Thread-like bridging strands: a morphologic feature present in all adenomatoid tumors

Hes, Ondřej; Montiel, Delia Pérez; Cabrero, Isabel Alvarado; Zámečnı́k, Michal; Podhola, Miroslav; Šulc, Miroslav; Hora, Milan; Mukenšnábl, Petr; Žalud, Radim; Ondič, Ondřej; Michal, Michal

doi:10.1016/s1092-9134(03)00085-6

Cited by 51 publications

(27 citation statements)

References 13 publications

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“…In contrast, the presence of thread-like bridging strands traversing tubular spaces ( Figure 1g) appears to be a reproducible corroborative diagnostic feature for genital tract adenomatoid tumors regardless of gender, although it may require diligent search to identify them. 36,38 A variety of other morphologic patterns, each of which has been previously described in adenomatoid tumors, were also identified in female and male tumors in this series. These include adenoid, angiomatoid, cystic, glandular, solid, and tubular patterns, and when encountered in pure form they may pose diagnostic problems.…”

Section: Discussionsupporting

confidence: 68%

Adenomatoid tumors of the female and male genital tracts: a clinicopathological and immunohistochemical study of 44 cases

et al. 2009

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Adenomatoid tumors of the female and male genital tracts are well characterized as mesothelial in origin, but a detailed histological and immunohistochemical analysis comparing both traditional and newer mesothelial markers across gender and site has not been formally conducted. A variety of morphologic features previously described as characteristic of adenomatoid tumors were evaluated in 44 adenomatoid tumors from the male and female genital tracts. Immunohistochemical analysis with pankeratin (AE1/CAM5.2), WT-1, calretinin, CK5/6, D2-40, and caldesmon was also performed. The extent and intensity of staining were scored semiquantitatively on one representative section per case and mean value for each parameter was calculated. All (n ¼ 44) the adenomatoid tumors from both the female and male genital tracts demonstrated a distinctive thread-like bridging strand pattern. Lymphoid aggregates were seen in all 12 adenomatoid tumors of male patients, but in only 4 of 32 (13%) tumors in female patients (Po0.0001). The remaining morphologic features were variably present with no clear sex predilection. Pankeratin, calretinin, and D2-40 reactivity were identified in all female (n ¼ 32) and male (n ¼ 12) genital tract adenomatoid tumors. Adenomatoid tumors expressed WT-1 in 11/12 (92%) male patients and in 31/32 (97%) female patients. In male patients, reactivity for CK5/6 and caldesmon was found in 1/12 (8%) and 0/12 (0%) adenomatoid tumors (respectively), whereas reactivity in female patients was found in 5/32 (16%) and 1/32 (3%); respectively. Female tumors differ from their male counterparts by the frequent absence of lymphoid aggregates and the presence of a circumscribed margin when occurring in the fallopian tube. Of the putative mesothelial markers evaluated, calretinin, D2-40, and WT-1 show a similar immunoprofile and have a higher sensitivity than CK5/6 and caldesmon in genital tract adenomatoid tumors. However, the presence of additional, often strong expression of WT-1 in normal tissues of the female genital tract limits the utility of WT-1 in this setting.

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Section: Discussionsupporting

confidence: 68%

Adenomatoid tumors of the female and male genital tracts: a clinicopathological and immunohistochemical study of 44 cases

et al. 2009

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“…Sometimes thread-like bridging strands may traverse tubular or pseudoglandular spaces, another finding essentially specific to this neoplasm. 26 Owing to the above range of appearance, adenomatoid tumor may pose a spectrum of potential diagnostic problems, as summarized in Table 3 ( Figure 9b). …”

Section: Reactive Mesothelial Hyperplasiamentioning

confidence: 99%

Selected other problematic testicular and paratesticular lesions: rete testis neoplasms and pseudotumors, mesothelial lesions and secondary tumors

2005

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and, in some instances, communication between several structures in the testis and paratestis (rete testis, epididymis, mesothelium, vestigial epithelium and paratesticular soft tissue) result in a plethora of interesting tumors and tumor-like lesions that together pose a formidable diagnostic challenge both because of their morphologic overlap and rarity. The occasional spread of tumors primarily at other sites to this region adds to the potential problem encountered. This review provides an overview of the pathology of nonmesenchymal paratesticular neoplasms and pseudotumors with a focus on the approach to tubulopapillary neoplasms for which diagnostic considerations may include carcinoma of the rete testis, malignant mesothelioma, ovarian-type epithelial tumors, epididymal carcinoma and metastatic carcinomas. The cornerstone of accurate characterization of these lesions is still a comprehensive, traditional clinicopathologic approach, clinical history (of another primary), gross examination (location) and routine light microscopy, but judicious incorporation of contemporary immunohistochemical markers may aid or in some instances be crucial in resolving the problems encountered. Modern Pathology (2005) 18, S131-S145.

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“…Only 11 well-documented ovarian examples have been reported, all in adults, and only two were symptomatic. 28,29 Most of the tumors were hilar and 3 cm or less in diameter, but two were 6 and 8 cm. They were typically solid but one was multicystic.…”

Section: Adenomatoid Tumormentioning

confidence: 99%

“…For example, a recently encountered case of ovarian adenomatoid tumor had extensive necrosis and contained numerous signet-ring-like cells with eosinophilic secretions, findings that led to initial diagnostic uncertainty. In such unusual cases, the presence of more typical features elsewhere in the tumor, including the recently described 'thread-like bridging strands' (due to apposition of attenuated cytoplasm between adjacent mesothelial cells), 29 as well as immunostains to confirm the mesothelial nature of the tumor, can be helpful.…”

Section: Adenomatoid Tumormentioning

confidence: 99%

Selected miscellaneous ovarian lesions: small cell carcinomas, mesothelial lesions, mesenchymal and mixed neoplasms, and non-neoplastic lesions

Clement

2005

Mod Pathol

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This contribution will cover a variety of uncommon tumors and tumor-like lesions of the ovary that can be associated with a myriad of diagnostic problems for the pathologist. A few of these lesions are not specific to the ovary and may be more common in the uterus or even extraovarian sites, but the mere knowledge that they also occasionally occur in, or involve, the ovary will facilitate their recognition by the pathologist. In contrast, the entity considered first, the highly malignant small cell carcinoma of hypercalcemic type, is an enigmatic tumor unique to the ovary. Modern Pathology (2005) 18, S113-S129.

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Thread-like bridging strands: a morphologic feature present in all adenomatoid tumors

Cited by 51 publications

References 13 publications

Adenomatoid tumors of the female and male genital tracts: a clinicopathological and immunohistochemical study of 44 cases

Adenomatoid tumors of the female and male genital tracts: a clinicopathological and immunohistochemical study of 44 cases

Selected other problematic testicular and paratesticular lesions: rete testis neoplasms and pseudotumors, mesothelial lesions and secondary tumors

Selected miscellaneous ovarian lesions: small cell carcinomas, mesothelial lesions, mesenchymal and mixed neoplasms, and non-neoplastic lesions

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