Category Archives: Gynecological

Gynecological, Uterus

FIGO Grading

The International Federation of Gynecology and Obstetrics (FIGO) grading system for endometrial endometrioid carcinoma:

  • FIGO Grade 1:  <=5% solid, non-glandular, non-squamous growth
  • FIGO Grade 2:  6-50% solid, non-glandular, non-squamous growth
  • FIGO Grade 3:  >50% solid, non-glandular, non-squamous growth

Marked cytologic atypia increases the grade by 1.

FIGO Grading is only performed on endometrioid and mucinous adenocarinomas.  Other tumor subtypes (clear cell, serous, carcinomasarcomas) carry their own associated grade.  Mucinous adenocarcinomas are considered to be closely related to endometrioid carcinomas.

References

  1. Soslow RA, Tornos C, Park KJ, Malpica A, Matias-Guiu X, Oliva E, et al. Endometrial Carcinoma Diagnosis: Use of FIGO Grading and Genomic Subcategories in Clinical Practice: Recommendations of the International Society of Gynecological Pathologists. Int J Gynecol Pathol. 2019;38 Suppl 1: S64–S74. doi:10.1097/PGP.0000000000000518
N - Z Antibodies, Cervix, Head & Neck

p16

p16 is a marker primary used as a surrogate marker for high risk HPV infection.  The physiologic role of p16 when it is expressed leads to cell cycle arrest.  Normal levels are below the threshold for detection by immunohistochemical methods (IHC).  Sometimes occasional non-proliferating epithelial cells may express p16 by IHC (these cells are usually in the upper aspects of the stratified epithelium.

Continue reading p16 →

Organ Systems, Gynecological, Cervix, Uterus, IHC Panels

Endometrial vs. Endocervical Adenocarcinoma

Endocervical vs. Endometrial Adenocarcinoma
Endocervical and endometrial adenocarcinomas may be morphologically indistinguishable morphologically.  The question often comes up as to whether a case represents an endometrial adenocarcinoma involving the cervix, or and endocervical adenocarcinoma involving the endometrium.  The following antibodies may be helpful in such circumstances:
 
 
Endocervical
Adenocarcinoma
Endometrial
Adenocarcinoma
Negative (7-8%+)
Positive (70-93%)
Positive (65-95%)
Usually Negative
Negative (4-20%+, 38% weak)
Strong Positive (67-90%)
Strong & Diffuse Positive (90-100%)
Patchy Positive cells (~35%)
HPV
Positive (67%)
Negative
References
AJSP 2002;26:998
 
“Endocervical vs. Endometrial Adenocarcinoma:  Update on Useful Immunohistochemical Markers.”  RT Miller,The Focus ProPath Immunohistochemistry.”   April 2003.
Organ Systems, Gynecological, Cervix

Cervix – HGSIL

High-Grade Squamous Intraepithelial Lesions
Strong diffuse cytoplasmic and nuclear positivity in the vast majority of cells.
Markedly increased proliferation indue with positive staining occurring in the upper half of the epithelium (occasionally extending to the epithelial surface.
References

Matt Quick, MD (personal communication)

Organ Systems, Gynecological, Uterus

Endometrial Adenocarcinoma

Endocervical vs. Endometrial Adenocarcinoma
Endocervical and endometrial adenocarcinomas may be morphologically indistinguishable morphologically.  The question often comes up as to whether a case represents an endometrial adenocarcinoma involving the cervix, or and endocervical adenocarcinoma involving the endometrium.  The following antibodies may be helpful in such circumstances:
 
 
Endocervical
Adenocarcinoma
Endometrial
Adenocarcinoma
Negative (7-8%+)
Positive (70-93%)
Positive (65-95%)
Usually Negative
Negative (4-20%+, 38% weak)
Strong Positive (67-90%)
Strong & Diffuse Positive (90-100%)
Patchy Positive cells (~35%)
HPV
Positive (67%)
Negative
References
AJSP 2002;26:998
 
“Endocervical vs. Endometrial Adenocarcinoma:  Update on Useful Immunohistochemical Markers.”  RT Miller,The Focus ProPath Immunohistochemistry.”   April 2003.