Ting Lin1, Wei Wang1, Lian Xu1, Ying He2. 1. West China Second University Hospital, Sichuan University, Chengdu, China. 2. West China Second University Hospital, Sichuan University, Chengdu, China. heyingpathology@163.com.
Abstract
PURPOSE: Invasive stratified mucin-producing carcinoma (ISMC), an invasive form of stratified mucin-producing intraepithelial lesion (SMILE), is a newly named human papillomavirus (HPV) associated mucous adenocarcinoma of cervix. We aim to provide more clinical and pathological data for this uncommon disease. METHODS: Fifteen cases diagnosed as ISMC in our hospital were included, and their clinical and pathological data were retrospectively analyzed. RESULTS: The patients' median age was 43 years (range, 30-54 years). The most prevalent symptom was abnormal vaginal bleeding. HPV test indicated high-risk HPV in all of our 15 cases. In addition, we observed several other architectural patterns of ISMC, including nest, gland-forming or lumen-forming, papillary with extravasated pools of mucin and solid. Immunohistochemically, all of our ISMC cases showed block-like expression of P16 and diffuse positive expression of CK8 and CK18, while P63, P40 and CK5/6 were spotted positive, or completely negative. Most importantly, ISMC has a relatively high lymph node metastasis rate of 33%. CONCLUSIONS: ISMC is a special type of HPV-associated adenocarcinoma, displaying a wide morphologic spectrum combined with a unique immunohistochemical profile. Clinically, ISMC may have a higher rate of lymph node metastasis, which suggests more attention to postoperative follow-up.
PURPOSE: Invasive stratified mucin-producing carcinoma (ISMC), an invasive form of stratified mucin-producing intraepithelial lesion (SMILE), is a newly named human papillomavirus (HPV) associated mucous adenocarcinoma of cervix. We aim to provide more clinical and pathological data for this uncommon disease. METHODS: Fifteen cases diagnosed as ISMC in our hospital were included, and their clinical and pathological data were retrospectively analyzed. RESULTS: The patients' median age was 43 years (range, 30-54 years). The most prevalent symptom was abnormal vaginal bleeding. HPV test indicated high-risk HPV in all of our 15 cases. In addition, we observed several other architectural patterns of ISMC, including nest, gland-forming or lumen-forming, papillary with extravasated pools of mucin and solid. Immunohistochemically, all of our ISMC cases showed block-like expression of P16 and diffuse positive expression of CK8 and CK18, while P63, P40 and CK5/6 were spotted positive, or completely negative. Most importantly, ISMC has a relatively high lymph node metastasis rate of 33%. CONCLUSIONS: ISMC is a special type of HPV-associated adenocarcinoma, displaying a wide morphologic spectrum combined with a unique immunohistochemical profile. Clinically, ISMC may have a higher rate of lymph node metastasis, which suggests more attention to postoperative follow-up.