bromochloroacetic-acid and Uterine-Neoplasms

Ewing sarcoma (ES) is a highly malignant tumor that rarely occurs in the uterine cervix. Herein, we report 8 cases with ES arising primarily in the uterine cervix by focusing on clinicopathologic and molecular cytogenetic features and differential diagnoses. Eight cases of cervical ES were diagnosed between February, 2012, and September, 2018. The age of patients ranged from 13 to 47 years. Abnormal vaginal bleeding and lower abdominal pain were the most common symptoms. Histologically, the tumor was composed of uniform, round, and oval cells with a narrow rim of eosinophilic cytoplasm. Fibrous septa were observed between tumor cell nests. The tumors showed brisk mitotic activity and areas of coagulative necrosis. According to immunohistochemical studies, 50% (4/8) of the cases were positive for cytokeratin (AE1/AE3), and 87.5% (7/8) were positive for synaptophysin, which resulted in a diagnostic confusion with small cell carcinoma, primarily when dealing with small cervical biopsies. Molecular testing demonstrated the rearrangement of the EWSR1 gene in all of the 8 cases, which confirmed the diagnosis of ES. Although rare, ES should be considered as indicators of cervical small round cell neoplasms. Molecular analysis may greatly contribute to the final diagnosis of ES occurring in this unusual location.

Topics: Adolescent; Adult; Biomarkers, Tumor; Diagnosis, Differential; Female; Gene Rearrangement; Humans; Immunohistochemistry; In Situ Hybridization, Fluorescence; Keratins; Middle Aged; Predictive Value of Tests; RNA-Binding Protein EWS; Sarcoma, Ewing; Uterine Neoplasms; Young Adult

We present a brief review of epithelioid trophoblastic tumor, a rare trophoblastic neoplasm derived from chorionic-type intermediate trophoblastic cells that typically presents in reproductive-age women between 1 and 18 years following a previous gestation. Histologic features include a nodular growth pattern of monomorphic, epithelioid cells within a hyaline matrix. Areas of necrosis and mitotic activity (0-9 mitoses per 10 high-power fields) are additional features of this neoplasm. Positive immunostaining for p63 and cytokeratin, frequent location in the lower uterine segment and endocervix, as well as the epithelioid appearance can lead to confusion with squamous cell carcinoma. Inhibin-alpha is typically expressed, as well as focal, more variable expression of other trophoblastic markers including beta-human chorionic gonadotropin, human placental lactogen, placental alkaline phosphate, and Mel-CAM (CD148). The clinical behavior of this rare form of gestational trophoblastic disease is difficult to predict. Although most cases follow a benign course following resection, there is a potential for metastatic disease.

Topics: Adult; Biomarkers, Tumor; Carcinoma, Squamous Cell; Diagnosis, Differential; Epithelioid Cells; Female; Humans; Immunohistochemistry; Keratins; Membrane Proteins; Mitosis; Necrosis; Pregnancy; Trophoblastic Tumor, Placental Site; Uterine Neoplasms

In diagnosing uterine cancers, cells and tissue samples can be directly obtained from the lesion. Cytologic and histologic investigation is the best method for screening and early detection of primary uterine cancers. Tumor markers may be useful for monitoring the clinical course of therapy and early detection of recurrence for which cytologic examination can not be done. Moreover, high levels of tumor markers may represent tumor invasiveness and metastasis to lymph nodes and/or other organs, and may indicate a poor prognosis for the patient. Strictly speaking, tumor markers are not tumor-specific but tumor-associated substances. They can be elevated in sera from healthy individuals under various conditions, and from patients with benign tumors. Squamous cell carcinoma-associated antigen (SCC) is relatively tumor-specific, and widely used for monitoring patients with squamous cell carcinoma not only of the uterine cervix. On the other hand, there is no specific tumor marker for uterine corpus carcinoma. Combination assay of several tumor markers including cancer antigen 125 (CA125) as a core marker may be of greater diagnostic value in cases of uterine corpus carcinoma.

Topics: Adenocarcinoma; Antigens, Neoplasm; Biomarkers, Tumor; CA-125 Antigen; CA-19-9 Antigen; Carcinoembryonic Antigen; Carcinoma, Squamous Cell; Female; Humans; Keratin-19; Keratins; Neoplasm Proteins; Serpins; Tissue Polypeptide Antigen; Uterine Cervical Neoplasms; Uterine Neoplasms

A uterine tumor resembling an ovarian sex-cord tumor (UTROSCT) is a very rare lesion with only 38 cases reported in the literature so far. Here, we show an additional case of a pure UTROSCT with a DNA stemline at 1c in a 49-year-old woman presenting with abnormal vaginal bleeding. Problems in differential diagnosis arise mainly due to the variable histological picture of UTROSCT. Immunohistochemically, these tumors express cytokeratin, epithelial membrane antigen, vimentin, and smooth muscle actin. Moreover, in some cases, CD99 and alpha-inhibin are detectable. Although 36% of UTROSCT have infiltrative margins, almost all of them behave benignly. It is thus questionable whether the same prognostic criteria apply for these tumors as for endometrial stromal sarcomas. However, in the so-called mixed UTROSCT, the endometrial stromal sarcoma component determines the outcome.

Topics: Antigens, Neoplasm; Biomarkers, Tumor; Cell Nucleus; DNA, Neoplasm; Female; Humans; Image Cytometry; Immunohistochemistry; Keratins; Middle Aged; Ovarian Neoplasms; Ploidies; Sex Cord-Gonadal Stromal Tumors; Treatment Outcome; Uterine Neoplasms; Vimentin

Adenoid basal carcinoma of the uterine cervix is rare and its cell origin is still obscure. We report a case of adenoid basal carcinoma of the uterine cervix discovered incidentally in a 69-year-old woman who had been hysterectomized due to endometrial adenocarcinoma of the uterine corpus. Histologically, small round-to-oval cancer cell nests with peripheral cell palisading were seen budding from the basal cell layer of the uterine cervix showing carcinoma in situ. Immunohistochemically, the basaloid cells of the adenoid basal carcinoma were positive for keratins 14, 17 and 19 and resembled reserve cells of the cervical epithelium. The results of this study clearly demonstrated that adenoid basal carcinoma shows a phenotype similar to reserve cells of the uterine cervix. A review of the literature indicated that this tumor has a favorable prognosis and should be clearly separated from adenoid cystic carcinoma, which has a much poorer outcome.

Topics: Aged; Biomarkers, Tumor; CA-125 Antigen; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Carcinoma, Endometrioid; Female; Humans; Immunohistochemistry; Keratins; Neoplasms, Multiple Primary; Proliferating Cell Nuclear Antigen; Receptors, Estrogen; Tumor Suppressor Protein p53; Uterine Cervical Neoplasms; Uterine Neoplasms

A tumor mass resected from the anterior bladder wall of a 68-year-old woman displayed unusual histologic features: sheets of hepatoid cells merging focally with a secondary glandular pattern of adenocarcinoma. Intracytoplasmic hyaline globules and bile production within the solid areas supported the impression of hepatocytic differentiation. Immunoreactivity for alpha-fetoprotein (AFP) and alpha-1-antitrypsin and a striking canalicular immunostaining pattern for carcinoembryonic antigen and epithelial membrane antigen all indicate hepatocellular differentiation within this bladder tumor. This represents a case of a hepatoid adenocarcinoma located in the urinary bladder. The use of the term "hepatoid" in the literature is reviewed and the reported cases are grouped into two distinct categories of tumors: (1) germ cell tumors with focal hepatoid areas and (2) true hepatoid adenocarcinomas that meet histologic and immunohistochemical criteria for hepatocellular differentiation. AFP-producing tumors without any other feature of hepatocellular differentiation should not be considered as hepatoid tumors. This classification of hepatoid tumors is likely to be important in elucidating the histogenesis and clinicopathologic features of these unusual neoplasms.

Topics: Adenocarcinoma; Aged; alpha 1-Antitrypsin; alpha-Fetoproteins; Antigens, Neoplasm; Carcinoembryonic Antigen; Carcinoma, Endometrioid; Carcinoma, Transitional Cell; Cell Nucleus; Cytoplasm; Female; Humans; Keratins; Liver; Membrane Glycoproteins; Mucin-1; Ureteral Neoplasms; Urinary Bladder Neoplasms; Uterine Neoplasms

A wide variety of human neoplasms were examined by immunocytochemical and ultrastructural techniques. In most, one intermediate filament (IF) type was expressed reflecting the tissue of origin. However, multiple classes of intermediate filaments were regularly found in a subgroup of these tumors. We chose to subdivide them into those with a complex or mixed growth pattern, and those which showed a more "monomorphic" histologic growth pattern. This latter group is the subject of this paper. Regular coexpression of cytokeratin and vimentin was observed in tumors of endometrial, thyroid, ovarian and renal origin, and coexpression of cytokeratin and neurofilament was observed in a subgroup of neuroendocrine tumors. Immunocytochemical/ultrastructural correlation demonstrated few, if any, observable intermediate filaments in tumors expressing only low molecular weight cytokeratin, whereas vimentin and neural filament characteristically were randomly dispersed or formed whorled bundles of cytoplasmic filaments. The potential diagnostic usefulness of these observations in surgical pathology is discussed.

Topics: Carcinoid Tumor; Carcinoma; Carcinoma, Small Cell; Cytoskeleton; Endocrine System Diseases; Female; Humans; Intermediate Filaments; Keratins; Kidney Neoplasms; Lung Neoplasms; Ovarian Neoplasms; Thyroid Neoplasms; Uterine Neoplasms; Vimentin

Uterine adenosarcomas are rare malignant gynaecological tumours. Due to its submucous localization, they can be easily confound with benign tumours like endometrial polyps or submucous myomas. However, the treatment of uterine adenosarcomas requires an oncologic surgical approach.. In the following case report, we present the minimally invasive treatment of a uterine adenosarcoma by hysteroscopy and laparoscopy in a 37-year-old patient and discuss the special role of hysteroscopy in such cases.. In case of unknown or suspect intrauterine tumours, a diagnostic and operative hysteroscopy with biopsy could be realized prior to laparoscopic hysterectomy especially when the use of a laparoscopic electric morcellation is planned. Thus, a correct oncologic approach can be guaranteed if an adenosarcoma is diagnosed.. ISRCTN.

Topics: Actins; Adenosarcoma; Adult; Biopsy; Female; Humans; Hysterectomy; Hysteroscopy; Keratins; Neoplasm Staging; Neprilysin; Ovariectomy; Ovary; Salpingectomy; Ultrasonography; Uterine Neoplasms

Topics: Adenocarcinoma; Adenomatoid Tumor; Adenomyoma; Adult; Antibodies, Monoclonal, Murine-Derived; Biomarkers, Tumor; Calbindin 2; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Keratins; Leiomyoma; Lymphatic Vessel Tumors; Middle Aged; Uterine Neoplasms; Young Adult

Topics: Adenoma; Adnexa Uteri; Adnexal Diseases; Carcinoma, Endometrioid; Diagnosis, Differential; Female; Granulosa Cell Tumor; Humans; Hysterectomy; Keratins; Leiomyomatosis; Microscopy, Electron; Middle Aged; Neoplasms, Multiple Primary; Sertoli-Leydig Cell Tumor; Uterine Neoplasms; Vimentin; WT1 Proteins

Topics: Actins; Adult; Anaplastic Lymphoma Kinase; Diagnosis, Differential; Female; Fibroma; Fibrosarcoma; Follow-Up Studies; Humans; Hysterectomy; Inflammation; Keratins; Leiomyoma; Neoplasm Recurrence, Local; Neoplasms, Muscle Tissue; Receptor Protein-Tyrosine Kinases; Uterine Neoplasms; Young Adult

Uterine tumors resembling ovarian sex cord tumors (UTROSCT) are tumors of unclear histogenesis. The authors analyzed the ultrastructural features of 13 UTROSCT and correlated the findings with their immunohistochemical profile. Features included cells with frequent organoid, nested or cord-like arrangement (8), lumen formation (2; one of which showed surface microvilli), nuclei with irregular indentations (8), intermediate filaments (13), prominent paranuclear aggregates (5), cell junctions (9), desmosome-like junctions (2), tonofilaments (2), basal lamina (1), and cytoplasmic lipid droplets (7; prominent in 3). No dense bodies, subplasmalemmal densities or pinocytotic vesicles were seen. Ultrastructural epithelial differentiation was present in 2 tumors (positive for keratin or epithelial membrane antigen). Prominent lipid droplets correlated with sex cord markers positivity in 2 tumors. Ultrastructural features of smooth muscle differentiation were lacking and abundant paranuclear filaments did not correlate with myoid markers. UTROSCT are polyphenotypic neoplasms ultrastructurally with focal epithelial and variable sex cord-like differentiation. These findings suggest that UTROSCT may result from divergent differentiation in endometrial stromal tumors or represent a distinct group of uterine tumors with sex cord-like differentiation that are closer in histogenesis to ovarian sex cord stromal tumors.

Topics: Adenocarcinoma; Biomarkers, Tumor; Calbindin 2; Cell Nucleus; Cytoplasmic Structures; Desmosomes; Diagnosis, Differential; Female; Humans; Intermediate Filaments; Keratins; Microscopy, Electron, Transmission; Ovarian Neoplasms; S100 Calcium Binding Protein G; Sex Cord-Gonadal Stromal Tumors; Uterine Neoplasms

Topics: Anaplastic Lymphoma Kinase; Biomarkers, Tumor; Carcinosarcoma; Diagnosis, Differential; Female; Granuloma, Plasma Cell; Humans; Immunohistochemistry; Keratins; Middle Aged; Mitosis; Neoplasm Recurrence, Local; Protein-Tyrosine Kinases; Receptor Protein-Tyrosine Kinases; Urinary Bladder Diseases; Uterine Neoplasms; Vimentin

We describe a highly unusual lesion characterized grossly by the formation of a cavity within the lower uterine segment and upper endocervix that communicated with bilateral fistulae to both parametria. Histologically, the cavity and fistulous tracts were entirely coated by fibrinous material with underlying intermediate trophoblastic cells with atypical degenerate nuclei, absent mitotic activity, and a low MIB1 proliferation index. The overall cellular morphology of the lesion was similar to that of the well-circumscribed placental site nodule or plaque. Apart from the lining of the fistulae, there was no invasion of the myometrium by the trophoblastic cells. The patient had undergone previous cesarean deliveries; the lesion was related to the surgical site and was probably secondary to the previous surgery. In a review of the literature, we identified only a single previous report of a somewhat similar case. We propose the term uterine diffuse intermediate trophoblastic lesion resembling placental site plaque for this rare condition.

Topics: Adult; Female; Fistula; Humans; Keratin-1; Keratin-3; Keratins; Placenta; Pregnancy; Trophoblasts; Uterine Neoplasms; Uterus

Uterine carcinosarcomas are highly aggressive malignant tumours, consisting of both epithelial and mesenchymal components. They represent 1-3% of the malignant uterine neoplasms. Their histogenesis is unclear. Because of their rarity and the very few clinical data available, the studies of potential therapeutic goals are scarce. We present clinical and pathohistological description of a rare case of a 76-year-old woman with a uterine carcinosarcoma with a chondroid differentiation, examined immunohistochemically with Cytokeratin, Vimentin and S-100 protein.

Topics: Aged; Carcinosarcoma; Female; Humans; Immunohistochemistry; Keratins; S100 Proteins; Uterine Neoplasms; Uterus; Vimentin

Uterine carcinosarcoma (malignant mixed Mullerian tumor) is an uncommon female genital tract neoplasm characterized by an admixture of epithelial and stromal malignant cells. We report a case of 50-year-old peri-menopausal woman diagnosed to have early-stage (IB due to FIGO) uterine carcinosarcoma of the homologous type with superficial (3mm) myo-invasion. The patient showed no clinical symptoms of the disease and had no family history of female genital tract malignancies. Positive immunostaining for steroid receptors (estrogen-alpha and progesterone receptors), cytokeratin, and EGFR was detected only in the carcinomatous area, whereas beta-catenin, BCL-2, COX-2, p16(INK4a), PTEN, RB-1, and vimentin were immunoreactive in both components. Androgen receptor, CD10, desmin, HER-2/neu, and P53 were found to be negative either in the carcinomatous or in the sarcomatous area. Tumor proliferative activity was higher in the carcinomatous (25%) than in the sarcomatous (2%) component. Based on these findings, immunohistochemical evaluation of multiple receptor status in the carcinomatous and sarcomatous areas of carcinosarcoma may provide a clue to the pathogenesis and hormonal receptor status of this uncommon uterine malignancy.

Topics: beta Catenin; Biomarkers, Tumor; Carcinosarcoma; Cyclin-Dependent Kinase Inhibitor p16; Cyclooxygenase 2; ErbB Receptors; Estrogen Receptor alpha; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Proto-Oncogene Proteins c-bcl-2; PTEN Phosphohydrolase; Receptors, Progesterone; Retinoblastoma Protein; Uterine Neoplasms; Vimentin

We describe 12 cases of leiomyoma with intracytoplasmic inclusion bodies, which were detected in a group of 447 leiomyomas examined at our institution between December 2005 and March 2006. Ten of these tumors were typical leiomyomas, and two cases represented atypical (bizarre) leiomyoma. In some cases, the presence of intracytoplasmic inclusion bodies resulted in a rhabdoid or skeletal muscle-like appearance of the tumor cells. Ultrastructurally, there were two types of inclusions. One of them consisted of an abnormal aggregation of intermediate and actin filaments. Another type of inclusions was composed of dense granular material without an apparent fibrillar structure. The ultrastructure of the inclusions correlates with immunohistochemical and histochemical stainings. The inclusions with apparent fibrillar arrangements were PAS negative, stained red by trichrome, and were, at least at the periphery, actin-, desmin-, and h-caldesmon-positive. The dense granular inclusions were at least focally PAS-positive, stained red by trichrome, and were negative immunohistochemically. The intracytoplasmic inclusions were found in atypical (bizarre) leiomyomas of the uterus and occasionally in epithelioid leiomyomas and leiomyosarcomas. However, to the best of our knowledge, these inclusions have not been found in typical uterine leiomyomas to date.

Topics: Actins; Adult; Aged; Azo Compounds; Biomarkers; Calmodulin-Binding Proteins; Desmin; Diagnosis, Differential; Eosine Yellowish-(YS); Female; Humans; Immunohistochemistry; Inclusion Bodies; Keratins; Leiomyoma; Methyl Green; Middle Aged; MyoD Protein; Myogenin; Periodic Acid-Schiff Reaction; Rhabdoid Tumor; Uterine Neoplasms; Vimentin

In this study, we present the clinicopathologic features and immunophenotypic characteristics of five cases of uterine tumors resembling ovarian sex cord tumors and three cases of endometrial stromal tumors with sex cord-like elements, with emphasis on immunohistochemical markers of sex cord differentiation. The mean patient age was 42 years (range 19-69 years), and vaginal bleeding was the most common clinical presentation. The tumors were usually polypoid masses arising in the uterine fundus, with a mean tumor size of 6.7 cm. Sex cord patterns in uterine tumors resembling ovarian sex cord tumors, including anastomosing cords, trabeculae, small nests, tubules, and in one case, a striking retiform architecture with Leydig-like cells, comprised from 70 to 100% of the tumor volume. All uterine tumors resembling ovarian sex cord tumors were positive for two or more markers of sex cord differentiation; all five cases showed strong immunoreactivity for calretinin, with coexpression of CD99 (four cases), Melan-A (two cases), and inhibin (two cases). Endometrial stromal tumors with sex cord-like elements were less frequently positive for markers of sex cord differentiation, with each case positive for one marker (calretinin, two cases; CD99, one case). In addition, all eight cases were frequently positive for cytokeratin, CD10, vimentin, estrogen receptor, and progesterone receptor; desmin immunoreactivity, when present, was limited to minor foci of smooth muscle. Overall, the morphologic and immunohistochemical findings in uterine tumors resembling ovarian sex cord tumors strongly support that these unusual uterine tumors are polyphenotypic neoplasms with true sex cord differentiation.

Topics: 12E7 Antigen; Adult; Aged; Antigens, CD; Antigens, Neoplasm; Biomarkers; Calbindin 2; Cell Adhesion Molecules; Cell Differentiation; Female; Follow-Up Studies; Humans; Immunohistochemistry; Inhibins; Keratins; MART-1 Antigen; Middle Aged; Neoplasm Proteins; Neprilysin; Ovarian Neoplasms; Receptors, Estrogen; Receptors, Progesterone; S100 Calcium Binding Protein G; Sex Cord-Gonadal Stromal Tumors; Uterine Neoplasms; Vimentin

Adenomatoid tumour is a neoplastic process of discussed origin, but the immunohistochemical phenotype leads a mesothelial derivation. The preferential site of origin is the genital apparatus of both sexes, however extragenital cases have been described. The histological pattern varies from tubular formation, to solid growth, to cystic areas. In the present report we described a case of Adenomatoid tumour of the uterus body in a 46 years old patient.

Topics: Actins; Adenomatoid Tumor; Calbindin 2; Diagnosis, Differential; Female; Humans; Immunoenzyme Techniques; Keratins; Leiomyoma; Middle Aged; Neoplasm Proteins; S100 Calcium Binding Protein G; Staining and Labeling; Uterine Neoplasms

We report a case of a retiform Sertoli-Leydig cell tumor of intermediate differentiation presenting as a uterine intracavity polypoid mass in a 63-year-old woman. In contrast to sertoliform endometrioid carcinoma and to hitherto reported uterine tumors resembling ovarian sex cord tumors (UTROSCTs), which are primarily characterized by tubular glands and solid tubules, this tumor, which most likely represents a UTROSCT, showed a large spectrum of histologic features typical of a genuine retiform Sertoli-Leydig cell tumor. The diagnosis was confirmed by a battery of immunohistochemical stains, which also served as a tool for differential diagnosis with other neoplasms. The tumor cells were positive for broad spectrum keratin (CK) CK18, vimentin, calretinin, and progesterone receptor. Only a few isolated cells stained for inhibin. The tumor cells were negative for CK7, CK5/6, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), thrombomodulin, 013 (CD99), melan A, alpha-fetoprotein (AFP), placental alkaline phosphatase (PLAP), alpha-1-antitrypsin, estrogen receptor, S100, neurone specific enolase (NSE), chromogranin, synaptophysin, desmin, caldesmon, and CD10. Divergent differentiation of uterine cells seems to be the most likely pathogenetic mechanism. To the best of our knowledge, no UTROSCT showing such a variety of histologic features indicative of a true sex cord tumor has been reported before.

Topics: Calbindin 2; Cell Differentiation; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Phenotype; Receptors, Progesterone; S100 Calcium Binding Protein G; Sertoli-Leydig Cell Tumor; Sex Cord-Gonadal Stromal Tumors; Uterine Neoplasms; Uterus; Vimentin

Topics: Adenomatoid Tumor; Adult; Biomarkers, Tumor; Female; Humans; Hysterectomy; Keratins; Lymphangioma; Uterine Neoplasms; Vimentin

Conflicting evidence exists on whether in vivo morphological characteristics can distinguish Ovarian Surface Epithelium (OSE) of ovaries obtained from women with and without a predisposition to develop female adnexal (ovarian and fallopian tube) carcinoma. This study aims to detect differences in growth potential and morphology that are maintained or specifically expressed in vitro.. Ovarian surfaces were scraped to retrieve OSE cells from 56 women at hereditary high risk for female adnexal carcinoma, of whom 33 are BRCA1 and four are BRCA2 mutation carriers (Predisposed OSE, POSE) and from 26 women without such risk (Non Predisposed OSE, NPOSE). Number of passages and total cell yield until last passage, as well as morphology was compared between both groups. To confirm morphology, the expression of epithelial, mesothelial, and fibroblast markers was assessed.. Both POSE and NPOSE cultures displayed similar growth potential and morphology. The expression of epithelial markers cyto-keratins 7 and 8 was similar between both groups. Only in cultures in which cells did not uniformly exhibit these markers, the percentage of cells expressing these markers was significantly lower at last passage when compared to the initial culture. In these latter cultures, cells that were morphologically indistinguishable from fibroblasts were observed. Mesothelial marker calretinin was expressed in 75% of cells of both POSE and NPOSE cultures and correlates with cyto-keratins 7 and 8 expression. CA 125 expression was equally low in POSE and NPOSE cultures (4.3%). Fibroblast markers FSM and vimentin were expressed in 100% and collagen IV was expressed in 16% of cells in all cultures.. OSE cells derived from women with a hereditary predisposition to develop female adnexal cancer possess similar in vitro characteristics as OSE from women without this predisposition. On basis of our results, it seems advisable to study only 100% cyto-keratins 7 and 8 positive OSE cultures, since contamination of fibroblasts in some primary OSE cultures cannot be ruled out.

Topics: Adnexa Uteri; Adult; Aged; Biomarkers, Tumor; CA-125 Antigen; Calbindin 2; Cell Culture Techniques; Collagen Type IV; Epithelial Cells; Female; Genes, BRCA1; Genes, BRCA2; Genetic Predisposition to Disease; Humans; Keratin-7; Keratins; Middle Aged; Mutation; Ovary; S100 Calcium Binding Protein G; Uterine Neoplasms

Complete hydatidiform moles are totally paternally derived and represent complete allografts that might be expected to provoke maternal immune rejection. Our previous and other studies have shown expression of Fas by increased numbers of activated decidual CD4(+) T cells in both complete and partial molar pregnancy as well as increased FasL(+) expression by molar trophoblasts compared with trophoblasts in normal pregnancies. As the Fas/FasL system represents a major apoptotic pathway that can play a role in immune privilege, the aim of this study was to investigate whether apoptosis of decidual immune cells, particularly T cells, could be responsible for maternal immune tolerance in molar pregnancy. Using terminal deoxynucleotidyl transferase (TdT)-mediated nick end-labelling (TUNEL), a significant increase in TUNEL(+) cells was demonstrated in decidua associated with partial (P = 0.0052) and complete (P = 0.0096) hydatidiform mole compared with normal early pregnancy. Co-labelling immunoperoxidase studies showed that the TUNEL(+) cells in both normal and molar pregnancies were not activated CD45RO(+) immune cells, CD3(+) T cells, CD56(+) uterine natural killer (NK) cells or CD14(+) CD68(+) macrophages. Double immunohistochemical labelling with antiactive caspase-3 and leucocyte markers confirmed the lack of leucocyte apoptosis. Double immunostaining with anticytokeratin to detect trophoblast and M30 CytoDeath, which detects a neoepitope of cytokeratin 18 revealed after caspase-mediated cleavage, revealed apoptotic extravillous trophoblast cells within decidual tissue. We conclude that there is no evidence that apoptosis of decidual leucocytes plays a role in maintaining maternal tolerance in either normal or molar pregnancy.

Topics: Antigens, CD; Apoptosis; Caspase 3; Caspases; Decidua; Enzyme Precursors; Female; Humans; Hydatidiform Mole; Immune Tolerance; Immunoenzyme Techniques; In Situ Nick-End Labeling; Keratins; Killer Cells, Natural; Leukocytes; Pregnancy; T-Lymphocytes; Uterine Neoplasms

To investigate the clinicopathological features of intermediate trophoblastic non-tumor lesions, and to evaluate the position of immunohistochemistry in differential diagnoses.. Clinical presentation and morphological study of 15 cases of exaggerated placental site (EPS) and 4 cases of placental site nodule or plaque (PSNP) were reviewed. Immunohistochemical stains for hCG, hPL, inhibin-alpha, PLAP, CK18 and Ki-67 were performed.. The age of patients ranged from 25 to 40 years with an average of 31.5 years for EPS and 26 to 39 years with an average of 34.3 years for PSNP. Microscopically, EPS was characterized by cords and small sheets of implantation site intermediate trophoblasts infiltrating the endometrium, myometrium and arterial walls. The general histological structures of the endometrium and myometrium were preserved. PSNP was characterized by multiple circumscribed nodular lesions consisting of so-called chorionic-type intermediate trophoblasts and hyaline-like matrix present in the endometrium. Immunohistochemical stainings for hPL and CK18 were positive in the 15 EPS cases. Immunoreactivity for CK18, Inhibin-alpha and PLAP was detected in 4 PSNP cases. The Ki-67 labeling index in 15 EPS cases was low (< or = 5%), while Ki-67 index in 4 PSNP cases was close to 0.. The clinical presentation and pathological features of EPS and PSNP differ from those of trophoblastic tumors (placental site trophoblastic tumor, epithelioid trophoblastic tumor and choriocarcinoma). Immunochemical staining is of great value in their differential diagnoses.

Topics: Adult; Diagnosis, Differential; Endometrium; Female; Follow-Up Studies; Humans; Hysterectomy; Inhibins; Keratins; Myometrium; Placenta; Placenta Diseases; Placental Lactogen; Pregnancy; Trophoblastic Neoplasms; Trophoblastic Tumor, Placental Site; Trophoblasts; Uterine Neoplasms

Uterine tumors resembling ovarian sex-cord tumors (UTROSCTs) are unusual neoplasms with histologic features that resemble those within ovarian Sertoli and granulosa cell tumors. We report the case of a 24-year-old woman with a UTROSCT presenting as a cervical mass, which on initial evaluation was thought to represent cervical adenocarcinoma. The patient's cervical biopsy specimen contained epithelioid cells arranged in tubules and anastomosing cords, without significant cellular atypia or mitotic activity. Because this morphology elicited a broad differential diagnosis, immunohistochemical studies were performed. The tumor was found to be diffusely positive for cytokeratin cocktail, calretinin, and desmin, focally positive for CK7 and SMA, and negative for EMA, CEA, inhibin, CD10, CK20, chromogranin, and synaptophysin. Ultrastructural examination revealed occasional gland-like lumens with cells joined by desmosomes and a continuous basal lamina. UTROSCTs have features that may cause them to be confused with more common tumors, especially in limited biopsy samples, and should be included in the differential diagnosis when a gland-forming neoplasm with an unusual appearance is identified in a cervical or endometrial biopsy specimen.

Topics: Actins; Adenocarcinoma; Adult; Biopsy; Calbindin 2; Cell Nucleus; Cytoplasm; Desmin; Diagnosis, Differential; Female; Humans; Hysterectomy; Immunohistochemistry; Keratin-7; Keratins; Microscopy, Electron; Muscle, Smooth; Ovarian Neoplasms; S100 Calcium Binding Protein G; Sex Cord-Gonadal Stromal Tumors; Uterine Cervical Neoplasms; Uterine Neoplasms

Using archival material, we studied the immunoreactivity and utility of monoclonal anti-human inhibin alpha subunit in the identification of chorionic villi (CV) and trophoblastic subpopulations in endometrial curettings (EC) from patients who had intra-uterine, ectopic, molar and, particularly, probable intra-uterine pregnancies. We also compared its expression with those of betaHCG, HPL and CAM 5.2.. The four groups of EC investigated included: Group 1, 15 patients with intra-uterine pregnancies (IUP); Group 2, 15 patients with tubal pregnancies (TP); Group 3, 15 patients with hydatidiform moles (HM); and Group 4, 20 patients with purported history of intra-uterine pregnancies (PIUP). Positive and negative control cases were from Groups 1 and 3 and Group 2, respectively. The test cases were from Group 4. Immunohistochemistry was performed on each case testing for expression of inhibin alpha, betaHCG, HPL and CAM 5.2.. Trophoblastic populations, which included syncytiotrophoblast (ST), cytotrophoblast (CT) and intermediate trophoblast (IT), were absent in all 15 negative control cases (Group 2). The 30 positive control cases (Groups 1 and 3) revealed the following: (a) ST, CT and IT were identified in all cases and were positive for CAM 5.2, (b) inhibin alpha, betaHCG and HPL (except one case) were reactive for all cases with ST, but not CT, and (c) IT positivity for betaHCG, HPL and inhibin alpha was 67, 80-93 and 100%, respectively. From the 20 test cases (Group 4), the findings were: (a) CT was absent in all cases, (b) scattered ST cells, which were identified only in 10 cases, were positive for all antibodies, (c) scattered IT cells were present in 17 cases and showed 100% CAM 5.2 positivity, and (d) IT positivity for betaHCG, inhibin alpha and HPL was 58.8% (10/17), 76.5% (13/17) and 82.4% (14/17), respectively. Background staining was observed in 22 of 65 cases (33.8%) stained with betaHCG and HPL; half of these cases came from Group 3. Inhibin alpha and CAM 5.2 staining did not show this problem.. We suggest that inhibin alpha is a useful antibody in diagnosing IUP and HM and in documenting intra-uterine gestations in cases with PIUP because it is a sensitive marker in immunolabelling IT and ST. Combined application of inhibin alpha and CAM 5.2 might be more useful than betaHCG and HPL because the latter showed background staining in one third of the cases.

Topics: Adolescent; Adult; Biomarkers; Chorionic Gonadotropin, beta Subunit, Human; Chorionic Villi; Dilatation and Curettage; Endometrium; Female; Humans; Hydatidiform Mole; Immunohistochemistry; Inhibins; Keratins; Placental Lactogen; Pregnancy; Pregnancy, Tubal; Retrospective Studies; Trophoblasts; Uterine Neoplasms

Sixty cases of uterine adenomatoid tumors (ATs) are reported. All except four were incidental findings in hysterectomy specimens, three of these being discovered preoperatively as large multicystic tumors. ATs were classified into two distinctive macroscopic patterns: small, solid tumors and large, cystic ones. The 56 small, solid ATs ranged from 0.2 to 3.5 cm, (average 2.1 cm); 48 were nodular and 8 diffuse. The four large, cystic tumors ranged from 7 to 10 cm. Inflammation occurred in 65% of the tumors, and a smooth muscle reaction, identified by an increased Ki-67 index, was present in most cases. Both types were histologically similar except for the presence of short papillae in cystic tumors, which also showed serosal involvement. Both were immunoreactive for cytokeratins, calretinin, HMBE-1, and vimentin. Estrogen and progesterone nuclear receptors and EMA were negative. These tumors represent a spectrum ranging from small and solid to large and cystic ATs in the female genital tract, whereas outside the genital tract they are morphologically similar to multicystic mesothelioma. Although a reactive origin for ATs often seems plausible, especially when inflammation is present, their neoplastic nature should not be ignored.

Topics: Adenomatoid Tumor; Adult; Aged; Calbindin 2; Female; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Middle Aged; Mucin-1; Receptors, Estrogen; Receptors, Progesterone; Retrospective Studies; S100 Calcium Binding Protein G; Thrombomodulin; Uterine Neoplasms; Vimentin

Benign mesothelioma is a rare tumor nearly always find in relation to the genital tract. We report the case of a 47-year, old woman admit in the gynecologic department for metrorragia. The tumor was composed of irregular tubules between smooth muscle cells, lined by flattened or cuboidal cells without nuclear atypia or mitoses. The tumor cells express cytokeratins and vimentin. Histologically, differential diagnosis can be made with adenocarcinoma or vascular proliferation like lymphangioma, hemangioma or angiomyoma. Clinical outcome is always favourable without recurrence or malignant transformation.

Topics: Diagnosis, Differential; Female; Humans; Hysterectomy; Immunohistochemistry; Keratins; Mesothelioma; Middle Aged; Uterine Neoplasms; Vimentin

The expression of desmin, h-caldesmon, calponin, CD10, CD34, CD99, inhibin, and keratin (AE1/3-Cam 5.2) was studied in 10 conventional leiomyomas, 9 highly cellular leiomyomas, 9 epithelioid smooth muscle tumors, 9 leiomyosarcomas, 10 endometrial stromal tumors (4 with smooth muscle metaplasia), and 7 uterine tumors resembling ovarian sex cord tumors (UTROSCTs). c-kit expression was tested in 10 endometrial stromal tumors, 7 UTROSCTs, and 9 leiomyosarcomas. Desmin was positive in almost all smooth muscle tumors except those of epithelioid type, which were positive in only about half of the cases. It also stained areas of smooth muscle differentiation in endometrial stromal tumors and five of seven UTROSCTs. h-caldesmon was positive in almost all nonepithelioid smooth muscle tumors and in areas of smooth muscle differentiation in endometrial stromal tumors; it was positive in only about half of the epithelioid smooth muscle tumors and negative in all UTROSCTs. Calponin was positive in most tumor types. CD10 was positive in nine of 10 endometrial stromal tumors and five of seven UTROSCTs, although very focally in the latter group. It was also expressed, however, in almost all leiomyosarcomas, almost 50% of highly cellular leiomyomas, and rarely in the other smooth muscle tumors. CD34 was negative in the tested tumors with rare exceptions. CD99 and inhibin were positive in four of seven and one of seven UTROSCTs. Keratin positivity was found in most (five of seven) UTROSCTs and occasionally in smooth muscle tumors (seven of 37). c-kit was negative in all endometrial stromal tumors, UTROSCTs, and leiomyosarcomas. The major conclusions of this study are as follows: 1) Pure endometrial stromal tumors are usually desmin negative. 2) In contrast to some previous studies, CD10 expression was often seen in smooth muscle tumors, including most leiomyosarcomas and almost half of highly cellular leiomyomas. As a result, a panel of CD10, h-caldesmon, and desmin should be used and will distinguish endometrial stromal tumors from highly cellular leiomyomas in most cases. 3) In contrast to a previous study, no significant differences in immunoreactivity were seen between h-caldesmon and desmin in tumors with smooth muscle differentiation. 4) The absence of h-caldesmon in UTROSCTs helps separate them from epithelioid smooth muscle tumors. 5) UTROSCTs may express epithelial, stromal, and smooth muscle markers, suggesting divergent differentiation. 6) Our study shows less fr

Topics: Adenosine Triphosphatases; Antigens, CD; Antigens, CD34; Apyrase; Calcium-Binding Proteins; Calmodulin-Binding Proteins; Calponins; Desmin; Female; Humans; Immunohistochemistry; Inhibins; Keratins; Leiomyoma; Leiomyosarcoma; Microfilament Proteins; Neprilysin; Proto-Oncogene Proteins c-kit; Uterine Neoplasms

Epithelioid trophoblastic tumor (ETT) is a new entity of trophoblastic tumor and 14 such cases were reported by Shih and Kurman in 1998. However, only three subsequent cases supporting ETT have been reported. Recently, we experienced a case of ETT in a 37-year-old woman whose preoperative endometrial brushings showed atypical mononucleate giant cells and who underwent hysterectomy with the diagnosis of a uterine fibroid. The specimens revealed a 2.5 x 3.0 cm yellow-tan intramural nodule located in the lower uterine segment, which was composed of a neoplastic proliferation of intermediate trophoblasts in epithelioid arrangements. Immunohistochemically, the tumor cells were diffusely positive for cytokeratin and inhibin-alpha, and focally positive for human chorionic gonadotropin and human placental lactogen. She presented an uneventful clinical course as of September 2001.

Topics: Adult; Chorionic Gonadotropin; Epithelioid Cells; Female; Humans; Immunohistochemistry; Inhibins; Keratins; Placental Lactogen; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

A case of uterine tumors resembling ovarian sex-cord tumors (UTROSCT) producing parathyroid hormone-related protein (PTH-rP) of the uterine cervix is reported. A 66-year-old woman underwent total hysterectomy with bilateral salpingo -oophorectomy due to the possibility of a malignant uterine tumor. A fairly well-circumscribed tumor, measuring 8 x 5 x 7 cm, was present in the myometrium of the cervix and extended into the endocervical mucosa. Histologically, the tumor showed predominantly sex-cord-like differentiation and the features of conventional endometrial low-grade stromal sarcoma were observed in part. Immunohistochemically, the tumor cells were negative for CD10. From these findings, we diagnosed the present case as Clement and Scully's group II UTROSCT arising from the uterine cervix. To our knowledge, this is the first report of the cervical occurrence of UTROSCT. Furthermore, in this tumor, production of PTH-rP was demonstrated by normalization of serum PTH-rP after the tumorectomy and immunoreactivity for PTH-rP in the tumor cells.

Topics: 12E7 Antigen; Aged; Antigens, CD; Cell Adhesion Molecules; Cervix Uteri; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Keratins; Ovarian Neoplasms; Parathyroid Hormone-Related Protein; Protein Biosynthesis; Sex Cord-Gonadal Stromal Tumors; Uterine Neoplasms; Vimentin

The objective of this study was to assess apoptotic activity in gestational trophoblastic disease (GTD) and its prognostic value in hydatidiform mole (HM).. Expression of the specific caspase cleavage site within cytokeratin 18 was assessed immunohistochemically using the monoclonal antibody M30 CytoDeath in 12 spontaneous abortions, 22 partial and 57 complete HM, eight choriocarcinoma (CCA) and 28 normal placentas. The M30 immunoreactivity occurred predominantly in the syncytiotrophoblasts. A significantly higher M30 index in HM and CCA was found when compared with normal placentas and spontaneous abortions (P < 0.001). The M30 index of those HM which spontaneously regressed was significantly higher than those HM which developed persistent disease requiring chemotherapy (P < 0.001). The M30 index correlated with another apoptotic index previously detected by TdT-mediated dUTP nick-end labelling (TUNEL) (P = 0.007) and the proliferation index assessed by the Ki67 antigen (P = 0.034).. We conclude that apoptosis is important in the pathogenesis of GTD. Assessment of apoptotic activity in HM by the M30 index may be considered as an alternative prognostic indicator for predicting the clinical behaviour.

Topics: Abortion, Spontaneous; Apoptosis; Caspases; Choriocarcinoma; Female; Follow-Up Studies; Humans; Hydatidiform Mole; In Situ Nick-End Labeling; Keratins; Pregnancy; Prognosis; Trophoblastic Neoplasms; Trophoblastic Tumor, Placental Site; Uterine Neoplasms

Topics: Adult; Biomarkers; Cell Culture Techniques; Cell Lineage; Choriocarcinoma; Female; Humans; Keratin-7; Keratins; Models, Biological; Pregnancy; Reproducibility of Results; Trophoblasts; Tumor Cells, Cultured; Uterine Neoplasms; Vimentin

The distribution of cytokeratins (CKs) and vimentin in the normal genital tract of calves and cows at different stages of the oestrous cycle and in epithelial tumours of the tract was studied immunohistochemically. Few differences in CK and vimentin immunolabelling were detected in relation to age or stage of the oestrous cycle. Coexpression of CKs in simple epithelia and in basal cells of stratified epithelia was detected in the oviduct and endocervix; this coexpression was different from that previously described in women. The demonstration of CKs but not vimentin in the neoplastic cells of a serous superficial ovarian papilloma suggested an origin from the ovarian surface epithelium, while the coexpression of CKs and vimentin in serous papillary and mucinous cystadenomas pointed to a possible origin from the rete ovarii. Studies on three uterine adenocarcinomas and the ovarian metastases from two of these showed an endometrial-CK phenotype. The intermediate filament profile of normal endometrium, conserved in uterine adenocarcinomas and their ovarian metastases, may be useful in discriminating between ovarian metastases from endometrial carcinomas and those originating from primary carcinomas in other organs.

Topics: Adenocarcinoma; Age Factors; Animals; Antibodies, Monoclonal; Cattle; Cattle Diseases; Cystadenoma; Estrus; Female; Genitalia, Female; Immunoenzyme Techniques; Keratins; Ovarian Neoplasms; Ovary; Oviducts; Papilloma; Uterine Neoplasms; Uterus; Vimentin

Carcinosarcomas of the uterus are characterized by admixtures of malignant epithelial and stromal cells, and their histogenesis remains controversial.. An operated case of carcinosarcoma of the uterus in a 49-year-old woman is reported with clonal analysis. The tumor was composed of carcinomatous, sarcomatous, and transitional elements in the frontal wall of the uterine body and therefore was diagnosed as a carcinosarcoma. On immunohistochemical analysis, the sarcomatous component proved negative for epithelial membrane antigen and keratin while both components were positive for vimentin. Analysis of X-chromosome inactivation showed the same pattern throughout and additionally, the same K-ras and p53 mutations were homogeneously detected. Microsatellite instability analysis showed loss of heterozygosity at D5S346 in the sarcomatous but not the carcinomatous component.. This tumor appears monoclonal in line with the combination tumor theory, with late divergence in genetic alteration in the sarcomatous elements.

Topics: Carcinosarcoma; Clone Cells; DNA, Neoplasm; Female; Genes, p53; Genes, ras; Humans; Immunohistochemistry; Keratins; Microsatellite Repeats; Middle Aged; Mucin-1; Uterine Neoplasms; X Chromosome

Mesonephric (wolffian) neoplasms of the female genital tract are infrequent and found in sites where embryonic remnants of wolffian origin are usually detected, such as the uterine cervix, broad ligament, mesosalpinx, and ovary. Their diagnosis is difficult because of the absence of specific immunohistochemical markers for mesonephric derivatives. We present the first report of adenocarcinoma of mesonephric type arising as a purely myometrial mass without endometrial or cervical involvement in the uterine corpus of a 33-year-old woman. The tumor showed a combination of patterns, with retiform areas, ductal foci, and small tubules with eosinophilic secretion, which merged with solid sheets of cells with a sarcomatoid appearance. Immunohistochemically, neoplastic cells were diffusely positive for cytokeratin 7, epithelial membrane antigen, and CD15 and focally positive for BerEP4 and vimentin. A hitherto unreported feature was the positivity for CD10 in neoplastic cells, which was also present in a large number of control tissues obtained from male mesonephric derivatives and female mesonephric remnants and tumors. Furthermore, CD10 was negative in controls from müllerian epithelia of the female genital tract and in their corresponding tumors. Therefore, the expression of CD10 by mesonephric remnants may be useful in establishing the diagnosis of tumors with mesonephric differentiation.

Topics: Adenocarcinoma; Adult; Antigens, Neoplasm; Antigens, Surface; Biomarkers, Tumor; Cell Differentiation; Female; Humans; Hysterectomy; Immunohistochemistry; Keratin-7; Keratins; Lewis X Antigen; Mesonephroma; Mesonephros; Mucin-1; Neprilysin; Radiotherapy, Adjuvant; Treatment Outcome; Uterine Neoplasms; Vimentin

To study the immunohistochemical feature and the differential diagnosis of adenomatoid tumors in uterus and ovaries.. Clinical pathological analysis and immunohistochemical studies were performed on 24 cases of adenomatoid tumors in the uterus and ovaries.. Of the 24 cases, 21 cases were in the uterus, 2 cases in the ovaries and 1 cases in both the uterus and the ovary. Grossly, the mean diameter of the 22 uterus tumors was 2.2 cm, ranging from 0.2 - 5.5 cm. 14 (63.6%) were located in the subserosa or near by the subserosa of the uterine cornua. The other 8 tumors located in the myometrium. The cut surface presented a nodular pattern with grayish white or yellowish in color, partially cystic. 3 ovarian tumors became all cystic, without a clear-cut margin from the surroundings. Microscopically, the tumor consisted of various gland-like structure or luminal spaces lined with flat, cuboidal or low columnar cells, similar to blood vessels in structure. Among the tumor cells, there were scattered vesicular cells with large or small vacuoles, but no nuclear atypia and mitotic figures detected. Immunohistochemical staining showed the tumor cells positive for vimentin, AE(1)/AE(3) and calretinin, but negative for F VIII-Rag. S-100 and EMA were positive in 20 (83.3%) and 4 (16.7%) cases respectively.. Adenomatoid tumor of the female genital tract is mesothelial in origin and uterus was considered as the most common site of occurance. Immunohistochemical phenotypes can be used as an important evidence for differential diagnosis. The biological behavior of adenomatoid tumor is benign and with a good prognosis.

Topics: Adenomatoid Tumor; Adult; Calbindin 2; Diagnosis, Differential; Female; Humans; Keratins; Middle Aged; Neoplasms, Multiple Primary; Ovarian Neoplasms; S100 Calcium Binding Protein G; S100 Proteins; Uterine Neoplasms; Vimentin

Although 'aberrant' expression of the epithelial markers, cytokeratin (CK) and epithelial membrane antigen (EMA), in leiomyosarcoma has been described previously, there has not been a study of this phenomenon with clinicopathological correlation in a large series of lesions at different anatomical sites. We investigated systematically the immunohistochemical reactivity for CK and EMA in 100 cases of leiomyosarcoma. CK and EMA were positive in 38% and 44% of the cases, respectively. Although staining was usually focal, extensive immunoreactivity was observed in 11% with CK and 6% with EMA. There was no correlation between immunoreactivity for CK and EMA in leiomyosarcomas and non-neoplastic smooth muscle at the same location. Immunoreactivity for CK and EMA was not correlated with the location, age, sex, histological grade, or histological features, except for more frequent EMA positivity in vascular and uterine tumors than in soft tissue cases. These results indicate that CK and/or EMA-positive leiomyosarcomas do not have distinctive clinicopathological features differing from those of negative cases. However, the considerable frequency of immunoreactivity for these epithelial markers in leiomyosarcoma, occasionally with diffuse and strong immunopositivity, should be recognized as a potentially serious diagnostic pitfall in the differential diagnosis of other malignant spindle cell neoplasms.

Topics: Abdominal Neoplasms; Adult; Aged; Aged, 80 and over; Biomarkers; Female; Humans; Immunoenzyme Techniques; Keratins; Leiomyosarcoma; Male; Middle Aged; Mucin-1; Muscle, Smooth; Skin Neoplasms; Soft Tissue Neoplasms; Uterine Neoplasms; Vascular Neoplasms

We describe an epithelioid trophoblastic tumor (ETT) metastatic to the vagina in a 30-year-old Japanese woman. A polypoid tumor in the vaginal orifice was composed of nests of intermediate trophoblastic cells that showed a striking epithelioid appearance. In the hysterectomy specimen, a tumor infiltrated through the myometrium and showed histologic findings similar to those of the vaginal tumor. The tumor cells were positive for cytokeratin, inhibin-alpha, and melanoma cell adhesion molecule (Mel-CAM, CD146) but were only focally positive for human placental lactogen. Electron microscopic examination revealed bundles of well-developed, intermediate-type filaments surrounding the nuclei.

Topics: Adult; Antigens, CD; Antigens, Surface; Biopsy; CD146 Antigen; Cell Nucleus; Cytoplasm; Epithelioid Cells; Female; Humans; Immunohistochemistry; Inhibins; Intermediate Filaments; Keratins; Membrane Glycoproteins; Microscopy, Electron; Myometrium; Neural Cell Adhesion Molecules; Placental Lactogen; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms; Vaginal Neoplasms

Invasive hydatidiform mole is a relative rare form of gestational trophoblastic disease (GTD). Most of hydatidiform moles remit after evacuation but some of them have the tendency to invade the myometrium. In some rare cases the trophoblastic tissue can be found in other tissues like lungs, vulva, vagina or broad ligament. The aim of the study was to demonstrate some of clinical, immunohistochemical and DNA analysis findings of a patient with a previous diagnosis of a complete hydatidiform mole.

Topics: Base Sequence; Chorionic Gonadotropin; DNA Primers; DNA, Neoplasm; Female; Humans; Hydatidiform Mole, Invasive; Immunohistochemistry; Keratins; Middle Aged; Minisatellite Repeats; Pregnancy; Uterine Neoplasms

We present rare case of a uterine adenomatoid tumor. In order to characterize the diversity of immunoreactive antigens associated with mesothelial differentiation, we immunohistochemically examined the tumor's epithelioid and myofibromatoid components, as well as the biphasic pattern of its adenomatoid changes. Immunostaining of tumor cells was positive for high- and low-molecular-weight cytokeratins and vimentin. Specific immunoreactions with antibodies against desmin, alpha-actin, and the S-100 protein also were observed. The present adenomatoid tumor can be explained in terms of various transformations and typical alterations in mesothelioma cells: (1) the mesothelial cells had differentiated to epithelial and stromal components, concomitant with the presence of predominant reactive foci; (2) intermediate cells expressed different types of cytoskeletal intermediate filament proteins (IMPs); and (3) the patterns of fibromatoid and leiomyoid differentiation resembled those of a benign mesothelioma of the ovarian or oviductal peritoneum. Our immunohistochemical investigations indicated that the present tumor exhibited the histogenesis of a true mesothelioma, an adenomatoid mesothelioma.

Topics: Actins; Adenomatoid Tumor; Adult; Antibodies, Monoclonal; Desmin; Epithelium; Female; Humans; Immunohistochemistry; Keratins; Mesothelioma; Microscopy, Electron; S100 Proteins; Uterine Neoplasms; Vimentin

Topics: Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Lobular; Female; Humans; Immunohistochemistry; Keratins; Leiomyoma; Middle Aged; Uterine Neoplasms

Seven examples of Clement and Scully's type II uterine tumors resembling ovarian sex cord tumors were studied immunohistochemically with markers of sex cord, steroid cell differentiation (inhibin, O13, A103), or both, and were found to be immunoreactive for one or more of these markers in all cases. There was also constant immunoreactivity for vimentin and for hormone receptors and variable positivity for keratin, actin, and desmin. These findings provide strong evidence for the presence of true sex cord elements in these tumors, the derivation of which remains speculative.

Topics: Actins; Adult; Aged; Desmin; Female; Humans; Immunophenotyping; Keratins; Middle Aged; Neoplasm Proteins; Sex Cord-Gonadal Stromal Tumors; Uterine Neoplasms; Vimentin

The expression of cholesterol sulfate (CS) is known to increase during squamous differentiation of keratinocytes and to activate the epsilon, eta, and zeta forms of protein kinase C as a signal transduction molecule for the subsequent expression of transglutaminase-1 (TG-1) and cytokeratins. To gain further insight into the regulation of cellular differentiation and tumorigenesis by CS, we examined the concentration and the potential for synthesis of CS in seven and four surgical specimens from human ovarian and uterine cervical cancer patients, respectively, and eight cell lines established from human uterine cervical cancer patients and compared them for the rate of expression of cytokeratin. CS was present in all of the uterine cervical cancer tissue specimens but only in the mucinous type of cystadenocarcinoma among ovarian cancer tissue specimens, and cytokeratin was highly expressed in the tissues with a high concentration of CS, which were classified as well-differentiated on the basis of morphological examination. Similarly, cells derived from a keratinizing type of well-differentiated cervical carcinoma demonstrated strong potential for synthesis of CS, stained positive with anti-cytokeratin antibody, and exhibited a higher specific activity of TG-1, whereas the cells without CS did not stain positive with anti-cytokeratin antibody and exhibited a lower specific activity of TG-1. These findings indicate that CS is coexpressed with TG-1 and cytokeratin in the well-differentiated types of squamous cell cancers as a tumor marker.

Topics: Biomarkers, Tumor; Carcinoma, Squamous Cell; Cholesterol Esters; Female; Humans; Immunohistochemistry; Keratins; Lipid Metabolism; Lipids; Ovarian Neoplasms; Tumor Cells, Cultured; Uterine Cervical Neoplasms; Uterine Neoplasms

We report two cases of the so-called adenomatoid tumor of the uterus, which have been detected in patients who underwent surgery for leiomyomas. The clinical signs, origin and immunohistochemical characteristics of the adenomatoid tumor are described. Adenomatoid tumors are slow growing epithelioid neoplasias with a co-expression of vimentin and cytokeratins. The characteristic cytokeratins are numbered 7, 8, 18, 19 and 5. The mesothelial histogenesis of the tumor can be confirmed. Our results rule out origins from Müllerian or mesonephrogenous ducts and angioma or adenoma. Considering our experiences, adenomatoid and leiomyoma cannot be distinguished macroscopically. The hysterectomy or salpingo-oophorectomy, primarily performed under other diagnoses, are the therapies of choice.

Topics: Adenomatoid Tumor; Adult; Biomarkers, Tumor; Diagnosis, Differential; Female; Humans; Hysterectomy; Keratins; Leiomyoma; Middle Aged; Neoplasms, Multiple Primary; Uterine Neoplasms; Uterus

Expression of intermediate filaments (IFs) has been suggested to be a reliable marker for differentiating epithelial and non-epithelial tumors. Moreover, the c-erbB-2 and p53 genes are considered to be involved relatively early in the process of human carcinogenesis. In order to elucidate the origin of uterine carcinosarcomas, we analyzed IF, c-erbB-2 and p53 expression in and the ultrastructural characteristics of clones derived from a human uterine-carcinosarcoma cell line, EMTOKA. The expression of IFs and other proteins in the EMTOKA clones was identical to that in the EMTOKA cell line. It and its 7 clones all expressed cytokeratins 8, 17, 18 and 19, vimentin, epithelial membrane antigen, S-100, myoglobin, type-II collagen, alpha-smooth-muscle actin, placental alkaline phosphatase and epidermal-growth-factor receptor. The c-erbB-2 and p53 expression levels of all the cell types of the EMTOKA cell line and its clones were the same. Interestingly, an ultrastructural study showed that the EMTOKA cell line and its clones at early and late passages possessed the characteristics of epithelial cell types without either transitional forms between the epithelial and stromal components or differentiation into sarcomatous components. The results of this study lend particular support to the combination tumor hypothesis that a precursor (stem) cell gives rise both to epithelial and to mesenchymal components during the histogenesis of uterine carcinosarcoma, the epithelial component of which appears to be dominant, suggesting that the established cell lines derived from a common stem cell.

Topics: Biomarkers, Tumor; Carcinosarcoma; Cell Lineage; Clone Cells; Female; Humans; Immunohistochemistry; Intermediate Filament Proteins; Karyotyping; Keratins; Microscopy, Electron; Neoplastic Stem Cells; Receptor, ErbB-2; Tumor Cells, Cultured; Tumor Suppressor Protein p53; Uterine Neoplasms; Vimentin

Human ovarian malignancies from three different patients (histology: two serous cystadenocarcinomata and one mixed Müllerian tumor, homologous type) were successfully serially transplanted intraperitoneally into severe combined immunodeficient (SCID) mice where the tumor cells spread around the peritoneal cavity. If the ascites derived from cystadenocarcinoma cells engrafted in the female genital tract of the SCID mice, they formed cystic tumors resembling remarkably well the original tumors in the patients. Immunohistochemical analysis revealed that the immunophenotype of the patients' original tumor and those grown in SCID mice were similar in the case of the two cystadenocarcinomata; in addition, the marker expression in general was stable during serial transplantation. If distant metastases occurred in the lungs, they immunophenotypically resembled those grown intraperitoneally. In contrast, the cells derived from the mixed Müllerian tumor shifted during serial transplantation from a spindle cell morphology toward a morphology characterized by cuboidal cells. The transition toward a more epithelial phenotype was accompanied by a changed immunophenotype of the tumor cells which became positive for epithelial cell markers such as carcinoembryonic antigens, CA 19-9 and CA 125. Concurrently with this differentiation, the p53 immunophenotype changed from positive to negative, indicating a further mutation in the p53 gene during serial passages.

Topics: Animals; Biomarkers, Tumor; Cystadenocarcinoma; Female; Humans; Keratins; Mice; Mice, SCID; Middle Aged; Mixed Tumor, Mullerian; Ovarian Neoplasms; Phenotype; Uterine Neoplasms

This report reviews proliferative diseases of intermediate trophoblast cells and summarises clinical findings and pathohistological and immunohistochemical features of a placental site nodule. This recently described entity is an endometrial or endocervical benign proliferation of intermediate trophoblast cells occurring after intrauterine gestation. Patients usually present with a history of abnormal vaginal bleeding and frequently cells that are present in their cervical smears are misinterpreted as squamous dysplasia. In such cases it is important to distinguish the placental site nodule from squamous lesions or decidual polyps; this is possible by means of immunohistochemistry.

Topics: Adult; Biomarkers, Tumor; Chorionic Gonadotropin; Endometrium; Female; Humans; Immunoenzyme Techniques; Keratins; Placenta; Pregnancy; Trophoblastic Tumor, Placental Site; Uterine Neoplasms; Vimentin

Adenomatoid tumors arising in the uterus are not well-recognized and sometimes mistaken for other benign or malignant neoplasms. This study describes three cases of uterine adenomatoid tumors with clinical, light microscopic, histochemical and electron microscopical studies. Four distinctive histologic patterns (solid, adenoid, angiomatoid, cystic) were identified. Acid mucopolysaccharide was present in three cases and was digested by hyaluronidase. Immunohistochemically, tumor cells were positive for cytokeratin and vimentin. Electron microscopy revealed microvilli, intermediate filaments and dilated intercellular spaces. This gives further support to a mesothelial origin of the adenomatoid tumor. Interestingly, one case showed that the adenomatoid tumor was multiple and one nodule was connected with leiomyomatous nodule. In the other case, the tumor was large 5 x 4 x 4.5 cm). These features were unusual.

Topics: Adenomatoid Tumor; Adult; Female; Glycosaminoglycans; Humans; Immunohistochemistry; Keratins; Microscopy, Electron; Middle Aged; Uterine Neoplasms; Vimentin

The placental site nodule (PSN), a recently described benign lesion of intermediate trophoblast, is usually an incidental finding in younger women. It is a well-circumscribed, round to oval lesion that is extensively hyalinized and immunohistochemically stains for cytokeratin, placental alkaline phosphatase (PLAP), human placental lactogen (HPL) and, focally, for human chorionic gonadotropin (HCG) and epithelial membrane antigen (EMA). Thus far, the cases reported have been found in endometrial curettage or hysterectomy specimens. The pathogenesis of PSN is yet to be ascertained; however, there is wide acceptance of the fact that it represents a remnant of the placental implantation site. If this is indeed the case, it should not be surprising to find PSN occurring at sites of ectopic gestation. We describe herewith a case in which PSN was found in a fallopian tube segment resected in a postpartum tubal ligation.

Topics: Adult; Alkaline Phosphatase; Chorionic Gonadotropin; Fallopian Tubes; Female; Humans; Immunochemistry; Keratins; Placental Lactogen; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

A description of the clinical diagnosis, localisation and the histological structure of an adenomatoid tumour of the uterus is presented. The tumour was diagnosed during investigation of sterility and localised in the uterus wall. Fallopian tubes and ovaries can also be affected. Adenomatoid tumours are small, slow growing and of benign origin, and hence organ-preserving tumourectomy is an adequate therapy. Histogenesis of this kind of tumour has been established by means of immunological techniques as being of mesothelial origin.

Topics: Adenomatoid Tumor; Adult; Biomarkers, Tumor; Diagnosis, Differential; Female; Follow-Up Studies; Humans; Immunoenzyme Techniques; Infant, Newborn; Infertility, Female; Keratins; Pregnancy; Uterine Neoplasms; Uterus

We report on six patients with tumours of visceral organs (three patients with endometrial adenocarcinoma with squamous cell differentiation, one patient with atypical hyperplasia of endometrium, and two patients with adenocarcinoma of the colon with squamous cell differentiation), where unquestionable differentiation into shadow cells was observed. In all six cases the shadow cells were found mostly in the morules of immature squamous cells. The shadow cells were morphologically identical, on the light microscopical and ultrastructural level, to similar cells found in pilomatricomas. They were often accompanied by granulomatous giant cell reaction and calcification.

Topics: Adenocarcinoma; Adult; Carcinoma, Squamous Cell; Cell Differentiation; Colonic Neoplasms; Endometrial Neoplasms; Endometrium; Female; Humans; Hyperplasia; Keratins; Male; Microscopy, Electron; Middle Aged; Uterine Neoplasms; Uterus

We reviewed 51 serous effusions (50 peritoneal/one pleural) from 38 patients with uterine (30 cases) and ovarian (eight cases) malignant mixed Müllerian tumors (MMMT). There were 16 patients (42%) with positive effusion cytology specimens; 13 cases (81%) were diagnosed as adenocarcinoma with three cases (19%) interpreted as having a sarcomatous component. Eight of 16 positive effusion specimens had cell block material available for immunoperoxidase (IP) study that included cytokeratin (AE1/3), vimentin, muscle specific actin (HHF) and S-100 protein to determine if unsuspected mesenchymal components were present in the cases originally diagnosed as carcinoma (six cases), or sarcomas (two cases). In the six cases originally interpreted as carcinoma, three were diagnosed as adenocarcinoma and three as poorly differentiated carcinoma. All three of the cases considered adenocarcinoma and two of those diagnosed as poorly differentiated carcinoma reacted only with AE1/3 and vimentin. The remaining case, considered a poorly differentiated carcinoma, stained only with vimentin. In the two cases having cell blocks interpreted as having a sarcomatous component, only vimentin was positive in one while AE1/3, vimentin, HHF, and S-100 were positive in the other. The case where all immunohistochemical stains were reactive contained both carcinomatous and sarcomatous components. In the three cases considered sarcomatous, the cytomorphologic features helpful in the recognition of a mesenchymal component included a dissociated smear pattern of pleomorphic round to oval cells and/or spindle cells. In retrospect, the IP stains did not alter any of the original diagnoses.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Ascitic Fluid; Female; Humans; Immunohistochemistry; Keratins; Mixed Tumor, Mullerian; Ovarian Neoplasms; Pleural Effusion, Malignant; Staining and Labeling; Uterine Neoplasms; Vimentin

We measured serum cytokeratin fragment 21-1 (CYFRA 21-1) levels by a solid-phase immunoradiometric assay in 102 healthy Japanese women, and set the reference value at 1.9 ng/ml (mean +2 SD of the serum levels based on a linear distribution). Pretreatment serum CYFRA 21-1 levels were also analyzed in 235 women with benign (n = 94) or malignant (n = 141) gynecologic disease, and were compared with the serum levels of CA 125 and SCC. The respective positivity rates for CYFRA 21-1 and CA 125 were 64.0 and 77.2% in ovarian malignancy, while they were 4.2 and 30.8% in benign ovarian masses. CYFRA 21-1 had an accuracy of 61.3% in diagnosing ovarian malignancy, which was higher than that of CA 125 (53.4%). The positive predictive value of CYFRA 21-1 for ovarian malignancy reached 94.1%, which was significantly (p < 0.005) higher than that of CA 125 (68.8%). These findings indicate the potential usefulness of CYFRA 21-1 as a tumor marker for ovarian malignancy. In addition, the positivity rates fo CYFRA 21-1 in cervical cancer (51.2%) and endometrial cancer (52.2%) were also similar to the respective rates for SCC and CA 125, which suggests that CYFRA 21-1 seems to be a general tumor marker for gynecologic malignancy.

Topics: Adolescent; Adult; Biomarkers, Tumor; CA-125 Antigen; Cysts; Endometrial Neoplasms; Female; Genital Neoplasms, Female; Humans; Immunoradiometric Assay; Keratins; Middle Aged; Ovarian Diseases; Ovarian Neoplasms; Reference Values; Uterine Cervical Neoplasms; Uterine Diseases; Uterine Neoplasms

This report describes the clinical, histological, and immunohistochemical features of 38 cases of placental site nodule (PSN), a recently described lesion of intermediate trophoblast (IT). The patients ranged in age from 20 to 47 years (mean, 31.1 years). PSNs were diagnosed in endometrial (30 cases), endocervical (seven cases), and both endometrial and endocervical specimens (one case). The majority of biopsies were prompted by an abnormal Pap smear (13 cases) or complaints of menorrhagia (21 cases). All PSNs were microscopically detected, lobulated nodules composed of acellular, hyalinized material admixed with IT. Mitotic activity was noted in seven cases. Immunohistochemically, the IT expressed human placental lactogen (hPL) in 78% of cases and human chorionic gonadotropin (hCG) in 42% of cases, but their expression was weak and focal in contrast to uniform, strong staining for placental alkaline phosphatase (PLAP) (100%), cytokeratins (96%), and epithelial membrane antigen (EMA) (84%). Type IV collagen outlined the IT and stained the extracellular material in the cellular areas. Vimentin-positive cells within the lesions were fewer in number and in a different distribution than those expressing PLAP, CK, and EMA. Two consecutive PSNs occurred in one patient, but no patient developed gestational trophoblastic disease or a significant gynecologic neoplasm.

Topics: Adult; Alkaline Phosphatase; Chorionic Gonadotropin; Female; Follow-Up Studies; Humans; Immunoenzyme Techniques; Keratins; Membrane Glycoproteins; Middle Aged; Mucin-1; Mucins; Placental Lactogen; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

In 2 cases of adenomatoid tumors of the uterus FVIII, keratin, vimentin and carcinoembryonic antigen (CEA) were observed by immunohistochemical method. No staining for FVIII and CEA were seen in the tumor cells but staining for keratin and vimentin were seen coexistent in the tumor cells. Electron microscopic finding showed tumor cells attached to one another by numerous long slender microvill. Adenomatoid tumors had typical mesothelial features. It suggests that adenomatoid tumor may be a mesothelioma.

Topics: Adenomatoid Tumor; Female; Humans; Keratins; Middle Aged; Uterine Neoplasms; Vimentin

An immunohistochemical study analyzing distributions of beta-subunit human chorionic gonadotropin (beta HCG), human placental lactogen (HPL), placental alkaline phosphatase (PLAP), and monoclonal anti-cytokeratin (PKK1) was undertaken to determine whether the reactivity of these antigens might assist in the differential diagnosis of molar and non-molar hydropic placentas. A total of 16 complete hydatidiform moles, 15 partial hydatidiform moles, 12 hydropic abortuses and 39 non-hydropic placentas with gestational age ranging from 4 to 40 weeks was examined. In both the complete and partial moles, many syncytiotrophoblasts stained for beta HCG, HPL, PLAP and PKK1 although the staining intensity of beta HCG in the partial moles was weak compared with the complete moles. The staining patterns in the hydropic abortuses were almost the same as those in the normal first trimester placentas and had no distinct features from the partial moles. Trophoblastic hyperplasia is an essential feature in differentiating partial moles from hydropic abortuses. With regard to the immunostaining patterns of these antibodies, there was no significant difference to enable delineation between partial and complete moles, or between a hydropic abortus and a partial mole. Monoclonal anti-cytokeratin was most sensitive for trophoblasts, but less specific for intermediate trophoblasts than HPL. Although an immunohistochemical study using antibodies against beta HCG, HPL, PLAP and PKK1 is very useful for characterizing various trophoblasts, it is considered that an immunohistochemical study may not be a suitable tool for the differential diagnosis of molar and non-molar hydropic placentas.

Topics: Adolescent; Adult; Alkaline Phosphatase; Antibodies, Monoclonal; Biomarkers, Tumor; Chorionic Gonadotropin; Chorionic Gonadotropin, beta Subunit, Human; Diagnosis, Differential; Female; Humans; Hydatidiform Mole; Hydrops Fetalis; Immunohistochemistry; Keratins; Peptide Fragments; Placenta; Placenta Diseases; Placental Lactogen; Ploidies; Pregnancy; Uterine Neoplasms

In an attempt to clarify the histogenesis of carcinosarcoma (malignant mixed müllerian tumor) of the female genital tract, 20 uterine and eight ovarian tumors were studied by light microscopy, transmission electron microscopy, and immunohistochemistry. Cytokeratins (MAK-6 and AE1:AE3) and epithelial membrane antigen were detected in the epithelial component of all tumors and in the stromal component of 15 cases (55%). Vimentin was detected in the stromal component of all cases and was focally positive in the epithelial component of 18 cases (69%). Tumors showing rhabdomyosarcomatous or chondrosarcomatous differentiation were positive for myoglobin and S-100 protein, respectively. At the ultrastructural level epithelial cells were observed in tight clusters (usually surrounded by a basal lamina), in loose aggregates, and singly (sometimes spindle shaped), and were surrounded by cells displaying variable differentiation. The closest examples of "hybrid" epithelial/stromal cells were those with a prominent rough endoplasmic reticulum, cytoplasmic projections, poorly formed intercellular junctions, and an incomplete basal lamina. The observations support the view that carcinosarcomas of the female genital tract could represent examples of biphasic (metaplastic) carcinomas.

Topics: Aged; Antigens, Neoplasm; Carcinosarcoma; Female; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Middle Aged; Mucin-1; Myoglobin; Ovarian Neoplasms; S100 Proteins; Uterine Neoplasms; Vimentin

A carcinoid tumour occurred in the uterine fundus causing an enlargement (12-14 weeks size). The patient did not have the carcinoid syndrome, despite elevated urinary 5-hydroxyindole acetic acid levels. The tumour had a typical organoid pattern with argentaffin-positive cells. Whilst a metastasis from an occult primary lesion cannot be entirely excluded, it is felt that this is a primary tumour most likely arising from resident endocrine cells in the endometrium.

Topics: Aged; Aged, 80 and over; Carcinoid Tumor; Chromogranins; Female; Humans; Keratins; Uterine Neoplasms; Uterus

To elucidate the relationship between the epithelial and mesenchymal elements of malignant mixed Müllerian tumors (MMMT), the authors examined the biologic properties of two clones of different cell types (designated as FU-MMT-2-C1 and FU-MMT-2-S1) established from a uterine MMMT cell line (FU-MMT-2), which they previously have reported.. By morphologic and immunocytochemical analyses, FU-MMT-2-C1 exhibited features of adenocarcinoma cells, whereas FU-MMT-2-S1 showed characteristics of sarcoma cells with myogenic differentiation. Some FU-MMT-2-C1 cells at confluence differentiated spontaneously into myogenic mesenchymal cells in vitro. In addition, transitional-type cells between epithelial cells and sarcomatous cells were observed in the areas of mesenchymal differentiation in FU-MMT-2-C1 by light and electron microscopic study. Ultrastructurally, the transitional-type cells represented biphasic morphologic characteristics consisting of epithelial and myogenic features, which proved to coexpress epithelial, mesenchymal, and muscle markers by double immunoenzymatic staining. However, no epithelial differentiations were apparent in the sarcoma clone FU-MMT-2-S1. FU-MMT-2-C1 produced tumor in nude mice, the histologic study of which showed a mixture of adenocarcinoma and myogenic sarcomatous elements that resembled the original tumor. Cytogenetic studies demonstrated that these two clones were monoclonal in origin because of the presence of common karyotypic abnormalities in both cells. In addition, the amplified (approximately fourfold to eightfold) c-myc oncogene was found in the cloned cells and the original tumor cells.. The current results strongly support the theory of single cell origin in uterine MMMT and suggest that the mesenchymal elements originated from primitive Müllerian epithelial cells capable of differentiating into epithelial, mesenchymal, or both elements.

Topics: Animals; Cell Division; Chromosome Aberrations; Chromosome Disorders; Desmin; DNA, Neoplasm; Epithelium; Female; Gene Amplification; Genes, myc; Immunoenzyme Techniques; Keratins; Membrane Glycoproteins; Mice; Mice, Nude; Mucin-1; Myoglobin; Neoplasm Transplantation; Tumor Cells, Cultured; Uterine Neoplasms; Vimentin

The expression of cytokeratins (CK) 1, 4, 5/6, 8, 13, 18, 19 and 20 and involucrin in 42 cases of squamous cell carcinomas from various locations was examined. The tumours expressed CK5/6 in 55%, CK8 in 76%, CK13 in 43% and CK19 in 95% of cases. The CK5/6-positive primary tumours were from uterine cervix, head and neck, lung, skin, oesophagus and urinary bladder, and the CK13-positive primary tumours were from uterine cervix, lung and vulva. Metastatic squamous cell carcinomas from head and neck more frequently expressed CK5/6 and 13, 7/7 (100%) and 6/7 (86%) compared with 3/5 (60%) and 0/5 (0%) in the primary squamous cell carcinomas. Few cases were CK1, CK4 and CK18 immunoreactive. CK20 immunoreactivity was not observed. Involucrin was expressed in 71% of tumours, and most of the involucrin-positive cells were located at the central parts of tumour cell clusters except for one case in which the peripheral cells around tumour cell clusters were positive. Thus, expression of the so-called simple epithelial markers CK8 and CK19 occurs in the majority of squamous cell carcinomas. The absence of CK20 immunoreactivity may be helpful in differential diagnosis.

Topics: Carcinoma, Squamous Cell; Female; Humans; Immunohistochemistry; Keratins; Lung Neoplasms; Lymphatic Metastasis; Mouth Neoplasms; Protein Precursors; Skin Neoplasms; Urinary Bladder Neoplasms; Uterine Neoplasms

Pathologic findings and immunohistochemical characterizations of 18 cases of uterine sarcomas were studied. In endometrial stromal sarcoma (ESS), 5 out of 10 cases had ovarian sex cord-like pattern and 4 out of 10 cases had smooth muscle differentiation. Immunohistochemical findings showed vimentin, desmin and cytokeratin positive in 9/10, 6/10, 2/10 cases respectively which reflects that ESS may differentiate into both epithelium and muscle components morphologically. In malignant mixed Mullerian tumors (MMT), its carcinomatous structure may be positive about vimentin, and its sarcomatous structure may be positive to the epithelium markers, which indicates that both the sarcoma and carcinoma structures have possibly a common origin. It is considered to be of value for the diagnosis of MMT, if the tumor has differentiated both epithelium and mesoderm components or to be positive to myoglobin, NSE* in immunoreaction, accompanying with the morphologic characterizations of the tumor.

Topics: Desmin; Female; Humans; Immunohistochemistry; Keratins; Neoplasms, Germ Cell and Embryonal; Sarcoma; Uterine Neoplasms; Vimentin

The null hypothesis is that partial hydatidiform moles have normal differentiated function (human chorionic gonadotropin and human placental lactogen secretion) in response to epidermal growth factor and 8-bromo-cyclic adenosine monophosphate.. Two complete moles, 10 partial hydatidiform moles, and 19 normal first-trimester placentas in monolayer culture were exposed to 10 ng/ml epidermal growth factor, 1 mmol/L 8-bromo-cyclic adenosine monophosphate plus 1 mmol/L theophylline, or control. Human chorionic gonadotropin and human placental lactogen secretion was measured. Frequency of response to stimuli was compared by chi 2 analysis, and hormone secretion was compared by analysis of variance.. Partial moles demonstrated reduced frequencies of response of human chorionic gonadotropin and human placental lactogen to epidermal growth factor (partial moles 2/8 and 2/8, respectively; normal placentas 16/19 and 7/18, respectively; p less than 0.025) and of human chorionic gonadotropin to 8-bromo-cyclic adenosine monophosphate (partial moles 3/5, normal placentas 13/16; p less than 0.005).. Partial hydatidiform moles demonstrate impaired human chorionic gonadotropin and human placental lactogen secretory responsiveness to epidermal growth factor and cyclic nucleotides in comparison with normal first-trimester trophoblast.

Topics: 8-Bromo Cyclic Adenosine Monophosphate; Calcium-Binding Proteins; Chorionic Gonadotropin; Epidermal Growth Factor; Female; Humans; Hydatidiform Mole; Immunoenzyme Techniques; Keratins; Placental Lactogen; Pregnancy; Tumor Cells, Cultured; Uterine Neoplasms; Vimentin

Keratin expression in human cervical squamous cell carcinoma (SCC) lines differed significantly from both normal and human papillomavirus (HPV) immortalized exocervical cells. Keratin 14 (K14) expression, determined by protein synthesis and mRNA levels, was dramatically down-regulated in the cervical SCC lines while keratin 5 (K5) expression was not. K14 expression was similarly down-regulated in an HPV-16 immortalized cervical cell line after tumorigenic transformation with recombinant v-Ha-ras DNA. Cultures derived from nude mouse tumor explants also exhibited an altered keratin profile and the levels of K14 protein synthesis, as well as K14 mRNA, were not detectable. In both cases K5 protein synthesis was not significantly down-regulated. In addition, neoplastic cervical SCC lines exhibited up-regulation of keratins 7, 8, 13, and 19, combined with slight down-regulation of keratins 6 and 16. Epidermal keratinocytes responded in a different manner to exocervical cells. Transfection of human papillomavirus-immortalized epidermal keratinocytes with the BglII N fragment of herpes simplex virus 2 produced a neoplastic cell line, but K5 and K14 expression remained unchanged. Thus, neoplastic transformation of human exocervical cells, both in vivo (spontaneous cervical SCC) and in vitro (HPV-16- and v-Ha-ras-induced cervical SCC), is accompanied by characteristic changes in keratin expression. The specific down-regulation of K14 in these tumorigenic cervical cells, in the absence of significant changes in the expression of K5, implies that the normal coordinate regulation of K5 and K14 gene expression has been uncoupled.

Topics: Blotting, Northern; Carcinoma, Squamous Cell; Cell Line, Transformed; Cervix Uteri; Down-Regulation; Electrophoresis, Gel, Two-Dimensional; Female; Genes, ras; Humans; Keratins; Papillomaviridae; RNA, Messenger; Transfection; Uterine Cervical Neoplasms; Uterine Neoplasms

Twenty-three cases (12 low grade, 11 high grade) of endometrial stromal sarcoma were studied with monoclonal antibodies to vimentin, keratin, desmin, muscle actin, epithelial membrane antigen, and collagen type IV, using the avidin-biotin immunoperoxidase method. Tumors were highly variable in the expression of these antigens. Some tumors contained both epithelial and smooth muscle-related antigens; others were immunoreactive only for the intermediate filament vimentin. Immunoreactivity patterns for metastases or recurrences were similar to the respective primary tumor and no correlation was observed between tumor grade and antigen expression. Normal myometrium, when present, was keratin-positive and variably epithelial membrane antigen-positive. We conclude that endometrial stromal sarcoma, as well as normal myometrium, may express both epithelial and/or muscle-related antigens. These findings most likely reflect a common mesodermal-mullerian derivation and illustrate the intimate relationship of the endometrial stromal cell to the endometrial glands and myometrium. Knowledge of these immunoreactivity patterns is essential when evaluating poorly differentiated uterine tumors or spindle cell tumors presenting in extrauterine locations.

Topics: Actins; Adult; Aged; Collagen; Desmin; Female; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Middle Aged; Mucin-1; Myometrium; Sarcoma; Uterine Neoplasms; Vimentin

The purpose of this study was to determine the nature of the argyrophilic cells in the ectocervix and to analyze the different morphologic varieties of argyrophil cell-containing ectocervical epithelia, notably to reappraise the degree of analogy with transitional epithelium. A systematic study of 39 ectocervices was carried out using histochemical and immunohistochemical techniques. Immunodetection of cytokeratins was used to specify the differentiation of the ectocervical linings. Argyrophilic cells were detected in 43% of our specimens. They have been found in several varieties of ectocervical lining: normal-appearing or hyperkeratotic squamous epithelium, "transitional-like" epithelium extending onto the portio, and immature squamous metaplasia from the transformation zone. The term "transitional-like" refers to a stratified nonsquamous epithelium that differs from true urothelium by the absence of superficial differentiation leading to the layer of "umbrella" cells. Two main types of argyrophilic cells have been delineated: serotonin cells and Merkel-type cells. The nature of the argyrophilic cells was dependent on the type of epithelium: Serotonin cells were essentially associated with "transitional-like" epithelium and Merkel-type cells with squamous epithelium. The latter cells were particularly frequent in hyperkeratotic squamous epithelium from uterine prolapse, reinforcing the homology with epidermis.

Topics: Adult; Aged; Cervix Uteri; Chromogranin A; Chromogranins; Epithelium; Female; Histocytochemistry; Humans; Immunoenzyme Techniques; Keratins; Middle Aged; Serotonin; Uterine Diseases; Uterine Neoplasms

Nine cases of endometrial stromal tumors were examined by light microscopy and a battery of immunostains for diagnostic purposes. Eight of the cases were originally classified as endometrial stromal tumors and one as an epithelioid leiomyoma. Three of six (50%) endometrial stromal sarcomas stained positively for keratin/cytokeratin. All of these same tumors stained for vimentin. One case originally considered an epithelioid leiomyoma on light microscopy was later diagnosed as a uterine tumor with sex cord features following strong positive immunostaining with keratin/cytokeratin antibodies and negative staining with antidesmin. These results show that immunoreactivity for epithelial differentiation may be present in endometrial stromal tumors. The diverse immunostaining patterns of the stromal tumors reflect the probable histogenesis of these neoplasms from primitive totipotential stem cells which may differentiate along epithelial and various mesenchymal cell lines.

Topics: Desmin; Female; Humans; Immunoenzyme Techniques; Keratins; Uterine Neoplasms; Vimentin

We examined the histologic, immunohistochemical, and clinical features of a series of 23 endometrial, five cervical, and one ovarian carcinosarcomas (malignant mixed müllerian [mesodermal] tumors) and nine associated distant peritoneal metastases. The primary tumors all showed epithelial differentiation (cytokeratin and/or epithelial membrane antigen expression) of the carcinomatous component, while sarcomatous areas showed epithelial differentiation in all but one case. The metastases showed uniform staining for cytokeratin (eight of eight cases) and epithelial membrane antigen (eight of eight cases), including the spindle cell component that was present in four of nine cases. Desmin significantly changed the interpretation of rhabdomyosarcoma differentiation by refuting putative rhabdomyoblasts in two cases and identifying rhabdomyoblasts in two other cases where they were unrecognized on hematoxylineosin staining. S100 protein was positive in all five cases with chondrosarcoma differentiation. Muscle-specific actin and vimentin were positive in the sarcomatous component of all cases and in the carcinomatous component of seven and 10 cases, respectively. After immunostaining, heterologous elements were present in 18 of 29 cases (11 cases of rhabdomyosarcoma, three cases of chondrosarcoma, three cases of mixed rhabdomyosarcoma and chondrosarcoma, and one case of liposarcoma). Only six of 27 patients with follow-up were disease free for 12 months or longer (associated with stage I or II disease, smaller size, no lymphatic invasion in the resection specimen, and no invasion of the outer two thirds of myometrium). Presence and type of heterologous elements, grade of sarcomatous or carcinomatous components, histologic type of carcinomatous component, gross appearance, presence of necrosis, or use of chemotherapy or radiotherapy did not affect outcome. Carcinosarcomas are clinically aggressive distinctive mixed epithelial-stromal neoplasms with histologic and immunohistochemical features that overlap with metaplastic carcinoma in many cases.

Topics: Aged; Aged, 80 and over; Antigens, Neoplasm; Carcinosarcoma; Desmin; Female; Humans; Immunoenzyme Techniques; Keratins; Membrane Glycoproteins; Middle Aged; Mucin-1; Neoplasm Metastasis; Ovarian Neoplasms; S100 Proteins; Uterine Neoplasms

A higher prevalence of positive lymph node metastases can be found with immunohistological methods in comparison with conventional technique. We examined the lymph nodes from 20 patients with gynecological malignant tumors. We found in 304 lymph nodes with conventional technique 3.3% metastases. With immunohistological methods we showed in 9.9% of the lymph nodes metastases.

Topics: Antibodies, Monoclonal; Biomarkers, Tumor; Female; Fluorescent Antibody Technique; Genital Neoplasms, Female; Humans; Keratins; Lymph Nodes; Mesonephroma; Neoplasm Staging; Ovarian Neoplasms; Uterine Cervical Neoplasms; Uterine Neoplasms

Sixty-three pure mesenchymal tumors of the uterus were studied to explore the value of immunostaining in the diagnosis of unusual mesenchymal tumors encountered in the uterus, some not reported previously. Each tumor was evaluated using a panel of immunostains including actin, desmin, vimentin, S-100 protein, and cytokeratin. The final classification, which incorporated the immunohistochemical findings, resulted in the identification of 33 relatively common pure mesenchymal tumors (13 benign and malignant endometrial stromal tumors and 20 benign and malignant smooth muscle tumors) and 30 uncommon tumors (five leiomyosarcomas with osteoclastic giant cells, two xanthomatous leiomyosarcomas, one melanotic schwannoma, one pure rhabdomyosarcoma, one neurofibroma, five plexiform tumorlets, and 15 combined smooth muscle-stromal tumors). The normal endometrial stroma, present in 14 cases, invariably showed a negative reaction for all antibodies. With rare exceptions, the pure endometrial stromal tumors displayed a negative immunoreaction for all antibodies utilized, while the pure smooth muscle tumors consistently showed a positive reaction for actin. Only the two tumors of neural origin (a neurofibroma and a melanotic schwannoma) reacted with S-100 protein. Immunostaining influenced most the final classification of neoplasms initially interpreted as uterine tumors with a sex-cord stromal pattern, endometrial stromal tumors that diverged from the classic lesions by having a spindle cell component, and intravascular leiomyomas with areas of compact proliferation of small round cells with prominent vascularity. All tumors in these three groups were reclassified as combined smooth muscle-stromal tumors following immunohistochemical studies.(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Actins; Aged; Aged, 80 and over; Child, Preschool; Desmin; Female; Humans; Immunohistochemistry; Keratins; Leiomyosarcoma; Mesenchymoma; Middle Aged; Neurilemmoma; Neurofibroma; Rhabdomyosarcoma; S100 Proteins; Uterine Neoplasms; Vimentin

Endometrial carcinomas may originate from endometrial glandular epithelium and show endometrial differentiation, or from various types of metaplasias developing in the endometrium from pluripotent Müllerian epithelium. They then show endocervical or serous papillary differentiation. Because of their differences in spread, speed of growth and survival rates, it is important to subclassify these endometrial carcinomas. Immunohistochemically, adenocarcinoma with endometrial differentiation including adenoacanthomas and adenosquamous carcinomas can be recognized by their coexpression of cytokeratin 8 and vimentin, and by their negative reaction for CEA. Distinction from adenocarcinomas with mucinous differentiation, including mucoepidermoid adenocarcinomas, is possible by their negative reaction for vimentin and by their positive reaction for CEA. On the other hand, carcinomas with mucinous differentiation primarily located in the endometrium can not be distinguished from those primarily located in the endocervix by immunohistochemistry; that distinction must be made topographically. The same holds true for clear cell carcinomas of both locations. Over the past decade, mucinous adenocarcinomas and clear cell carcinomas originating from the endometrium have increased, whereas adenocarcinomas with endometrial differentiation have become less frequent. This shift is closely related to the altered postmenopausal hormone substitution with the addition of the synthetic gestagens. These apparently stimulate proliferation of endocervical epithelium not only in the endocervix, but also that arising in endocervical metaplasias of the endometrium.

Topics: Adenocarcinoma; Carcinoembryonic Antigen; Carcinoma; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Keratins; Uterine Neoplasms; Vimentin

A case of dedifferentiated leiomyosarcoma of the uterus was examined using immunohistochemistry. The tumor arose in the myometrium, and was a whitish large nodule with hemorrhage and necrosis. Histologically it was a well differentiated leiomyosarcoma with foci showing epithelioid pattern, and in part resembling malignant fibrous histiocytoma (MFH) and giant cell tumor (GCT). Additionally, small round neoplastic cells arranged in an alveolar manner, simulating alveolar rhabdomyosarcoma, were seen in some areas. Neoplastic cells in well differentiated areas expressed desmin, muscle-specific actin and LeuM1, whereas those in epithelioid and poorly differentiated areas lacked these antigens. Instead, tumor cells in epithelioid and small round cell areas were positive for keratin. Interestingly, most tumor cells in well differentiated, epithelioid and small round cell areas were also positive for MB1. However, tumor cells in GCT- and MFH-like areas reacted with none of the antibodies used. Ultrastructurally, some tumor cells possessed various amounts of microfilaments with or without dense patches, whereas others lacked them. These findings suggest that the divergent antigen expression was attributable to different levels of differentiation, and that poorly differentiated components had lost their native features.

Topics: Actins; Antigens, Differentiation, Myelomonocytic; Desmin; Female; Humans; Immunohistochemistry; Keratins; Leiomyosarcoma; Microscopy, Electron; Middle Aged; Uterine Neoplasms; Vimentin

Immunohistochemical study was carried out in a case of adenomatoid tumor of the uterine corpus. The patient was a 35-year-old female. The tumor showed classical histochemical and immunohistochemical findings of mesothelioma, i.e., presence of hyaluronic acid on the cellular surface and cytokeratin in the cytoplasm. In addition, the tumor showed positive reaction to anti-vimentin. Furthermore, absence of Ber-Ep4 supports mesothelial origin of this tumor. EMA reaction was reported only in one case in the literature. The result was negative as in our case. Therefore, it was suggested that at least some of the adenomatoid tumor were negative for EMA as in malignant mesothelioma, although this tumor was benign. Therefore, it was suggested that loss of EMA in mesothelial tumor was not always related to anaplastic change.

Topics: Adenoma; Adult; Female; Humans; Hyaluronic Acid; Immunohistochemistry; Keratins; Mesothelioma; Uterine Neoplasms; Vimentin

We report a case of primary endodermal sinus tumor (EST) of the endometrium in a 42-year-old female. Although numerous extragonadal EST have been reported, primary EST of the endometrium is exceedingly rare. To our knowledge this is the fourth documented case of this nature. The tumor had the typical microscopic features of EST, with papillary, tubular, reticular, and solid growth patterns; occasional Schiller-Duval bodies and many intracellular and extracellular periodic-acid Schiff positive hyaline globules were seen. The neoplastic cells stained positively for alpha-fetoprotein (AFP), alpha-1-antitrypsin (A1AT), cytokeratin, and placental alkaline phosphatase. The globules were positive for AFP, A1AT, albumin, transferrin, and fibronectin. The tumor cells were negative for type IV collagen and the beta subunit of human chorionic gonadotropin (B hcG). Electron microscopic examination showed intracellular and extracellular basement membrane-like material, intracytoplasmic lumina with microvilli, and glycogen. The patient was treated with total abdominal hysterectomy and bilateral salpingo-oophorectomy, followed by four cycles of adjunct chemotherapy (vinblastine, bleomycin, and cisplatinum) repeated every 3 weeks. The serum AFP level was elevated significantly before the surgery and the tumor response was monitored by serial determination of serum AFP level. There was no evidence of recurrence 24 months after surgery.

Topics: Adult; Alkaline Phosphatase; alpha 1-Antitrypsin; alpha-Fetoproteins; Basement Membrane; Cell Nucleus; Cytoplasm; Female; Fibronectins; GPI-Linked Proteins; Humans; Immunohistochemistry; Isoenzymes; Keratins; Mesonephroma; Uterine Neoplasms

A case of glassy cell carcinoma of the endometrium in a 62-year-old woman is reported. Microscopically, a cytoplasm of ground-glass appearance was observed with a distinct cell wall and large nuclei containing prominent nucleoli. These histologic characteristics are consistent with those of glassy cell carcinoma of the cervix. Treatment consisted of total abdominal hysterectomy and bilateral salpingo-oophorectomy with pelvic lymph node dissection followed by external irradiation to the whole pelvis. The patient was alive without evidence of disease at 5 1/2 years.

Topics: Adenocarcinoma; Carcinoma, Squamous Cell; Female; Humans; Keratins; Middle Aged; Uterine Neoplasms

The present study aimed to examine possible changes in keratin expression during neoplastic transformation of the uterine mucosa and possible differences in keratin expression between endocervical and endometrial adenocarcinomas. Routinely processed specimens with normal morphology or neoplastic changes were stained immunohistochemically using 5 commercial antibodies to keratin-filaments of molecular weight 39-58 kD: CAM 5.2, RCK 102, MCA 144, PKE and PRE. We generally found a change in keratin expression during the neoplastic transformation, consisting of pronounced heterogeneity compared with normal epithelia. In distinguishing koilocytic atypia from CIN, RCK 102 (52.5, 58 Kd) may prove helpful as it stains neoplastic cells strongly and shows no reaction in koilocytic. Staining with the antibody CAM 5.2 (reactive with 39, 43, 50 kD filaments) may aid in distinguishing between cervical and endometrial adenocarcinomas. The former is stained uniformly; the latter shows a more variable staining.

Topics: Adenocarcinoma; Cervix Uteri; Female; Humans; Immunohistochemistry; Keratins; Metaplasia; Mucous Membrane; Neoplasm Invasiveness; Pregnancy; Staining and Labeling; Uterine Cervical Neoplasms; Uterine Neoplasms; Uterus

Primary and metastatic tumor tissues of serous papillary adenocarcinoma of the endometrium were examined for the following: (1) amplification of int-2, c-erbB-2 and c-myc proto-oncogenes by Southern blot hybridization; (2) DNA ploidy by flow cytometric study; (3) and expression of specific proteins, such as estrogen and progesterone receptors, keratin, vimentin, and carcinoembryonic antigen (CEA) using immunohistochemical and biochemical techniques. Amplification of c-myc was observed in the specimens from the endometrium (ten-fold) and from omental metastasis (five-fold). Both int-2 and c-erbB-2 amplification were not observed. The tumor showed aneuploidy, with the specimens from the endometrium and omental metastasis exhibiting multiple populations of aneuploid tumor cells. Estrogen and progesterone receptors could not be detected biochemically; however, immunohistochemically, estrogen receptors were observed in tumor cells forming papillary structures but not in the tumor cells of the solid, more poorly differentiated areas. A similar distribution was observed for both low and high molecular weight keratin. The findings of c-myc amplification and aneuploidy in the serous papillary adenocarcinoma of the endometrium are consistent with its aggressive behavior observed clinically and emphasize the importance of distinguishing this lesion from other types of endometrial carcinoma.

Topics: Blotting, Southern; Cystadenocarcinoma; DNA, Neoplasm; Female; Flow Cytometry; Gene Amplification; Humans; Immunoenzyme Techniques; Keratins; Middle Aged; Molecular Weight; Peritoneal Neoplasms; Ploidies; Proto-Oncogene Mas; Proto-Oncogenes; Receptors, Estrogen; Receptors, Progesterone; Uterine Neoplasms

An autopsy case of high-grade endometrial stromal sarcoma (ESS) is reported. Immunohistochemical study of the ESS was done in comparison with carcinosarcoma (CS), leiomyosarcoma (LMS) and normal endometrium in the uterus in order to trace the origin of ESS, which is a point of some controversy. Co-expression of keratin and vimentin and/or desmin positivity in several elements of CS and LMS, and glandular or stromal tissues in normal endometrium made it difficult immunohistochemically to be certain of the origin of ESS.

Topics: Antigens; Antigens, Differentiation; Autopsy; Carcinosarcoma; CD57 Antigens; Desmin; Endometrium; Female; Humans; Immunohistochemistry; Keratins; Leiomyosarcoma; Middle Aged; Phosphopyruvate Hydratase; S100 Proteins; Sarcoma; Uterine Neoplasms; Vimentin

Two new lines of human endometrial carcinoma (HEC) cells, one from an adenocarcinoma and one from a highly metastatic serous papillary carcinoma, were established in culture. Structural and morphologic properties of these cells at early passage were compared with those of cultured normal human endometrial epithelial (NHEE) cells. For these studies, cells were grown on a conventional plastic surface or on an extracellular matrix substrate (Matrigel), and examined by transmission electron microscopy and immunofluorescent light microscopy. The HEC cells appeared morphologically similar on plastic and Matrigel, whereas the NHEE cells showed significantly greater epithelial morphologic differentiation on Matrigel than on plastic. On extracellular matrix, the morphologic differences observed between HEC cells and NHEE cells were primarily of an architectural nature, which may be in part explained by differences between NHEE and HEC cells in the arrangement of actin microfilaments and cytokeratin intermediate filaments. Furthermore, HEC cells displayed extensive networks of vimentin intermediate filaments, which were absent from the NHEE cells. These observations support the hypothesis that architectural deregulation is a prominent feature of endometrial carcinoma, and that cytoskeletal alterations may uncouple HEC cell ultrastructural morphology from the influence of extracellular matrix.

Topics: Actin Cytoskeleton; Actins; Aged; Cells, Cultured; Cytoskeleton; Endometrium; Epithelial Cells; Extracellular Matrix; Female; Humans; Intermediate Filaments; Keratins; Microscopy, Fluorescence; Plastics; Tumor Cells, Cultured; Uterine Neoplasms; Vimentin

The case of a woman who died from cerebral metastasis of adenocarcinoma of the uterine corpus, clinical stage IA at the time of first referral, is described. Three months after preoperative endocavitary radiotherapy followed by radical surgery followed by postoperative radiotherapy, the 59-year-old patient developed neurological symptoms. A cerebral tumor was diagnosed and subsequently excised. Histology showed metastasis of an adenocarcinoma. The patient died 3 weeks after cranial surgery. Meticulous postmortem examination failed to reveal any other tumor besides the endometrial neoplasm. Comparative immunohistochemical examination of the primary tumor and the cerebral process supported the assertion that the brain metastasis derived from the adenocarcinoma of the endometrium. Literature reports on cerebral metastasis of endometrial carcinoma are discussed.

Topics: Adenocarcinoma; Antigens, Tumor-Associated, Carbohydrate; Brain Neoplasms; Carcinoembryonic Antigen; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Uterine Neoplasms

Twenty-two cases of keratin granulomas of the peritoneum associated with endometrioid adenocarcinoma with squamous differentiation of the endometrium, the ovary, or both, and with an atypical polypoid adenomyoma of the endometrium were reviewed. Follow-up data were available in 18 cases. Twelve patients were well and disease free 13 months to 15.2 years postoperatively; one patient died of unrelated disease 21 years postoperatively; three patients were tumor free with a short duration of follow-up; one patient, who had a stage Ic ovarian tumor, died of pulmonary embolism during the treatment of recurrent tumor 1 year after operation; and a final patient, who had been followed for 3 months after operation for stage IV disease, was alive with residual tumor. At least six patients with stage I carcinomas were treated with postoperative irradiation because the granulomas had raised a suspicion of advanced disease. Follow-up data on the patients in this series suggest that peritoneal keratin granulomas have no prognostic significance and should be distinguished from viable tumor implants on microscopic examination.

Topics: Adenocarcinoma; Adult; Aged; Endometriosis; Female; Follow-Up Studies; Granuloma; Humans; Keratins; Middle Aged; Neoplasms, Multiple Primary; Ovarian Neoplasms; Peritoneal Diseases; Uterine Neoplasms

Recent studies suggest that the proliferation and expression of HLA-DR molecules in endometrial epithelium may be regulated by systemic steroids and local cytokines. To test the interacting influences of cytokines and steroids on the expression of HLA-DR and proliferation of epithelial cells, an endometrial cell model is required that is sensitive to both signals. In this study, we characterize cells of carcinoma cell lines of endometrial lineage for their responsiveness to cytokines and steroids. Independently developed for its response to steroid hormones from a well-differentiated adenocarcinoma of human endometrium, EnCa101AE cell line is further cloned for the expression of progesterone receptor. Immunohistochemical localization using monoclonal antibodies demonstrates that both EnCa101AE cell line and cloned ECC1 cells are purely epithelial, as evidenced by the expression of cytokeratin and epithelial membrane antigen, express estrogen receptors, and concomitantly exhibit IFN-gamma receptor. Experiments using radioiodinated IL-1 reveal that these cell lines also possess high affinity receptors for IL-1. As indicated by the induction of HLA-DR molecules, and alterations in morphologic characteristics, these cell lines are sensitive to both IFN-gamma and IL-1 action. The class II molecules (HLA-DR, HLA-DP, and HLA-DQ) are differentially induced by IFN-gamma treatment in carcinoma cell lines, with HLA-DR being the prevailing induced molecule. IFN-gamma inhibits and estradiol-17 beta promotes growth of ECC1 cells in a dose- and time-dependent manner. These findings indicate that the interacting effect(s) of the cytokines and steroid hormones on endometrial epithelium may be studied in these unique steroid- and cytokine-sensitive epithelial cell lines.

Topics: Adenocarcinoma; Cell Division; Cytokines; Estradiol; Female; HLA-DP Antigens; HLA-DQ Antigens; HLA-DR Antigens; Humans; Immunohistochemistry; Interferon-gamma; Interleukin-1; Keratins; Membrane Glycoproteins; Mucin-1; Receptors, Estrogen; Receptors, Immunologic; Receptors, Interleukin-1; Receptors, Progesterone; Steroids; Tumor Cells, Cultured; Uterine Neoplasms

The paper describes an image analysis technique for automated estimation of the epithelial percentage in standard paraffin tissue sections of invasive ductal breast cancers. Two staining procedures are evaluated: Feulgen (pararosanilin) and CAM 5.2-demonstrating the presence of cytokeratin 8 and 18-, both counterstained with naphthol yellow. In the technique, one image is recorded with a filter to visualize where the epithelium lies. This filter is chosen corresponding to the type of staining: it is yellow for Feulgen and blue for anti-cytokeratin CAM 5.2. To visualize where the stroma lies, the same image can be used for anti-cytokeratin CAM 5.2, whereas for Feulgen, a second image has to be recorded from the same microscope field with a blue filter. The image processing steps to determine the total tissue area comprise correction for shading, segmentation of the tissue area, and restoration of the segmented image by removal of small artefacts and closure of small tears in the tissue. The method for determination of the epithelial area consists of the following steps: correction for shading, gaussian blurring, segmentation of nuclei or epithelial cells, and editing of the segmented image by removal of small objects and closure of small spaces between the epithelial nuclei or cells. These image processing steps are compared to those for quantification of the epithelial percentage in gynecologic tumors of epithelial origin. For the Feulgen stain, the method is evaluated on 30 breast cancers of the ductal type (4 grade I, 12 grade II, and 14 grade III).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Antibodies, Monoclonal; Breast Neoplasms; Coloring Agents; Epithelium; Female; Genital Neoplasms, Female; Humans; Image Processing, Computer-Assisted; Immunohistochemistry; Keratins; Ovarian Neoplasms; Rosaniline Dyes; Uterine Neoplasms

The estrogen receptor content, determined immunohistochemically by staining with monoclonal antibodies, was studied in seven consecutive cases of endometrial stromal sarcoma. In addition, the mitotic rate and immunohistochemical patterns (vimentin, desmin, actin, cytokeratins) were determined. Five of seven cases contained estrogen receptors, three low-grade (fewer than 10 mitoses/10 high-power fields [hpf]) and two high-grade (10 or more mitoses/10 hpf), the latter having a relatively low mitotic rate. The two negative cases were high-grade with a very high number of mitoses. Tumor cells were positive only to vimentin. Based on these results, we postulate that estrogen receptors are undetectable only in highly proliferating neoplasms. Thus, immunohistochemically determined estrogen receptor levels may indicate the aggressiveness of endometrial stromal sarcoma, and might be a guideline in selecting patients for hormonal therapy. The presence of positive immunostaining to vimentin confirms the mesenchymal origin of endometrial stromal sarcoma.

Topics: Actins; Adult; Aged; Antibodies, Monoclonal; Desmin; Female; Humans; Immunoenzyme Techniques; Keratins; Middle Aged; Mitosis; Receptors, Estrogen; Sarcoma; Uterine Neoplasms; Vimentin

Topics: Adenocarcinoma; Douglas' Pouch; Female; Granuloma; Humans; Keratins; Middle Aged; Peritoneal Diseases; Uterine Neoplasms

Tumors transplanted into nude mice using the TTK-1 cell lines [TTK-1(E) and TTK-1(F)] derived from normal human early decidual tissue were studied morphologically. The epithelial-like cell line TTK-1(E) and the fibroblast-like cell line TTK-1(F) were maintained in culture through one hundred and ten subcultures since July 1979. Rapidly growing tumor nodules formed at the implantation sites. The incidence of tumor growth was 100% for both cell lines. Histologically the tumors were composed of poorly-differentiated cells arranged in a cord-like structure and showed typical malignant characteristics. Immunohistochemical studies, electron microscopy and immunocytochemical studies revealed that the tumors from the two cell lines differed in many respects. The tumors formed by TTK-1(E) showed epithelial characteristics and the tumors formed by TTK-1(F) showed both epithelial and mesenchymal characteristics. Therefore, TTK-1(E) might be useful as an in vitro model of endometrial cancer and TTK-1(F) as an in vitro model of both endometrial cancer and endometrial stromal tumor (containing mixed mesodermal tumor). These tumors will be valuable for future studies of the tumorigenicity and therapy of uterine malignant tumors. They may reflect the various functions of decidual tissue.

Topics: Animals; Cell Line; Cell Transformation, Neoplastic; Decidua; Epithelium; Female; Fibroblasts; Humans; Immunoenzyme Techniques; Keratins; Mesoderm; Mice; Mice, Inbred ICR; Mice, Nude; Models, Biological; Neoplasm Transplantation; Neoplasms, Experimental; Pregnancy; Uterine Neoplasms; Vimentin

We studied one case of atypical polypoid adenomyoma of the uerus immunohistochemically using antisera against keratins, vinentin, S-100 protein, desmin and actin. The stromal cells were reactive with anti-actin and antidesmin antibodies suggesting a muscular phenotype and confirming previous ultrastructural data. Immunohistochemical investigations have proved to be useful in differential diagnosis of APA with invasive adenocarcinoma, adenosarcoma and adenofibroma of the endometrium.

Topics: Actins; Adenocarcinoma; Adenofibroma; Desmin; Diagnosis, Differential; Endometriosis; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; S100 Proteins; Uterine Neoplasms; Vimentin

The cytoplasmic filament composition of two pure high-grade endometrial stromal sarcomas and five pure endometrial rhabdomyosarcomas was studied using the immunoperoxidase avidin-biotin method. Ultrastructural correlates were performed on the same tissues. While four of the seven tumors presented as high-grade undifferentiated neoplasms, they were readily categorized on the basis of immunocytochemical findings in which the five rhabdomyosarcomas were positive for muscle-specific actin (HHF 35) and the two stromal sarcomas were positive for vimentin only. Ultrastructure on the HHF 35-positive cases showed the presence of thick filaments and Z-band material, whereas the other tumors showed no cytoplasmic differentiation. Muscle-type actin differs stromal cells, and is useful when used in conjunction with a panel of antibodies in the categorization of undifferentiated endometrial sarcomas.

Topics: Biomarkers, Tumor; Cytoskeletal Proteins; Desmin; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Myoglobin; Rhabdomyosarcoma; Sarcoma; Uterine Neoplasms; Vimentin

Cytoskeletal typing of five chorangiomas revealed diffuse staining of the blood vessels with antibodies to vimentin and to alpha smooth muscle (alpha-SM) actin, while cytokeratin 18 decorated the blood vessels focally. Focal staining for desmin was observed in two chorangiomas. Blood vessels of the placentas in which these chorangiomas arose stained for vimentin and alpha-SM actin. In addition, there was positive staining for cytokeratin polypeptide 18 in blood vessels within the chorionic plate and anchoring villi, and occasional staining for desmin. The vasculature of the terminal villi lacked cytokeratins. The stromal elements of the chorangiomas stained for vimentin and focally for alpha-SM actin and cytokeratin 18. A similar staining pattern was also found in the placental stroma, with most of the cytokeratin positivity encountered in the chorionic plate and anchoring villi. Blood vessels in extraplacental hemangiomas were devoid of cytokeratins. These results indicate that chorangiomas originate most likely from blood vessels of the chorionic plate and anchoring villi, which, as chorangiomas, are the site of vascular cytokeratin expression.

Topics: Actins; Blood Vessels; Cytoskeleton; Desmin; Female; Hemangioma; Humans; Immunohistochemistry; Intermediate Filaments; Keratins; Microscopy, Electron; Placenta; Pregnancy; Uterine Neoplasms; Vimentin

Rhabdoid tumors are highly malignant neoplasms resembling rhabdomyosarcomas, which most commonly occur in the kidney in young children. Several cases of extrarenal malignant rhabdoid tumors have been described, many in adolescents and young adults. We describe a 46-year-old woman with a primary uterine tumor that has the histologic, immunohistochemical, and ultrastructural characteristics of a malignant rhabdoid tumor. To our knowledge, this is the first report of a rhabdoid tumor in this site. Furthermore, this woman's age expands the range for which pathologists and clinicians should consider this diagnosis, even in extrarenal sites.

Topics: Female; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Microscopy, Electron; Middle Aged; Mucin-1; Rhabdomyosarcoma; Uterine Neoplasms

A post-gestational rat choriocarcinoma has been studied for its immunological and morphological characteristics. The tumor can be transplanted in syngeneic (WKA/H rats) as well as in allogeneic rats (BN, R/A). Even after immunization of the allogeneic hosts with tissues of the WKA/H rats, the development of the tumor was not inhibited. This neoplasm is composed of giant cells, surrounding spaces filled with blood, and of proliferating cytotrophoblasts. Ultrastructurally, these cells are very similar to those found in normal rat placenta. In some rats lung metastases were also observed. The tumor is hormonally active as demonstrated by proliferation of and secretions from the mammary glands in tumor-bearing animals and by the presence of delta 5-3 beta-hydroxysteroid dehydrogenase in the giant cells of the neoplasms. These 2 findings indicate that the rat choriocarcinoma cells secrete lactogen and might produce progesterone, like cells of rat placenta. All the described features of this tumor point to its similarity to human choriocarcinoma.

Topics: Animals; Choriocarcinoma; Female; Immunohistochemistry; Keratins; Male; Microscopy, Electron; Neoplasm Transplantation; Rats; Rats, Inbred Strains; Uterine Neoplasms; Vimentin

An immunohistochemical study of keratin, epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), vimentin, desmin, myoglobin and S-100 protein in 15 cases of uterine mixed Müllerian tumor was performed in order to analyze the expression of various antigens in different elements of this tumor. In general, the epithelial and mesenchymal components were separated easily by the presence of keratin/EMA or vimentin, respectively. However, in eight cases vimentin was expressed by epithelial cells and in four cases keratin by solid "sarcomatous" element. EMA was also identified in the "sarcomatous" areas of two cases. Specific differentiation was much easier to identify by immunohistochemical staining than by routine histologic examination. Areas with muscle differentiation were positive for desmin; myoglobin was identified in rhabdomyoblasts. S-100 protein was present in chondrosarcomatous and liposarcomatous areas. S-100 protein was also widely distributed in other elements. Quite diverse expression of various antigens revealed by immunohistochemistry reflects the histologic multiplicity of this tumor.

Topics: Antigens, Neoplasm; Carcinoembryonic Antigen; Desmin; Female; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Mucin-1; Neoplasms, Germ Cell and Embryonal; S100 Proteins; Uterine Neoplasms; Vimentin

A malignant fibrous histiocytoma of the sacrum complicating the course of radiation therapy for endometrial carcinoma is presented. Although the tumor fulfilled the clinical, radiologic, and histologic criteria for a postirradiation malignant fibrous histiocytoma of bone, it also expressed cytokeratin. That this immunoreactivity reflected keratin synthesis by the tumor and not an unusual pattern of cross-reactivity with another intermediate filament such as vimentin is strongly suggested by the reproducibility of the immunoreactivity utilizing both polyclonal and monoclonal antibodies and extinction of the immunoreactivity following absorption of the primary antiserum with keratin proteins. This is the first reported instance of keratin expression by a malignant fibrous histiocytoma; it indicates that sarcomas apart from synovial sarcoma and epithelioid sarcoma may sometimes express this protein.

Topics: Aged; Bone Neoplasms; Female; Histiocytoma, Benign Fibrous; Humans; Immunohistochemistry; Keratins; Neoplasms, Radiation-Induced; Uterine Neoplasms; Vimentin

Twenty-six intracranial germ cell tumours (11 germinomas, 10 teratomas, 2 endodermal sinus tumours, 1 teratocarcinoma, and 2 undifferentiated embryonal carcinomas) and 26 gonadal germ cell tumours (13 testicular seminomas, 2 ovarian dysgerminomas, 9 ovarian teratomas, and 2 myometrial choriocarcinomas) were studied by immunoperoxidase with monoclonal antibodies (MAbs) against epithelial membrane antigen (EMA), cytokeratin, and vimentin. Typical tumour cells in three of the 11 germinomas (two of the latter being situated in the posterior fossa) expressed both EMA and cytokeratin, whereas those in the seminomas and dysgerminomas did not. In one seminoma, a few multinucleated giant cells expressed cytokeratin. In three of seven germinomas, vimentin-positive tumour cells were found, but all seminomas and dysgerminomas were negative. In the other forms of intracranial and gonadal germ cell tumours, epithelial and mesenchymal elements displayed the expected patterns of immunoreactivity to the respective determinants. The immunoperoxidase differences between the intracranial germinomas and their gonadal equivalents indicate that, in the former, early epithelial or mesenchymal differentiation of the primordial germ cells may be present. The findings draw attention to the heterogeneous cellular composition of these otherwise morphologically homogeneous-appearing tumours and, especially in the posterior fossa, to their transitional links to the immature teratomas.

Topics: Adolescent; Adult; Antigens, Neoplasm; Brain Neoplasms; Child; Child, Preschool; Choriocarcinoma; Dysgerminoma; Epitopes; Female; Humans; Immunoenzyme Techniques; Infant; Keratins; Male; Membrane Glycoproteins; Mesonephroma; Middle Aged; Mucin-1; Ovarian Neoplasms; Teratoma; Testicular Neoplasms; Uterine Neoplasms; Vimentin

Intermediate filament composition was studied in the following endometrial stromal tumors: low-grade stromal sarcoma (endolymphatic stromal myosis), high-grade stromal sarcoma with an associated adenocarcinoma (collision tumor), diffuse clear cell stromal sarcoma and a mesodermal mixed tumor (carcinosarcoma). The tumor cells of the stromal tumors as well as the mesenchymal elements of the mixed mesodermal tumor were decorated exclusively with antibodies to vimentin. Desmin was not demonstrated in these tumor cells. A biochemical study of the cytoskeletal filaments present in the low-grade stromal sarcoma revealed, in addition to vimentin, beta and gamma actin as seen in normal endometrial stroma. Cytokeratins were only identified in epithelial components which were present in some of these tumors. Intermediate filament typing in these endometrial neoplasms contributes to the elucidation of histogenetic problems, may delineate mesenchymal from epithelial elements, may separate muscle from stromal lesions and in one instance helped to define a hitherto unreported diffuse clear cell stromal sarcoma.

Topics: Actins; Adult; Aged; Desmin; Endometrium; Female; Fluorescent Antibody Technique; Histocytochemistry; Humans; Isoelectric Focusing; Keratins; Middle Aged; Myometrium; Neoplasm Metastasis; Sarcoma; Uterine Neoplasms; Vimentin

The expression of cytokeratin intermediate filaments by a tumour has been accepted as evidence of an epithelial origin. Although there have been anecdotal reports of cytokeratin expression within tissues and neoplasms of non-epithelial origin, particularly muscle, there have been no comprehensive studies of its frequency and distribution. In order to investigate this we have studied 51 cases of normal smooth muscle and benign and malignant smooth muscle tumours using a panel of monoclonal antibodies against a range of intermediate filaments (cytokeratins, desmin and vimentin). Cytokeratin expression was noted overall in 50% of normal, benign and malignant smooth muscle tissues. Such expression tended to have a focal or patchy distribution. No case expressed cytokeratins in the absence of both desmin and vimentin. The implication of these findings for diagnostic immunocytochemistry is that intermediate filaments alone are not completely reliable markers of tumour histogenesis and should be used as part of a larger panel of monoclonal antibodies.

Topics: Desmin; Female; Gastrointestinal Neoplasms; Histocytochemistry; Humans; Keratins; Leiomyoma; Leiomyosarcoma; Muscle, Smooth; Myometrium; Neoplasms, Muscle Tissue; Skin Neoplasms; Uterine Neoplasms; Vimentin

Topics: Adenocarcinoma; Adult; Aged; Antibodies, Monoclonal; Carcinoembryonic Antigen; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Uterine Cervical Neoplasms; Uterine Neoplasms

Topics: Adenocarcinoma; Antibodies, Monoclonal; Diagnosis, Differential; Female; Humans; Keratins; Uterine Cervical Neoplasms; Uterine Neoplasms; Vimentin

Immunoperoxidase staining for human keratin proteins was performed cytologically on samples from 90 patients with malignant tumors, and histologically on samples from 164 patients with malignant tumors. At the cytological level, almost all tumor cells not only in squamous cell carcinoma but also in nonsquamous cell carcinoma were positive for keratin proteins, in contrast with the apparent abscence of keratin proteins in sarcoma. At the histological level, almost all neoplastic cells of squamous cell carcinoma were positive for keratin proteins, the same as at the cytological level. In contrast, among cases of nonsquamous cell carcinoma, the frequency of appearance of keratin proteins varied according to the organ; it tended to be low in tumors with relatively good prognosis, such as carcinomas in the digestive system or thyroid cancer, and to be high in tumor with poor prognosis, such as pulmonary cancer, gallbladder cancer and endometrial cancer. However, there was a marked difference between the frequency of appearance of keratin proteins at the cytological level and that at the histological level, particularly in the cases of gastric cancer.

Topics: Antibodies; Breast Neoplasms; Colonic Neoplasms; Female; Gallbladder Neoplasms; Histocytochemistry; Humans; Keratins; Lung Neoplasms; Neoplasms; Sarcoma; Stomach Neoplasms; Thyroid Neoplasms; Uterine Neoplasms

We examined the distribution of high- and low-molecular-weight cytokeratins, vimentin, and carcinoembryonic antigen (CEA) in normal endometrial glands and endocervical glands (20 cases each) and in endometrial and endocervical adenocarcinomas (29 cases and 15 cases respectively). Low- and high-molecular-weight cytokeratin staining was present in normal endometrial and endocervical epithelium and in carcinomas. Coexpression of vimentin and cytokeratin was universally present in normal proliferative endometrial glands, with marked decrease or absence of vimentin staining in secretory phase patterns. Vimentin staining had a perinuclear distribution within the cells, in contrast to the cytokeratins, which stained diffusely. Vimentin was found in only 65% of endometrial adenocarcinomas. Staining was typically focal as well as regional in portions of the tumors. Vimentin was never observed in normal or neoplastic endocervical epithelium. Ultrastructural studies corroborate the perinuclear vimentin immunostaining pattern we observed in endometrial adenocarcinomas. CEA staining results were similar to those previously reported. These data indicate that the presence of vimentin may readily distinguish endometrial from endocervical carcinoma and is diagnostically useful in the study of metastatic adenocarcinomas.

Topics: Adenocarcinoma; Carcinoembryonic Antigen; Cytoskeleton; Diagnosis, Differential; Female; Humans; Intermediate Filaments; Keratins; Microscopy, Electron; Retrospective Studies; Uterine Cervical Neoplasms; Uterine Neoplasms; Vimentin

In normal and molar pregnancy, a morphological discrimination between nonvillous trophoblasts which lie scattered in the placental bed and surrounding maternal cells is considered to be difficult. We examined the reactivity of two monoclonal antibodies (Troma 1 and CAM 5.2) against cytokeratin by an immunoperoxidase technique and analyzed their usefulness as a histological trophoblast marker. Materials were taken from 42 uteri with normal pregnancy, 7 uteri with hydatidiform mole, 2 uteri with gestational choriocarcinoma, 1 fallopian tube with nongestational choriocarcinoma, 5 delivered term placentae of normal pregnancy, and 5 nongestational uteri. The reactivities of Troma 1 on frozen sections and those of CAM 5.2 on paraffin sections were identical. They reacted with surface epithelium and gland epithelium in the nongestational uterine corpus. In the implantation site of normal and molar pregnancy, they reacted with villous and nonvillous trophoblasts as well as endometrial gland epithelium. In gestational and nongestational choriocarcinoma, they reacted with carcinoma cells specifically. Since the histological detection of gland epithelium may not be difficult, it was concluded that the two antibodies were very beneficial as a histological marker for trophoblasts in normal pregnancy and trophoblastic disease.

Topics: Antibodies, Monoclonal; Choriocarcinoma; Female; Humans; Hydatidiform Mole; Immunoenzyme Techniques; Keratins; Pregnancy; Trophoblastic Neoplasms; Uterine Neoplasms

A uterine tumor from a 34-year-old woman was investigated morphologically and immunohistochemically. The tumor tissue was composed of multiple cystic spaces of various sizes. The cyst wall was covered by a single layer or occasionally multiple layers of flattened cells. Electron micrographs of the tumor tissue revealed that the cells were delimited with conspicuous basal lamina from the stroma, possessed numerous microvilli at the apical surface, and connected with desmosomes. Furthermore, immunohistochemical staining with antikeratin antibody disclosed the strong positivity of the tumor cells, whereas anti-UEA-I antibody could not stain the tumor cells. The results did not favor the theory of endothelial origin of the tumor and confirmed the mesothelial origin, namely, adenomatoid tumor of the uterus.

Topics: Adult; Female; Histocytochemistry; Humans; Hyaluronic Acid; Immunologic Techniques; Keratins; Mesothelioma; Uterine Neoplasms

Endometrial cells in suspension were stained with propidium iodide and a monoclonal antibody against a cytokeratin intermediate filament protein specific for glandular and columnar cells (RGE 53). In this way columnar epithelial cells of the normal endometrium and of adenocarcinomas can be distinguished and separated by flow cytometry from non-epithelial cells (fibroblasts and inflammatory cells) and squamous epithelial cells, all of which are negative for RGE 53. This makes it possible to analyse and also sort pure fractions of this particular tissue type for further studies. The use of propidium iodide allows simultaneous DNA flow cytometry of these columnar epithelial cells. Therefore, the use of antibodies to cytokeratin in combination with propidium iodide can be of help in analyzing and sorting pure fractions of both normal and malignant cells. This allows a more refined examination of complex cell mixtures using flow cytometry.

Topics: Adenocarcinoma; Antibodies, Monoclonal; Cell Separation; Endometrium; Epithelium; Female; Flow Cytometry; Humans; Immunochemistry; Keratins; Uterine Neoplasms

A 34-year-old woman with an adenomatoid tumor of the uterus is reported. Light-microscopic examination showed the tumor to be cystic with a canalicular pattern. The ultrastructural findings were numerous microvilli, various intercellular spaces, desmosomes, and rich 10-nm microfilaments like tonofilament. Histochemically, the tumor cells secreted hyaluronic acids. Keratin was demonstrated diffusely in the cytoplasms of tumor cells by PAP staining. From these findings, we concluded that the histogenesis of the adenomatoid tumor was of mesothelial origin.

Topics: Adult; Female; Histocytochemistry; Humans; Hyaluronic Acid; Keratins; Mesothelioma; Microscopy, Electron; Uterine Neoplasms

A study was undertaken to determine whether immunoperoxidase stains for keratin and involucrin, the latter a protein present in cells of stratified squamous epithelium that have differentiated beyond the basal stage, distinguish any differences in squamous cells present in the adenoacanthoma from those in the adenosquamous carcinoma of the uterine corpus. Forty-eight tumors were studied, of which 33 were adenoacanthomas and 15 adenosquamous carcinomas. The patients with adenoacanthomas were slightly younger (mean 61.5 vs. 64.5 years) and had tumors that were generally better differentiated than the adenosquamous carcinomas. The squamous epithelium in every tumor, regardless of histologic type, stained positively for keratin. There were no obvious differences in staining when tumors were stratified for histologic type, grade, or location within the tumor. The glandular portion of both tumor types stained irregularly, but nonetheless positively, for keratin in 71% of the cases. Involucrin was detected in 57% of adenoacanthomas and 87% of adenosquamous carcinomas. The deeper or more central portion of the squamous morules stained only if the more superficial or peripheral areas were positive. The extent of the involucrin staining was less in the adenosquamous carcinomas than in the adenoacanthomas. The glandular component of the tumors did not stain for involucrin. It is concluded that no qualitative differences in the staining reactions with respect to keratin and involucrin distinguish the adenoacanthomas from the adenoaquamous carcinoma. These findings support the argument that the adenoacanthoma and adenosquamous carcinoma represent a spectrum of squamous differentiation in a single tumor type.

Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Squamous Cell; Cell Differentiation; Diagnosis, Differential; Female; Humans; Immunoenzyme Techniques; Keratins; Middle Aged; Protein Precursors; Uterine Neoplasms

The authors investigated the presence and distribution of keratin in germ cell tumors using a rabbit-anti-keratin antiserum and a monoclonal antikeratin antibody--which is specific for keratin classes of 40, 50, and 56.5 kdaltons--by various immunohistochemical methods on frozen sections, alcohol-fixed, and formalin-fixed paraffin-embedded tissues. Thirty-four germ cell tumors were studied. These were the following: 18 seminomas, 10 embryonal carcinomas, 2 teratocarcinomas, 3 yolk sac tumors and 1 choriocarcinoma. All seminomas, including four poorly differentiated (so-called anaplastic seminomas), gave negative results, regardless of the method employed. Embryonal carcinoma, the epithelial component of the teratocarcinoma, the yolk sac tumors, and choriocarcinoma were at least focally positive for keratin. The monoclonal antibody provided a cleaner background and stronger staining than the rabbit-anti-total-human-epidermal-keratin antibody. Best results were obtained from fresh-frozen sections or alcohol-fixed, paraffin-embedded materials. Formalin-fixed, nonseminomatous tumors, when predigested with trypsin and incubated overnight with primary antibody, gave no false-negative results but staining was often focal. The authors' results agree with the reported absence of detectable keratin in primordial germ cells of the normal testis, and with prevailing concepts of the histogenesis of germ cell tumors. These results indicate that the presence or absence of keratin by immunocytochemical methods can be helpful in distinguishing seminoma from embryonal carcinoma.

Topics: Antibodies, Monoclonal; Choriocarcinoma; Diagnosis, Differential; Dysgerminoma; Female; Frozen Sections; Humans; Immunologic Techniques; Keratins; Male; Mesonephroma; Ovarian Neoplasms; Pregnancy; Teratoma; Testicular Neoplasms; Uterine Neoplasms

We have described a previously unreported lesion--peritoneal keratin globules in uterine adenosquamous carcinoma. We postulate that the keratin globules are derived from sloughed uterine adenosquamous carcinoma which gains access to the peritoneum through retrograde dissemination via the fallopian tubes, and we suggest that the finding of these globules does not alter the prognosis and staging of the primary carcinoma.

Topics: Adenocarcinoma; Aged; Carcinoma, Squamous Cell; Female; Histocytochemistry; Humans; Keratins; Peritoneum; Uterine Neoplasms

Immunoperoxidase staining for human keratin proteins (hKP) was performed cytochemically in samples from 79 cancer patients, and histochemically in samples from 134 cancer patients. Immunohistochemically, hKP was present in almost all patients with squamous cell carcinoma (lung), transitional cell carcinoma (urinary bladder), adenocarcinoma (lung, stomach, breast, ovary), bronchiole-alveolar carcinoma (lung), and large cell carcinoma (lung). It was detected in 40% of the patients with small cell carcinoma (lung). Histochemically, hKP was present in patients with squamous cell carcinoma (lung, uterine body), adenocarcinoma (lung, stomach, colon, gall bladder, thyroid, uterine body), adenosquamous cell carcinoma (gall bladder, uterine body), Signet-ring cell carcinoma (stomach), clear cell carcinoma (uterine body) and undifferentiated carcinoma (uterine body). However, it was not detected in patients with brochiole ++-alveola ++ carcinoma (lung) and mucinous carcinoma (gall bladder).

Topics: Breast Neoplasms; Colonic Neoplasms; Female; Histocytochemistry; Humans; Keratins; Lung Neoplasms; Male; Neoplasms; Stomach Neoplasms; Urinary Bladder Neoplasms; Uterine Neoplasms

We studied the expression of cytoskeletal intermediate filaments in different types of ovarian and uterine sarcomas and carcinomas. In both uterine and ovarian leiomyosarcomas, in endometrial stromal sarcomas, and also in ovarian sarcomas, most tumor cells appeared to be positive for desmin, the muscle type of intermediate filament protein. In most of the tumors, vimentin was present only in some neoplastic cells and in the vascular endothelia. Interestingly, both uterine and ovarian malignant mixed mesodermal tumors appeared to express several types of intermediate filaments, most of the stromal cells being positive for vimentin or desmin, and the epithelial component expressing keratin. The results show that most of the sarcomatous tumors of the ovary and uterus express mainly muscle type of intermediate filament protein. The results also demonstrate the ability of cells of mesodermal origin to express epithelial cytoskeleton markers--cytokeratins.

Topics: Adenocarcinoma; Cystadenocarcinoma; Desmin; Female; Histocytochemistry; Humans; Intermediate Filament Proteins; Keratins; Leiomyosarcoma; Neoplasms, Germ Cell and Embryonal; Ovarian Neoplasms; Sarcoma; Uterine Neoplasms; Vimentin

We extracted hKP by Sun and Green's method and injected it into a rabbit to raise antibody. hKP was demonstrated in 14/18 well differentiated EC by Sternberger's Pap method. In 2/4 hKP (+) cases, the carcinoma cells invaded. If hKP was present, undifferentiated EC (5/5) and clear cell carcinoma (2/2) all invaded. Among ER (+) PR (+) cases, hKP was demonstrated in 6/10; 4 of these invaded. Both ER (+) PR (-) (1/1) and ER (-) PR (-) (6/6) cases revealed invasion with hKP. In the foci of squamous arrangements and at the top of the invading carcinoma cells, hKP was strongly demonstrated. These results suggest that hKP endows the cells with "stiffness" and that this protein is closely associated with cancer invasive growth, no less than are ER, PR or/and microscopical architecture.

Topics: Adenocarcinoma; Aged; Carcinoma, Squamous Cell; Female; Humans; Keratins; Middle Aged; Receptors, Estrogen; Receptors, Progesterone; Uterine Neoplasms

Four cases of well-differentiated adenocarcinoma with squamous metaplasia (so-called adenocanthoma) of the uterus were associated with granulomatous inflammation of the pelvic peritoneum. The inflammation was the result of a foreign-body response to keratin that desquamated from the surface of the tumor and was carried to the peritoneal cavity through the lumen of the Fallopian tubes. The absence of viable neoplastic cells and favorable follow-up examinations in these patients indicate that the presence of peritoneal keratin granulomas in association with endometrial adenoacanthoma should not be regarded as an indicator of metastatic spread.

Topics: Adenocarcinoma; Aged; Female; Granuloma; Humans; Keratins; Middle Aged; Peritoneal Diseases; Uterine Neoplasms

Topics: Adenocarcinoma; Carcinoma, Squamous Cell; Cell Nucleus; Chromatin; Cytoplasmic Granules; Desmosomes; Endometriosis; Endometrium; Female; Humans; Hyalin; Keratins; Microscopy, Electron; Middle Aged; Uterine Neoplasms

Topics: Animals; Carcinoma, Squamous Cell; Epithelium; Estrogens; Female; Hyalin; Inclusion Bodies; Intrauterine Devices; Keratins; Leukocytes; Neoplasms, Experimental; Rats; Time Factors; Uterine Neoplasms; Uterus

Topics: Animals; Carcinoma, Squamous Cell; Cell Nucleus; Cytoplasm; Edema; Endometrium; Endoplasmic Reticulum; Female; Foreign Bodies; Golgi Apparatus; Keratins; Lysosomes; Microscopy; Microscopy, Electron; Mitochondria; Neoplasms, Experimental; Neutrophils; Paraffin; Polyvinyls; Rats; Suppuration; Uterine Neoplasms; Uterus