Malignant endometrial pathology.
This review discusses recent papers on endometrial carcinoma variants, immunohistochemical studies, and prognostic indicators. The aggressive nature of uterine papillary serous carcinoma is confirmed, even in the absence of myometrial or vascular invasion, with a comprehensive review of the histology, clinical presentation, and proposed treatment protocols. The possible etiologic role of radiation in the development of uterine papillary serous carcinoma is alluded to. The virulence of endometrial carcinomas with trophoblastic differentiation, endometrial carcinomas with a malignant giant cell component, and clear cell carcinomas of the endometrium is documented. A series of immunohistochemical studies is presented suggesting that uterine carcinosarcomas are metaplastic carcinomas derived from a common stem cell and that a shared histogenesis of endometrial stromal tumors and uterine mesoderm exists. Immunohistochemical techniques may clarify diagnostic problems of uterine tumors and their metastases and differentiate mucinous tumors of endometrium from endocervical origin. Staining of both carcinoembryonic antigen and ferritin in neoplastic endometria may be helpful in their differentiation from hyperplasias in curettage specimens. Significant prognosticators in endometrial carcinoma are depth of myometrial invasion and lymphovascular space involvement with greatest prognostic information provided by the depth of myometrial invasion above DNA index.
Nieberg
R K
RK
Department of Pathology, University of California, Los Angeles 90024.
Hirschowitz
S L
SL
D000367:Age Factors; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D004247:DNA / Q000032:analysis; D016889:Endometrial Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006133:Growth Substances / Q000032:analysis; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D008875:Middle Aged; D009367:Neoplasm Staging; D009857:Oncogenes; D011379:Prognosis
D014408:Biomarkers, Tumor; D006133:Growth Substances; D004247:DNA