High grade endometrial stromal sarcoma on thinprep

Ginter, Paula S.; Pirog, Edyta C.; Hoda, Rana S.

doi:10.1002/dc.23316

Cited by 6 publications

(5 citation statements)

References 19 publications

(24 reference statements)

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“…One helpful clue is that the neoplastic cells in UC are more pleomorphic than those in high‐grade ESS. In cytologic specimens, high‐grade ESS shows neoplastic cells that are moderately variable in size and shape, moderate‐to‐mild hyperchromasia, and delicate, poorly defined cytoplasmic borders 34,35 . Low‐grade ESS shows bland cells, often singly arranged or in small clusters, with scant cytoplasm, round‐to‐oval nuclei, occasional small, prominent nucleoli, and sometimes stromal matrix and intervening vessels (usually not present in cytologic specimens) 36‐38 .…”

Section: Discussionmentioning

confidence: 99%

Cytologic features of undifferentiated and dedifferentiated carcinomas of the endometrium

Akbari

Wang

Soslow

et al. 2020

Cancer Cytopathology

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Background Undifferentiated carcinoma (UC) is a rare, aggressive subtype of endometrial carcinoma. Dedifferentiated carcinomas (DCs) are UCs associated with a component of well differentiated endometrioid carcinoma. The authors sought to describe the morphologic features of UCs and DCs in cytologic specimens. Methods Cytologic specimens from 23 women (aged 46‐86 years; median age, 59 years) were reviewed, including cervicovaginal specimens (n = 7), peritoneal washings (n = 5), touch preparations of core biopsies from various sites (n = 5), fine‐needle biopsies of lymph nodes (n = 3), ascitic fluid (n = 1), pleural fluid (n = 1), and intrauterine fluid (n = 1). Results There were 10 UCs (43%) and 13 DCs (57%). Tumor cells were arranged as single cells (9 UCs, 90%; 12 DCs, 92%) and 3‐dimensional groups (8 UCs, 80%; 11 DCs, 85%). Most cases showed high nuclear‐to‐cytoplasmic ratios. Nuclear molding was observed in 3 UCs (30%) and in 5 DCs (38%). Nuclear chromatin was often coarsely granular 6 UCs, 60%; 9 DCs, 69%). Nucleoli were inconspicuous in some cases (6 UCs, 60%; 8 DCs, 62%) but were appreciable in others. Necrosis was observed in 5 UCs (50%) and in 5 DCs (38%). Most cases exhibited clean backgrounds, and a few showed acute inflammation. Comparison of the cytologic features of UCs and DCs did not reveal any statistically significant differences. Conclusions UCs and DCs have a spectrum of cytomorphologic appearances that are not pathognomonic, but the presence of some of these (relatively uniform population of predominantly singly dispersed cells with high nuclear‐to‐cytoplasmic ratios and variably conspicuous nucleoli) should prompt consideration of UC and DC in the differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Cytologic features of undifferentiated and dedifferentiated carcinomas of the endometrium

Akbari

Wang

Soslow

et al. 2020

Cancer Cytopathology

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“…The cytology descriptions of this entity are very limited due to the rarity of these lesions and a relatively recent enhanced understanding of their morphologic spectrum. A single case report by Ginter et al [63] discussed the cytologic features of a high-grade endometrial stromal sarcoma metastatic to a para-aortic lymph node. The cells had scant cytoplasm, were round or showed short, tapered extensions ("comet cells").…”

Section: Endometrial Stromal Sarcomasmentioning

confidence: 99%

Role of Fine Needle Aspiration Cytology in the Diagnosis of Gynecologic Tumors

Goyal¹

2023

Acta Cytologica

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Background: The tumors involving the gynecologic tract encompass a wide range of lesions including those of epithelial, mesenchymal, sex cord-stromal, and germ cell origin. Amongst the carcinomas of tubo-ovarian origin, high-grade serous carcinoma is the most common malignancy. The primary role of fine needle aspiration (FNA) cytology in the management of gynecologic tract malignancies is in the diagnosis of their recurrences/metastases. In patients presenting with advanced disease, the cytology specimen may be the initial or the only sampling performed before the initiation of treatment. Summary: This review will discuss the cytologic findings of various gynecologic tract neoplasms with regard to their morphologic features, differential diagnoses, and the ancillary studies that can assist in their recognition. Key Messages: FNA cytology serves as a valuable tool in the diagnosis and management of gynecologic tract malignancies. However, making an accurate diagnosis of these entities, especially on limited cytology specimens, can be challenging. Awareness regarding the morphologic spectrum of these tumors, their potential mimics, and the ancillary studies that can be employed to refine their characterization, can assist in arriving at the correct diagnosis.

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“…The annual incidence of ESS is 1-2 per million women ( 1 ). There are four types of ESS: endometrial stromal nodule, undifferentiated uterine sarcoma, high-grade ESS and low-grade ESS ( 2 , 3 ).…”

Section: Related Literature Learningmentioning

confidence: 99%

“…Clinical symptoms are variable, non-specific, and largely depend upon the location of ESS. When ESS is located in the uterus, abnormal vaginal bleeding and abdominal pain are the most common symptoms ( 3 , 6 ).…”

Section: Related Literature Learningmentioning

confidence: 99%

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Case report: High-grade endometrial stromal sarcoma with adrenal glands metastases: An unreported site of metastasis

et al. 2022

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BackgroundEndometrial stromal sarcoma is a relatively rare malignant tumor that derives from the malignant transformation of primitive uterine mesenchymal cells. It can lead to distant metastases. High-grade endometrial stromal sarcoma is extremely rare. The adrenal glands are an unreported site of metastasis.Case summaryA 71-year-old woman with a diagnosis of endometrial stromal sarcoma 30 months ago. After receiving treatment with radiotherapy and chemotherapy, the patient was kept asymptomatic during the follow-up until 2 years later, when she complained of dyspnea. Pulmonary and right adrenal gland metastases were detected by 18F-FDG PET/CT. The right upper lobe mass was diagnosed as a high-grade endometrial stromal sarcoma metastasis after postoperative pathology. Due to the patient’s high risk of surgery, as she had many underlying diseases, we performed adequate preoperative preparation. The physical examination revealed that a hard mass was palpable in the right renal area. The right adrenal mass was resected in our hospital. Immunohistochemistry showed ER (-), PR (-), CD10 (+), P16 (+), Ki-67 (50%). The final diagnosis on pathological examination was a high-grade ESS metastatic to the right adrenal gland. The patient continued treatment in other hospitals after surgical resection. After four months of postoperative follow-up, metastasis was detected again during a PET/CT examination at an outside hospital.ConclusionEndometrial stromal sarcoma is rare, and the adrenal glands are an unreported site of metastasis. It has no specific clinical symptoms and mainly found for other reasons. The diagnosis still depends on pathology and immunohistochemistry. If there is no relevant past history, it is difficult to exclude a primary adrenal tumor.

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High grade endometrial stromal sarcoma on thinprep

Cited by 6 publications

References 19 publications

Cytologic features of undifferentiated and dedifferentiated carcinomas of the endometrium

Cytologic features of undifferentiated and dedifferentiated carcinomas of the endometrium

Role of Fine Needle Aspiration Cytology in the Diagnosis of Gynecologic Tumors

Case report: High-grade endometrial stromal sarcoma with adrenal glands metastases: An unreported site of metastasis

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