Expression of neuroendocrine markers in non-neuroendocrine endometrial carcinomas

Moritz, August W.; Schlumbrecht, Matthew; Nadji, Mehrdad; Pinto, André

doi:10.1016/j.pathol.2019.02.003

Cited by 19 publications

(13 citation statements)

References 18 publications

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“…One of the major differential diagnoses of the endometrial LCNEC is the dedifferentiated endometrial carcinoma [16]. Both of them share many histologic and immunophenotypic features including loss of MMR protein expression as well as positive for neuroendocrine markers [17,19]. However, 3 cases presented here do not represent dedifferentiated carcinoma.…”

Section: Discussionmentioning

confidence: 78%

“…SYN was the most commonly expressed neuroendocrine marker, followed by CGA and CD56. However, neuroendocrine markers, especially positive CD56 expression is relatively common in endometrial cancers even without classic neuroendocrine histology [17]. Combined with morphological features, we would like to emphasize that at least 2 NE marker should be reactive in >10% of tumor cells as the diagnostic criteria of NEC.…”

Section: Discussionmentioning

confidence: 93%

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Endometrial neuroendocrine carcinoma frequently associated with mismatch repair deficiency

Zhou

Chen

et al. 2020

Preprint

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Background: Endometrial neuroendocrine carcinoma (NEC) is a uncommon histologic subtype of endometrial cancer. It is currently unclear if the endometrial NEC has any particular relationship with mismatch repair (MMR) protein expression patterns. Here we report 3 endometrial NEC cases showing loss of MMR expression.Case presentation: The cancers had two components with one poorly differentiated or NEC component, accounting for 60–90% of the neoplasms and the other of well differentiated glandular component. The NEC cells mainly showed solid sheets and organoid patterns, whereas insular, trabecular and rosette/pseudorosette patterns were also found. The NEC component was composed of cells with large, polygonal, vesicular nuclei, prominent nucleoli, and abundant eosinophilic cytoplasm. In all cases, the NEC component was diffusely positive for p16 and at least 2 of the 3 neuroendocrine markers (CGA, SYN, CD56) reactive in > 10% of the cancer cells. Loss of MMR protein expression was found in all three cases with loss of MLH1 in cases 1 and 2 and loss of MSH2 and MSH 6 in case 3. No PMS2 loss was found. In addition, aberrant TP53 and SMARCB1 (INI1) expression was found in case 3 only. All patients underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy, and two of them received postoperative chemotherapy and/or radiation therapy. The patients remained alive with no disease for 51, 17 and 6 months, respectively.Conclusion: Endometrial NEC is frequently associated with MMR deficiency, some of which may have a better prognosis than we expect.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 93%

Endometrial neuroendocrine carcinoma frequently associated with mismatch repair deficiency

Zhou

Chen

et al. 2020

Preprint

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“…4 These neoplasms are either "pure" LCNEC or mixed with other histologic components. [5][6][7][9][10][11][12][13][14][15][16][17][18][19] Among other histologic components of endometrial LCNEC, endometrioid carcinoma is the most common histologic type, followed by serous carcinoma. Based on prior reports and our case studies, the most common clinical symptoms are postmenopausal or perimenopausal vaginal bleeding and/or abnormal vaginal discharge.…”

Section: Discussionmentioning

confidence: 99%

“…However, expression of neuroendocrine markers, especially CD56, is a common feature of endometrial cancers, even without classic neuroendocrine histology. 17 There is evidence that NEC originates from neuroendocrine cells in the endometrium as a result of "divergent differentiation". 9 Yasuoka et al 20 found identical clonality between cervical adenocarcinoma and NEC in an X-chromosome clonality assay.…”

Section: Discussionmentioning

confidence: 99%

<p>Dedifferentiated Endometrioid Carcinomas with Neuroendocrine Differentiation: A Clinicopathological and Immunohistochemical Study of Three Cases</p>

Zhou

Zhang

Chen

et al. 2020

CMAR

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“…Markers of neuroendocrine differentiation are not uncommonly expressed in endometrial carcinomas, typically in a minor percentage of tumor cells. 12 Given that the patient's endometrial carcinoma and breast lesion showed similar histomorphology and immunophenotypes, a diagnosis of an endometrial primary with breast metastasis was rendered.…”

Section: Discussionmentioning

confidence: 99%

High-Grade Endometrioid Carcinoma of the Endometrium With a GATA-3-Positive/PAX8-Negative Immunophenotype Metastatic to the Breast: A Potential Diagnostic Pitfall

Salibay

Fadare

2020

Int J Surg Pathol

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This report describes clinicopathologic findings from the case of a patient with a breast mass that was ultimately diagnosed as a metastatic high-grade endometrioid carcinoma of endometrial origin. The breast lesion as well as the solid areas of the endometrial lesion displayed a similar immunoprofile: GATA3-positive; synaptophysin positive; negative for mammaglobin, gross cystic disease fluid protein-15, chromogranin, estrogen receptor, progesterone receptor, and HER2/neu; and intact expression of the DNA mismatch repair proteins MLH1, MSH2, MSH6, and PMS2. The breast lesion was negative for PAX-8, whereas the solid areas of the endometrial lesion showed focal weak positivity. A review of the literature on GATA-3 expression in endometrial carcinomas found a reported frequency of expression that ranged from 0% to 13% of cases, typically in a patchy, focal, and generally restricted pattern. However, GATA-3 may be diffusely expressed in high-grade endometrial carcinomas. Since the potential for PAX-8 expression to be lost in high-grade endometrioid carcinomas is well known, a GATA-3-positive/PAX8-negative immunoprofile may be encountered in high-grade endometrioid carcinomas of the endometrium, and this composite immunoprofile is a potential diagnostic pitfall when such a lesion is being evaluated in a breast metastasis.

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Expression of neuroendocrine markers in non-neuroendocrine endometrial carcinomas

Cited by 19 publications

References 18 publications

Endometrial neuroendocrine carcinoma frequently associated with mismatch repair deficiency

Endometrial neuroendocrine carcinoma frequently associated with mismatch repair deficiency

<p>Dedifferentiated Endometrioid Carcinomas with Neuroendocrine Differentiation: A Clinicopathological and Immunohistochemical Study of Three Cases</p>

High-Grade Endometrioid Carcinoma of the Endometrium With a GATA-3-Positive/PAX8-Negative Immunophenotype Metastatic to the Breast: A Potential Diagnostic Pitfall

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