Difference between revisions of "Ovarian tumours"

Jump to navigation Jump to search

Ovarian tumours (view source)

Revision as of 02:27, 9 January 2014

5,892 bytes removed ,  02:27, 9 January 2014
→‎Clear cell carcinoma of the ovary: split out
Line 561: Line 561:
*[[AKA]] ''ovarian clear cell carcinoma''.
*[[AKA]] ''ovarian clear cell carcinoma''.
*[[AKA]] ''clear cell adenocarcinoma of the ovary''.
*[[AKA]] ''clear cell adenocarcinoma of the ovary''.
 
{{Main|Clear cell carcinoma of the ovary}}
===General===
Prognosis:
* Worse prognosis versus other surface epithelial tumours.<ref name=pmid18035678>{{cite journal |author=Hauptmann S, Köbel M |title=[Prognostic factors in ovarian carcinoma] |language=German |journal=Verh Dtsch Ges Pathol |volume=89 |issue= |pages=92-100 |year=2005 |pmid=18035678 |doi= |url=}}</ref>
**Poor response to platinum-based chemotherapy.<ref name=pmid22885379/>
**~2.5x risk for thromboembolism compared to other ovarian carcinomas.<ref name=pmid19922988>{{Cite journal  | last1 = Duska | first1 = LR. | last2 = Garrett | first2 = L. | last3 = Henretta | first3 = M. | last4 = Ferriss | first4 = JS. | last5 = Lee | first5 = L. | last6 = Horowitz | first6 = N. | title = When 'never-events' occur despite adherence to clinical guidelines: the case of venous thromboembolism in clear cell cancer of the ovary compared with other epithelial histologic subtypes. | journal = Gynecol Oncol | volume = 116 | issue = 3 | pages = 374-7 | month = Mar | year = 2010 | doi = 10.1016/j.ygyno.2009.10.069 | PMID = 19922988 }}</ref>
 
Epidemiology:
* Asians appear to be at an increased risk.<ref name=pmid22885379>{{Cite journal  | last1 = Offman | first1 = SL. | last2 = Longacre | first2 = TA. | title = Clear cell carcinoma of the female genital tract (not everything is as clear as it seems). | journal = Adv Anat Pathol | volume = 19 | issue = 5 | pages = 296-312 | month = Sep | year = 2012 | doi = 10.1097/PAP.0b013e31826663b1 | PMID = 22885379 }}</ref>
* Thought to be related to endometrioid carcinoma.<ref name=Ref_PBoD1098>{{Ref PBoD |1098}}</ref>
*Association with endometriosis:<ref name=pmid22885379/>
** Increased risk of ovarian clear cell carcinoma ~ 3x.
** Seen in 50-70% of ovarian CCC.
 
===Gross===
Features:<ref name=pmid22885379/>
*Usually unilateral (unlike [[serous carcinoma of the ovary|serous carcinoma]]).
*Yellow colour.
 
===Microscopic===
Features:
*Cystic/tubular architecture - important low power feature.
**May be papillary and/or solid.
*Clear cells - cytoplasm is clear - '''key feature'''. †
*[[Hobnail morphology]] - apical surface larger than basal surface.
**"Nuclei bulge into the lumen".
*Hyaline droplets -- common, as in ''[[clear cell renal cell carcinoma]]''.
**Eosinophilic bodies within lumen.
**Seen in approximately 1/4 of cases.<ref name=pmid22885379/>
*Nucleoli - prominent.
 
Note:
*† Clear cell adenocarcinoma does not have to have clear cells. Yes, this is stupid; it is like ''[[papillary thyroid carcinoma]]'' -- which often isn't papillary -- see ''[[no truth in names]]''.
**The ''hobnail morphology'' is important if this is the case.
 
DDx:
*[[Serous carcinoma of the ovary]] - have larger papillae +/- branching +/-multilayered epithelium, more mitotic activity,<ref name=pmid22885379/> more group pleomorphism.
*[[Serous borderline tumour of the ovary]].
*High-grade [[endometrioid carcinoma of the ovary]].
*[[Metastasis|Metatstatic]] [[clear cell carcinoma]], esp. [[clear cell renal cell carcinoma]].
*Borderline clear cell lesion of the ovary - very rare; an under sampled carcinoma considered more probable.<ref name=pmid22885379/>
*[[Arias-Stella reaction]] within [[endometriosis]].
 
====Images====
<gallery>
Image:Ovarian_clear_cell_carcinoma_-a-_very_high_mag_-_cropped.jpg | Clear cell carcinoma - very high mag. - cropped (WC)
Image:Ovarian_clear_cell_carcinoma_-a-_intermed_mag.jpg | Clear cell carcinoma - intermed. mag. (WC)
Image:Ovarian_clear_cell_carcinoma_-_low_mag.jpg | Clear cell carcinoma - low mag. (WC)
Image:Ovarian clear cell carcinoma - intermed mag.jpg | Clear cell carcinoma - intermed. mag. (WC)
Image:Ovarian clear cell carcinoma - high mag.jpg | Clear cell carcinoma - high mag. (WC)
Image:Ovarian clear cell carcinoma - very high mag.jpg | Clear cell carcinoma - very high mag. (WC)
</gallery>
www:
*[http://path.upmc.edu/cases/case343.html Clear cell carcinoma of the ovary - several images (upmc.edu)].
 
===IHC===
*HNF-1beta +ve.<ref>{{Cite journal  | last1 = Tsuchiya | first1 = A. | last2 = Sakamoto | first2 = M. | last3 = Yasuda | first3 = J. | last4 = Chuma | first4 = M. | last5 = Ohta | first5 = T. | last6 = Ohki | first6 = M. | last7 = Yasugi | first7 = T. | last8 = Taketani | first8 = Y. | last9 = Hirohashi | first9 = S. | title = 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. | journal = Am J Pathol | volume = 163 | issue = 6 | pages = 2503-12 | month = Dec | year = 2003 | doi =  | PMID = 14633622 | url = http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892387/?tool=pubmed }}</ref><ref name=omim189907>{{OMIM|189907}}</ref>
**Usu. -ve in serous carcinoma.
*WT-1 -ve.
**Usu. +ve in serous carcinoma.
 
Panel for high grade serous vs. clear cell:<ref name=pmid18830127>{{cite journal |author=Köbel M, Kalloger SE, Carrick J, ''et al.'' |title=A limited panel of immunomarkers can reliably distinguish between clear cell and high-grade serous carcinoma of the ovary |journal=Am. J. Surg. Pathol. |volume=33 |issue=1 |pages=14–21 |year=2009 |month=January |pmid=18830127 |doi=10.1097/PAS.0b013e3181788546 |url=}}</ref>
*ER (+ve in serous),<ref name=pmid21164285>{{Cite journal  | last1 = DeLair | first1 = D. | last2 = Oliva | first2 = E. | last3 = Köbel | first3 = M. | last4 = Macias | first4 = A. | last5 = Gilks | first5 = CB. | last6 = Soslow | first6 = RA. | title = Morphologic spectrum of immunohistochemically characterized clear cell carcinoma of the ovary: a study of 155 cases. | journal = Am J Surg Pathol | volume = 35 | issue = 1 | pages = 36-44 | month = Jan | year = 2011 | doi = 10.1097/PAS.0b013e3181ff400e | PMID = 21164285 }}</ref> HNF-1beta (+ve in clear cell), WT-1 (+ve in serous).
 
Others:<ref name=pmid22885379/>
*CK7 +ve -- may be focal.
*CK20 -ve.
*CD10 -ve.
**Often +ve in [[clear cell renal cell carcinoma]].


==Transitional cell carcinoma of the ovary==
==Transitional cell carcinoma of the ovary==
Michael
48,474

edits

Retrieved from "https://librepathology.org/wiki/Special:MobileDiff/27634"

Navigation menu