Intestinal-type endocervical adenocarcinoma

Intestinal-type endocervical adenocarcinoma and AIS contain goblet cells and intestinal type epithelium and may be mistaken for spread of primary intestinal adenocarcinoma. The intestinal marker CDX2 is expressed in intestinal type endocervical adenocarcinoma and AIS as well as in some non-intestinal types (Fig. 18.10). Therefore CDX2 does not help define site of origin. Instead, CK7, CK20, and pl6 should be used. Whereas primary endocervical adenocarcinoma expresses CK7 and pl6 but not CK20, the converse... 

FIGURE 18.10 Intestinal-type endocervical adenocarcinoma with prominent goblet cells (A) (H E) may resemble primary intestinal adenocarcinomas that spread to the cervix. CDX2 (B) is expressed in the nuclei of this variant of endocervical adenocarcinoma and therefore should not be used to determine site of origin. CK7, CK20, and pi 6 should be used instead. 

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