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| Micro = | | Micro = | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = high-grade [[endometrioid endometrial carcinoma]], [[clear cell carcinoma of the endometrium]],[[Arias-Stella reaction]] | | LMDDx = high-grade [[endometrioid endometrial carcinoma]], [[clear cell carcinoma of the endometrium]],[[Arias-Stella reaction]], [[serous carcinoma]] from elsewhere | ||
| Stains = | | Stains = | ||
| IHC = p16 +ve (strong), p53 +ve usu. (diffuse & strong > 50% ''or'' 75% of the tumour), Ki-67 "high", ER -ve, PR -ve | | IHC = p16 +ve (strong), p53 +ve usu. (diffuse & strong > 50% ''or'' 75% of the tumour), Ki-67 "high", ER -ve, PR -ve | ||
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*[[Clear cell carcinoma of the endometrium]] - usually have less nuclear pleomorphism and less mitoses. | *[[Clear cell carcinoma of the endometrium]] - usually have less nuclear pleomorphism and less mitoses. | ||
*[[Arias-Stella reaction]]. | *[[Arias-Stella reaction]]. | ||
*Metastatic [[serous carcinoma]]. | |||
*[[Endometrium with psammoma bodies]] - no atypical cells. | |||
===Images=== | ===Images=== | ||
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==IHC== | ==IHC== | ||
*p16 +ve<ref name=pmid17581420>{{Cite journal | last1 = Chiesa-Vottero | first1 = AG. | last2 = Malpica | first2 = A. | last3 = Deavers | first3 = MT. | last4 = Broaddus | first4 = R. | last5 = Nuovo | first5 = GJ. | last6 = Silva | first6 = EG. | title = Immunohistochemical overexpression of p16 and p53 in uterine serous carcinoma and ovarian high-grade serous carcinoma. | journal = Int J Gynecol Pathol | volume = 26 | issue = 3 | pages = 328-33 | month = Jul | year = 2007 | doi = 10.1097/01.pgp.0000235065.31301.3e | PMID = 17581420 }}</ref> - should be strong. | *[[p16]] +ve<ref name=pmid17581420>{{Cite journal | last1 = Chiesa-Vottero | first1 = AG. | last2 = Malpica | first2 = A. | last3 = Deavers | first3 = MT. | last4 = Broaddus | first4 = R. | last5 = Nuovo | first5 = GJ. | last6 = Silva | first6 = EG. | title = Immunohistochemical overexpression of p16 and p53 in uterine serous carcinoma and ovarian high-grade serous carcinoma. | journal = Int J Gynecol Pathol | volume = 26 | issue = 3 | pages = 328-33 | month = Jul | year = 2007 | doi = 10.1097/01.pgp.0000235065.31301.3e | PMID = 17581420 }}</ref> - should be strong. | ||
*p53 +ve<ref name=pmid19623034>{{Cite journal | last1 = Yemelyanova | first1 = A. | last2 = Ji | first2 = H. | last3 = Shih | first3 = IeM. | last4 = Wang | first4 = TL. | last5 = Wu | first5 = LS. | last6 = Ronnett | first6 = BM. | title = Utility of p16 expression for distinction of uterine serous carcinomas from endometrial endometrioid and endocervical adenocarcinomas: immunohistochemical analysis of 201 cases. | journal = Am J Surg Pathol | volume = 33 | issue = 10 | pages = 1504-14 | month = Oct | year = 2009 | doi = 10.1097/PAS.0b013e3181ac35f5 | PMID = 19623034 }}</ref> diffuse & strong > 50% ''or'' 75% of the tumour - depending on the paper one reads. | *p53 +ve<ref name=pmid19623034>{{Cite journal | last1 = Yemelyanova | first1 = A. | last2 = Ji | first2 = H. | last3 = Shih | first3 = IeM. | last4 = Wang | first4 = TL. | last5 = Wu | first5 = LS. | last6 = Ronnett | first6 = BM. | title = Utility of p16 expression for distinction of uterine serous carcinomas from endometrial endometrioid and endocervical adenocarcinomas: immunohistochemical analysis of 201 cases. | journal = Am J Surg Pathol | volume = 33 | issue = 10 | pages = 1504-14 | month = Oct | year = 2009 | doi = 10.1097/PAS.0b013e3181ac35f5 | PMID = 19623034 }}</ref> diffuse & strong > 50% ''or'' 75% of the tumour - depending on the paper one reads. | ||
**Subset is p53 -ve. | **Subset is p53 -ve. | ||
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Notes: | Notes: | ||
*p16 +ve in tubal metaplasia.<ref name=pmid17429140>{{Cite journal | last1 = Horree | first1 = N. | last2 = Heintz | first2 = AP. | last3 = Sie-Go | first3 = DM. | last4 = van Diest | first4 = PJ. | title = p16 is consistently expressed in endometrial tubal metaplasia. | journal = Cell Oncol | volume = 29 | issue = 1 | pages = 37-45 | month = | year = 2007 | doi = | PMID = 17429140 }}</ref> | *[[p16]] +ve in tubal metaplasia.<ref name=pmid17429140>{{Cite journal | last1 = Horree | first1 = N. | last2 = Heintz | first2 = AP. | last3 = Sie-Go | first3 = DM. | last4 = van Diest | first4 = PJ. | title = p16 is consistently expressed in endometrial tubal metaplasia. | journal = Cell Oncol | volume = 29 | issue = 1 | pages = 37-45 | month = | year = 2007 | doi = | PMID = 17429140 }}</ref> | ||
*WT1 usu. -ve -- useful to differentiate from [[ovarian serous carcinoma]].<ref name=pmid21993272>{{Cite journal | last1 = Bárcena | first1 = C. | last2 = Oliva | first2 = E. | title = WT1 expression in the female genital tract. | journal = Adv Anat Pathol | volume = 18 | issue = 6 | pages = 454-65 | month = Nov | year = 2011 | doi = 10.1097/PAP.0b013e318234aaed | PMID = 21993272 }}</ref> | *WT1 usu. -ve -- useful to differentiate from [[ovarian serous carcinoma]].<ref name=pmid21993272>{{Cite journal | last1 = Bárcena | first1 = C. | last2 = Oliva | first2 = E. | title = WT1 expression in the female genital tract. | journal = Adv Anat Pathol | volume = 18 | issue = 6 | pages = 454-65 | month = Nov | year = 2011 | doi = 10.1097/PAP.0b013e318234aaed | PMID = 21993272 }}</ref> | ||
==Sign out== | |||
<pre> | |||
ENDOMETRIUM, BIOPSY: | |||
- SEROUS CARCINOMA, HIGH-GRADE. | |||
COMMENT: | |||
The tumour stains as follows: | |||
POSITIVE: p16 (strong, diffuse), p53 (strong >85% of tumour). | |||
NEGATIVE: ER, PR. | |||
PROLIFERATION (Ki-67): 80% of the tumour. | |||
</pre> | |||
==See also== | ==See also== |
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