Brenner tumour

From Libre Pathology
Revision as of 18:41, 7 March 2016 by Michael (talk | contribs)
Jump to navigation Jump to search

The Brenner tumour, abbreviated BT, is an ovarian tumour in the epithelial group of ovarian tumours.

Brenner tumour
Diagnosis in short

Brenner tumour. H&E stain.

LM nests cells that have a "coffee bean nucleus" (nucleus = elliptical shape, nuclear groove along long axis), distinct nucleoli, moderate-to-abundant gray/pale cytoplasm, dense fibrous stroma around nests
Subtypes benign (most common), borderline, malignant
LM DDx granulosa cell tumour, ovarian fibroma, thecoma, Walthard cell rest
IHC AR +ve, calretinin -ve
Gross classically solid (may be cystic), usu. well-circumscribed, light yellow colour
Site ovary (see ovarian tumours), fallopian tube

Prevalence uncommon
Prognosis usu. good, may be poor

General

Epidemiology

  • Mostly benign clinical course - 99% of Brenner tumours benign.[6]
  • Thought to arise from Walthard cell rest.
  • Frequently an incidental finding, i.e. oophorectomy was done for another reason.
  • May be malignant - rarely (~1% of Brenner tumours[7]).

Gross

Features:[8]

  • Classically solid, well-circumscribed, light yellow.
  • May be cystic.

Note:

  • Borderline tumours classically solid and cystic with papillary projections into the cystic component.[8]

Microscopic

Features:

  • Nests of transitional epithelium with cells that have:[9]
    • A "coffee bean nucleus".
      • Elliptical shape (nucleus).
      • Nuclear grooves.
      • Distinct nucleoli.
    • Moderate-to-abundant gray/pale cytoplasm.
  • Dense fibrous stroma around nests.

Notes:

DDx:[6]

  • Benign:
  • Borderline:
    • Benign Brenner tumour.
    • Malignant Brenner tumour.
    • Metastatic papillary urothelial carcinoma.
  • Malignant:
    • Undifferentiated carcinoma - no Brenner tumour component.
    • Granulosa cell tumour.
    • Serous carcinoma.
    • Metastatic urothelial carcinoma.
  • Walthard cell rest - typically one nest of cells, lack the surrounding fibromatous stroma.

Images

IHC

Features:[4]

  • AR +ve.
  • Calretinin -ve.
    • Surrounding stroma +ve.
  • Inhibin +ve.[4]

See also

References

  1. Bilici, A.; Inanc, M.; Ulas, A.; Akman, T.; Seker, M.; Babacan, NA.; Inal, A.; Bal, O. et al. (2013). "Clinical and pathologic features of patients with rare ovarian tumors: multi-center review of 167 patients by the anatolian society of medical oncology.". Asian Pac J Cancer Prev 14 (11): 6493-9. PMID 24377556.
  2. Arnogiannaki, N.; Grigoriadis, C.; Zygouris, D.; Terzakis, E.; Sebastiadou, M.; Tserkezoglou, A. (2011). "Proliferative Brenner tumor of the ovary. clinicopathological study of two cases and review of the literature.". Eur J Gynaecol Oncol 32 (5): 576-8. PMID 22053680.
  3. Ali, RH.; Seidman, JD.; Luk, M.; Kalloger, S.; Gilks, CB. (Nov 2012). "Transitional cell carcinoma of the ovary is related to high-grade serous carcinoma and is distinct from malignant brenner tumor.". Int J Gynecol Pathol 31 (6): 499-506. doi:10.1097/PGP.0b013e31824d7445. PMID 23018212.
  4. 4.0 4.1 4.2 Kuhn, E.; Ayhan, A.; Shih, IeM.; Seidman, JD.; Kurman, RJ. (Dec 2013). "Ovarian Brenner tumour: a morphologic and immunohistochemical analysis suggesting an origin from fallopian tube epithelium.". Eur J Cancer 49 (18): 3839-49. doi:10.1016/j.ejca.2013.08.011. PMID 24012099.
  5. Amin MB (February 2005). "Selected other problematic testicular and paratesticular lesions: rete testis neoplasms and pseudotumors, mesothelial lesions and secondary tumors". Mod. Pathol. 18 Suppl 2: S131–45. doi:10.1038/modpathol.3800314. PMID 15502808.
  6. 6.0 6.1 Nucci, Marisa R.; Oliva, Esther (2009). Gynecologic Pathology: A Volume in Foundations in Diagnostic Pathology Series (1st ed.). Churchill Livingstone. pp. 437. ISBN 978-0443069208.
  7. Gezginç, K.; Karatayli, R.; Yazici, F.; Acar, A.; Çelik, Ç.; Çapar, M.; Tavli, L. (Aug 2012). "Malignant Brenner tumor of the ovary: analysis of 13 cases.". Int J Clin Oncol 17 (4): 324-9. doi:10.1007/s10147-011-0290-7. PMID 21796330.
  8. 8.0 8.1 Borah, T.; Mahanta, RK.; Bora, BD.; Saikia, S. (Jan 2011). "Brenner tumor of ovary: An incidental finding.". J Midlife Health 2 (1): 40-1. doi:10.4103/0976-7800.83273. PMC 3156501. PMID 21897739. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3156501/.
  9. Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 1098. ISBN 0-7216-0187-1.