title: Mucinous epithelial lesions in endometrial curettage material:  a diagnostic challenge.
abstract: OBJECTIVE
  To evaluate the immunohistochemical expression of several benign or malignant mucinous lesions that can be encountered in endometrial curettage material.
  
  
  METHODS
  Nineteen well-differentiated mucinous endometrial carcinomas, 12 papillary mucinous metaplasias, 11 cervical microglandular hyperplasias, 11 endocervical adenocarcinomas, 2 goblet cell metaplasias, 1 minimal-deviation adenocarcinoma, and 1 lobular endocervical glandular hyperplasia entered the study. Immunohistochemistry was performed with the following antibodies against: estrogen receptors, progesterone receptors, vimentin, p16, p63, carcinoembryonic antigen, and Ki-67.
  
  
  RESULTS
  Immunohistochemistry could easily distinguish endocervical adenocarcinoma of usual type from all other lesions under study. A Vim(-)/p16(-)/p63(high) signature was found to favor a cervical microglandular hyperplasia, whereas both mucinous endometrial carcinoma and mucinous papillary metaplasia would be preferentially characterized by a Vim(+)/p16(+)/p63(low) immunophenotype. A high Ki-67 expression would be of help in differentiating the latter 2 conditions. Statistically, the expression of estrogen receptors, progesterone receptors, and carcinoembryonic antigen did not aid in the differential diagnosis of these 3 conditions. For the 4 cases representing goblet cell metaplasia, minimal-deviation adenocarcinoma and lobular endocervical glandular hyperplasia, no results could be drawn.
  
  
  CONCLUSIONS
  In endometrial curettage material, the differential diagnosis of lesions comprising mucinous epithelium might be rendered by combining the immunohistochemical expression of vimentin, p16, p63, and Ki-67. Of all lesions, endocervical adenocarcinoma of usual type is the most easily identified.
authors.affiliation: Department of Pathology, National and Kapodistrian University of Athens, Greece.
authors.forename: Kitty
authors.initials: K
authors.lastname: Pavlakis
authors.forename: Thomas
authors.initials: T
authors.lastname: Vrekoussis
authors.forename: Irini
authors.initials: I
authors.lastname: Messini
authors.forename: Zannis
authors.initials: Z
authors.lastname: Voulgaris
authors.forename: Dimitris
authors.initials: D
authors.lastname: Chrysanthakis
authors.forename: Petros
authors.initials: P
authors.lastname: Yiannou
authors.forename: Anastasios
authors.initials: A
authors.lastname: Stofas
authors.forename: Theodore
authors.initials: T
authors.lastname: Panoskaltsis
mesh_terms: D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D004848:Epithelium / Q000473:pathology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D009077:Mucins / Q000378:metabolism*
chemical_list: D009077:Mucins