Difference between revisions of "Serous carcinoma of the ovary"

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{| class="wikitable sortable"  
{| class="wikitable sortable"  
! Grade
! Grade
! Nuclei (most important)
! Nuclear atypia (most important)
! Mitotic rate
! Mitotic rate  
|-
|-
| Low-grade (Type I)
| Low-grade (Type I)

Revision as of 23:20, 1 January 2014

Serous carcinoma of the ovary, also ovarian serous carcinoma, is relatively common malignant ovarian tumour.

General

Microscopic

Features:

  • Nuclear pleomorphism:
    • Variation in size - often marked.
    • Variation in staining.
    • Variation in shape.
  • +/-Macronucleolus - key feature.
  • Eccentric nucleus.
  • Architecture:
    • Solid.
    • Papillary - classic.
    • Glandular - uncommon.
  • +/-Psammoma bodies - uncommon.
  • +/-Necrosis - often extensive.

DDx:

Grading

Serous carcinoma is subdivided into:[2][3]

Grade Nuclear atypia (most important) Mitotic rate
Low-grade (Type I) mild/moderate atypia: round/oval nuclei, evenly distributed
chromatin, +/-conspicuous nucleoli 		<=12 mitoses/HPF †
High-grade (Type II) severe atypia: >=3:1 size variation, irregular
chromatin, +/-macronucleoli 		>12 mitoses/HPF †

Notes:

  • † Definition suffers from HPFitis.
  • Tumours very rarely transform from low-grade to high-grade.[4]

Images

  • Serous carcinoma - cytology. (WC)

www:

IHC

  • WT-1 +ve - key immunostain.[6]
  • CK7 +ve.
  • CA-125 +ve.
  • ER +ve.[7]
  • p53 +ve.

Others:

See also

References

  1. ↑ Vang, R.; Shih, IeM.; Kurman, RJ. (Jan 2013). "Fallopian tube precursors of ovarian low- and high-grade serous neoplasms.". Histopathology 62 (1): 44-58. doi:10.1111/his.12046. PMID 23240669.
  2. ↑ Vang, R.; Shih, IeM.; Kurman, RJ. (Sep 2009). "Ovarian low-grade and high-grade serous carcinoma: pathogenesis, clinicopathologic and molecular biologic features, and diagnostic problems.". Adv Anat Pathol 16 (5): 267-82. doi:10.1097/PAP.0b013e3181b4fffa. PMID 19700937.
  3. ↑ Malpica, A.; Deavers, MT.; Lu, K.; Bodurka, DC.; Atkinson, EN.; Gershenson, DM.; Silva, EG. (Apr 2004). "Grading ovarian serous carcinoma using a two-tier system.". Am J Surg Pathol 28 (4): 496-504. PMID 15087669.
  4. ↑ Garg, K.; Park, KJ.; Soslow, RA. (Sep 2012). "Low-grade serous neoplasms of the ovary with transformation to high-grade carcinomas: a report of 3 cases.". Int J Gynecol Pathol 31 (5): 423-8. doi:10.1097/PGP.0b013e31824ae6f2. PMID 22833081.
  5. ↑ Ayhan, A.; Kurman, RJ.; Yemelyanova, A.; Vang, R.; Logani, S.; Seidman, JD.; Shih, IeM. (Aug 2009). "Defining the cut point between low-grade and high-grade ovarian serous carcinomas: a clinicopathologic and molecular genetic analysis.". Am J Surg Pathol 33 (8): 1220-4. doi:10.1097/PAS.0b013e3181a24354. PMC 2716424. PMID 19461510. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716424/.
  6. ↑ Köbel, M.; Kalloger, SE.; Carrick, J.; Huntsman, D.; Asad, H.; Oliva, E.; Ewanowich, CA.; Soslow, RA. et al. (Jan 2009). "A limited panel of immunomarkers can reliably distinguish between clear cell and high-grade serous carcinoma of the ovary.". Am J Surg Pathol 33 (1): 14-21. doi:10.1097/PAS.0b013e3181788546. PMID 18830127.
  7. ↑ DeLair, D.; Oliva, E.; Köbel, M.; Macias, A.; Gilks, CB.; Soslow, RA. (Jan 2011). "Morphologic spectrum of immunohistochemically characterized clear cell carcinoma of the ovary: a study of 155 cases.". Am J Surg Pathol 35 (1): 36-44. doi:10.1097/PAS.0b013e3181ff400e. PMID 21164285.
  8. ↑ Tsuchiya, A.; Sakamoto, M.; Yasuda, J.; Chuma, M.; Ohta, T.; Ohki, M.; Yasugi, T.; Taketani, Y. et al. (Dec 2003). "Expression profiling in ovarian clear cell carcinoma: identification of hepatocyte nuclear factor-1 beta as a molecular marker and a possible molecular target for therapy of ovarian clear cell carcinoma.". Am J Pathol 163 (6): 2503-12. PMID 14633622. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892387/?tool=pubmed.
  9. ↑ Online 'Mendelian Inheritance in Man' (OMIM) 189907
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