereas no relationship was found among bax, bcl-2, and ER immunopositivity.

The differences in immunohistochemical profiles of endometrioid and serous carcinomas support the existence of different molecular pathways of their development.

(http://www.nature.com/modpathol/journal/v13/n4/full/3880062a.html)

Differential diagnosis

 Ciliary metaplasia
 Papillary change
 Progesterone treatment related changes
 Shedding endometrium with papillary syncytial metaplasia
 Villoglandular endometrioid carcinoma
 Well differentiated tumors: atypical hyperplasia / EIN (Mod Pathol 2000;13:309)
 Poorly differentiated tumors: serous carcinoma

Reporting

 Dilemmas in Reporting of Endometrial Carcinomas http://www.pathsoc.org/files/meetings/edinburghpreswed/0940%20Weds%20Fintry%20McCluggage%201%20of%202.pdf

Comparative genomic hybridization (CGH)

 CGH gains

• 1q25-q42 gains (30%)
• 19pter-p13.1 (26%)
• 19q13.1-q13.3 (19%).
• 8q21—qter (17%)
• 10q21—>q23 (14%)
• 10p (13%)

 CGH losses

• 4q22-qter losses (8%)
• 16q21-qter losses (8%)
• 18q21-qter losses (8%)

See also

 endometrial tumors
 endometrioid adenocarcinomas
 Tumors
 Oncobase
 Oncogen

References

 Levan K, Partheen K, Osterberg L, Helou K, Horvath G. Chromosomal alterations in 98 endometrioid adenocarcinomas analyzed with comparative genomic hybridization. Cytogenet Genome Res. 2006;115(1):16-22. PMID: 16974079