Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors

Mesonephric-like adenocarcinoma (MLA) of the uterine corpus is a rare but distinct malignant tumor of the female genital tract, demonstrating a characteristic morphology and unique immunohistochemical profiles and molecular alterations. We conducted immunohistochemical staining (IHC) to make precise...

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Autores principales:	Hyunjin Kim, Kiyong Na, Go Eun Bae, Hyun-Soo Kim
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	uterus mesonephric-like adenocarcinoma endometrium endometrioid carcinoma serous carcinoma immunohistochemistry Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/b2af5d494139414aadbf57c578f01e9b
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spelling	oai:doaj.org-article:b2af5d494139414aadbf57c578f01e9b2021-11-25T17:21:06ZMesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors10.3390/diagnostics111120422075-4418https://doaj.org/article/b2af5d494139414aadbf57c578f01e9b2021-11-01T00:00:00Zhttps://www.mdpi.com/2075-4418/11/11/2042https://doaj.org/toc/2075-4418Mesonephric-like adenocarcinoma (MLA) of the uterine corpus is a rare but distinct malignant tumor of the female genital tract, demonstrating a characteristic morphology and unique immunohistochemical profiles and molecular alterations. We conducted immunohistochemical staining (IHC) to make precise differential diagnoses of uterine MLAs from common histological subtypes of endometrial carcinomas. We collected 25 uterine MLAs and performed IHC for GATA3, TTF1, CD10, ER, PR, p16, p53, and HER2. Seventeen cases (68.0%) showed at least moderate nuclear GATA3 immunoreactivity in ≥25% of tumor cells. Most cases expressed TTF1 (17/21, 81.0%) and CD10 (luminal; 17/21, 81.0%). Heterogeneous TTF1 expression was noted in 12 cases. An inverse pattern of GATA3 and TTF1 staining was observed in eight cases (32.0%). Three cases (12.0%) showed moderate-to-strong ER expression in ≥25% of tumor cells, and two cases (8.0%) showed moderate-to-strong PR expression in ≥5% of tumor cells. These hormone receptor-positive MLAs varied in intensity and proportion of GATA3 staining. None of the 25 cases exhibited either diffuse and strong p16 expression or aberrant p53 expression. Five cases (20.0%) showed equivocal HER2 immunoreactivity (score 2+), but <i>HER2</i> FISH confirmed that none of them exhibited <i>HER2</i> gene amplification. In summary, a small subset of uterine MLAs displayed atypical IHC results: focal but strong expression of ER or PR, the complete absence of GATA3 immunoreactivity, the concurrent expression of mesonephric and hormone receptors, and the inverse pattern of GATA3 and TTF1 staining. These unusual immunophenotypes may complicate the differential diagnosis of MLA. Moreover, pathologists should be encouraged to interpret the IHC results cautiously.Hyunjin KimKiyong NaGo Eun BaeHyun-Soo KimMDPI AGarticleuterusmesonephric-like adenocarcinomaendometriumendometrioid carcinomaserous carcinomaimmunohistochemistryMedicine (General)R5-920ENDiagnostics, Vol 11, Iss 2042, p 2042 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	uterus mesonephric-like adenocarcinoma endometrium endometrioid carcinoma serous carcinoma immunohistochemistry Medicine (General) R5-920
spellingShingle	uterus mesonephric-like adenocarcinoma endometrium endometrioid carcinoma serous carcinoma immunohistochemistry Medicine (General) R5-920 Hyunjin Kim Kiyong Na Go Eun Bae Hyun-Soo Kim Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
description	Mesonephric-like adenocarcinoma (MLA) of the uterine corpus is a rare but distinct malignant tumor of the female genital tract, demonstrating a characteristic morphology and unique immunohistochemical profiles and molecular alterations. We conducted immunohistochemical staining (IHC) to make precise differential diagnoses of uterine MLAs from common histological subtypes of endometrial carcinomas. We collected 25 uterine MLAs and performed IHC for GATA3, TTF1, CD10, ER, PR, p16, p53, and HER2. Seventeen cases (68.0%) showed at least moderate nuclear GATA3 immunoreactivity in ≥25% of tumor cells. Most cases expressed TTF1 (17/21, 81.0%) and CD10 (luminal; 17/21, 81.0%). Heterogeneous TTF1 expression was noted in 12 cases. An inverse pattern of GATA3 and TTF1 staining was observed in eight cases (32.0%). Three cases (12.0%) showed moderate-to-strong ER expression in ≥25% of tumor cells, and two cases (8.0%) showed moderate-to-strong PR expression in ≥5% of tumor cells. These hormone receptor-positive MLAs varied in intensity and proportion of GATA3 staining. None of the 25 cases exhibited either diffuse and strong p16 expression or aberrant p53 expression. Five cases (20.0%) showed equivocal HER2 immunoreactivity (score 2+), but <i>HER2</i> FISH confirmed that none of them exhibited <i>HER2</i> gene amplification. In summary, a small subset of uterine MLAs displayed atypical IHC results: focal but strong expression of ER or PR, the complete absence of GATA3 immunoreactivity, the concurrent expression of mesonephric and hormone receptors, and the inverse pattern of GATA3 and TTF1 staining. These unusual immunophenotypes may complicate the differential diagnosis of MLA. Moreover, pathologists should be encouraged to interpret the IHC results cautiously.
format	article
author	Hyunjin Kim Kiyong Na Go Eun Bae Hyun-Soo Kim
author_facet	Hyunjin Kim Kiyong Na Go Eun Bae Hyun-Soo Kim
author_sort	Hyunjin Kim
title	Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
title_short	Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
title_full	Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
title_fullStr	Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
title_full_unstemmed	Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors
title_sort	mesonephric-like adenocarcinoma of the uterine corpus: comprehensive immunohistochemical analyses using markers for mesonephric, endometrioid and serous tumors
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/b2af5d494139414aadbf57c578f01e9b
work_keys_str_mv	AT hyunjinkim mesonephriclikeadenocarcinomaoftheuterinecorpuscomprehensiveimmunohistochemicalanalysesusingmarkersformesonephricendometrioidandseroustumors AT kiyongna mesonephriclikeadenocarcinomaoftheuterinecorpuscomprehensiveimmunohistochemicalanalysesusingmarkersformesonephricendometrioidandseroustumors AT goeunbae mesonephriclikeadenocarcinomaoftheuterinecorpuscomprehensiveimmunohistochemicalanalysesusingmarkersformesonephricendometrioidandseroustumors AT hyunsookim mesonephriclikeadenocarcinomaoftheuterinecorpuscomprehensiveimmunohistochemicalanalysesusingmarkersformesonephricendometrioidandseroustumors
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Mesonephric-like Adenocarcinoma of the Uterine Corpus: Comprehensive Immunohistochemical Analyses Using Markers for Mesonephric, Endometrioid and Serous Tumors

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