The immunohistochemical profile of atypical eosinophilic syncytial changes vs serous carcinoma

Susan L. Haley, Reenu K. Malhotra, Suimin Qiu, Mahmoud E. Eltorky

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Endometrial epithelial cytoplasmic change (EECC) is an adaptive cytoplasmic change commonly seen in the endometrium. Previously considered "metaplasia," EECC is now the preferred term because it offers a descriptive designation without implying a specific mechanism of development. There are 5 types of EECC: squamous, ciliated cell, eosinophilic, mucinous, and secretory (clear cell and hobmail cell) changes. Eosinophilic syncytial change (ESC) is a similar but unrelated degenerative change seen in endometrial breakdown. Some cases of ESC show atypical cytologic features that may resemble endometrial adenocarcinoma. Thirteen endometrial biopsy and curettage specimens with atypical ESCs (AESCs) were compared against 10 hysterectomy specimens with endometrial serous carcinoma. Clinical information and immunohistochemical staining profiles for markers phosphatase and tensin homologue deleted on chromosome 10 (PTEN), p53, and Ki-67 were evaluated in each case. All 13 cases of AESC (100%) showed moderate-to-strong staining for PTEN, whereas PTEN expression was absent in all endometrial serous carcinomas (P <.001). Seven cases of AESC (54%) showed focal, weak positivity for p53, whereas all cases of serous carcinoma (100%) showed strong staining (P <.001). The Ki-67 index was low (3%-15%) and found in only 3 cases in AESC (32%) but was high (60%-90%) in all cases of endometrial serous carcinoma (100%) (P <.001). Atypical ESC and serous carcinoma share several morphological features on hematoxylin and eosin-stained sections that may complicate accurate diagnosis. The PTEN, p53, and Ki-67 staining profile can effectively distinguish between AESC and malignancy in difficult cases, providing an invaluable tool for a challenging diagnostic dilemma.

Original languageEnglish (US)
Pages (from-to)402-406
Number of pages5
JournalAnnals of Diagnostic Pathology
Volume15
Issue number6
DOIs
StatePublished - Dec 2011

Fingerprint

Endometrial Neoplasms
Staining and Labeling
Carcinoma
Chromosomes, Human, Pair 10
Curettage
Metaplasia
Hematoxylin
Eosine Yellowish-(YS)
Endometrium
Hysterectomy
Phosphoric Monoester Hydrolases
Adenocarcinoma
Epithelial Cells
Biopsy
Neoplasms

Keywords

  • Atypical eosinophilic syncytial change
  • Endometrial epithelial cytoplasmic change
  • Endometrial metaplasia
  • Eosinophilic syncytial change
  • Ki-67
  • p53
  • PTEN

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

The immunohistochemical profile of atypical eosinophilic syncytial changes vs serous carcinoma. / Haley, Susan L.; Malhotra, Reenu K.; Qiu, Suimin; Eltorky, Mahmoud E.

In: Annals of Diagnostic Pathology, Vol. 15, No. 6, 12.2011, p. 402-406.

Research output: Contribution to journalArticle

Haley, Susan L. ; Malhotra, Reenu K. ; Qiu, Suimin ; Eltorky, Mahmoud E. / The immunohistochemical profile of atypical eosinophilic syncytial changes vs serous carcinoma. In: Annals of Diagnostic Pathology. 2011 ; Vol. 15, No. 6. pp. 402-406.
@article{8b709c00efd946148afea9fe2efaba3e,
title = "The immunohistochemical profile of atypical eosinophilic syncytial changes vs serous carcinoma",
abstract = "Endometrial epithelial cytoplasmic change (EECC) is an adaptive cytoplasmic change commonly seen in the endometrium. Previously considered {"}metaplasia,{"} EECC is now the preferred term because it offers a descriptive designation without implying a specific mechanism of development. There are 5 types of EECC: squamous, ciliated cell, eosinophilic, mucinous, and secretory (clear cell and hobmail cell) changes. Eosinophilic syncytial change (ESC) is a similar but unrelated degenerative change seen in endometrial breakdown. Some cases of ESC show atypical cytologic features that may resemble endometrial adenocarcinoma. Thirteen endometrial biopsy and curettage specimens with atypical ESCs (AESCs) were compared against 10 hysterectomy specimens with endometrial serous carcinoma. Clinical information and immunohistochemical staining profiles for markers phosphatase and tensin homologue deleted on chromosome 10 (PTEN), p53, and Ki-67 were evaluated in each case. All 13 cases of AESC (100{\%}) showed moderate-to-strong staining for PTEN, whereas PTEN expression was absent in all endometrial serous carcinomas (P <.001). Seven cases of AESC (54{\%}) showed focal, weak positivity for p53, whereas all cases of serous carcinoma (100{\%}) showed strong staining (P <.001). The Ki-67 index was low (3{\%}-15{\%}) and found in only 3 cases in AESC (32{\%}) but was high (60{\%}-90{\%}) in all cases of endometrial serous carcinoma (100{\%}) (P <.001). Atypical ESC and serous carcinoma share several morphological features on hematoxylin and eosin-stained sections that may complicate accurate diagnosis. The PTEN, p53, and Ki-67 staining profile can effectively distinguish between AESC and malignancy in difficult cases, providing an invaluable tool for a challenging diagnostic dilemma.",
keywords = "Atypical eosinophilic syncytial change, Endometrial epithelial cytoplasmic change, Endometrial metaplasia, Eosinophilic syncytial change, Ki-67, p53, PTEN",
author = "Haley, {Susan L.} and Malhotra, {Reenu K.} and Suimin Qiu and Eltorky, {Mahmoud E.}",
year = "2011",
month = "12",
doi = "10.1016/j.anndiagpath.2011.05.006",
language = "English (US)",
volume = "15",
pages = "402--406",
journal = "Annals of Diagnostic Pathology",
issn = "1092-9134",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - The immunohistochemical profile of atypical eosinophilic syncytial changes vs serous carcinoma

AU - Haley, Susan L.

AU - Malhotra, Reenu K.

AU - Qiu, Suimin

AU - Eltorky, Mahmoud E.

PY - 2011/12

Y1 - 2011/12

N2 - Endometrial epithelial cytoplasmic change (EECC) is an adaptive cytoplasmic change commonly seen in the endometrium. Previously considered "metaplasia," EECC is now the preferred term because it offers a descriptive designation without implying a specific mechanism of development. There are 5 types of EECC: squamous, ciliated cell, eosinophilic, mucinous, and secretory (clear cell and hobmail cell) changes. Eosinophilic syncytial change (ESC) is a similar but unrelated degenerative change seen in endometrial breakdown. Some cases of ESC show atypical cytologic features that may resemble endometrial adenocarcinoma. Thirteen endometrial biopsy and curettage specimens with atypical ESCs (AESCs) were compared against 10 hysterectomy specimens with endometrial serous carcinoma. Clinical information and immunohistochemical staining profiles for markers phosphatase and tensin homologue deleted on chromosome 10 (PTEN), p53, and Ki-67 were evaluated in each case. All 13 cases of AESC (100%) showed moderate-to-strong staining for PTEN, whereas PTEN expression was absent in all endometrial serous carcinomas (P <.001). Seven cases of AESC (54%) showed focal, weak positivity for p53, whereas all cases of serous carcinoma (100%) showed strong staining (P <.001). The Ki-67 index was low (3%-15%) and found in only 3 cases in AESC (32%) but was high (60%-90%) in all cases of endometrial serous carcinoma (100%) (P <.001). Atypical ESC and serous carcinoma share several morphological features on hematoxylin and eosin-stained sections that may complicate accurate diagnosis. The PTEN, p53, and Ki-67 staining profile can effectively distinguish between AESC and malignancy in difficult cases, providing an invaluable tool for a challenging diagnostic dilemma.

AB - Endometrial epithelial cytoplasmic change (EECC) is an adaptive cytoplasmic change commonly seen in the endometrium. Previously considered "metaplasia," EECC is now the preferred term because it offers a descriptive designation without implying a specific mechanism of development. There are 5 types of EECC: squamous, ciliated cell, eosinophilic, mucinous, and secretory (clear cell and hobmail cell) changes. Eosinophilic syncytial change (ESC) is a similar but unrelated degenerative change seen in endometrial breakdown. Some cases of ESC show atypical cytologic features that may resemble endometrial adenocarcinoma. Thirteen endometrial biopsy and curettage specimens with atypical ESCs (AESCs) were compared against 10 hysterectomy specimens with endometrial serous carcinoma. Clinical information and immunohistochemical staining profiles for markers phosphatase and tensin homologue deleted on chromosome 10 (PTEN), p53, and Ki-67 were evaluated in each case. All 13 cases of AESC (100%) showed moderate-to-strong staining for PTEN, whereas PTEN expression was absent in all endometrial serous carcinomas (P <.001). Seven cases of AESC (54%) showed focal, weak positivity for p53, whereas all cases of serous carcinoma (100%) showed strong staining (P <.001). The Ki-67 index was low (3%-15%) and found in only 3 cases in AESC (32%) but was high (60%-90%) in all cases of endometrial serous carcinoma (100%) (P <.001). Atypical ESC and serous carcinoma share several morphological features on hematoxylin and eosin-stained sections that may complicate accurate diagnosis. The PTEN, p53, and Ki-67 staining profile can effectively distinguish between AESC and malignancy in difficult cases, providing an invaluable tool for a challenging diagnostic dilemma.

KW - Atypical eosinophilic syncytial change

KW - Endometrial epithelial cytoplasmic change

KW - Endometrial metaplasia

KW - Eosinophilic syncytial change

KW - Ki-67

KW - p53

KW - PTEN

UR - http://www.scopus.com/inward/record.url?scp=81155133876&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=81155133876&partnerID=8YFLogxK

U2 - 10.1016/j.anndiagpath.2011.05.006

DO - 10.1016/j.anndiagpath.2011.05.006

M3 - Article

VL - 15

SP - 402

EP - 406

JO - Annals of Diagnostic Pathology

JF - Annals of Diagnostic Pathology

SN - 1092-9134

IS - 6

ER -