Serous tubal intraepithelial carcinoma

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Serous tubal intraepithelial carcinoma, abbreviated STIC[1] (pronounced stick), is considered to be the precursor of serous carcinoma.

Serous tubal intraepithelial carcinoma
Diagnosis in short

Micrograph showing serous tubal intraepithelial carcinoma. H&E stain.

LM three of the following five: (1) atypical chromatin pattern, (2) nuclear enlargement, (3) nuclear pleomorphism, (4) nuclear moulding, (5) loss of nuclear polarity or epithelial stratification
IHC p16 +ve, p53 +ve, Ki-67 increased
Molecular BRCA1 mutation or BRCA2 mutation
Gross not apparent on gross
Site fallopian tubes

Clinical history BRCA mutation carrier
Symptoms none
Prevalence uncommon

It is also known as tubal intraepithelial carcinoma.

General

  • Considered the precursor lesion for tubal serous carcinoma.[2]
  • Seen in ~6% of prophylactic salpingo-oophorectomies in BRCA-mutation carriers.[3]

Gross

  • Not apparent on gross.
  • Usually at the fimbriated end of the tube.

Microscopic

Features:[4]

  • Discrete papillary growth - low power.
  • Formal criteria - need 3 or more:
    1. Atypical chromatin pattern.
    2. Nuclear enlargement.
    3. Nuclear pleomorphism.
    4. Nuclear moulding.
    5. Loss of nuclear polarity or epithelial stratification.

Notes:

  • At low power STIC is usually tall cells that are too blue.
  • Cilia suggest benign.

DDx:

  • Atypical tubal lesion (STIL or TILT) - lack proliferation.[citation needed]

Images

www

IHC

Features:[1]

  • p53 +ve.
  • Ki-67 increased ~10%. (???)
  • p16 +ve.[4]

See also

References

  1. 1.0 1.1 Visvanathan, K.; Vang, R.; Shaw, P.; Gross, A.; Soslow, R.; Parkash, V.; Shih, IeM.; Kurman, RJ. (Dec 2011). "Diagnosis of serous tubal intraepithelial carcinoma based on morphologic and immunohistochemical features: a reproducibility study.". Am J Surg Pathol 35 (12): 1766-75. doi:10.1097/PAS.0b013e31822f58bc. PMID 21989347.
  2. Lee, Y.; Miron, A.; Drapkin, R.; Nucci, MR.; Medeiros, F.; Saleemuddin, A.; Garber, J.; Birch, C. et al. (Jan 2007). "A candidate precursor to serous carcinoma that originates in the distal fallopian tube.". J Pathol 211 (1): 26-35. doi:10.1002/path.2091. PMID 17117391.
  3. Mingels MJ, Roelofsen T, van der Laak JA, et al. (October 2012). "Tubal epithelial lesions in salpingo-oophorectomy specimens of BRCA-mutation carriers and controls". Gynecol. Oncol. 127 (1): 88–93. doi:10.1016/j.ygyno.2012.06.015. PMID 22710074.
  4. 4.0 4.1 4.2 Sehdev, AS.; Kurman, RJ.; Kuhn, E.; Shih, IeM. (Jun 2010). "Serous tubal intraepithelial carcinoma upregulates markers associated with high-grade serous carcinomas including Rsf-1 (HBXAP), cyclin E and fatty acid synthase.". Mod Pathol 23 (6): 844-55. doi:10.1038/modpathol.2010.60. PMID 20228782.
  5. 5.0 5.1 5.2 Kurman, RJ.; Shih, IeM. (Jul 2011). "Molecular pathogenesis and extraovarian origin of epithelial ovarian cancer--shifting the paradigm.". Hum Pathol 42 (7): 918-31. doi:10.1016/j.humpath.2011.03.003. PMID 21683865.
  6. Gross, AL.; Kurman, RJ.; Vang, R.; Shih, IeM.; Visvanathan, K. (2010). "Precursor lesions of high-grade serous ovarian carcinoma: morphological and molecular characteristics.". J Oncol 2010: 126295. doi:10.1155/2010/126295. PMID 20445756.
  7. URL: http://www.ovariancancerprevention.org/?page_id=191. Accessed on: 13 May 2014.

External links