Serous tubal intraepithelial carcinoma

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Serous tubal intraepithelial carcinoma
Diagnosis in short

Micrograph showing serous tubal intraepithelial carcinoma. H&E stain.
LM three of the following five: (1) atypical chromatin pattern, (2) nuclear enlargement, (3) nuclear pleomorphism, (4) nuclear moulding, (5) loss of nuclear polarity or epithelial stratification
IHC p16 +ve, p53 +ve, Ki-67 increased
Molecular BRCA1 mutation or BRCA2 mutation
Gross not apparent on gross
Site fallopian tubes
Symptoms none
Prevalence uncommon

Serous tubal intraepithelial carcinoma, abbreviated STIC[1] (pronounced stick), is considered to be the precursor of serous carcinoma.

It is also known as tubal intraepithelial carcinoma.

General

  • Considered the precursor lesion for tubal serous carcinoma.[2]
  • Seen in ~6% of prophylactic salpingo-oophorectomies in BRCA-mutation carriers.[3]

Gross

  • Not apparent on gross.
  • Usually at the fimbriated end of the tube.

Microscopic

Features:[4]

  • Discrete papillary growth - low power.
  • Formal criteria - need 3 or more:
    1. Atypical chromatin pattern.
    2. Nuclear enlargement.
    3. Nuclear pleomorphism.
    4. Nuclear moulding.
    5. Loss of nuclear polarity or epithelial stratification.

Notes:

  • At low power STIC is usually tall cells that are too blue.
  • Cilia suggest benign.

DDx:

  • Atypical tubal lesion (STIL or tubal intraepithelial lesions in transition (TILT)[5]) - lack proliferation.[citation needed]

Images

  • STIC - extremely low mag. (WC)

  • STIC - very low mag. (WC)

  • STIC - low mag. (WC)

  • STIC - intermed. mag. (WC)

  • STIC - intermed. mag. (WC)

  • STIC - high mag. (WC)

  • STIC - high mag. (WC)

  • STIC - very high mag. (WC)

www

IHC

Features:[1]

  • p53 +ve.
  • Ki-67 increased ~10%. (???)
  • p16 +ve.[4]

Images

  • STIC - p16 - very low mag. (WC)

  • STIC - p16 - low mag. (WC)

  • STIC - p16 - intermed. mag. (WC)

  • STIC - p16 - high mag. (WC)

  • STIC - p53 - very low mag. (WC)

  • STIC - p53 - low mag. (WC)

  • STIC - p53 - intermed. mag. (WC)

  • STIC - p53 - high mag. (WC)

  • STIC - Ki-67 - very low mag. (WC)

  • STIC - Ki-67 - low mag. (WC)

  • STIC - Ki-67 - high mag. (WC)

See also

References

  1. ↑ 1.0 1.1 Visvanathan, K.; Vang, R.; Shaw, P.; Gross, A.; Soslow, R.; Parkash, V.; Shih, IeM.; Kurman, RJ. (Dec 2011). "Diagnosis of serous tubal intraepithelial carcinoma based on morphologic and immunohistochemical features: a reproducibility study.". Am J Surg Pathol 35 (12): 1766-75. doi:10.1097/PAS.0b013e31822f58bc. PMID 21989347.
  2. ↑ Lee, Y.; Miron, A.; Drapkin, R.; Nucci, MR.; Medeiros, F.; Saleemuddin, A.; Garber, J.; Birch, C. et al. (Jan 2007). "A candidate precursor to serous carcinoma that originates in the distal fallopian tube.". J Pathol 211 (1): 26-35. doi:10.1002/path.2091. PMID 17117391.
  3. ↑ Mingels MJ, Roelofsen T, van der Laak JA, et al. (October 2012). "Tubal epithelial lesions in salpingo-oophorectomy specimens of BRCA-mutation carriers and controls". Gynecol. Oncol. 127 (1): 88–93. doi:10.1016/j.ygyno.2012.06.015. PMID 22710074.
  4. ↑ 4.0 4.1 4.2 Sehdev, AS.; Kurman, RJ.; Kuhn, E.; Shih, IeM. (Jun 2010). "Serous tubal intraepithelial carcinoma upregulates markers associated with high-grade serous carcinomas including Rsf-1 (HBXAP), cyclin E and fatty acid synthase.". Mod Pathol 23 (6): 844-55. doi:10.1038/modpathol.2010.60. PMID 20228782.
  5. ↑ Nishida N, Murakami F, Higaki K (June 2016). "Detection of serous precursor lesions in resected fallopian tubes from patients with benign diseases and a relatively low risk for ovarian cancer". Pathol Int 66 (6): 337–42. doi:10.1111/pin.12419. PMID 27250113.
  6. ↑ 6.0 6.1 6.2 Kurman, RJ.; Shih, IeM. (Jul 2011). "Molecular pathogenesis and extraovarian origin of epithelial ovarian cancer--shifting the paradigm.". Hum Pathol 42 (7): 918-31. doi:10.1016/j.humpath.2011.03.003. PMID 21683865.
  7. ↑ Gross, AL.; Kurman, RJ.; Vang, R.; Shih, IeM.; Visvanathan, K. (2010). "Precursor lesions of high-grade serous ovarian carcinoma: morphological and molecular characteristics.". J Oncol 2010: 126295. doi:10.1155/2010/126295. PMID 20445756.
  8. ↑ URL: http://www.ovariancancerprevention.org/?page_id=191. Accessed on: 13 May 2014.

External links

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