Category Archives: Organ Systems

Cervix – LGSIL

October 10, 2017 peferguson

Low-Grade Squamous Intraepithelial Lesions

p16	Patchy cytoplasmic and nuclear positivity. Some cases may show diffuse positivity.
Ki67	Variably increased, but should not frequently extend into the upper half of the epithelium.

References

Matt Quick, MD (personal communication)

Organ Systems, Gynecological, Cervix

Cervix – Reactive

October 10, 2017 peferguson

Reactive Squamous Conditions

p16	Negative to patchy and focally positive.
Ki67	Should show a low proliferation index in a metaplastic lesion, but may be normal to markedly increased in reactive lesions. This is why it should be paired with p16.

References

Matt Quick, MD (personal communication)

Organ Systems, Gynecological, Uterus

Endometrial Stromal Sarconoma

October 10, 2017 peferguson

IHC Characteristics

ER	Positive
PR	Positive
Beta-Catenin	Strong nuclear positivity in 67%
AE1/AE3	+/- (~50%+, usually due to CK19)

References

Mod Pathol 2008;21:756

Hum Pathol 2008;39:1459

Organ Systems, Gynecological, Uterus

Malignant Mixed Mullerian Tumor (MMMT)

October 10, 2017 peferguson

IHC Characteristics

AE1/AE3	Usually stains both the epithelial and sarcomatous components.
p53	+/-
EMA	Often stains both the epithelial and sarcomatous components.

Organ Systems, Gynecological, Uterus

Endometrial Serous (High Grade) Carcinoma

October 10, 2017 peferguson

High-grade tumor of the uterus with the following IHC characteristics:

p53	Often positive, and usually negative in endometrioid carcinoma.
CK7	Positive
CA125	Positive
p16	Positive
Ki-67	Usually high proliferation index
Vimentin	Positive
CK20	Negative
ER	Negative (may see low level expression)
CEA	Negative

Organ Systems, Gynecological, Uterus

Endometrial Adenocarcinoma

October 10, 2017 peferguson

Endocervical vs. Endometrial Adenocarcinoma

Endocervical and endometrial adenocarcinomas may be morphologically indistinguishable morphologically. The question often comes up as to whether a case represents an endometrial adenocarcinoma involving the cervix, or and endocervical adenocarcinoma involving the endometrium. The following antibodies may be helpful in such circumstances:

	Endocervical Adenocarcinoma	Endometrial Adenocarcinoma
Vimentin	Negative (7-8%+)	Positive (70-93%)
CEA	Positive (65-95%)	Usually Negative
ER	Negative (4-20%+, 38% weak)	Strong Positive (67-90%)
p16	Strong & Diffuse Positive (90-100%)	Patchy Positive cells (~35%)
HPV	Positive (67%)	Negative

References

AJSP 2002;26:998

“Endocervical vs. Endometrial Adenocarcinoma: Update on Useful Immunohistochemical Markers.” RT Miller,The Focus ProPath Immunohistochemistry.” April 2003.

Organ Systems, Gynecological, Uterus

Uterus

October 10, 2017 peferguson

FIGO Grading

Organ Systems, Gynecological, Cervix

Cervical Adenocarcinoma

October 10, 2017 peferguson

Endocervical vs. Endometrial Adenocarcinoma

Endocervical and endometrial adenocarcinomas may be morphologically indistinguishable morphologically. The question often comes as to whether a case represents an endometrial adenocarcinoma involving the cervix, or and endocervical adenocarcinoma involving the endometrium. The following antibodies may be helpful in such circumstances:

	Endocervical Adenocarcinoma	Endometrial Adenocarcinoma
Vimentin	Negative (7-8%+)	Positive (70-93%)
CEA	Positive (65-95%)	Usually Negative
ER	Negative (4-20%+, 38% weak)	Strong Positive (67-90%)
p16	Strong & Diffuse Positive (90-100%)	Patchy Positive cells (~35%)
HPV	Positive (67%)	Negative

References

AJSP 2002;26:998

“Endocervical vs. Endometrial Adenocarcinoma: Update on Useful Immunohistochemical Markers.” RT Miller,The Focus ProPath Immunohistochemistry.” April 2003.

Organ Systems, Gynecological

Cervix

October 10, 2017 peferguson

Organ Systems, Gynecological

Gynecological Pathology

October 10, 2017 peferguson

Vaginal
Cervix
Uterus
Ovary