Pathology Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy.
Pathology Unit, Department of Advanced Biomedical Sciences, Federico II University of Naples, Naples, Italy.
Virchows Arch. 2023 Mar;482(3):635-640. doi: 10.1007/s00428-022-03411-7. Epub 2022 Oct 7.
Herein, we present a clinicopathological and molecular analysis of four cases of endometrial carcinoma (EC) diffusely exhibiting dyshesive cells with wide eosinophilic and vacuolated cytoplasm (histiocyte-like tumor cells, HLTCs). We compared these HLTCs to similar cells found in microcystic, elongated and fragmented (MELF) pattern (n = 20) or after neoadjuvant chemotherapy (NAC) (n = 5). The four cases were endometrioid, serous, clear cell, and gastric-type; all were at FIGO stage ≥ III. HLTCs showed an epithelial Müllerian phenotype and at least focal CK20, HNF1β, and CK5/6 expression, with aberrant e-cadherin and β-catenin expression; two cases were MMR-deficient, and one was p53-abnormal; all were POLE wild type. MELF-associated and NAC-associated HLTCs showed similar morphological/immunophenotypical features. However, MELF-associated HLTCs were mainly intraglandular and inflammation-associated, did not form a distinct tumor component, and showed no relationship with lymph node metastases. In conclusion, different histotypes of EC may show a prominent HLTC component, which shows peculiar morphological/immunophenotypical features and appears associated with aggressive behavior.
在此，我们报告了 4 例弥漫性表现为黏附性差、胞质宽大嗜酸性和空泡状（组织细胞样肿瘤细胞，HLTCs）的子宫内膜癌（EC）的临床病理和分子分析。我们将这些 HLTCs 与微囊状、拉长和碎裂（MELF）模式（n=20）或新辅助化疗（NAC）后（n=5）发现的类似细胞进行了比较。这 4 例均为子宫内膜样、浆液性、透明细胞和胃型，FIGO 分期均≥III 期。HLTCs 表现出上皮 Müllerian 表型，至少局灶性 CK20、HNF1β 和 CK5/6 表达，存在异常的 E-钙黏蛋白和β-连环蛋白表达；2 例存在 MMR 缺陷，1 例存在 p53 异常；所有病例均为 POLE 野生型。MELF 相关和 NAC 相关的 HLTCs 具有相似的形态/免疫表型特征。然而，MELF 相关的 HLTCs 主要位于腺体内部，与炎症相关，不形成明显的肿瘤成分，与淋巴结转移无关。总之，不同组织学类型的 EC 可能表现出突出的 HLTC 成分，其具有特殊的形态/免疫表型特征，并与侵袭性行为有关。
