Difference between revisions of "Serous carcinoma of the ovary"

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===Grading===
===Grading===
Serous carcinoma is subdivided into:<ref name=pmid22833081>{{Cite journal  | last1 = Garg | first1 = K. | last2 = Park | first2 = KJ. | last3 = Soslow | first3 = RA. | title = Low-grade serous neoplasms of the ovary with transformation to high-grade carcinomas: a report of 3 cases. | journal = Int J Gynecol Pathol | volume = 31 | issue = 5 | pages = 423-8 | month = Sep | year = 2012 | doi = 10.1097/PGP.0b013e31824ae6f2 | PMID = 22833081 }}</ref><ref name=pmid19700937>{{Cite journal  | last1 = Vang | first1 = R. | last2 = Shih | first2 = IeM. | last3 = Kurman | first3 = RJ. | title = Ovarian low-grade and high-grade serous carcinoma: pathogenesis, clinicopathologic and molecular biologic features, and diagnostic problems. | journal = Adv Anat Pathol | volume = 16 | issue = 5 | pages = 267-82 | month = Sep | year = 2009 | doi = 10.1097/PAP.0b013e3181b4fffa | PMID = 19700937 }}</ref>
Serous carcinoma is subdivided into:<ref name=pmid19700937>{{Cite journal  | last1 = Vang | first1 = R. | last2 = Shih | first2 = IeM. | last3 = Kurman | first3 = RJ. | title = Ovarian low-grade and high-grade serous carcinoma: pathogenesis, clinicopathologic and molecular biologic features, and diagnostic problems. | journal = Adv Anat Pathol | volume = 16 | issue = 5 | pages = 267-82 | month = Sep | year = 2009 | doi = 10.1097/PAP.0b013e3181b4fffa | PMID = 19700937 }}</ref><ref name=pmid15087669>{{Cite journal  | last1 = Malpica | first1 = A. | last2 = Deavers | first2 = MT. | last3 = Lu | first3 = K. | last4 = Bodurka | first4 = DC. | last5 = Atkinson | first5 = EN. | last6 = Gershenson | first6 = DM. | last7 = Silva | first7 = EG. | title = Grading ovarian serous carcinoma using a two-tier system. | journal = Am J Surg Pathol | volume = 28 | issue = 4 | pages = 496-504 | month = Apr | year = 2004 | doi = | PMID = 15087669 }}</ref>
*Low-grade (Type I).
{| class="wikitable sortable"
*High-grade (Type II).
! Grade
! Nuclei (most important)
! Mitotic rate
|-
| Low-grade (Type I)
| mild/moderate atypia
| <=12 mitoses/HPF
|-
| High-grade (Type II)
| severe atypia
| >12 mitoses/HPF
|}


Note:
Note:
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</gallery>
</gallery>
www:
www:
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716424/figure/F1/ Serous carcinoma - grade 1, 2 and 3 (nih.gov)].<ref name=pmid19461510>{{Cite journal  | last1 = Ayhan | first1 = A. | last2 = Kurman | first2 = RJ. | last3 = Yemelyanova | first3 = A. | last4 = Vang | first4 = R. | last5 = Logani | first5 = S. | last6 = Seidman | first6 = JD. | last7 = Shih | first7 = IeM. | title = Defining the cut point between low-grade and high-grade ovarian serous carcinomas: a clinicopathologic and molecular genetic analysis. | journal = Am J Surg Pathol | volume = 33 | issue = 8 | pages = 1220-4 | month = Aug | year = 2009 | doi = 10.1097/PAS.0b013e3181a24354 | PMID = 19461510 }}</ref>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716424/figure/F1/ Serous carcinoma - grade 1, 2 and 3 (nih.gov)].<ref name=pmid19461510>{{Cite journal  | last1 = Ayhan | first1 = A. | last2 = Kurman | first2 = RJ. | last3 = Yemelyanova | first3 = A. | last4 = Vang | first4 = R. | last5 = Logani | first5 = S. | last6 = Seidman | first6 = JD. | last7 = Shih | first7 = IeM. | title = Defining the cut point between low-grade and high-grade ovarian serous carcinomas: a clinicopathologic and molecular genetic analysis. | journal = Am J Surg Pathol | volume = 33 | issue = 8 | pages = 1220-4 | month = Aug | year = 2009 | doi = 10.1097/PAS.0b013e3181a24354 | PMID = 19461510 | PMC = 2716424 }}</ref>


==IHC==
==IHC==

Revision as of 22:34, 1 January 2014

Serous carcinoma of the ovary, also ovarian serous carcinoma, is relatively common malignant ovarian tumour.

General

Microscopic

Features:

  • Marked nuclear pleomorphism:
    • Variation in size - usually marked.
    • Variation in staining.
    • Variation in shape.
  • Prominent nucleolus - key feature.
  • Eccentric nucleus.
  • Architecture:
    • Solid.
    • Papillary - classic.
    • Glandular - uncommon.
  • +/-Psammoma bodies - uncommon.
  • +/-Necrosis - often extensive.

DDx:

Grading

Serous carcinoma is subdivided into:[2][3]

Grade Nuclei (most important) Mitotic rate
Low-grade (Type I) mild/moderate atypia <=12 mitoses/HPF
High-grade (Type II) severe atypia >12 mitoses/HPF

Note:

  • Tumours very rarely transform from low-grade to high-grade.[4]

Images

  • Serous carcinoma - cytology. (WC)

www:

IHC

  • WT-1 +ve - key immunostain.[6]
  • CK7 +ve.
  • CA-125 +ve.
  • ER +ve.[7]
  • p53 +ve.

Others:

See also

References

  1. ↑ Vang, R.; Shih, IeM.; Kurman, RJ. (Jan 2013). "Fallopian tube precursors of ovarian low- and high-grade serous neoplasms.". Histopathology 62 (1): 44-58. doi:10.1111/his.12046. PMID 23240669.
  2. ↑ Vang, R.; Shih, IeM.; Kurman, RJ. (Sep 2009). "Ovarian low-grade and high-grade serous carcinoma: pathogenesis, clinicopathologic and molecular biologic features, and diagnostic problems.". Adv Anat Pathol 16 (5): 267-82. doi:10.1097/PAP.0b013e3181b4fffa. PMID 19700937.
  3. ↑ Malpica, A.; Deavers, MT.; Lu, K.; Bodurka, DC.; Atkinson, EN.; Gershenson, DM.; Silva, EG. (Apr 2004). "Grading ovarian serous carcinoma using a two-tier system.". Am J Surg Pathol 28 (4): 496-504. PMID 15087669.
  4. ↑ Cite error: Invalid <ref> tag; no text was provided for refs named pmid22833081
  5. ↑ Ayhan, A.; Kurman, RJ.; Yemelyanova, A.; Vang, R.; Logani, S.; Seidman, JD.; Shih, IeM. (Aug 2009). "Defining the cut point between low-grade and high-grade ovarian serous carcinomas: a clinicopathologic and molecular genetic analysis.". Am J Surg Pathol 33 (8): 1220-4. doi:10.1097/PAS.0b013e3181a24354. PMC 2716424. PMID 19461510. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2716424/.
  6. ↑ Köbel, M.; Kalloger, SE.; Carrick, J.; Huntsman, D.; Asad, H.; Oliva, E.; Ewanowich, CA.; Soslow, RA. et al. (Jan 2009). "A limited panel of immunomarkers can reliably distinguish between clear cell and high-grade serous carcinoma of the ovary.". Am J Surg Pathol 33 (1): 14-21. doi:10.1097/PAS.0b013e3181788546. PMID 18830127.
  7. ↑ DeLair, D.; Oliva, E.; Köbel, M.; Macias, A.; Gilks, CB.; Soslow, RA. (Jan 2011). "Morphologic spectrum of immunohistochemically characterized clear cell carcinoma of the ovary: a study of 155 cases.". Am J Surg Pathol 35 (1): 36-44. doi:10.1097/PAS.0b013e3181ff400e. PMID 21164285.
  8. ↑ Tsuchiya, A.; Sakamoto, M.; Yasuda, J.; Chuma, M.; Ohta, T.; Ohki, M.; Yasugi, T.; Taketani, Y. et al. (Dec 2003). "Expression profiling in ovarian clear cell carcinoma: identification of hepatocyte nuclear factor-1 beta as a molecular marker and a possible molecular target for therapy of ovarian clear cell carcinoma.". Am J Pathol 163 (6): 2503-12. PMID 14633622. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1892387/?tool=pubmed.
  9. ↑ Online 'Mendelian Inheritance in Man' (OMIM) 189907
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