Hysterectomy in a middle aged woman..section from the cervix.
Too far to diagnose? Any guesses?
#gynpath
@levitan_daniel @UJoneja @natzpat @SheilaSegura3 @KayParkMD @Teclis82
Too far to diagnose? Any guesses?
#gynpath
@levitan_daniel @UJoneja @natzpat @SheilaSegura3 @KayParkMD @Teclis82
Thank you all for engaging!
@UJoneja and @AMALHAB33821456, you are absolutely right...This is indeed a invasive stratified mucin producing carcinoma (ISMC) ! Check out the stains and additional images below
@MarcAnthony_Rod @MarcosLepeMD
@UJoneja and @AMALHAB33821456, you are absolutely right...This is indeed a invasive stratified mucin producing carcinoma (ISMC) ! Check out the stains and additional images below
@MarcAnthony_Rod @MarcosLepeMD
This lesion had a deceptive squamo-transtional look on low power..some areas showed well developed stratified mucin though...on closer look, almost all of this tumor has mucin, though not very conspicuous.
A comp of glandular differentiation (AIS) & HSIL also present
#gynpath
A comp of glandular differentiation (AIS) & HSIL also present
#gynpath
The expansile, deep stromal involvement with mild desmoplasia at the invasive front prompted a diagnosis of invasive carcinoma (ISMC)
Mucin stain shows stratified mucin in almost all the lesion and p16 nicely highlights the cytoplasmic holes giving it a sieve-like look
#gynpath
Mucin stain shows stratified mucin in almost all the lesion and p16 nicely highlights the cytoplasmic holes giving it a sieve-like look
#gynpath
SMILE (described in 2000) – unusual variant of endocx AIS
Composed of - HSIL-like epithelium
- w/ conspicuous mucin in mid & lower 3rd of the epithelium
Mucin can be present as vacuoles or mild cytoplasmic clearing.
HPV related
May have asso. AIS/HSIL
pubmed.ncbi.nlm.nih.gov/11023104/
Composed of - HSIL-like epithelium
- w/ conspicuous mucin in mid & lower 3rd of the epithelium
Mucin can be present as vacuoles or mild cytoplasmic clearing.
HPV related
May have asso. AIS/HSIL
pubmed.ncbi.nlm.nih.gov/11023104/
Lastra et al defined invasive carcinoma with features of SMILE --> invasive stratified mucin producing carcinoma (i-SMILE/ISMC)
Criteria - architectural complexity + desmoplastic stromal reaction >> SIL
OR infiltrative or destructive growth pattern
pubmed.ncbi.nlm.nih.gov/26523540/
Criteria - architectural complexity + desmoplastic stromal reaction >> SIL
OR infiltrative or destructive growth pattern
pubmed.ncbi.nlm.nih.gov/26523540/
Morphologic spect of ISMC –
Architectural – insular, glandular, solid, papillary, trabecular, micropapillary, single cell
Cytologic – eosinophilic, clearing, histiocytoid, glassy cell, signey like
Others bizzare nuclear atypia, squamoid diff, mucin pools, and hyaline globules
Architectural – insular, glandular, solid, papillary, trabecular, micropapillary, single cell
Cytologic – eosinophilic, clearing, histiocytoid, glassy cell, signey like
Others bizzare nuclear atypia, squamoid diff, mucin pools, and hyaline globules
Lastly, other components may be present- usual adenoca (UEA), AIS, SMILE, high grade NEC
Potentially more aggressive > UEA
Higher stage at presentation
More destructive stromal invasion (Pat C)
pubmed.ncbi.nlm.nih.gov/32235154/
Potentially more aggressive > UEA
Higher stage at presentation
More destructive stromal invasion (Pat C)
pubmed.ncbi.nlm.nih.gov/32235154/
• • •
Missing some Tweet in this thread? You can try to
force a refresh
