Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
Cancer Cytopathol. 2019 Aug;127(8):521-528. doi: 10.1002/cncy.22160. Epub 2019 Jul 18.
Mesonephric adenocarcinomas are rare neoplasms which most commonly arise in the lateral cervix and vagina. Tumors with similar morphologic, immunophenotypic, and molecular characteristics recently have been described in the uterine corpus and ovary. Herein, the authors sought to characterize the cytomorphologic features of adenocarcinomas exhibiting mesonephric-like differentiation arising in the upper gynecologic tract.
Institutional databases were queried retrospectively for tumors of the upper gynecologic tract described as a "tumor of Wolffian origin" or "with mesonephric features" between 2007 and 2017. All available cytologic material was reviewed. Cytomorphologic characteristics were evaluated by 3 pathologists.
The current study cohort consisted of 8 cases taken from 7 patients. Primary sites included the ovary (3 cases); endometrium (4 cases); and pelvis, not otherwise specified (1 case). All cases demonstrated tight 3-dimensional clusters of overlapping cells. Additional architectural features included tubular (5 of 8 cases; 63%) and papillary (3 of 8 cases; 38%) formations. Cells were small with scant (7 of 8 cases; 88%) to moderate (1 of 8 cases; 12%) cytoplasm. Three of the 8 cases (38%) demonstrated extracellular hyaline globules. Nuclei were uniform in size (6 of 8 cases; 75%) or showed mild anisonucleosis (2 of 8 cases; 25%). Nuclear grooves and indentations were observed in all cases. Mitoses (5 of 8 cases; 63%) and apoptotic bodies (4 of 8 cases; 50%), when present, were rare. No necrosis was noted.
Adenocarcinomas exhibiting mesonephric-like differentiation show a monotonous population of small cells with scant to moderate cytoplasm and abundant nuclear grooves arranged in tight, overlapping, 3-dimensional clusters. Occasionally, papillary or tubular architecture, as well as extracellular hyaline globules, may be seen. These features should prompt further testing (eg, immunohistochemistry) to confirm the diagnosis and to exclude potential mimics.
中肾腺癌是一种罕见的肿瘤，最常见于宫颈和阴道的侧部。最近在子宫体和卵巢中描述了具有相似形态、免疫表型和分子特征的肿瘤。在此，作者试图描述在上生殖道中出现的具有中肾样分化的腺癌的细胞形态学特征。
回顾性地在 2007 年至 2017 年期间，通过机构数据库查询了被描述为“沃氏起源的肿瘤”或“具有中肾特征”的上生殖道肿瘤的病例。回顾了所有可用的细胞学材料。由 3 名病理学家评估细胞形态学特征。
本研究队列由 7 名患者的 8 例组成。原发部位包括卵巢（3 例）；子宫内膜（4 例）；和骨盆，未特指（1 例）。所有病例均显示紧密的三维重叠细胞簇。其他的结构特征包括管状（8 例中的 5 例；63%）和乳头状（8 例中的 3 例；38%）形成。细胞较小，细胞质稀少（8 例中的 7 例；88%）至中等（8 例中的 1 例；12%）。8 例中有 3 例（38%）显示细胞外透明小体。核大小均匀（8 例中的 6 例；75%）或轻度异型核（8 例中的 2 例；25%）。所有病例均可见核沟和切迹。有丝分裂（8 例中的 5 例；63%）和凋亡小体（8 例中的 4 例；50%），如果存在，也很少见。未见坏死。
具有中肾样分化的腺癌表现为小细胞的单调群体，细胞质稀少至中等，丰富的核沟排列在紧密、重叠的三维簇中。偶尔，可见乳头状或管状结构以及细胞外透明小体。这些特征应提示进一步的检查（例如免疫组织化学）以确认诊断并排除潜在的模拟物。
