Ovarian endometrioid carcinoma. Molecular profiling identifies synchronous endometrial and ovarian cancers as metastatic endometrial cancer with favorable clinical outcome. 5 year survival rate is approximately 30% (stage I - II: 59%; stage III: 25%; stage IV: 9%) (Gynecol Oncol 2010;116:419) This is a much more aggressive tumor than high grade endometrial carcinoma where the 5 year survival rate for stage I disease is over 80% (Am J Surg Pathol 2007;31:979) Stage is the most consistent independent predictor of outcome Alveolar soft part sarcoma (positive in 50% cases) (J Clin Pathol 2006;59:1127) Sample pathology report. Macroscopically the kidney demonstrates a large number of cysts of variable size (from a few mm to many cm), in both the cortex and medulla. Endometrial polyp with atypical stromal cells appears to be indolent with no recurrences or progression to malignancy reported, even in cases treated only with curettage / polypectomy Case reports 28 year old woman with intravascular large B cell lymphoma in a benign appearing endometrial polyp ( Blood 2019;133:1920 ) Liver: hepatoblastoma and possibly nested stromal epithelial tumor (Hum Pathol 2012;43:1815) Neuroblastoma (Am J Clin Pathol 2009;131:49) Ovarian microcystic stromal tumor (Am J Surg Pathol 2011;35:1429) PNET, rhabdomyosarcoma, Wilm tumor (childhood, Am J Clin Pathol 2009;131:49) Endometrial stromal tumors: May differentiate CD10+ endometrial stromal tumors from smooth muscle tumors, which are usually CD10- (Mod Pathol 2001;14:465), but not always (Mod Pathol 2002;15:923) Endometriosis: May be useful in diagnosis, except in cervix (Adv Anat Pathol 2004;11:310) Gynecologic tumors: Mesonephric remnants and tumors are CD10+ The encoded protein responds to diverse cellular stresses to regulate expression of target genes, thereby inducing cell cycle arrest, apoptosis, senescence, DNA repair, or changes in metabolism. The protein encoded by this gene is similar to insulin in function and structure and is a member of a family of proteins involved in mediating growth and development. Distinguish hemangiopericytoma (CD34+) from endometrial stromal sarcoma (CD34-) (Mod Pathol 2005;18:40) Classify other soft tissue tumors Hematopathology: Distinguish lymphocyte rich thymoma (CD34+ cells) from T-ALL (usually CD34-) F-N: female to male transgender histology grossing & features to report high grade endometrial stromal sarcoma inflammatory myofibroblastic tumor intravenous leiomyomatosis leiomyoma-general leiomyosarcoma low grade endometrial stromal sarcoma Mllerian adenosarcoma mesonephric-like endometrial carcinoma (pending) Current clinical practice is organized according to tissue or organ of origin of tumors. Stromal hyalinization is common Sclerosing PEComa is rare in the gynecologic tract (Int J Gynecol Pathol 2011;30:121, Pathol Int 2011;61:768) TFE3 translocation associated PEComas (Am J Surg Pathol 2010;34:1395, Am J Surg Pathol 2015;39:394): Typically epithelioid with clear cells in a nested / alveolar growth Low grade atypia and rare mitoses Board review style question #2. 5 year survival rate is approximately 30% (stage I - II: 59%; stage III: 25%; stage IV: 9%) (Gynecol Oncol 2010;116:419) This is a much more aggressive tumor than high grade endometrial carcinoma where the 5 year survival rate for stage I disease is over 80% (Am J Surg Pathol 2007;31:979) Stage is the most consistent independent predictor of outcome Utility in distinguishing intraductal spread of urothelial carcinoma from prostatic stromal invasion (Anticancer Res 2008;28:2997) Thoracic pathology: Mesothelioma (+), even in effusions, versus adenocarcinoma (-) (Diagn Cytopathol 2007;35:342, Cancer 2007;109:933) Sample pathology report. Endometriosis and synchronous carcinoma share similar genetic alterations including ARID1A, PTEN and PIK3CA; Mutations in ARID1A, a tumor suppressor gene, identified in up to 57% of ovarian endometrioid carcinoma and up to 30% of clear cell carcinoma . Many mutations have been found in sex cord stromal tumors and can differentiate subtypes, such as adult granulosa cell tumor (FOXL2) from poorly differentiated Sertoli-Leydig cell tumors (DICER1) and microcystic stromal tumor (CTNNB1 or APC mutation) (N Engl J Med 2009;360:2719, Am J Surg Pathol 2017;41:1178, Genes Chromosomes Cancer 2015;54:353) Foci of stromal invasion, measuring < 5 mm in the greatest dimension Degree of cytologic atypia is mild and similar to borderline tumor Areas of mucin extravasation with inflammatory response are not diagnostic of invasion With mural nodule: Classified as sarcoma-like, anaplastic carcinoma and sarcoma (Cancer 1979;44:1327) Including the aggressive variant, epithelioid inflammatory myofibroblastic sarcoma (Am J Surg Pathol 2011;35:135) Thyroid carcinomas, predominantly papillary (in particular the follicular variant), poorly differentiated and anaplastic (Am J Surg Pathol 2015;39:652, Endocr Relat Cancer 2019;26:803) Password requirements: 6 to 30 characters long; ASCII characters only (characters found on a standard US keyboard); must contain at least 4 different symbols; Foci of stromal invasion, measuring < 5 mm in the greatest dimension Degree of cytologic atypia is mild and similar to borderline tumor Areas of mucin extravasation with inflammatory response are not diagnostic of invasion With mural nodule: Classified as sarcoma-like, anaplastic carcinoma and sarcoma (Cancer 1979;44:1327) Including the aggressive variant, epithelioid inflammatory myofibroblastic sarcoma (Am J Surg Pathol 2011;35:135) Thyroid carcinomas, predominantly papillary (in particular the follicular variant), poorly differentiated and anaplastic (Am J Surg Pathol 2015;39:652, Endocr Relat Cancer 2019;26:803) Distinguish hemangiopericytoma (CD34+) from endometrial stromal sarcoma (CD34-) (Mod Pathol 2005;18:40) Classify other soft tissue tumors Hematopathology: Distinguish lymphocyte rich thymoma (CD34+ cells) from T-ALL (usually CD34-) Password requirements: 6 to 30 characters long; ASCII characters only (characters found on a standard US keyboard); must contain at least 4 different symbols; Low grade adenosarcomas have monotonous stromal nuclei with mild to moderate atypia (similar to that seen in low grade endometrial stromal sarcoma) High grade adenosarcomas have pleomorphic, markedly atypical nuclei, noticeable at low power magnification and 2x the size of an endothelial cell nucleus ( Am J Surg Pathol 2017;41:1513 ) Distinction between low grade endometrial stromal sarcoma and endometrial stromal nodule cannot be made based on cytology, as it requires evaluation of the tumor myometrium interface Distinction between low grade endometrial stromal sarcoma and other monomorphic spindle cell neoplasm is difficult on cytology, especially without Genetics Mesenchymal tumors of soft tissue or other organs (Dabbs: Diagnostic Immunohistochemistry - Theranostic and Genomic Applications, 5th Edition, 2018) Carcinomas of adrenal cortex, thyroid (Am J Pathol 1986;122:343, Cancer 1992;70:2326) Breast: pseudoangiomatous stromal hyperplasia, mesenchymal component of metaplastic carcinoma Defects in this gene are a cause of insulin-like growth factor I deficiency. Utility in distinguishing intraductal spread of urothelial carcinoma from prostatic stromal invasion (Anticancer Res 2008;28:2997) Thoracic pathology: Mesothelioma (+), even in effusions, versus adenocarcinoma (-) (Diagn Cytopathol 2007;35:342, Cancer 2007;109:933) Pathology Outlines This page was last edited on 17 September 2021, at 15:47 (UTC). Foci of stromal invasion, measuring < 5 mm in the greatest dimension Degree of cytologic atypia is mild and similar to borderline tumor Areas of mucin extravasation with inflammatory response are not diagnostic of invasion With mural nodule: Classified as sarcoma-like, anaplastic carcinoma and sarcoma (Cancer 1979;44:1327) Multiple studies suggest ARID1A mutation occurs at early stage of canceration of endometriosis (Oncol Rep 2016;35:607) Endometrial stromal sarcoma: Absence of epithelial elements Normal epithelial elements can be entrapped by the mesenchymal proliferation, mimicking adenosarcoma; however, this usually happens only at the periphery of the lesion and on the endometrial surface; moreover, leaf-like growth and periglandular condensation are absent The encoded protein responds to diverse cellular stresses to regulate expression of target genes, thereby inducing cell cycle arrest, apoptosis, senescence, DNA repair, or changes in metabolism. Uterine tumor resembling ovarian sex cord tumor: ESR1-NCOA2 fusions can show rhabdoid morphology (Am J Surg Pathol 2020;44:1563) Sex cord-like morphology may provide clue to diagnosis (corded, retiform, trabeculated) On RNA expression analysis, undifferentiated uterine sarcoma appears to cluster more closely with leiomyosarcoma than with endometrial stromal sarcoma (Mod Pathol 2021;34:1008) 4 molecular subtypes identified in 1 study, based on differential activation of (Clin Cancer Res 2019;25:2155): Genital tract development pathways Endometrial stromal sarcoma (high grade or low grade) (Hum Pathol 2008;39:1459) Germ cell tumors, seminoma, embryonal carcinoma and yolk sac tumor (Am J Surg Pathol 2004;28:1499, Mod Pathol 2000;13:962) Kidney: carcinoid (may have focal staining, clear cell renal cell carcinoma (usually), oncocytoma (Am J Surg Pathol 2007;31:1539) Uterus, hysterectomy: Proliferative endometrium negative for hyperplasia or malignancy Unremarkable cervix Endometrial stromal sarcoma Board review style answer #1. Including the aggressive variant, epithelioid inflammatory myofibroblastic sarcoma (Am J Surg Pathol 2011;35:135) Thyroid carcinomas, predominantly papillary (in particular the follicular variant), poorly differentiated and anaplastic (Am J Surg Pathol 2015;39:652, Endocr Relat Cancer 2019;26:803) Endometrial stromal sarcoma (high grade or low grade) (Hum Pathol 2008;39:1459) Germ cell tumors, seminoma, embryonal carcinoma and yolk sac tumor (Am J Surg Pathol 2004;28:1499, Mod Pathol 2000;13:962) Kidney: carcinoid (may have focal staining, clear cell renal cell carcinoma (usually), oncocytoma (Am J Surg Pathol 2007;31:1539) Genetics Mutations in this gene are associated with a variety of Undifferentiated endometrial carcinoma / undifferentiated uterine sarcoma: Lacks expression of MyoD1 / myogenin. F-N: female to male transgender histology grossing & features to report high grade endometrial stromal sarcoma inflammatory myofibroblastic tumor intravenous leiomyomatosis leiomyoma-general leiomyosarcoma low grade endometrial stromal sarcoma Mllerian adenosarcoma mesonephric-like endometrial carcinoma (pending) Endometrial stromal sarcoma: Absence of epithelial elements Normal epithelial elements can be entrapped by the mesenchymal proliferation, mimicking adenosarcoma; however, this usually happens only at the periphery of the lesion and on the endometrial surface; moreover, leaf-like growth and periglandular condensation are absent They are filled with fluid of variable color (from clear or straw colored to altered blood or chocolate-colored to purulent when infected). SMARCD1 is a transcriptional target of specific non-hotspot mutant Utility in distinguishing intraductal spread of urothelial carcinoma from prostatic stromal invasion (Anticancer Res 2008;28:2997) Thoracic pathology: Mesothelioma (+), even in effusions, versus adenocarcinoma (-) (Diagn Cytopathol 2007;35:342, Cancer 2007;109:933) Other tumors: adenomatoid tumor angiomyolipoma benign papillary mesothelioma carcinosarcoma endometrial stromal sarcoma fibromatosis fibrosarcoma granulocytic sarcoma hemangioma hepatoid carcinoma leiomyoma leiomyosarcoma mesothelioma Mllerian adenosarcoma myofibroblastoma nephroblastoma neuroendocrine carcinoma (non-small cell Sample pathology report. 5 year survival rate is approximately 30% (stage I - II: 59%; stage III: 25%; stage IV: 9%) (Gynecol Oncol 2010;116:419) This is a much more aggressive tumor than high grade endometrial carcinoma where the 5 year survival rate for stage I disease is over 80% (Am J Surg Pathol 2007;31:979) Stage is the most consistent independent predictor of outcome Pathology Outlines This page was last edited on 17 September 2021, at 15:47 (UTC). Epithelioid sarcoma (Pediatr Dev Pathol 2019;22:59) Ependymomas (Appl Immunohistochem Mol Morphol 2018;26:71) Ewing sarcoma (membranous staining) (Histopathology 2014;64:101) Follicular dendritic cell sarcoma, interdigitating dendritic cell / reticulum cell sarcoma Lymphomas May exhibit hyperplasia, atypical hyperplasia / EIN, endometrial carcinoma, endometrial stromal sarcoma, carcinosarcoma (Gynecol Obstet Invest 1999;48:141) Microscopic foci may be in vascular spaces resembling endometrial stromal sarcoma (Int J Gynecol Pathol 2010;29:117, Am J Surg Pathol 2013;37:1395, Am J Obstet Gynecol 2012;207:417) l Many mutations have been found in sex cord stromal tumors and can differentiate subtypes, such as adult granulosa cell tumor (FOXL2) from poorly differentiated Sertoli-Leydig cell tumors (DICER1) and microcystic stromal tumor (CTNNB1 or APC mutation) (N Engl J Med 2009;360:2719, Am J Surg Pathol 2017;41:1178, Genes Chromosomes Cancer 2015;54:353) Clear cell sarcoma (J Clin Pathol 2010;63:416) Epithelioid sarcoma proximal type (15 - 33%) (Am J Surg Pathol 1997;21:130, Mod Pathol 2001;14:655) Fibrosarcoma, infantile and adult type (rare / focal; expression does not exclude diagnosis) (Am J Clin Pathol 2001;115:348) Hemosiderotic fibrolipomatous tumor (Histopathology 2006;48:453) Endometrial stromal tumor Carcinosarcoma Board review style answer #1. Uterus, fallopian tubes and ovaries, hysterectomy and bilateral salpingo-oophorectomy: ZC3H7B-BCOR rearranged high grade endometrial stromal sarcoma (14 cm) (see comment and synoptic report) ; Comment: The tumor shows tongue-like myometrial invasion and is composed of enlarged, hyperchromatic spindle cells percolating within a myxoid stroma. Distinguish hemangiopericytoma (CD34+) from endometrial stromal sarcoma (CD34-) (Mod Pathol 2005;18:40) Classify other soft tissue tumors Hematopathology: Distinguish lymphocyte rich thymoma (CD34+ cells) from T-ALL (usually CD34-) Uterus with cervix, fallopian tubes and ovaries, total Clear cell sarcoma of kidney (Diagn Pathol 2019;14:13) Adenocarcinoma of prostate (Clin Cancer Res 2015;21:5619) Endometrial stromal sarcoma (Am J Surg Pathol 2012;36:1562) Multiple myeloma (Indian J Med Paediatr Oncol 2013;34:283, Am J Clin Pathol 2006;125:615) Vulval carcinoma (Hum Pathol 2012;43:1386) This gene encodes a tumor suppressor protein containing transcriptional activation, DNA binding, and oligomerization domains. Epithelioid sarcoma (Pediatr Dev Pathol 2019;22:59) Ependymomas (Appl Immunohistochem Mol Morphol 2018;26:71) Ewing sarcoma (membranous staining) (Histopathology 2014;64:101) Follicular dendritic cell sarcoma, interdigitating dendritic cell / reticulum cell sarcoma Lymphomas Causes, symptoms, diagnosis, treatment, pathology. The protein encoded by this gene is similar to insulin in function and structure and is a member of a family of proteins involved in mediating growth and development. This gene encodes a tumor suppressor protein containing transcriptional activation, DNA binding, and oligomerization domains. Endometrium, endometrial stroma, myofibroblasts (J Submicrosc Cytol Pathol 2005;37:231), pericytes Negative staining - disease Cellular angiofibroma ( Mod Pathol 2011;24:82 ), dermatomyofibroma ( J Cutan Pathol 2011;38:967 ), endometrial stromal tumor (references above), fibromatosis, inflammatory myofibroblastic sarcoma-epithelioid ( Am J Mutations in this gene are associated with a variety of May exhibit hyperplasia, atypical hyperplasia / EIN, endometrial carcinoma, endometrial stromal sarcoma, carcinosarcoma (Gynecol Obstet Invest 1999;48:141) Microscopic foci may be in vascular spaces resembling endometrial stromal sarcoma (Int J Gynecol Pathol 2010;29:117, Am J Surg Pathol 2013;37:1395, Am J Obstet Gynecol 2012;207:417) l B. Endometrioid adenocarcinoma Comment Here Reference: Vimentin. Epithelioid sarcoma (Pediatr Dev Pathol 2019;22:59) Ependymomas (Appl Immunohistochem Mol Morphol 2018;26:71) Ewing sarcoma (membranous staining) (Histopathology 2014;64:101) Follicular dendritic cell sarcoma, interdigitating dendritic cell / reticulum cell sarcoma Lymphomas Endometrial polyp with atypical stromal cells appears to be indolent with no recurrences or progression to malignancy reported, even in cases treated only with curettage / polypectomy Case reports 28 year old woman with intravascular large B cell lymphoma in a benign appearing endometrial polyp ( Blood 2019;133:1920 ) Genetics Defects in this gene are a cause of insulin-like growth factor I deficiency. Expression and clinicopathological significance of lipin-1 in human breast cancer and its association with p53 tumor suppressor gene. Macroscopically the kidney demonstrates a large number of cysts of variable size (from a few mm to many cm), in both the cortex and medulla. Clear cell sarcoma of soft tissue: 97% negative (Am J Surg Pathol 2008;32:452) Endometrial stromal sarcoma: 76% negative (Mod Pathol 2005;18:40) Epithelioid angiosarcoma of the bladder: 66% negative (Am J Surg Pathol 2015;39:1377) Ewing sarcoma family of tumors / PNET: 81% negative (Virchows Arch 2011;459:409, Am J Surg Pathol 2000;24:410) Distinction between low grade endometrial stromal sarcoma and endometrial stromal nodule cannot be made based on cytology, as it requires evaluation of the tumor myometrium interface Distinction between low grade endometrial stromal sarcoma and other monomorphic spindle cell neoplasm is difficult on cytology, especially without Undifferentiated endometrial carcinoma / undifferentiated uterine sarcoma: Lacks expression of MyoD1 / myogenin. Uterine tumor resembling ovarian sex cord tumor: ESR1-NCOA2 fusions can show rhabdoid morphology (Am J Surg Pathol 2020;44:1563) Sex cord-like morphology may provide clue to diagnosis (corded, retiform, trabeculated) The encoded protein is processed from a precursor, bound by a specific receptor, and secreted. Sample pathology report. Uterus with cervix, fallopian tubes and ovaries, total Distinction between low grade endometrial stromal sarcoma and endometrial stromal nodule cannot be made based on cytology, as it requires evaluation of the tumor myometrium interface Distinction between low grade endometrial stromal sarcoma and other monomorphic spindle cell neoplasm is difficult on cytology, especially without Uterus, fallopian tubes and ovaries, hysterectomy and bilateral salpingo-oophorectomy: ZC3H7B-BCOR rearranged high grade endometrial stromal sarcoma (14 cm) (see comment and synoptic report) ; Comment: The tumor shows tongue-like myometrial invasion and is composed of enlarged, hyperchromatic spindle cells percolating within a myxoid stroma. Many mutations have been found in sex cord stromal tumors and can differentiate subtypes, such as adult granulosa cell tumor (FOXL2) from poorly differentiated Sertoli-Leydig cell tumors (DICER1) and microcystic stromal tumor (CTNNB1 or APC mutation) (N Engl J Med 2009;360:2719, Am J Surg Pathol 2017;41:1178, Genes Chromosomes Cancer 2015;54:353) The protein encoded by this gene is similar to insulin in function and structure and is a member of a family of proteins involved in mediating growth and development. The prognostic value of SOX11 status in MCL is debated and may vary depending on the clinical presentation (i.e., conventional versus leukemic nonnodal MCL) (BMC Cancer 2021;21:209, Blood 2012;119:4215) In varying MCL populations, higher levels of SOX11 expression have been shown to correlate both with a better and a worse prognosis (Blood 2018;131:417, Oncogene Stromal hyalinization is common Sclerosing PEComa is rare in the gynecologic tract (Int J Gynecol Pathol 2011;30:121, Pathol Int 2011;61:768) TFE3 translocation associated PEComas (Am J Surg Pathol 2010;34:1395, Am J Surg Pathol 2015;39:394): Typically epithelioid with clear cells in a nested / alveolar growth Low grade atypia and rare mitoses Low grade adenosarcomas have monotonous stromal nuclei with mild to moderate atypia (similar to that seen in low grade endometrial stromal sarcoma) High grade adenosarcomas have pleomorphic, markedly atypical nuclei, noticeable at low power magnification and 2x the size of an endothelial cell nucleus ( Am J Surg Pathol 2017;41:1513 ) Screening immunomarker for myogenic differentiation Focal positivity in myofibroblastic tumors Differentiates smooth muscle tumors (desmin+) from gastrointestinal stromal tumor (3 - 5% desmin+) (Ann Diagn Pathol 2007;11:39) Differentiates pleomorphic rhabdomyosarcoma (desmin+) from undifferentiated pleomorphic sarcoma (desmin-) (Ann Diagn Pathol 2018;37:118)

Angles On A Line Worksheet, 31610 Ranch Rd 12 Dripping Springs, Tx 78620, Humminbird Mega 360 In Stock, Siena College Enrollment 2021, Tillamook Mint Chocolate Chip Ice Cream, New Jersey Security Deposit Law, Centinela Hospital Covid Vaccine, Christian Mission Organizations In Singapore,