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Neuroendocrine carcinoma of the cervix in Rwanda - a case report
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Pathology (2014), 46(S2)
PATHOLOGY 2014 ABSTRACT SUPPLEMENT
Gynecologic Pathology: Poster#154 LEUKEMIA INHIBITING FACTOR EXPRESSION (LIF) IN THE ENDOMETRIUM OF FERTILE AND INFERTILE WOMEN THROUGHOUT DIFFERENT MENSTRUAL PHASES Magda Hassan Nasreldin, Ali Mohamad Sharaby, Mahmoud Abdel Aleem El Kholy and Nehal Mohamad Mousa Pathology Department, Faculty of Medicine, Aln Shams University, Cairo, Egypt Leukemia inhibiting factor (LIF) is a pleiotropic cytokine with effect on the growth promotion and cell differentiation. P53 regulated LIF has been shown to facilitate implantation in the mouse model. It is suggested that LIF might help to improve the implantation rate in women with unexplained infertility. Aim: To demonstrate the expression of LIF in different endometrial locations and compare it in fertile and infertile women. Study design: Immunohistochemical expression of LIF of endometrial specimens from 25 healthy fertile women and 25 cases with unexplained infertility in different locations within endometrial tissue, i.e., luminal, glandular and stromal, was done. Results: In cases of fertility, LIF expression varied according to the phase of menstrual cycle. Secretory endometrium expressed significantly higher LIF than proliferative endometrium with maximum expression in the midsecretory phase. In cases of infertility, the endometrium showed lower LIF expression during different phases of menstrual cycle in comparison with fertile group. Conclusion: LIF plays a role in implantation and supports the endometrial functions. Deregulation of this cytokine may be a cause of unexplained infertility.
Gynecologic Pathology: Poster#155 MUCINOUS BORDERLINE TUMOR OF THE FALLOPIAN TUBE: A CASE REPORT Hoiseon Jeong, Hyesun Kim, Yi Kyeong Chun, Sung Ran Hong and Hy Sook Kim Department of Pathology, Cheil General Hospital & Womens Healthcare Center, Kwandong University College of Medicine, Seoul, Korea We report a case of mucinous borderline tumor (MBT) of the fallopian tube, coexisting with an ovarian MBT. A 33-year-old woman was referred with right ovarian cystic mass which was found during the postpartum follow-up. She had a previous history of MBT in contralateral ovary, 6 years ago. Under the suspicion of recurrent ovarian tumor, right salpingo-oophoretomy was done. The ovarian mass was a 11 cm sized multilocular cyst with wall thickening. Microscopic findings showed proliferating mucinous epithelium forming complex papillae and tuftings, consistent with MBT. Evaluation of right fallopian tube also revealed a small focus of proliferating mucinous epithelium, suggesting MBT. It was present on the fimbrial end and contained areas of transition from normal ciliated tubal epithelium to neoplastic mucinous epithelium. On immunohistochemical staining, both the ovarian and fallopian tube MBT cells were negative for estrogen receptor
and p53, while positive for PAX8. Recent studies have suggested that some ovarian and peritoneal serous carcinomas could originate from the fallopian tube epithelial cells in fimbrial end. However, the origin of mucinous tumor is still unclear. The present case is an interesting occasion of which shows a coexistence of MBT in fallopian tube and ovary.
Gynecologic Pathology: Poster#156 NEUROENDOCRINE CARCINOMA OF THE CERVIX IN RWANDA – A CASE REPORT Marie Claire Ndayisaba1,2, Jean De Dieu Baryabagaya2, Jean Bosco Surwumwe2, John Gahima3, Belson Rugwizangoga1,2, Ve´ne´rand Bigirimana1,2 and Alvaro Laga Canales4 1Pathology Division, Department of Clinical Biology, University of Rwanda, Kigali, Rwanda, 2Laboratory Department, University Teaching Hospital of Kigali, Kigali, Rwanda, 3Department of Gynaecology and Obstetrics, University of Rwanda, Kigali, Rwanda, and 4Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America Introduction: Neuroendocrine carcinoma (NEC) rarely affects the uterine cervix, and accounts for 0.5–1% of all cervical cancers. NEC is very aggressive and includes small cell and large cell types. Diagnostic histochemistry and immunohistochemistry may be paramount in addition to morphology. Methods: We report a 56-year-old Rwandan female patient, who presented at Gynaecology Department of University Teaching Hospital of Kigali in March 2014 with a 5 month history of pelvic pain and abnormal vaginal bleeding. Clinical examination revealed a fungating and haemorrhagic mass involving almost the entire cervix. Other organs were unremarkable. Cervical biopsy was done, the specimen fixed in 10% buffered formalin, processed for routine histology and immunohistochemistry. Results: There were multiple fragments of tissue weighing 3 g. They were grayish, haemorrhagic, soft and friable. Microscopy showed an invasive trabecular malignant neoplasm composed of intermediate to large atypical cells with moderate cytoplasm, hyperchromatic nuclei with salt and pepper chromatin and frequent mitoses. Immunoperoxidase staining showed strong focal cytoplasmic granular positivity to chromogranin-A. It was concluded as a cervical NEC, large cell type. Conclusion: Cervical NEC is rare; the use of advanced diagnostic techniques may be paramount to differentiate it from poorly differentiated types of carcinoma.
Gynecologic Pathology: Poster#157 OVARIAN CARCINOSARCOMA ASSOCIATED WITH MATURE CYSTIC TERATOMA AND TUBAL CARCINOMA – A CASE REPORT Sunida Rewsuwan1, Nopporn Satabongkoch1, Surapan Khunamornpong1 and Prapaporn Suprasert2 1Department of Pathology, and 2Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.
Pathology (2014), 46(S2)
PATHOLOGY 2014 ABSTRACT SUPPLEMENT
Gynecologic Pathology: Poster#154 LEUKEMIA INHIBITING FACTOR EXPRESSION (LIF) IN THE ENDOMETRIUM OF FERTILE AND INFERTILE WOMEN THROUGHOUT DIFFERENT MENSTRUAL PHASES Magda Hassan Nasreldin, Ali Mohamad Sharaby, Mahmoud Abdel Aleem El Kholy and Nehal Mohamad Mousa Pathology Department, Faculty of Medicine, Aln Shams University, Cairo, Egypt Leukemia inhibiting factor (LIF) is a pleiotropic cytokine with effect on the growth promotion and cell differentiation. P53 regulated LIF has been shown to facilitate implantation in the mouse model. It is suggested that LIF might help to improve the implantation rate in women with unexplained infertility. Aim: To demonstrate the expression of LIF in different endometrial locations and compare it in fertile and infertile women. Study design: Immunohistochemical expression of LIF of endometrial specimens from 25 healthy fertile women and 25 cases with unexplained infertility in different locations within endometrial tissue, i.e., luminal, glandular and stromal, was done. Results: In cases of fertility, LIF expression varied according to the phase of menstrual cycle. Secretory endometrium expressed significantly higher LIF than proliferative endometrium with maximum expression in the midsecretory phase. In cases of infertility, the endometrium showed lower LIF expression during different phases of menstrual cycle in comparison with fertile group. Conclusion: LIF plays a role in implantation and supports the endometrial functions. Deregulation of this cytokine may be a cause of unexplained infertility.
Gynecologic Pathology: Poster#155 MUCINOUS BORDERLINE TUMOR OF THE FALLOPIAN TUBE: A CASE REPORT Hoiseon Jeong, Hyesun Kim, Yi Kyeong Chun, Sung Ran Hong and Hy Sook Kim Department of Pathology, Cheil General Hospital & Womens Healthcare Center, Kwandong University College of Medicine, Seoul, Korea We report a case of mucinous borderline tumor (MBT) of the fallopian tube, coexisting with an ovarian MBT. A 33-year-old woman was referred with right ovarian cystic mass which was found during the postpartum follow-up. She had a previous history of MBT in contralateral ovary, 6 years ago. Under the suspicion of recurrent ovarian tumor, right salpingo-oophoretomy was done. The ovarian mass was a 11 cm sized multilocular cyst with wall thickening. Microscopic findings showed proliferating mucinous epithelium forming complex papillae and tuftings, consistent with MBT. Evaluation of right fallopian tube also revealed a small focus of proliferating mucinous epithelium, suggesting MBT. It was present on the fimbrial end and contained areas of transition from normal ciliated tubal epithelium to neoplastic mucinous epithelium. On immunohistochemical staining, both the ovarian and fallopian tube MBT cells were negative for estrogen receptor
and p53, while positive for PAX8. Recent studies have suggested that some ovarian and peritoneal serous carcinomas could originate from the fallopian tube epithelial cells in fimbrial end. However, the origin of mucinous tumor is still unclear. The present case is an interesting occasion of which shows a coexistence of MBT in fallopian tube and ovary.
Gynecologic Pathology: Poster#156 NEUROENDOCRINE CARCINOMA OF THE CERVIX IN RWANDA – A CASE REPORT Marie Claire Ndayisaba1,2, Jean De Dieu Baryabagaya2, Jean Bosco Surwumwe2, John Gahima3, Belson Rugwizangoga1,2, Ve´ne´rand Bigirimana1,2 and Alvaro Laga Canales4 1Pathology Division, Department of Clinical Biology, University of Rwanda, Kigali, Rwanda, 2Laboratory Department, University Teaching Hospital of Kigali, Kigali, Rwanda, 3Department of Gynaecology and Obstetrics, University of Rwanda, Kigali, Rwanda, and 4Department of Pathology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, United States of America Introduction: Neuroendocrine carcinoma (NEC) rarely affects the uterine cervix, and accounts for 0.5–1% of all cervical cancers. NEC is very aggressive and includes small cell and large cell types. Diagnostic histochemistry and immunohistochemistry may be paramount in addition to morphology. Methods: We report a 56-year-old Rwandan female patient, who presented at Gynaecology Department of University Teaching Hospital of Kigali in March 2014 with a 5 month history of pelvic pain and abnormal vaginal bleeding. Clinical examination revealed a fungating and haemorrhagic mass involving almost the entire cervix. Other organs were unremarkable. Cervical biopsy was done, the specimen fixed in 10% buffered formalin, processed for routine histology and immunohistochemistry. Results: There were multiple fragments of tissue weighing 3 g. They were grayish, haemorrhagic, soft and friable. Microscopy showed an invasive trabecular malignant neoplasm composed of intermediate to large atypical cells with moderate cytoplasm, hyperchromatic nuclei with salt and pepper chromatin and frequent mitoses. Immunoperoxidase staining showed strong focal cytoplasmic granular positivity to chromogranin-A. It was concluded as a cervical NEC, large cell type. Conclusion: Cervical NEC is rare; the use of advanced diagnostic techniques may be paramount to differentiate it from poorly differentiated types of carcinoma.
Gynecologic Pathology: Poster#157 OVARIAN CARCINOSARCOMA ASSOCIATED WITH MATURE CYSTIC TERATOMA AND TUBAL CARCINOMA – A CASE REPORT Sunida Rewsuwan1, Nopporn Satabongkoch1, Surapan Khunamornpong1 and Prapaporn Suprasert2 1Department of Pathology, and 2Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
Copyright © Royal College of pathologists of Australasia. Unauthorized reproduction of this article is prohibited.