Minimal deviation endocervical adenocarcinoma

Diagnosis of minimal deviation endocervical adenocarcinoma can be challenging since the cytologic and architectural features of this tumor can be subtle. Robust forms of lobular or diffuse endocervical glandular hyperplasia or deep endocervical glands may mimic minimal deviation adenocarcinoma. A subtle type of endocervical... 

FIGURE 18.11 Minimal deviation endocervical adenocarcinoma consists of a deeply invasive, haphazardly infiltrative proliferation of bland endocervical glands that, in a small tissue sampling, may mimic endocervical glandular hyperplasia or mesonephric remnants (A). (H E.) Some cases may express CEA (B), which is not expressed by its benign mimics. 

Mesonephric duct remnants may be found in the deep wall of cervix specimens. Sometimes, hyperplasia may be pronounced and raise concern for minimal deviation type endocervical adenocarcinoma. Apical expression of CD 10 is common in these remnants, as is expression by the intraluminal secretions. CD 10, however, is not pathognomonic for mesonephric differentiation because some endocervical and endometrial adenocarcinomas may express CDIO. Minimal deviation type endocervical adenocarcinoma, however, lacks CDIO expression. Variable expression of pi6 is reported in mesonephric remnants and may lead to misinterpretation as endocervical adenocarcinoma however, MIBl is not increased. ER, PR, and CEA are generally negative. The immuno-phenotype is similar in mesonephric adenocarcinoma as well. " ... 

Xu JY, Hashi A, Kondo T, et al. Absence of human papillomavirus infection in minimal deviation adenocarcinoma and lobular endocervical glandular hyperplasia. Int J Gynecol Pathol. 2005 24 296-302. 

---