title: Ovarian serous carcinoma presenting with mediastinal lymphadenopathy 20 months before the intraabdominal mass: role of immunohistochemistry.
abstract: BACKGROUND
  Metastatic involvement of the mediastinal lymph nodes is an extremely uncommon finding in epithelial ovarian cancers.
  
  
  METHODS
  A 63-year-old woman was admitted to hospital for dyspnoea due to an anterior mediastinal mass. The surgical biopsy showed a 6-cm metastatic lymph node with a papillary pattern, scattered psammomas and immunoreactivity for WT1, Cytokeratin 7, EMA and negative for E-cadherin, GCFDP-15, Thyroglobulin, Cytokeratin 20, Cytokeratin 5/6, CEA, Vimentin, Calretinin, TTF1. After 20 months a follow-up CT identified an ovarian mass with the same histological pattern and immunoreactivity of the mediastinal nodule.
  
  
  RESULTS
  Immunohistochemistry, especially WT1, is useful in assessing the ovarian origin of an unusual metastasis particularly if it is the first presentation of the disease.
authors.affiliation: Department of Pathology, Faculty of Medicine Agostino Gemelli, Catholic University, 00168 Rome, Italy. gfzannoni@rm.unicatt.it
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Zannoni
authors.forename: Valerio Gaetano
authors.initials: VG
authors.lastname: Vellone
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Distefano
authors.forename: Guido
authors.initials: G
authors.lastname: Fadda
authors.forename: Giovanni
authors.initials: G
authors.lastname: Scambia
mesh_terms: D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008206:Lymphatic Diseases / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology