Uterine endometrioid carcinoma

FIGURE 18.14 Markers of emerging importance in distinguishing uterine endometrioid carcinoma and uterine serous carcinoma include p33, p-catenin, and PTEN. While serous carcinomas characteristically overexpress p53 (A), endometrioid adenocarcinomas, especially when gland-forming, frequently express estrogen receptors (B), commonly show at least focal nuclear and cytoplasmic staining with anti-P-catenin (C), and lose expression of PTEN (D). 

FIGURE 18.16 p53 immunohistochemical staining can be used when the differential diagnosis includes uterine serous carcinoma (USQ and uterine endometrioid carcinoma (UEC). USC shows diffuse and intense nuclear immunoreactivity for p53 (A, B), as does the USC precursor EIC (C, D). Not infrequently, USC can demonstrate a glandular architectural pattern (E). Diffuse and intense p53 immunoreactivity in glandular use (F) can provide support for this entity when simple atypical hyperplasia and endometrioid adenocarcinoma are considerations. 

Lax SF, Pizer ES, Rormett BM, et al. Comparison of estrogen and progesterone receptor, Ki-67, and p53 immunoreactivity in uterine endometrioid carcinoma and endometrioid carcinoma with squamous, mucinous, secretory, and ciliated cell differentiation. Hum Pathol. 1998 29 924-931. 

Lax SF, Kendall B, Tashiro H, et al. The frequency of p53, K-ras mutations, and microsatellite instability differs in uterine endometrioid and serous carcinoma—Evidence of distinct molecular genetic pathways. Cancer. 2000 88 814-824. 

Schlosshauer PW, Pirog EC, Levine RL, et al. Mutational analysis of the CTNNBl and APC genes in uterine endometrioid carcinoma. Mod Pathol. 2000 13 1066-1071. 

Catasus L, Bussaglia E, Rodrguez I, et al. Molecular genetic alterations in endometrioid carcinomas of the ovary Similar frequency of beta-catenin abnormalities but lower rate of microsatellite instability and PTEN alterations than in uterine endometrioid carcinomas. Hum Pathol. 2004 35 1360-1368. 

Vimentin coexpression is especially useful in differentiating endometrial endometrioid carcinomas in uterine curettage specimens from endocervical adenocarcinomas including the endometrioid variant of endocervical adenocarcinoma. Endometrial endometrioid carcinomas immunostain strongly for vimentin, but endocervical carcinomas rarely stain (weak focal staining in up to 13% of endocervical carcinomas). i > i However, with the current antigen retrieval techniques, moderate to occasionally strong vimentin expression may be seen in endocervical carcinomas, and a panel approach is more useful in this distinction. ... 

Al-Hussaini M, Stockman A, Foster H, McCluggage WG. WT-1 assists in distinguishing ovarian from uterine serous carcinoma and in distinguishing between serous and endometrioid ovarian carcinoma. Histopathology. 2004 44 109-115. 

ER and PR expression is seen in a wide range of non-uterine tissues and in both benign and malignant tumors. Of note, ER and PR expression is moderate to strong in endometrioid carcinomas, but is not expressed or only weakly expressed in clear cell carcinomas.ER and... 

Irving JA, Catasus L, Gallardo A, et al. Synchronous endometrioid carcinomas of the uterine corpus and ovary Alterations in the beta-catenin (CTNNBl) pathway are associated with independent primary tumors and favorable prognosis. Hum Pathol. 2005 36 605-619. 

Clement PB, Young RH (2002) Endometrioid carcinoma of the uterine corpus a review of its pathology with emphasis on recent advances and problematic aspects. Adv Anat Pathol 9 145-184... 

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