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Morules with optically clear nuclei in ovarian borderline endometrioid tumor
Authors:Li Chiun Chei  Hirokawa Mitsuyoshi  Qian Zhirong  Fujii Yoshiyuki  Ino Hiroyasu  Wakatsuki Shingo  Horiguchi Hidehisa  Kagawa Noriko  Sano Toshiaki
Institution:Department of Pathology, Veterans General Hospital-Taipei and National Yang-Ming University, Taiwan.
Abstract:Optically clear nuclei (OCN) have been observed in morules of some neoplasms and in some conditions unrelated to the development of the morules. We first report a case of ovarian borderline endometrioid tumor (BET) showing the morules associated with OCN. The patient was a 47-year-old premenopausal woman with a left ovarian cystic tumor, atypical endometrial hyperplasia, and elevated serum levels of FSH, LH, estradiol, and CA 125. The resected ovarian tumor measured 6 cm in diameter, and showed a papillary growth. Histologically, the ovarian tumor was consistent with BET, and the morules with OCN were scattered. Immunohistochemically, OCN were proven to be rich in biotin. An aberrant nuclear expression of beta-catenin was observed in both the tumor cells and the morular cells. Our case may suggest the possibility that the appearance of OCN with or without morules in ovarian tumors is related to endometrioid differentiation of the tumor cells, and should be recognized as a diagnostic clue of ovarian endometrioid tumors. Although female sex hormones have been reported to play a role in the occurrence of OCN, the participation of beta-catenin mutation has also been suggested.
Keywords:Ovary  borderline endometrioid tumor  morules  optically clear nuclei  biotin  immunohistochemistry
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