Immunophenotype of Atypical Polypoid Adenomyoma of the Uterus: Diagnostic Value and Insight on Pathogenesis.
Journal
Applied immunohistochemistry & molecular morphology : AIMM
ISSN: 1533-4058
Titre abrégé: Appl Immunohistochem Mol Morphol
Pays: United States
ID NLM: 100888796
Informations de publication
Date de publication:
09 2020
09 2020
Historique:
pubmed:
20
12
2019
medline:
6
8
2021
entrez:
20
12
2019
Statut:
ppublish
Résumé
Atypical polypoid adenomyoma (APA) is a rare uterine lesion constituted by atypical endometrioid glands, squamous morules, and myofibromatous stroma. We aimed to assess the immunophenotype of the 3 components of APA, with regard to its pathogenesis and its differential diagnosis. A systematic review was performed by searching electronic databases from their inception to January 2019 for immunohistochemical studies of APA. Thirteen studies with 145 APA cases were included. APA glands appeared analogous to atypical endometrial hyperplasia (endometrioid cytokeratins pattern, Ki67≤50%, common PTEN loss, and occasional mismatch repair deficiency); the prominent expression of hormone receptors and nuclear β-catenin suggest that APA may be a precursor of "copy number-low," CTNNB1-mutant endometrial cancers. Morules appeared as a peculiar type of hyperdifferentiation (low KI67, nuclear β-catenin+, CD10+, CDX2+, SATB2+, p63-, and p40-), analogous to morular metaplasia in other lesions and distinguishable immunohistochemically from both conventional squamous metaplasia and solid cancer growth. Stroma immunphenotype (low Ki67, α-smooth-muscle-actin+, h-caldesmon-, CD10-, or weak and patchy) suggested a derivation from a metaplasia of normal endometrial stroma. It was similar to that of nonatypical adenomyoma, and different from adenosarcoma (Ki67 increase and CD10+ in periglandular stroma) and myoinvasive endometrioid carcinoma (h-caldesmon+ in myometrium and periglandular fringe-like CD10 pattern).
Identifiants
pubmed: 31855579
doi: 10.1097/PAI.0000000000000780
pii: 00129039-202009000-00010
doi:
Substances chimiques
Biomarkers, Tumor
0
CTNNB1 protein, human
0
Ki-67 Antigen
0
MKI67 protein, human
0
beta Catenin
0
PTEN Phosphohydrolase
EC 3.1.3.67
PTEN protein, human
EC 3.1.3.67
Neprilysin
EC 3.4.24.11
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
646-653Références
Mazur MT. Atypical polypoid adenomyomas of the endometrium. Am J Surg Pathol. 1981;5:473–482.
Jiang QY, Wang L, Wu RJ. A multiple perspectives on atypical polypoid adenomyoma of uterus. Gynecol Endocrinol. 2013;29:623–625.
Young RH, Treger T, Scully RE. Atypical polypoid adenomyoma of the uterus. A report of 27 cases. Am J Clin Pathol. 1986;86:139–145.
Longacre TA, Chung MH, Rouse RV, et al. Atypical polypoid adenomyofibromas (atypical polypoid adenomyomas) of the uterus. A clinicopathologic study of 55 cases. Am J Surg Pathol. 1996;20:1–20.
Raffone A, Travaglino A, Saccone G, et al. Management of women with atypical polypoid adenomyoma of the uterus: a quantitative systematic review. Acta Obstet Gynecol Scand. 2019. [Epub ahead of print].
McCluggage WG, Van de Vijver K. SATB2 is consistently expressed in squamous morules associated with endometrioid proliferative lesions and in the stroma of atypical polypoid adenomyoma. Int J Gynecol Pathol. 2018. [Epub ahead of print].
Heatley MK. Atypical polypoid adenomyoma: a systematic review of the English literature. Histopathology. 2006;48:609–610.
McCluggage WG. A practical approach to the diagnosis of mixed epithelial and mesenchymal tumours of the uterus. Mod Pathol. 2016;29(suppl 1):S78–S91.
Kurman RJ, Carcangiu ML, Herrington CS, et al. WHO Classification of Tumours of Female Reproductive Organs, 4th ed. Lyon, France: IARC; 2014.
Travaglino A, Raffone A, Saccone G, et al. Endometrial hyperplasia and risk of coexistent cancer: WHO vs EIN criteria. Histopathology. 2019;74:676–687.
Takahashi H, Yoshida T, Matsumoto T, et al. Frequent β-catenin gene mutations in atypical polypoid adenomyoma of the uterus. Hum Pathol. 2014;45:33–40.
Cancer Genome Atlas Research Network. Integrated genomic characterization of endometrial carcinoma. Nature. 2013;497:67–73.
Ota S, Catasus L, Matias-Guiu X, et al. Molecular pathology of atypical polypoid adenomyoma of the uterus. Hum Pathol. 2003;34:784–788.
Němejcová K, Kenny SL, Laco J, et al. Atypical polypoid adenomyoma of the uterus: an immunohistochemical and molecular study of 21 cases. Am J Surg Pathol. 2015;39:1148–1155.
Di Palma S, Santini D, Martinelli G. Atypical polypoid adenomyoma of the uterus. An immunohistochemical study of a case. Tumori. 1989;75:292–295.
Fukunaga M, Endo Y, Ushigome S, et al. Atypical polypoid adenomyomas of the uterus. Histopathology. 1995;27:35–42.
Kuwashima Y, Uehara T, Kurosumi M, et al. Atypical polypoid adenomyoma of the uterus in a very old woman. Report of a case with immunohistochemical characterization of its stromal components and proliferative status. Eur J Gynaecol Oncol. 1995;16:115–119.
Soslow RA, Chung MH, Rouse RV, et al. Atypical polypoid adenomyofibroma (APA) versus well-differentiated endometrial carcinoma with prominent stromal matrix: an immunohistochemical study. Int J Gynecol Pathol. 1996;15:209–216.
Ramos P, Valenzuela P, Santana A, et al. Atypical polypoid adenomyoma of the uterine cervix: a diagnostic problem. J Obstet Gynaecol. 2003;23:319–321.
Chiarelli S, Buriticá C, Litta P, et al. An immunohistochemical study of morules in endometrioid lesions of the female genital tract: CD10 is a characteristic marker of morular metaplasia. Clin Cancer Res. 2006;12(pt 1):4251–4256.
Houghton O, Connolly LE, McCluggage WG. Morules in endometrioid proliferations of the uterus and ovary consistently express the intestinal transcription factor CDX2. Histopathology. 2008;53:156–165.
Ohishi Y, Kaku T, Kobayashi H, et al. CD10 immunostaining distinguishes atypical polypoid adenomyofibroma (atypical polypoid adenomyoma) from endometrial carcinoma invading the myometrium. Hum Pathol. 2008;39:1446–1453.
Horita A, Kurata A, Maeda D, et al. Immunohistochemical characteristics of atypical polypoid adenomyoma with special reference to h-caldesmon. Int J Gynecol Pathol. 2011;30:64–70.
Terada T. Atypical polypoid adenomyoma of the uterus: an immunohistochemical study on 5 cases. Ann Diagn Pathol. 2011;15:338–341.
Aggarwal N, Bhargava R, Elishaev E. Uterine adenosarcomas: diagnostic use of the proliferation marker Ki-67 as an adjunct to morphologic diagnosis. Int J Gynecol Pathol. 2012;31:447–452.
Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1.
Lu B, Yu M, Shi H, et al. Atypical polypoid adenomyoma of the uterus: a reappraisal of the clinicopathological and immunohistochemical features. Pathol Res Pract. 2019;215:766–771.
Raffone A, Travaglino A, Saccone G, et al. Loss of PTEN expression as diagnostic marker of endometrial precancer: a systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2019;98:275–286.
Travaglino A, Raffone A, Saccone G, et al. PTEN as a predictive marker of response to conservative treatment in endometrial hyperplasia and early endometrial cancer. A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2018;231:104–110.
Raffone A, Travaglino A, Saccone G, et al. PTEN expression in endometrial hyperplasia and risk of cancer: a systematic review and meta-analysis. Arch Gynecol Obstet. 2019. [Epub ahead of print].
Travaglino A, Raffone A, Saccone G, et al. PTEN immunohistochemistry in endometrial hyperplasia: which are the optimal criteria for the diagnosis of precancer? APMIS. 2019;127:161–169.
Raffone A, Travaglino A, Saccone G, et al. Endometrial hyperplasia and progression to cancer: which classification system stratifies the risk better? A systematic review and meta-analysis. Arch Gynecol Obstet. 2019;299:1233–1242.
Travaglino A, Raffone A, Saccone G, et al. Complexity of glandular architecture should be reconsidered in the classification and management of endometrial hyperplasia. APMIS. 2019. [Epub ahead of print].
European Society of Gynaecological Oncology. 2018 ESGO Gynaecological Cancers Guidelines. Available at: https://esgo.org/wp-content/uploads/2015/12/Endometrial_broz_A6_b.pdf. Accessed December 4, 2018.
Raffone A, Travaglino A, Saccone G, et al. PAX2 in endometrial carcinogenesis and in differential diagnosis of endometrial hyperplasia. A systematic review and meta-analysis of diagnostic accuracy. Acta Obstet Gynecol Scand. 2019;98:287–299.
Travaglino A, Raffone A, Saccone G, et al. Loss of B-cell lymphoma 2 immunohistochemical expression in endometrial hyperplasia: a specific marker of precancer and novel indication for treatment: A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2018;97:1415–1426.
Ayhan A, Mao TL, Suryo Rahmanto Y, et al. Increased proliferation in atypical hyperplasia/endometrioid intraepithelial neoplasia of the endometrium with concurrent inactivation of ARID1A and PTEN tumour suppressors. J Pathol Clin Res. 2015;1:186–193.
Talhouk A, McConechy MK, Leung S, et al. Confirmation of ProMisE: a simple, genomics-based clinical classifier for endometrial cancer. Cancer. 2017;123:802–813.
Nei H, Saito T, Yamasaki H, et al. Nuclear localization of beta-catenin in normal and carcinogenic endometrium. Mol Carcinog. 1999;25:207–218.
Raffone A, Travaglino A, Saccone G, et al. Should progesterone and estrogens receptors be assessed for predicting the response to conservative treatment of endometrial hyperplasia and cancer? A systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2019. [Epub ahead of print].
Travaglino A, Raffone A, Saccone G, et al. Immunohistochemical predictive markers of response to conservative treatment of endometrial hyperplasia and early endometrial cancer: a systematic review. Acta Obstet Gynecol Scand. 2019. [Epub ahead of print].
Nomura H, Sugiyama Y, Tanigawa T, et al. Long-term outcomes of fertility-sparing treatment of atypical polypoid adenomyoma with medroxyprogesterone acetate. Arch Gynecol Obstet. 2016;293:177–181.
Nomura H, Sugiyama Y, Tanigawa T, et al. Maintenance hormonal therapy after treatment with medroxyprogesterone acetate for patients with atypical polypoid adenomyoma. Jpn J Clin Oncol. 2018;48:255–258.
Giampaolino P, Di Spiezio Sardo A, Mollo A, et al. Hysteroscopic endometrial focal resection followed by levonorgestrel intrauterine device insertion as a fertility-sparing treatment of atypical endometrial hyperplasia and early endometrial cancer: a retrospective study. J Minim Invasive Gynecol. 2019;26:648–656.
Zhang Q, Qi G, Kanis MJ, et al. Comparison among fertility-sparing therapies for well differentiated early-stage endometrial carcinoma and complex atypical hyperplasia. Oncotarget. 2017;8:57642–57653.
Ma B, Zhu Y, Liu Y. Management of atypical polypoid adenomyoma of the uterus: a single center’s experience. Medicine (Baltimore). 2018;97:e0135.
Travaglino A, Raffone A, Saccone G, et al. Immunohistochemical nuclear expression of β-catenin as a surrogate of CTNNB1 exon 3 mutation in endometrial cancer. Am J Clin Pathol. 2019;151:529–538.
Stelloo E, Nout RA, Osse EM, et al. Improved risk assessment by integrating molecular and clinicopathological factors in early-stage endometrial cancer-combined analysis of the PORTEC Cohorts. Clin Cancer Res. 2016;22:4215–4224.
McAlpine J, Leon-Castillo A, Bosse T. The rise of a novel classification system for endometrial carcinoma; integration of molecular subclasses. J Pathol. 2018;244:538–549.
Lin MC, Lomo L, Baak JP, et al. Squamous morules are functionally inert elements of premalignant endometrial neoplasia. Mod Pathol. 2009;22:167–174.
Strickland KC, Yuan L, Quade BJ, et al. Clinicopathologic and immunohistochemical features of uterine adenomyomatous polyps. Hum Pathol. 2019;84:239–245.