Atypical Endometrial Stromal Cells Related With a Polypoid Leiomyoma With Bizarre Nuclei

Usubütün, Alp; Karaman, Nazmiye; Ayhan, Ali̇; Küçükali, T.

doi:10.1097/01.pgp.0000166996.57196.cb

Cited by 7 publications

(4 citation statements)

References 2 publications

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“…described a polypoid leiomyoma with bizarre nuclei and atypical endometrial stromal cells adjacent to a leiomyoma. They regarded these atypical cells as degenerative in nature and stated that they should not be mistaken for malignant cells on histologic examination, especially when examining small endometrial samples ( 13 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: An atypical case of uterine adenosarcoma with extensive bizarre stromal cells and amplification of MDM2

Xiao,

2024

Front. Oncol.

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Polypoid lesions in the uterus are very common. There are a lot of benign lesions and malignant tumor should be considered. Adenosarcoma, one of the differential diagnoses, is a rare mixed epithelial and mesenchymal tumor consisting of benign epithelial components and sarcoma stroma. Here, we present a case of atypical adenosarcoma that has never been reported. This tumor was composed of benign endometrial epithelium and hyperplastic stroma with extensive bizarre stromal cells. But the cleft-like spaces and papillary stomal fronds which were the typical histological images of adenosarcoma were absent. These stomal cells, including bizarre cells, were positive for vimentin, CD10, ER, PR, cyclin D1 and P16 but were immunonegative for caldesmon. Furthermore, this tumor harbored amplification of MDM2, as revealed by fluorescence in situ hybridization testing (FISH) and next-generation DNA sequencing (NGS).

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Section: Discussionmentioning

confidence: 99%

Case report: An atypical case of uterine adenosarcoma with extensive bizarre stromal cells and amplification of MDM2

Xiao,

2024

Front. Oncol.

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“…Historically described as atypical (bizarre/symplastic) cells, these cells are multinucleated or multilobate, often with enlarged nuclei, smudgy chromatin, eosinophilic intranuclear pseudoinclusions, a low proliferation/mitotic index, and may be encountered in lesions throughout the gynecologic tract. The lesional cells have been described in the endometrial stroma, ovarian endometriotic cysts, ovarian sex-cord stromal neoplasms, uterine leiomyoma, endometrial polyps, and fibroepithelial polyps, and normal submucosal stroma of the lower genital tract 1–16. This type of bizarre atypia can appear alarming and create concern for malignancy, particularly sarcoma, when the atypia is present in mesenchymal lesions.…”

Section: Discussionmentioning

confidence: 99%

“…The lesional cells have been described in the endometrial stroma, ovarian endometriotic cysts, ovarian sex-cord stromal neoplasms, uterine leiomyoma, endometrial polyps, and fibroepithelial polyps, and normal submucosal stroma of the lower genital tract. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] This type of bizarre atypia can appear alarming and create concern for malignancy, particularly sarcoma, when the atypia is present in mesenchymal lesions. In this study, we described the clinicopathologic features of 17 cases of bizarre chorionic-type intermediate trophoblast in second-trimester and third-trimester placentas.…”

Section: Discussionmentioning

confidence: 99%

“…H istorically referred to as atypical or bizarre/symplastic nuclei, these types of cells can be found in normal tissues and benign neoplasms of the gynecologic tract including endometrial stroma, ovarian endometriotic cysts, ovarian sexcord stromal neoplasms, uterine leiomyoma, endometrial polyps, and fibroepithelial polyps and normal submucosal stroma of the lower genital tract. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Such bizarre cells have large, multilobated, or multinucleated nuclei with smudgy chromatin and occasional pseudoinclusions. Despite the appearance of these nuclei, the aforementioned lesions follow a benign clinical course.…”

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confidence: 99%

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Bizarre Chorionic-type Trophoblast in Second-trimester and Third-trimester Placentas

Murdock¹,

Varghese

Xing³

et al. 2021

American Journal of Surgical Pathology

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Bizarre (atypical/symplastic) cells have been described in various gynecologic normal tissues and benign neoplasms. This type of bizarre cytologic change is usually an incidental finding and is regarded as a benign process. We describe 17 cases of bizarre chorionic-type trophoblast in second-trimester and third-trimester placentas that created concern for an underlying/undersampled or incipient intraplacental trophoblastic neoplasm, predominantly found in intervillous trophoblastic islands (11/17), placental septae (6/17), chorionic plate (1/17), and/or the chorion layer of fetal membranes (2/17). The bizarre trophoblastic cells exhibited sheet-like or nested architecture, had a multifocal/patchy distribution, and/or were present as individual cells within hyaline stroma; they were characterized by large nuclei with smudgy chromatin and occasional intranuclear pseudoinclusions. The degree of atypia was classified as mild (0/17), moderate (3/17), or severe (14/17). Mitotic figures and necrosis were not identified. A dual immunohistochemical stain for trophoblast (hydroxyl-delta-5-steroid dehydrogenase) and a proliferation marker (Ki-67), performed in 15 cases, demonstrated 0% to very low proliferative activity within the bizarre trophoblast (0% to 2% [10/15], 3% to 8% [5/15]). Immunohistochemical stains for fumarate hydratase showed intact/retained expression in the bizarre cells in 7 of 7 cases. Clinical follow-up ranged from 1 to 45 months, and all patients were alive and well without subsequent evidence of a gestational trophoblastic or other neoplasms. We conclude that bizarre chorionic-type trophoblast in second-trimester or third-trimester placentas have the potential to mimic an intraplacental trophoblastic neoplasm but are likely a benign degenerative change. This study expands the spectrum of bizarre cells that occur in the gynecologic tract.

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Benign Diseases of the Endometrium

McCluggage¹

2011

Blaustein’s Pathology of the Female Genital Tract

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Atypical Endometrial Stromal Cells Related With a Polypoid Leiomyoma With Bizarre Nuclei

Cited by 7 publications

References 2 publications

Case report: An atypical case of uterine adenosarcoma with extensive bizarre stromal cells and amplification of MDM2

Case report: An atypical case of uterine adenosarcoma with extensive bizarre stromal cells and amplification of MDM2

Bizarre Chorionic-type Trophoblast in Second-trimester and Third-trimester Placentas

Benign Diseases of the Endometrium

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