Cytologic Findings of Low Grade Endometrial Stromal Sarcoma with Sex Cord–like Differentiation

Nishikimi, Kyoko; Habuka, Nobuya; Okazima, Yuko; Tate, Shinichi; Nagai, Yuichiro; Nakano, Masayuki; Okawa, Reiko; Shozu, Makio

doi:10.1159/000324975

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…The presence of permeative, tongue‐like myometrial and/or vascular invasion distinguishes ESSs from their much less frequent benign counterpart, ESNs. Both tumour types can display variant histological features such as smooth muscle, glandular, sex cord, rhabdomyoblastic or adipocytic differentiation; fibrous, myxoid, rhabdoid, epithelioid, clear or granular change; the presence of bizarre, foamy or osteoclast‐like giant cells; and true papillae or pseudopapillae …”

Section: Endometrial Stromal Tumoursmentioning

confidence: 99%

Recent developments in uterine mesenchymal neoplasms

Chiang

Oliva

2012

Histopathology

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Smooth muscle and endometrial stromal tumours represent the two most common uterine mesenchymal neoplasms that may present diagnostic dilemmas for the practising surgical pathologist. Recent changes in morphological and staging criteria, as well as the discovery of new immunohistochemical markers, have improved the diagnosis and classification of these tumours. We highlight the difficulty in distinguishing tumour cell necrosis from infarct-type necrosis and the limited utility of p16 immunohistochemical expression in the diagnosis of leiomyosarcoma. We also discuss the controversial use of mitotic activity and necrosis as prognostic factors in endometrial stromal sarcomas. Emerging genetic information has also greatly expanded our understanding of 'sarcomagenesis' in both tumour types and may provide insight into potential therapeutic targets for the treatment of leiomyosarcoma and endometrial stromal sarcomas, harboring MED12 (mediator complex subunit 12) mutations and recurrent gene rearrangements, respectively. In this review, we discuss the core updates in the diagnosis and classification of uterine leiomyosarcomas and endometrial stromal sarcomas, highlighting new and important molecular genetic findings that may drive pathogenesis.

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Section: Endometrial Stromal Tumoursmentioning

confidence: 99%

Recent developments in uterine mesenchymal neoplasms

Chiang

Oliva

2012

Histopathology

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“…11 To our knowledge, this is the first cytologic report of unusual metastatic lung tumors from Group II UTROSCT. However, based on the absence of EMA expression, the endometrioid adenocarcinoma was denied.…”

Section: Histology Of Resected Lung Tumorsmentioning

confidence: 73%

Lung metastases of a uterine tumor resembling ovarian sex‐cord tumor: Report of a rare case

Kondo

Sakaguchi

Mikubo

et al. 2017

Diagnostic Cytopathology

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Uterine tumor resembling an ovarian sex-cord tumor (UTROSCT) is a rare type of uterine neoplasm.We present an extremely rare case of lung metastases from a UTROSCT focusing on the cytologic features. A 69-year-old Japanese woman was admitted to our hospital for further examination and treatment for abnormal shadows in the right lung field. She had a history of total hysterectomy for UTROSCT. Moreover, she underwent wedge resection of the right middle lobe for lung metastasis of UTROSCT in 2011. Enhanced chest computed tomography scan revealed a solid nodule 8 mm in diameter in the right upper lobe and a well-demarcated 33-mm mass or nodule in the lower lobe.Under the diagnosis of metastatic tumors from UTROSCT, she underwent wedge resection of the right upper lobe and segmentectomy of the right S8. Cytologically, the stump smear from the resected tumors revealed round to short spindle-shaped neoplastic small cells arranged in sheets with poor cohesion and no cluster formation. The nuclei were irregular in shape, and the chromatin was finely granular, uniform, and increased. Mitotic figures were not observed. Necrosis was absent in the background. Histologically, the final diagnosis was UTROSCT group II. This is an unusual case of metastatic UTROSCT to the lung in which the cytologic features are described. We can find fewer than 10 cases of UTROSCTs reported in the literature to date. These clinical features are summarized in Table 1. 3-8 Herein, we describe an extremely rare case of lung metastasis from a Group II UTROSCT with particular interest in the cytologic features and discuss the current literature regarding the spectrum of this disease. | C ASE R EP OR T | Clinical findingsA 69-year-old Japanese woman was admitted to Kitasato University Hospital for further examination and treatment for abnormal shadows in the right lung field. She had a history of total hysterectomy for UTROSCT. In 2011, she underwent wedge resection of the right middle lobe for lung metastasis of UTROSCT. She has never smoked.Enhanced chest computed tomography scan revealed a solid nodule 8 mm in diameter with a clear margin in the right upper lobe ( Figure 1A) and a well-demarcated nodule of 33 mm in size in the right lower lobe ( Figure 1B). Under the diagnosis of metastatic tumors from UTROSCT, she underwent wedge resection of the right upper lobe and segmentectomy of the right anterior basal segment. | Cytologic findings

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“…Nishikimi et al reported the intraoperative touch imprint of ESTSCLEs. 6 Cytological examination revealed abundant hyaline-like substances and tumor cells aligned in a cord or glandular form, with scant cytoplasm and ovoidto-spindle-shaped nuclei with little atypia. More recently, Kondo et al described stump smears from resected lung metastases of a UTROSCT.…”

Section: Discussionmentioning

confidence: 98%

“…We could find only 2 cases in the literature that described cytological features obtained by touch imprint. Nishikimi et al reported the intraoperative touch imprint of ESTSCLEs . Cytological examination revealed abundant hyaline‐like substances and tumor cells aligned in a cord or glandular form, with scant cytoplasm and ovoid‐to‐spindle‐shaped nuclei with little atypia.…”

Section: Discussionmentioning

confidence: 99%

“…The last World Health Organization Classification of Tumors of the Female Reproductive Organs placed UTROSCTs in the category of “endometrial stromal and related neoplasms.” Approximately 43 cases have been reported histologically in the literature . However, only two reports have described the cytological features with touch imprint, and none have been described with conventional or liquid‐based cytology (LBC). Current cervical screening programs using LBC increase the possibility of encountering UTROSCTs in such specimens, thus leading to potential diagnostic pitfalls.…”

Section: Introductionmentioning

confidence: 99%

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Cytological features of uterine tumors resembling ovarian sex‐cord tumors in liquid‐based cervical cytology: a potential pitfall. Report of a unique and rare case

Dubruc

Flores

Bernier

et al. 2019

Diagnostic Cytopathology

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Uterine tumors resembling ovarian sex‐cord tumors (UTROSCTs) are rare uterine neoplasms of uncertain etiology that resemble the sex cord tumors of the ovary and display a combined sex cord, epithelial, and smooth muscle immunophenotype. Most tumors are associated with a benign clinical course. We report the first cytological description of uterine UTROSCTs in liquid‐based cervical cytology (LBC). A menopausal woman was discovered to have a uterine intraluminal polypoid mass protruding through the vagina. A Pap test was performed, and the LBC preparation showed isolated tumor cells with scant cytoplasm and slightly irregular, ovoid nuclei with fine chromatin and small nucleoli. Final histological evaluation identified a UTROSCT. This diagnostic possibility, albeit rare, should be included in the differential diagnosis when isolated malignant‐appearing adenocarcinomatous cells are seen in women in the above scenario. As these features are not specific, they may result in misinterpretation with tumors that are more common and aggressive.

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Cytologic Findings of Low Grade Endometrial Stromal Sarcoma with Sex Cord–like Differentiation

Cited by 5 publications

References 12 publications

Recent developments in uterine mesenchymal neoplasms

Recent developments in uterine mesenchymal neoplasms

Lung metastases of a uterine tumor resembling ovarian sex‐cord tumor: Report of a rare case

Cytological features of uterine tumors resembling ovarian sex‐cord tumors in liquid‐based cervical cytology: a potential pitfall. Report of a unique and rare case

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