Department of Pathology, King Edward Memorial Hospital, Perth, WA, Australia.
School for Women's and Infants' Health, University of Western Australia, Perth, WA, Australia.
Histopathology. 2018 Mar;72(4):626-633. doi: 10.1111/his.13419. Epub 2017 Dec 14.
Micropapillary carcinomas, or carcinomas with a micropapillary component, are well recognised in the breast and other anatomical sites. However, they have seldom been described in the cervix. In this article, we present a clinicopathological analysis of eight cervical tumours that showed at least a focal (≥5%) component of micropapillary carcinoma.
The study group comprised eight cervical carcinomas (four adenocarcinomas and four adenosquamous carcinomas) with a micropapillary component. The median patient age was 41.5 years (range 27-65 years). At presentation, five patients were stage IB, two were stage IIB, and one was stage IV. The micropapillary component accounted for ≤25% of the tumour on initial biopsy or resection specimens in all but one case. Immunohistochemistry showed 'inside-out' (reverse polarity) mucin 1 staining along the cell membrane abutting the stroma. Four patients developed metastasis, all of whom showed a pure micropapillary pattern; this led to a misdiagnosis of an apparently independent peritoneal serous carcinoma in one case. All tumours showed diffuse p16 expression, and all three cases that were tested were positive for human papillomavirus (HPV) 18. Three of the six patients with at least 12 months of follow-up died of disease, and one is alive with distant metastasis.
Usual-type (HPV-related) cervical carcinomas may show micropapillary differentiation, usually as a focal finding, and the cells show reverse polarity like similar tumours arising in other sites. Micropapillary cervical carcinoma appears to be a clinically aggressive malignancy, although this needs to be confirmed in larger studies.
微乳头癌或具有微乳头成分的癌在乳腺和其他解剖部位已得到广泛认识。然而，它们在宫颈中很少被描述。在本文中，我们对 8 例至少具有微乳头癌局灶性（≥5%）成分的宫颈肿瘤进行了临床病理分析。
研究组包括 8 例具有微乳头成分的宫颈癌（4 例腺癌和 4 例腺鳞癌）。中位患者年龄为 41.5 岁（范围 27-65 岁）。就诊时，5 例患者为 IB 期，2 例为 IIB 期，1 例为 IV 期。除 1 例外，微乳头成分在初始活检或切除标本中占肿瘤的比例≤25%。免疫组化显示细胞膜与基质相邻处的 MUC1 染色呈“内翻”（反向极性）。4 例患者发生转移，均表现为纯微乳头模式；这导致 1 例误诊为明显独立的腹膜浆液性癌。所有肿瘤均表现出弥漫性 p16 表达，且 3 例经检测的病例均为 HPV18 阳性。在至少 12 个月随访的 6 例患者中，有 3 例死亡，1 例仍存活且有远处转移。
普通型（HPV 相关）宫颈癌可能出现微乳头分化，通常为局灶性表现，且细胞表现出与其他部位类似肿瘤相同的反向极性。微乳头宫颈癌似乎是一种具有临床侵袭性的恶性肿瘤，但这需要在更大的研究中证实。
