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Pathology Feb 2018This article reviews the most relevant pathological and molecular features of ovarian tumours that are associated with endometriosis. Endometriosis is a common... (Review)
Review
This article reviews the most relevant pathological and molecular features of ovarian tumours that are associated with endometriosis. Endometriosis is a common condition, affecting 5-15% of all women, and it has been estimated that 0.5-1% of cases are complicated by neoplasia. The most common malignant tumours in this setting are endometrioid adenocarcinoma and clear cell adenocarcinoma, each accounting for approximately 10% of ovarian carcinomas in Western countries. A minority of cases are associated with Lynch syndrome. These carcinomas are often confined to the ovaries at presentation in which case they have relatively favourable outcomes. However, high-stage tumours, particularly clear cell carcinomas, generally have a poor prognosis and this partly reflects relative resistance to current treatment. Histological diagnosis is straightforward in the majority of cases but some variants, for example endometrioid carcinomas with sex cord-like appearances or oxyphil cells, may create diagnostic difficulty. Similarly, clear cell carcinomas can show a range of architectural and cytological patterns that overlap with other tumours, both primary and metastatic, involving the ovaries. Endometriosis-associated borderline tumours are less common, and they often show mixed patterns of differentiation (seromucinous tumours). Atypical endometriosis may represent an intermediate step in neoplastic progression and some of these lesions demonstrate immunohistological and molecular alterations similar to those observed in endometriosis-related tumours. ARID1A mutations are relatively common in all of these tumours, but each has additional characteristic molecular alterations which are likely to be of increasing clinical relevance as targeted therapies are developed. Less is known of the pathogenesis of rarer endometriosis-associated ovarian tumours including endometrioid stromal sarcoma, mesodermal (Müllerian) adenosarcoma, and carcinosarcoma. This article also briefly reviews the issue of synchronous endometrioid carcinomas of the endometrium and the ovary, including the most recent developments on pathogenesis.
Topics: Carcinoma; Endometriosis; Female; Humans; Ovarian Neoplasms
PubMed: 29241974
DOI: 10.1016/j.pathol.2017.10.006 -
Diagnostic Cytopathology Jun 2019Oncocytic and oncocytoid lesions represent a distinct subset of salivary gland lesions. True oncocytic lesions of the salivary gland are entirely composed of oncocytes.... (Review)
Review
Oncocytic and oncocytoid lesions represent a distinct subset of salivary gland lesions. True oncocytic lesions of the salivary gland are entirely composed of oncocytes. These are characterized by the presence of abundant eosinophilic granules due to the presence of abundant cytoplasmic mitochondria. Oncocytic lesions of the salivary gland include oncocytosis, oncocytoma, and oncocytic carcinoma. In addition to the true oncocytic lesion, there exists another group of salivary gland lesions, which demonstrate cells with abundant and occasionally granular cytoplasm. These are often termed as "oncocytoid" lesions. The recently proposed Milan System for reporting salivary gland cytology clearly states that fine-needle aspiration specimens representing oncocytic/oncocytoid lesions of salivary gland cannot effectively distinguish between a nonneoplastic lesion, benign and malignant neoplasms. Therefore, most lesions lacking classic cytomorphologic features will be classified under the umbrella diagnostic term of "Salivary Gland Neoplasm of Uncertain Malignant Potential" (SUMP). In this review, we discuss and illustrate key clinicopathologic and radiologic features that can help the practicing cytopathologist narrow down the differential and provide the best management based diagnosis.
Topics: Adenoma, Oxyphilic; Humans; Oxyphil Cells; Salivary Gland Neoplasms
PubMed: 30912629
DOI: 10.1002/dc.24175 -
Diagnostic Cytopathology Oct 2019Salivary glands located in the head and neck area are known to have different lesions with prominent oncocytic features. Fine needle aspiration is usually the initial... (Review)
Review
Salivary glands located in the head and neck area are known to have different lesions with prominent oncocytic features. Fine needle aspiration is usually the initial approach in the management of these lesions, whether they represent neoplastic or non-neoplastic processes. Owing to the limited material present upon cytopathologic examination, knowledge of variants and subtypes of various oncocytic lesions that can occur in this area is of major importance to provide the most accurate interpretation to the patients and clinicians. In this article, we selected rare lesions of the salivary glands that may exhibit oncocytic changes, and provided a brief discussion of each one of them, with emphasis on challenges in navigating the differential diagnosis that these cases may pose, from the cytopathology standpoint.
Topics: Carcinoma; Diagnosis, Differential; Humans; Oxyphil Cells; Salivary Gland Neoplasms
PubMed: 31397091
DOI: 10.1002/dc.24297 -
The American Journal of Dermatopathology Jun 1996Oncocytic neoplasms are most commonly of salivary, thyroid, parathyroid, and renal origin. Ocular adnexal tumors with oncocytosis have been reported. We report an...
Oncocytic neoplasms are most commonly of salivary, thyroid, parathyroid, and renal origin. Ocular adnexal tumors with oncocytosis have been reported. We report an unusual example of a skin adnexal tumor from the back. A tumor of uncertain duration was excised from a 54-year-old man. Light microscopy of hematoxylin and eosin-stained sections showed a large, fairly well-defined cystic nodular hidradenoma with areas infiltrated by numerous closely arranged, large, uniform, oval and polygonal cells with abundant intensely eosinophilic cytoplasm and small central, dark, round nuclei. No significant cellular atypia or mitotic figures were observed. The cytoplasm of these cells showed markedly positive immunostaining with monoclonal antimitochondrial antibodies. Electron microscopy demonstrated cytoplasm packed with mitochondria. Pure oncocytic tumors usually follow a benign clinical course. The focal presence of oncocytes in an otherwise histologically recognizable tumor apparently does not affect the prognosis, which in this case is the favorable outcome expected for a nodular hidradenoma.
Topics: Adenoma, Oxyphilic; Adenoma, Sweat Gland; Back; Cell Nucleus; Cytoplasm; Epithelium; Humans; Male; Middle Aged; Mitochondria; Sweat Gland Neoplasms; Treatment Outcome
PubMed: 8806968
DOI: 10.1097/00000372-199606000-00013 -
Human Pathology Apr 2009Oncocytic rectal carcinomas are rare and have only been documented sporadically. Oncocytes are encountered in 2 distinct settings: after preoperative chemoradiation...
Oncocytic rectal carcinomas are rare and have only been documented sporadically. Oncocytes are encountered in 2 distinct settings: after preoperative chemoradiation (commoner) and without antecedent chemoradiation (uncommon). The aim of this study was to ascertain the incidence and clinicopathologic features of rectal cancers with a significant (>25%) component of oncocytes in cases not receiving chemoradiation. Of 72 cases encountered over the study period, 8 fulfilled the criteria as oncocytes. These tumors, except for the cellular component of oncocytes, were similar to conventional adenocarcinomas pathologically and immunophenotypically. Cells with eosinophilic cytoplasm are commonly seen in rectal adenocarcinomas, and they should be separated from oncocytic examples. True oncocytes may be seen in conventional adenocarcinomas as individual cells or glands, especially at the infiltrating edge of the tumor. All 8 cases appeared to have behaved aggressively with rapid local and/or distant spread over a short duration.
Topics: Adenocarcinoma; Aged; Aged, 80 and over; Female; Humans; Immunohistochemistry; Male; Middle Aged; Oxyphil Cells; Rectal Neoplasms
PubMed: 19144383
DOI: 10.1016/j.humpath.2008.10.005 -
Pathology Feb 2021
Review
Topics: Adenocarcinoma; Biomarkers, Tumor; Diagnosis, Differential; Humans; Oxyphil Cells; Parietal Cells, Gastric; Stomach Neoplasms
PubMed: 32981699
DOI: 10.1016/j.pathol.2020.06.023 -
The American Journal of Surgical... May 1998Oncocytic neoplasms of the adrenal gland are rare. We describe the clinicopathologic and immunohistochemical findings of seven oncocytic adrenocortical neoplasms, five... (Review)
Review
Oncocytic neoplasms of the adrenal gland are rare. We describe the clinicopathologic and immunohistochemical findings of seven oncocytic adrenocortical neoplasms, five oncocytomas, and two oncocytic neoplasms of uncertain malignant potential. Three tumors were studied using electron microscopy. These neoplasms occurred in five women and two men (median age, 55 years) with no clinical evidence that the neoplasms were functional. The size of the neoplasms varied from 5.0 cm to 13.5 cm. Histologically, each neoplasm was composed exclusively of oncocytes. The oncocytomas had very low or absent mitotic activity and no evidence of necrosis. The two oncocytic neoplasms of uncertain malignant potential had increased mitotic activity and necrosis but no evidence of invasion or metastases. Nuclear atypia, either focal or generalized, was found in all neoplasms. Immunohistochemical studies performed using fixed, paraffin-embedded sections showed strong reactivity with the mitochondrial antibody mES-13 in all neoplasms. Four of five oncocytomas and one oncocytic neoplasm of uncertain malignant potential expressed keratin, predominantly keratin 18, as shown using the CAM 5.2 and AE3 antibodies. Two neuroendocrine-associated markers, neuron specific enolase and synaptophysin, were positive in seven and five neoplasms, respectively. However, all neoplasms were negative for the other neuroendocrine markers tested, including chromogranin A, tyrosine hydroxylase, and dopamine beta-hydroxylase, as well as for epithelial membrane antigen, S100, and p53. Using the MIB-1 (Ki-67) antibody, proliferative activity was increased in both oncocytic neoplasms of uncertain malignant potential. All six patients with available clinical follow-up data are alive without evidence disease, although the follow-up interval is relatively short (< 2 years) for the two patients with oncocytic neoplasms of uncertain malignant potential. We conclude that oncocytic adrenocortical neoplasms are nonfunctional tumors that can become large before they are detected by radiologic studies. The majority of neoplasms are benign and should not be misdiagnosed as carcinoma.
Topics: Adenoma, Oxyphilic; Adrenal Cortex Neoplasms; Adult; Aged; Antigens, Nuclear; DNA; Female; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Male; Microscopy, Electron; Middle Aged; Nuclear Proteins; Phosphopyruvate Hydratase; Synaptophysin
PubMed: 9591731
DOI: 10.1097/00000478-199805000-00012 -
Applied Immunohistochemistry &... Oct 2022Oncocytic histologic features can be seen in a variety of salivary gland carcinomas. We performed a comprehensive molecular profiling of 15 salivary gland malignancies...
Oncocytic histologic features can be seen in a variety of salivary gland carcinomas. We performed a comprehensive molecular profiling of 15 salivary gland malignancies with oncocytic features (diagnosed as oncocytic carcinoma, carcinoma NOS with oncocytic features, or salivary duct carcinoma with oncocytic features). We reveal multiple novel molecular alterations that have not been previously described in other salivary gland malignancies, including, but not limited to, KEL amplification (13.3%, 2/15), PARP1 amplification (13.3%, 2/15), and EPHB4 amplification (13.3%, 2/15). Alterations in KMT2C (13.3%, 2/15), ERBB3 (13.3%, 2/15), CTNNA1 (13.3%, 2/15), and SMAD4 (20%, 3/15) were also found in this series and have been reported in other salivary gland malignancies. Alterations that have been reported in salivary duct carcinoma were also identified, including TP53 (40%, 6/15) , ERBB2 mutations (13.3%, 2/15) , ERBB2 amplification (13.3%, 2/15), PIK3CA (26.7%, 4/15) , PTEN (20%, 3/15), BRCA2 (20%, 3/15), BRAF (20%, 3/15), CDKN2A/B (20%, 3/15), CDH1 (13.3%, 2/15), and HRAS (13.3%, 2/15). Oncocytic salivary gland malignancies are a molecularly heterogenous group of tumors with partial overlap with salivary duct carcinoma subtypes.
Topics: Carcinoma; Carcinoma, Ductal; Class I Phosphatidylinositol 3-Kinases; Humans; Oxyphil Cells; Proto-Oncogene Proteins B-raf; Salivary Gland Neoplasms
PubMed: 35876752
DOI: 10.1097/PAI.0000000000001048 -
Applied Immunohistochemistry &... 2019It is a diagnostic challenge to differentiate benign and malignant thyroid neoplasms made up of Hürthle (or oncocytic) cells on cytologic material. They are large,... (Review)
Review
It is a diagnostic challenge to differentiate benign and malignant thyroid neoplasms made up of Hürthle (or oncocytic) cells on cytologic material. They are large, polygonal cells with marked eosinophilic, granular cytoplasm reflective of overly abundant mitochondria. These cells commonly occur in nodular goiters and dominant adenomatous or hyperplastic nodules though they may also be the predominant component of neoplastic lesions. There are significant controversies concerning the optimal management of patients with oncocytic cell carcinoma. This review provides an overview of the most significant studies addressing the distinction between benign and malignant Hürthle cell lesions on cytology and histology.
Topics: Adenocarcinoma; Adenoma, Oxyphilic; Diagnosis, Differential; Goiter, Nodular; Humans; Hyperplasia; Neoplasms; Oxyphil Cells; Thyroid Gland; Thyroid Neoplasms
PubMed: 30358610
DOI: 10.1097/PAI.0000000000000713 -
Acta Pathologica Japonica May 1992Among well differentiated thyroid tumors, oncocytic neoplasms feature a distinctive set of clinical, morphologic and biologic characteristics, some of which have been a... (Review)
Review
Among well differentiated thyroid tumors, oncocytic neoplasms feature a distinctive set of clinical, morphologic and biologic characteristics, some of which have been a matter of controversy. The world literature on this subject has been reviewed to show that: 1) Morphology accurately predicts the behavior of Hürthle cell tumors assuming that the specimen has been adequately sampled; 2) Capsular and/or vascular invasion is the sine qua non condition for a diagnosis of malignancy; 3) "Indeterminate" or "possibly malignant" categories are useless because in the absence of invasion these neoplasms almost invariably behave in a benign fashion; 4) Among cases histologically classified as malignant, a clinically aggressive behavior is to be expected in a high percentage of cases; 5) Size alone cannot be used as a criterion of malignancy; 6) Less than total thyroidectomy provides an adequate treatment for histologically benign tumors; aggressive surgical procedures (i.e. total thyroidectomy) do not diminish the incidence of metastasis; 7) Analysis of DNA content may be helpful in defining subsets of patients with Hürthle cell carcinomas having a particularly poor prognosis; 8) Mitochondrial and/or nuclear DNA abnormalities probably play an important role in the cellular alterations which characterize the phenotype of oncocytes.
Topics: Adenoma; Carcinoma; History, 19th Century; History, 20th Century; Humans; Terminology as Topic; Thyroid Neoplasms
PubMed: 1636432
DOI: 10.1111/j.1440-1827.1992.tb02879.x