TFE3‐rearranged hepatic epithelioid hemangioendothelioma—a case report with immunohistochemical and molecular study

A recurrent YAP1‐TFE3 gene fusion has been identified in WWTR1‐CAMTA1‐negative epithelioid hemangioendotheliomas arising in soft tissue, bone, and lung, but not in liver. We present the first case of TFE3‐rearranged hepatic epithelioid hemangioendothelioma in a 39‐year‐old Taiwanese woman. Computed tomography scan revealed multifocal, ill‐defined nodules involving both hepatic lobes. She then underwent deceased donor liver transplantation. Histologically, the tumors in the liver explant showed a biphasic growth pattern. One component was composed of dilated and well‐formed blood vessels lined by epithelioid cells with abundant eosinophilic cytoplasm, mimicking an alveolar pattern, whereas the other component was composed of cords and single cells, featuring intracytoplasmic vacuoles, separated by a myxoid stroma. The tumor cells showed vesicular nuclei and small indistinct nucleoli with mild to moderate cytologic atypia. Most tumor cells showed factor VIII, CD34, CD31, and TFE3 positivity in immunohistochemical study. Fluorescence in situ hybridization analysis for the tumor cells exhibited TFE3 gene rearrangement. The patient is currently alive, and no post‐operative tumor recurrence developed during a 13‐year follow‐up. Awareness of this rare vasoformative variant and identification of the gene rearrangement would be helpful on differential diagnosis with other high‐grade carcinoma and angiosarcoma of liver.     

肺上皮样血管内皮瘤临床病理观察

目的 探讨肺上皮样血管内皮瘤的临床病理特点。方法 4例肺上皮样血管内皮瘤,3例女性,1例男性,年龄28～40岁,无自觉症状或有轻度咳嗽、气短。肺活检或手术切除标本经甲醛固定,石蜡包埋,常规HE及免疫组织化学(Envision法)染色。所用抗体包括CD31、CD34、细胞角蛋白(AEl／AE3)、TTF-1、波形蛋白和上皮膜抗原。结果 本组肺上皮样血管内皮瘤病例女性多于男性,胸部CT显示双肺多发弥漫性小结节影。病理形态特点为结节周边上皮样肿瘤细胞呈花冠状充填于肺泡腔,病变中心为黏液透明样变间质,肺泡壁结构保留,肿瘤细胞胞质内有空泡形成,空泡内偶见红细胞,肿瘤细胞异型性不明显,核分裂和坏死均少见,免疫组织化学染色示CD31、CD34阳性,AE1／AE3偶见灶状阳性,其他抗体呈阴性。结论 肺上皮样血管内皮瘤是一种具有独特临床病理特点的低度恶性血管来源肿瘤。     

原发骨假肌源性血管内皮瘤2例临床病理学分析

目的:探讨原发骨假肌源性血管内皮瘤（pseudomyogenic hemangioendothelioma,PHE）的临床病理特征、免疫表型、分子遗传学特征及鉴别诊断。方法:回顾性分析2例PHE的临床资料、组织病理学特征及免疫表型,并进行分子检测及复习相关文献。结果:例1,男,28岁,磁共振成像示腰5椎体破坏性病变。例...     

Pleomorphic liposarcoma: A clinicopathological,immunohistochemical and molecular cytogenetic study of 32 additional cases

The purpose of this study is to report the author's experience with 32 cases of pleomorphic liposarcoma to further broaden the clinicopathological spectrum. The tumours occurred equally in males and females with ages ranging from 11 to 83 years (median, 56 years). Tumour site included the extremities (17 cases), abdomen/retroperitoneum (4 cases), internal organs (5 cases), thoracic cavity/mediastinum (2 cases), orbit, neck, groin and scrotum (1 case each). The diagnostic pleomorphic lipoblasts were identified in 31 primary tumours and one recurrent tumor but varied widely in proportion between cases or different areas of the same tumor. Four tumors contained sheets or focal aggregates of lipoblasts with epithelioid morphology. The nonlipogenic component in 26 cases had an appearance of undifferentiated pleomorphic sarcoma, whereas in six cases it was consistent with intermediate to high grade myxofibrosarcoma. The pleormorphic and epithelioid lipoblasts displayed variable expression of S100 protein. There was no signal of amplified MDM2 gene in 10 cases tested by fluorescence in situ hybridization. This study further illustrates that pleomorphic liposarcoma is a distinctive entity with no relationship to either well differentiated liposarcoma or dedifferentiated liposarcoma. Albeit very rare, pleomorphic liposarcoma can occur in teenaged patients and internal organs.     

上皮样血管内皮瘤的临床病理分析

目的：探讨上皮样（组织细胞样）血管内皮瘤的临床病理学特点及其意义。方法：对9例上皮样血管内皮瘤进行光镜和免疫组织化学SP法检测,1例作电镜观察,结果：年龄16－47岁,平均32岁,男女性别差异无显著性意义。部位：头面部4例,上肢3例,下肢2例,形态特征：瘤细胞具有上皮样或组织细胞样的形态;瘤细胞圆形或多角开,三五成群呈小巢状,索状,不规则状排列,分布于粘液间质中;间质可显著或少量粘液样变或玻璃样变,瘤细胞内含有原始血管腔,核分裂角,多形性及坏死少见,部分病例伴有梭形细胞血管内皮瘤改变,1例见破骨细胞样的多核巨细胞,免疫组织化学检测7例,7例波形蛋白均阳性,5例第八因子相关抗原,CD31,CD34阳性,2例细胞角蛋白弱阳性,1例CD68和a1-抗胰蛋白酶阳性,电镜观察1例见胞质内含丰富的微丝和少许的W－P小体,6例随访－8年,3例在原发部位有1或2次复发,但未见有转移,结论：上皮样血管内皮瘤是一种低度恶性的软组织肉瘤,其病因学尚不清楚,熟悉其形态特征对避免误诊为其他类似病变具具有重要意义。     

Vascular tumors of bone: A study of 17 cases other than ordinary hemangioma,with an evaluation of the relationship of hemangioendothelioma of bone to epithelioid hemangioma,epithelioid hemangioendothelioma,and high-grade angiosarcoma

Cases filed as vascular tumor of bone other than ordinary hemangioma were reviewed. They were included in the study if there was adequate histologic material and clinical information, clear evidence of bone origin, and at least 5 years follow-up. The study group comprised 17 cases, of which 13 were categorized as hemangioendothelioma of bone, 1 as epithelioid hemangioendothelioma, and 3 as high-grade angiosarcoma. Hemangioendothelioma of bone had growth patterns varying from vasoformative to solid, but well-formed vessels were present in at least some area in all cases. The cells generally had a rounded, epithelioid character, regular nuclei, and relatively few mitotic figures; occasional features included spindle cells and scattered enlarged, hyperchromatic or pleomorphic nuclei. Lymphoplasmacytic and eosinophilic inflammatory infiltrate ranged from prominent to slight or absent, and myxoid or hyaline stroma was never more than focal. Epithelioid hemangioma could not be separated from hemangioendothelioma of bone. The single epithelioid hemangioendothelioma for the most part had cords of relatively uniform epithelioid cells in a prominent myxoid stroma but focally demonstrated an angiosarcoma-like appearance, with irregular vascular spaces and marked nuclear pleomorphism. The high-grade angiosarcomas exhibited predominantly irregular vasoformation combined with solid areas, diffuse nuclear hyperchromatism and pleomorphism, and, in 2 cases, numerous mitotic figures (the third case had only a small biopsy and a postradiation amputation specimen). Of the hemangioendotheliomas of bone, 7 were unicentric and 6 were regionally multicentric either concurrently or sequentially. Three patients had intraosseous local recurrence, 2 had discontinuous regional skin or soft tissue involvement (including the popliteal artery in 1), and 1 had a solitary lung metastasis, but none died of tumor. The patient with epithelioid hemangioendothelioma had multicentric tumors in widely separated bones and died with liver and lung metastases. Two of the high-grade angiosarcomas were unicentric, and the third was regionally multicentric, with a popliteal artery-soft tissue component as well. All 3 of these patients died with metastases in various sites.     

上皮样肉瘤样血管内皮瘤的临床病理学观察

目的 探讨上皮样肉瘤样血管内皮瘤的临床病理学特征和鉴别诊断.方法 回顾性分析3例上皮样肉瘤样血管内皮瘤的临床表现、组织学特点和免疫表型.结果 3例均发生于成年男性,分别因左颈部肿块、髂部疼痛和双侧颈肩区复发性肿块就诊.镜下观察肿瘤由梭形和上皮样的细胞组成,两种细胞在形态上有移行.瘤细胞呈片状、模糊结节状或交织条束状排列,间质伴有胶原化.1例于结节中央可见凝固性坏死,形态上类似上皮样肉瘤.3例肿瘤内均无明显的血管形成,但其中1例于局灶区域可见胞质内空泡形成,类似上皮样血管内皮瘤.免疫组织化学标记,瘤细胞同时表达上皮性标记和内皮标记.3例均经手术切除,其中2例患者术后恢复良好,随访18个月和14个月均健在,无局部复发或远处转移,另1例术后6年内复发5次.结论上皮样肉瘤样血管内皮瘤属于一种少见的中间型血管内皮瘤,兼具上皮样肉瘤和上皮样血管内皮瘤的部分形态.仅凭光镜形态有时较难确定其内皮细胞分化,必须借助于免疫组织化学标记.上皮样肉瘤样血管内皮瘤与上皮样血管内皮瘤关系较为密切,可能是后者的一种富于细胞性梭形细胞变型.

Abstract：

Objective To study the clinicopathologic features and differential diagnosis of epithelioid sarcoma-like hemangioendothelioma (ES-H). Methods The clinical, radiologic and pathologic features of three cases of ES-H were analyzed. Results All the 3 cases occurred in male adults. The age ranged from 44 to 53 years. The presentations included left neck mass, iliac pain and bilateral shoulder masses. Histologically, ES-H was composed of a mixture of spindle and epithelioid tumor cells. Transition between the two cell types was demonstrated. The tumor cells were arranged in compact sheets, vague nodules or intersecting fascicles, amongst a collagenous stroma. Central coagulative necrosis was identified in one case, reminiscent the morphology that seen in epithelioid sarcoma. There was no evidence of angiogenesis, though focal presence of intracytoplasmic vacuoles was seen in one case, as in classic examples of epithelioid hemangioendothelioma. Immunohistochemical study showed that the tumor cells expressed both epithelial (AE1/AE3, CAM5.2 and epithelial membrane antigen) and endothelial (CD31,Fli-1 and factor Ⅷ-related antigen ) markers. Two of the cases were also positive for CD34. All of the patients were treated by surgical resection. Two patients remain well at 14-month and 9-month follow up,respectively. The remaining patient had repeated local recurrences during a 6-year period. Conclusions ES-H represents a rare morphologic type of hemangioendothelioma. It has some overlapping histologic features with epithelioid sarcoma and epithelioid hemangioendothelioma. The endothelial nature of ES-H is difficult to be verified on the basis of morphologic examination alone. Confirmation of the diagnosis with immunohistochemistry is necessary. ES-H is likely related to epithelioid hemangioendothelioma and may represent a cellular spindie cell variant of epithelioid hemangioendothelioma.     

异位错构瘤性胸腺瘤的临床病理学观察和免疫组织化学研究

目的探讨异位错构瘤性胸腺瘤的临床病理学特征、免疫学表型和组织发生。方法对2例异位错构瘤性胸腺瘤进行临床病理学分析,采用免疫组织化学LSAB法行AE1/AE3、细胞角蛋白(CK)5、CK7、CK8、CK20、上皮膜抗原(EMA)、波形蛋白、CD5、CD10、α-平滑肌肌动蛋白(SMA)、calponin、结蛋白、CD34、S-100蛋白、CD57、胶质纤维酸性蛋白(GFAP)、甲状腺转录因子(TTF)-1和CD99标记。结果两例均发生于男性,年龄分别为20岁和40岁,因发现胸骨柄上缘肿块6个月和左锁骨上肿块2个多月就诊。肿块呈球形和卵圆形,边界清楚,最大直径分别为5cm和3cm,切面呈灰白色,质地柔软。组织学上,肿瘤由梭形细胞、上皮细胞和成熟的脂肪细胞3种成分混合组成。梭形细胞成分在2例中分别占到85%和70%,形态上类似纤维母细胞,多呈束状、编织状或席纹状排列。上皮细胞成分在两例中均占10%左右,形态上以非角化性鳞状上皮为主,可呈实性的小岛屿状、类似造釉细胞瘤的条索状和扩张的囊肿样排列,部分区域显示腺样分化,可见腺管形成。上皮细胞和梭形细胞在形态上有移行。成熟的脂肪组织呈不规则性分布,在两例肿瘤中所占的比例分别为<5%和20%。免疫组织化学标记显示,上皮细胞表达AE1/AE3、CK5、CK7、CK8和EMA,梭形细胞除CK外还表达波形蛋白、CD10和CD34,并部分表达α-SMA和calponin。两种细胞成分均不表达CK20、CD5、TTF-1、结蛋白、S-100蛋白、CD57、GFAP和CD99。结论异位错构瘤性胸腺瘤是一种好发于中青年男性锁骨上和胸锁关节附近软组织内的良性肿瘤,是一种由上皮和肌上皮组成的混合性肿瘤,可能起自于His颈窦,采用鳃原基混合瘤来命名或许更为合适。     

假肌源性血管内皮瘤6例临床病理分析

目的 探讨假肌源性血管内皮瘤(pseudomyogenic hemangioendothelioma,PHE)的临床病理学特征、免疫表型、诊断及鉴别诊断.方法 对6例PHE的临床病理资料和免疫表型进行回顾性复习.结果 男性4例,女性2例.平均年龄32岁(10～70岁).3例原发于骨内,均为多骨性累及,其中1例伴发皮肤结节;另3例分别表现为软组织局部肿块、皮肤和软组织多灶性病变及皮肤黑色斑块.影像学检查:3例骨病变均表现为多骨性骨质破坏,1例皮肤和软组织多灶性病变累及多个组织平面.眼观:送检肿瘤组织呈灰白、灰红或灰褐色,直径0.5 ～4 cm,平均2 cm.镜检:病变边界不清,可累及真皮、皮下、肌肉或骨组织.肿瘤主要由疏松条束状、结节状或片状分布的胖梭形细胞组成,部分区域内瘤细胞呈上皮样,间质内可见散在的中性粒细胞.高倍镜下见瘤细胞胞质丰富,嗜伊红色,核染色质呈空泡状,可见小核仁,形态上类似横纹肌母细胞.除1例局部区域外,瘤细胞异型性不明显或仅有轻度异型性,核分裂象为1～2个/10 HPF.部分区域内可见炎性或液化性坏死.免疫表型:瘤细胞弥漫强阳性表达CK(AE1/AE3),不同程度表达CD31和FLI1,INI-1标记显示无缺失,Ki-67平均增殖指数约5％.本组6例中2例复发,其中1例在短期内发生双肺转移.结论 PHE是一种局部易复发偶有转移的中间性血管内皮瘤.     

骨上皮样血管内皮细胞瘤9例诊治分析

目的 探讨骨上皮样血管内皮细胞瘤(B-EHE)的诊断、治疗方法。方法 回顾性分析2002年2月—2015年9月解放军东部战区总医院骨科收治的9例B-EHE患者的临床资料。其中男6例、女3例,年龄15~64岁。术前X线及CT检查均表现为溶骨性改变,1例MRI可见周围软组织受累,1例出现肺部转移灶。3例选择病灶刮除、植骨内固定;1例腰椎病灶选择肿瘤切除椎板减压内固定;3例近关节病灶选择肿瘤切除假体置换,其中1例术后化疗;1例多发病灶伴肺转移选择活检确诊后化疗治疗;1例病理性骨折伴出血选择行截肢术后综合治疗。结果 9例中失访1例,其余随访时间8～72个月。现7例存活。3例行病灶刮除植骨内固定,2例局部复发,二次手术后治愈。1例腰椎肿瘤切除减压固定,术后恢复良好。3例行肿瘤切除假体置换术,1例失访;2例术后治愈,关节功能良好,其中1例术后辅助化疗,未出现局部复发和病灶转移。1例多发病灶伴肺部转移行化疗,肺部无进展,局部无进展。1例行截肢术后综合治疗者,肿瘤复发迁延性出血,最终因器官衰竭死亡。结论 B-EHE为低-中度恶性肿瘤,术前影像学无特异性,诊断困难,主要依靠术后病理结果诊断。治疗首选边界切除,辅以化疗或放疗,可降低局部复发率和远处转移。     

Pigmented thymic carcinoids: a clinicopathological and immunohistochemical study of two cases.

Two cases of pigmented thymic carcinoids are presented. The patients were two men, 32 and 47 years of age. The two patients were asymptomatic and the tumor was discovered on routine chest radiographic evaluation. The tumors were treated by surgical excision in both patients. Grossly, they presented as tan-white tumors without evidence of necrosis or hemorrhage or any visible pigmentation. Histologically, the tumors were characterized by a monotonous proliferation of tumor cells arranged in a trabecular or nesting pattern. The tumor cells showed moderate amounts of pale eosinophilic cytoplasm, round to oval nuclei, and inconspicuous nucleoli. Mitotic activity varied from three to eight per 10 high-power fields. In addition, both tumors showed prominent areas of intra- and extracellular dark pigment deposition. The pigment reacted positively with the Fontana-Masson stain and was negative for iron stain. Immunohistochemical studies performed in one case showed immunoreactivity of the tumor cells for chromogranin, Leu 7, and keratin. Synaptophysin and P53 immunostains were negative. Clinical follow-up was obtained in one patient who was alive and well 10 years after surgical resection. The presence of abundant melanin pigment in thymic carcinoids highlights an important pitfall for diagnosis in these tumors that should be taken into consideration in the evaluation of anterior mediastinal lesions.     

硬化性上皮样纤维肉瘤临床病理分析

目的 探讨硬化性上皮样纤维肉瘤（sclerosing epithelioid fibrosarcoma,SEF）的临床病理学特点、免疫表型和鉴别诊断。方法 对3例SEF进行细胞病理学、组织病理学及免疫表型观察。结果患者年龄60～64岁,其中女性2例,男性1例。临床表现为病程不等（2～15年）的软组织深部肿物,1例肿物明显增大,1例有疼痛。肿瘤分别位于大腿、前臂及臀部,累及骨骼肌,最大直径分别为3、9、10cm。肿瘤境界清楚,分叶状或多结节状,切面灰白色,质地坚硬。1例伴有钙化。细胞学印片显示肿瘤细胞散在,主要由小至中等大的上皮样细胞组成,圆形或卵圆形,有不等量的嗜酸性胞质,单个核,染色质稍深染,核仁不清,未见核分裂象及瘤巨细胞。冷冻切片检查：肿瘤细胞主要由小至中等大的上皮样细胞组成,多呈单个、单行或索状排列,夹杂分布于大量嗜伊红色、玻璃样变的胶原纤维中,类似于分化差的转移癌。石蜡切片显示在硬化的胶原性间质背景中上皮样肿瘤细胞呈单个、巢状、索状或腺泡状排列,形态相对均匀,细胞质稀少、透明或嗜酸,细胞核大小一致,椭圆形、圆形和多角形,染色质呈泡状或细点状,可见小嗜碱性核仁,异型性不明显,核分裂活性低（1～2／10HPF）。1例伴有局灶凝固性坏死。3例肿瘤的局部区域均有典型的纤维肉瘤形态。免疫表型：3例肿瘤均弥漫性表达vimentin,部分不同程度表达bcl-2（1／3）、p53（1／3）、EMA（1／3）、S-100蛋白（1／3）、CD34（2／3）。所有肿瘤均不表达细胞角蛋白、HMB-45、CIM5、CD68、desmin和CD99等。增值指数MIB．1为0～5％。3例术后随访6～30个月,无复发和转移。结论硬化性上皮样纤维肉瘤是一种罕见的特殊类型的纤维肉瘤,诊断需与一些具有上皮样细胞形态和硬化性间质的良恶性肿瘤鉴别。     

Cutaneous epithelioid angiosarcoma: a clinicopathological study of four cases

Four cases of cutaneous epithelioid angiosarcoma are described together with the potential diagnostic trap of mistaking these tumours for poorly differentiated carcinoma or malignant melanoma. The immunophenotypic profile using four endothelial markers showed positive staining in all cases for factor VIII related antigen in a predominantly paranuclear dot-like fashion and for CD31 (JC70); in three cases for CD34 (QB-END/10) and in two cases with UEA-1. All four cases were cytokeratin (CAM 5.2 and AE1/AE3) negative in contrast to the positive staining reported at non-cutaneous sites. Aberrant S-100 protein expression was seen in one case. In two cases subsequent recurrences showed better differentiation than the original tumour. Electronmicroscopy confirmed the absence of non-endothelial lines of differentiation but failed to reveal Weibel-Palade bodies.     

34例脊索瘤的临床病理及免疫组织化学研究

为了解脊索瘤的临床病理及免疫组化特点，我们对34例脊索瘤进行了临床病理学及免疫组织化学标记的研究，并以5例软骨肉瘤作为对照。根据有无软骨样区域，将脊索瘤分为两型：软骨样脊索瘤（14例）和经典型脊索瘤（20例）。软骨样脊索瘤发病年龄（平均40．9岁）较经典型（平均51．1岁）年轻。7例（50％）软骨样脊索瘤发生于骶尾部，4例（28．6％）发生于颅底蝶枕部。免疫组化标记染色显示：34例脊索瘤均对细胞角蛋白呈阳性反应，16例（47．1％）对上皮性膜抗原阳性；而5例软骨肉瘤均对细胞角蛋白和上皮性膜抗原阴性。波形蛋白及S-100蛋白在大部分脊索瘤及5例软骨肉瘤中均呈阳性巨应。其结果验证了脊索瘤的双重特性──上皮性及间叶性；同时也说明了免疫组化染色对鉴别脊索瘤和软骨肉瘤很有帮助。     

Pseudomyogenic (epithelioid sarcoma-like) hemangioendothelioma of bone: Clinicopathologic features of 5 cases

Pseudomyogenic hemangioendothelioma (PHE) is an uncommon mesenchymal tumor of intermediate malignant potential with characteristic clinicopathologic and genetic features. Although bone involvement accompanies nearly one-fourth of reported cases of soft tissue PHEs, primary intraosseous PHE is rare. Herein, we report five cases of primary intraosseous PHEs. Male to female ratio was 4:1, with an average age of 28 years (age range, 5–44 years). Radiologically, tumors presented as lytic lesions in the proximal femur (two), diaphysis of the tibia (one), distal radius (one) and vertebrae (one). Multifocal lesions were observed in four cases. Histopathologic examination revealed plump spindle cells and prominent nucleoli. New bone formation was noted in three cases. Immunohistochemically, all tumors were positive for CD31 and negative for CD34. Pan Cytokeratin (CK) (AE1/3) was positively expressed in all, except a single tumor, in which CK7 and Cam5.2 were expressed. INI1/SMARCB1 was completely retained in all tumors. A single patient underwent surgical resection. During follow-up, two cases showed no evidence of disease within two and five years, respectively. Differential diagnosis of a PHE of bone includes osteoblastoma, epithelioid angiosarcoma, metastatic carcinoma, metastatic rhabdomyosarcoma, and epithelioid sarcoma. Caution must be exercised as pan CK (AE1/3) might not be expressed; therefore, the use of other cytokeratins, such as Cam5.2 is recommended. Awareness of such an entity in bone is the key to the diagnosis.     

Primary follicular dendritic cell sarcoma of the pleura: A clinicopathological and immunohistochemical study of two cases

Two cases of primary follicular dendritic cell sarcoma (FDCS) of the pleura are presented. The patients are a woman 76-years-old and a man 64-years-old who presented with nonspecific symptoms including chest pain, dyspnea, and cough. Clinical history did not disclose any pertinent history of previous malignancy. Diagnostic imaging showed the presence of a pleural-based mass in both patients and a thoracotomy with resection of the pleural mass was performed. Both tumors were described as solid, light tan, and with ill-defined borders. Histologically, both tumors showed similar histological features, namely the presence of a spindle cellular proliferation composed of elongated cells with fibrillary cytoplasm, oval nuclei, and conspicuous nucleoli. Mild to moderate cellular atypia was present, while mitotic figures ranged from 3 to 4 per 10 high power fields. Mature lymphocytes and plasma cells were also present dispersed throughout the tumor. Immunohistochemical stains in both cases show positive staining for CD21 and CD35 while focal staining was present for D2-40 and clusterin, while negative for other markers including keratin, desmin, S-100 protein, calretinin, and STAT-6. Clinical follow up shows that both patients have remained alive 12 and 14 months after initial diagnosis. The cases herein described represent an unusual occurrence of FDCS arising in the pleural surface and one that must be kept in mind when dealing with spindle cell tumors of the pleura.     

Minimal deviation endometrioid adenocarcinoma of cervix: a clinicopathological and immunohistochemical study of two cases

We describe the clinicopathological features of two cases of minimal deviation endometrioid adenocarcinoma of cervix. This is a rare tumour whose predominant pattern is one of bland endometrial-type glands infiltrating the cervical wall without a stromal response. Thus, it may be confused with benign conditions such as cervical endometriosis. The two cases demonstrate that this tumour may behave aggressively despite its bland appearances. An immunohistochemical study was performed and showed only focal reactivity of neoplastic glands for carcinoembryonic antigen, which would limit its diagnostic use in small biopsy specimens.