Colin J R Stewart1,2, Mei H E Koay1, Connull Leslie3, Nathan Acott3, Yee C Leung2,4. 1. Department of Pathology, King Edward Memorial Hospital, Perth, WA, Australia. 2. School for Women's and Infants' Health, University of Western Australia, Perth, WA, Australia. 3. Division of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia. 4. Department of Gynaecological Oncology, King Edward Memorial Hospital, Perth, WA, Australia.
Abstract
AIMS: Micropapillary carcinomas, or carcinomas with a micropapillary component, are well recognised in the breast and other anatomical sites. However, they have seldom been described in the cervix. In this article, we present a clinicopathological analysis of eight cervical tumours that showed at least a focal (≥5%) component of micropapillary carcinoma. METHODS AND RESULTS: The study group comprised eight cervical carcinomas (four adenocarcinomas and four adenosquamous carcinomas) with a micropapillary component. The median patient age was 41.5 years (range 27-65 years). At presentation, five patients were stage IB, two were stage IIB, and one was stage IV. The micropapillary component accounted for ≤25% of the tumour on initial biopsy or resection specimens in all but one case. Immunohistochemistry showed 'inside-out' (reverse polarity) mucin 1 staining along the cell membrane abutting the stroma. Four patients developed metastasis, all of whom showed a pure micropapillary pattern; this led to a misdiagnosis of an apparently independent peritoneal serous carcinoma in one case. All tumours showed diffuse p16 expression, and all three cases that were tested were positive for human papillomavirus (HPV) 18. Three of the six patients with at least 12 months of follow-up died of disease, and one is alive with distant metastasis. CONCLUSIONS: Usual-type (HPV-related) cervical carcinomas may show micropapillary differentiation, usually as a focal finding, and the cells show reverse polarity like similar tumours arising in other sites. Micropapillary cervical carcinoma appears to be a clinically aggressive malignancy, although this needs to be confirmed in larger studies.
AIMS: Micropapillary carcinomas, or carcinomas with a micropapillary component, are well recognised in the breast and other anatomical sites. However, they have seldom been described in the cervix. In this article, we present a clinicopathological analysis of eight cervical tumours that showed at least a focal (≥5%) component of micropapillary carcinoma. METHODS AND RESULTS: The study group comprised eight cervical carcinomas (four adenocarcinomas and four adenosquamous carcinomas) with a micropapillary component. The median patient age was 41.5 years (range 27-65 years). At presentation, five patients were stage IB, two were stage IIB, and one was stage IV. The micropapillary component accounted for ≤25% of the tumour on initial biopsy or resection specimens in all but one case. Immunohistochemistry showed 'inside-out' (reverse polarity) mucin 1 staining along the cell membrane abutting the stroma. Four patients developed metastasis, all of whom showed a pure micropapillary pattern; this led to a misdiagnosis of an apparently independent peritoneal serous carcinoma in one case. All tumours showed diffuse p16 expression, and all three cases that were tested were positive for human papillomavirus (HPV) 18. Three of the six patients with at least 12 months of follow-up died of disease, and one is alive with distant metastasis. CONCLUSIONS: Usual-type (HPV-related) cervical carcinomas may show micropapillary differentiation, usually as a focal finding, and the cells show reverse polarity like similar tumours arising in other sites. Micropapillary cervical carcinoma appears to be a clinically aggressive malignancy, although this needs to be confirmed in larger studies.
Authors: Isabel Alvarado-Cabrero; W Glenn McCluggage; Rafael Estevez-Castro; Delia Pérez-Montiel; Simona Stolnicu; Raji Ganesan; Josefa Vella; Rosario Castro; Javier Canedo-Matute; Jessica Gomez-Cifuentes; Vilma M Rivas-Lemus; Kay J Park; Robert A Soslow; Esther Oliva; Raquel Valencia-Cedillo Journal: Am J Surg Pathol Date: 2019-06 Impact factor: 6.394
Authors: Richard Wing-Cheuk Wong; Joshua Hoi Yan Ng; Kam Chu Han; Yuen Ping Leung; Chiu Man Shek; Kin Nam Cheung; Carmen Ka Man Choi; Ka Yu Tse; Philip P C Ip Journal: Mod Pathol Date: 2020-07-22 Impact factor: 7.842