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发表于 2019-2-10 13:04:54
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Abstract: Mesonephric carcinomas of the gynecologic tract are
neoplasms that are often under-recognized due to their varied
morphologic appearances. Recently, GATA3 and TTF1 have
been reported to be useful immunohistochemical markers for
distinguishing mesonephric carcinomas from its morphologic
mimics. Herein, we compared the performance of GATA3 and
TTF1 to the traditional markers used for mesonephric carcinomas,
CD10 and calretinin. We studied 694 cases: 8 mesonephric
carcinomas (7 cervical [includes 3 mesonephric carcinosarcomas],
1 vaginal), 5 mesonephric-like carcinomas (4 uterine corpus, 1
ovarian), 585 endometrial adenocarcinomas, and 96 cervical
adenocarcinomas. Mesonephric-like carcinomas were defined as
tumors exhibiting the classic morphologic features of mesonephric
carcinoma, but occurring outside of the cervix and without convincing
mesonephric remnants. GATA3 had the highest sensitivity
and specificity (91% and 94%) compared with TTF1 (45% and
99%), CD10 (73% and 83%), and calretinin (36% and 89%). GATA3,
however, also stained a substantial number of uterine carcinosarcomas
(23/113, 20%). TTF1 was positive in 5/5 (100%)
mesonephric-like carcinomas and only 1/8 (13%) mesonephric carcinomas.
In 4/6 (67%) TTF1 positive cases, GATA3 exhibited an
inverse staining pattern with TTF1. In summary, GATA3 was the
best overall marker for mesonephric and mesonephric-like carcinomas,
but cannot be used to distinguish mesonephric carcinosarcomas
from Müllerian carcinosarcomas. The inverse staining
pattern between GATA3 and TTF1, suggests that TTF1 may be
useful when GATA3 is negative in small biopsies where mesonephric
or mesonephric-like carcinoma is suspected. The greater
TTF1 positivity in mesonephric-like carcinomas suggests they may
be biologically different from prototypical mesonephric carcinomas.
Key Words: mesonephric carcinoma, mesonephric-like carcinoma,
mesonephric carcinosarcoma, diagnosis, histology, immunohistochemistry,
GATA3, TTF1, CD10, calretinin
(Am J Surg Pathol 2018;42:1596–1606)
Mesonephric carcinomas are rare non–human papil |
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