Minimal deviation adenocarcinoma of the uterine cervix
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Minimal deviation adenocarcinoma of the uterine cervix is a very well-differentiated adenocarcinoma of the uterine cervix associated with Peutz-Jeghers syndrome.
It is also known as adenoma malignum and minimal deviation adenocarcinoma (abbreviated MDA).
It is a subset of adenocarcinoma of the uterine cervix, which is dealt with in the adenocarcinoma of the uterine cervix article.
General
- Rare and difficult diagnosis.[1]
- Requires a deep sampling;[2] thus, usually diagnosed on cone biopsy or hysterectomy.
- Associated with Peutz-Jeghers syndrome.[3][4]
- Poor prognosis.[5]
- Not associated with HPV - unlike most adenocarcinoma of the uterine cervix.
Note:
- Very well-differentiated adenocarcinoma may also be seen in the stomach;[6] however, this does not appear to be related to the well-differentiated adenocarcinoma in the cervix.
Microscopic
Features:[7]
- Deep infiltrating glands - key feature.
- Desmoplastic stroma - may be subtle.
- Perivascular and/or perineural location.
- Minimal nuclear atypia.
- Abnormal gland morphology[5] / loss of lobular (gland) architecture. †
Note:
- † Not a criterion required by all pathologists.[1]
DDx:[1]
- Adenocarcinoma of the uterine cervix - has "obvious" nuclear atypia.
- Tunnel cluster.
IHC
Features:
See also
References
- ↑ 1.0 1.1 1.2 Tsuda, H.; Mikami, Y.; Kaku, T.; Akiyama, F.; Hasegawa, T.; Okada, S.; Hayashi, I.; Kasamatsu, T. (Jul 2003). "Interobserver variation in the diagnosis of adenoma malignum (minimal deviation adenocarcinoma) of the uterine cervix.". Pathol Int 53 (7): 440-9. PMID 12828609.
- ↑ Lim, KT.; Lee, IH.; Kim, TJ.; Kwon, YS.; Jeong, JG.; Shin, SJ. (Mar 2012). "Adenoma malignum of the uterine cervix: Clinicopathologic analysis of 18 cases.". Kaohsiung J Med Sci 28 (3): 161-4. doi:10.1016/j.kjms.2011.10.009. PMID 22385609.
- ↑ Riegert-Johnson, D.; Roberts, M.; Gleeson, FC.; Krishna, M.; Boardman, L. (Sep 2011). "Case studies in the diagnosis and management of Peutz-Jeghers syndrome.". Fam Cancer 10 (3): 463-8. doi:10.1007/s10689-011-9438-x. PMID 21503748.
- ↑ Ito, M.; Minamiguchi, S.; Mikami, Y.; Ueda, Y.; Sekiyama, K.; Yamamoto, T.; Takakura, K. (Aug 2012). "Peutz-Jeghers syndrome-associated atypical mucinous proliferation of the uterine cervix: A case of minimal deviation adenocarcinoma ('adenoma malignum') in situ.". Pathol Res Pract. doi:10.1016/j.prp.2012.06.008. PMID 22878090.
- ↑ 5.0 5.1 5.2 Gilks, CB.; Young, RH.; Aguirre, P.; DeLellis, RA.; Scully, RE. (Sep 1989). "Adenoma malignum (minimal deviation adenocarcinoma) of the uterine cervix. A clinicopathological and immunohistochemical analysis of 26 cases.". Am J Surg Pathol 13 (9): 717-29. PMID 2764221.
- ↑ Nokubi, M.; Kawanowa, K.; Kawata, H.; Hanatsuka, K.; Hosoya, Y. (Nov 2004). "Extremely well-differentiated adenocarcinoma of the gastric cardia: a unique case with columnar cells and laminated stones.". Pathol Int 54 (11): 854-60. doi:10.1111/j.1440-1827.2004.01769.x. PMID 15533229.
- ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 441-2. ISBN 978-0781765275.
- ↑ He, Y.; Li, L.; Jiang, W.; Wang, DQ.; Xu, L.; Huang, Q.; Zhang, Y.; Yang, KX. (May 2011). "Expression of the insulin-like growth factor-II mRNA-binding protein 3 (IMP3) and carcinoembryonic antigen (CEA) in mucinous minimal deviation adenocarcinoma.". Pathol Res Pract 207 (5): 295-9. doi:10.1016/j.prp.2011.02.011. PMID 21497449.