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Article: Endometrial tumors with yolk sac tumor-like morphologic patterns or immunophenotypes: an expanded appraisal

TitleEndometrial tumors with yolk sac tumor-like morphologic patterns or immunophenotypes: an expanded appraisal
Authors
Issue Date2019
PublisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/modpathol/
Citation
Modern Pathology, 2019, v. 32, p. 1847-1860 How to Cite?
AbstractUterine yolk sac tumors have gained increased recognition in recent years. The current study is a multi-faceted examination of yolk sac tumor-like phenotypes in endometrial tumors, based on an analysis of 3 groups of uterine tumors: Group 1: 9 endometrial tumors that had been classified as yolk sac tumor, or as having a yolk sac tumor component, were assessed with a 35-marker immunohistochemical panel, with the goal of defining their immunophenotypic spectrum; Group 2, comprised of 70 endometrial carcinomas of various histotypes, were analyzed for their expression of SALL4, Glypican-3, and AFP, to assess the specificity of these markers for yolk sac tumors relative to endometrial carcinomas; Group 3, comprised of 626 archived cases of endometrial carcinoma/carcinosarcoma, reviewed to define the frequency of yolk sac tumor-like morphology therein. Yolk sac tumor areas in the Group 1 cases were consistently immunoreactive for SALL4 and Glypican-3; variably positive for AFP (89%), Villin (89%), PLAP (78%), 34βE12 (67%), CAM 5.2 (62.5%), EMA (56%), CD117 (50%), p16 (50%), CDX2 (44%), p53 (44% aberrant), MOC31 (37.5%), CK7 (33%), GATA3 (33%), CK5 (25%), and PAX8 (11%); and were negative for CD30, Napsin A, OCT4, estrogen, androgen, and progesterone receptors. 29 (41%) of the 70 group-2 cases expressed at least one of the 3 markers, and 96% of the positive cases was a high-grade histotype. Glypican-3, SALL4, and AFP were positive in 30, 20, and 2.8% of group-2 cases respectively; however, co-expression of any 2, or all 3 markers was uncommon (<9 and 1.4% of cases respectively). Potential yolk sac tumor-like morphology was identified in 5 (0.8%) of 626 group-3 cases, and three were ultimately deemed to be true yolk sac tumor phenotypes based on their morphologic and immunophenotypic similarity to the group 1 cases. These findings highlight the broad immunophenotypic spectrum of uterine yolk sac tumors, the potential pitfalls associated with using immunophenotypes alone to define yolk sac tumor differentiation in endometrial carcinoma, and the utility and limitations of morphologic assessment to identify yolk sac tumors at this site.
Persistent Identifierhttp://hdl.handle.net/10722/274105
ISSN
2019 Impact Factor: 5.988
2015 SCImago Journal Rankings: 2.803
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorFadare, O-
dc.contributor.authorShaker, N-
dc.contributor.authorAlghamdi, A-
dc.contributor.authorGanesan, R-
dc.contributor.authorHanley, KZ-
dc.contributor.authorHoang, LN-
dc.contributor.authorHecht, JL-
dc.contributor.authorIp, PP-
dc.contributor.authorShaker, N-
dc.contributor.authorRoma, AA-
dc.contributor.authorParkash, V-
dc.contributor.authorAbubakr, H-
dc.date.accessioned2019-08-18T14:55:11Z-
dc.date.available2019-08-18T14:55:11Z-
dc.date.issued2019-
dc.identifier.citationModern Pathology, 2019, v. 32, p. 1847-1860-
dc.identifier.issn0893-3952-
dc.identifier.urihttp://hdl.handle.net/10722/274105-
dc.description.abstractUterine yolk sac tumors have gained increased recognition in recent years. The current study is a multi-faceted examination of yolk sac tumor-like phenotypes in endometrial tumors, based on an analysis of 3 groups of uterine tumors: Group 1: 9 endometrial tumors that had been classified as yolk sac tumor, or as having a yolk sac tumor component, were assessed with a 35-marker immunohistochemical panel, with the goal of defining their immunophenotypic spectrum; Group 2, comprised of 70 endometrial carcinomas of various histotypes, were analyzed for their expression of SALL4, Glypican-3, and AFP, to assess the specificity of these markers for yolk sac tumors relative to endometrial carcinomas; Group 3, comprised of 626 archived cases of endometrial carcinoma/carcinosarcoma, reviewed to define the frequency of yolk sac tumor-like morphology therein. Yolk sac tumor areas in the Group 1 cases were consistently immunoreactive for SALL4 and Glypican-3; variably positive for AFP (89%), Villin (89%), PLAP (78%), 34βE12 (67%), CAM 5.2 (62.5%), EMA (56%), CD117 (50%), p16 (50%), CDX2 (44%), p53 (44% aberrant), MOC31 (37.5%), CK7 (33%), GATA3 (33%), CK5 (25%), and PAX8 (11%); and were negative for CD30, Napsin A, OCT4, estrogen, androgen, and progesterone receptors. 29 (41%) of the 70 group-2 cases expressed at least one of the 3 markers, and 96% of the positive cases was a high-grade histotype. Glypican-3, SALL4, and AFP were positive in 30, 20, and 2.8% of group-2 cases respectively; however, co-expression of any 2, or all 3 markers was uncommon (<9 and 1.4% of cases respectively). Potential yolk sac tumor-like morphology was identified in 5 (0.8%) of 626 group-3 cases, and three were ultimately deemed to be true yolk sac tumor phenotypes based on their morphologic and immunophenotypic similarity to the group 1 cases. These findings highlight the broad immunophenotypic spectrum of uterine yolk sac tumors, the potential pitfalls associated with using immunophenotypes alone to define yolk sac tumor differentiation in endometrial carcinoma, and the utility and limitations of morphologic assessment to identify yolk sac tumors at this site.-
dc.languageeng-
dc.publisherNature Publishing Group. The Journal's web site is located at http://www.nature.com/modpathol/-
dc.relation.ispartofModern Pathology-
dc.rightsThis is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: https://doi.org/[insert DOI]-
dc.titleEndometrial tumors with yolk sac tumor-like morphologic patterns or immunophenotypes: an expanded appraisal-
dc.typeArticle-
dc.identifier.emailIp, PP: philipip@hku.hk-
dc.identifier.authorityIp, PP=rp01890-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1038/s41379-019-0341-6-
dc.identifier.pmid31375771-
dc.identifier.scopuseid_2-s2.0-85075703873-
dc.identifier.hkuros301793-
dc.identifier.volume32-
dc.identifier.spage1847-
dc.identifier.epage1860-
dc.identifier.isiWOS:000477423800001-
dc.publisher.placeUnited Kingdom-

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