TY - JOUR
T1 - Immunophenotypic alteration of the stromal component in minimal deviation adenocarcinoma ('adenoma malignum') and endocervical glandular hyperplasia
T2 - A study using oestrogen receptor and α-smooth muscle actin double immunostaining
AU - Mikami, Y.
AU - Kiyokawa, T.
AU - Moriya, T.
AU - Sasano, H.
PY - 2005/2
Y1 - 2005/2
N2 - Aims: To define the phenotypic alteration of the stromal component in association with destructive invasion which is a crucial feature in distinguishing minimal deviation adenocarcinoma (MDA) from benign endocervical glandular lesions. Methods and results: We studied endocervical glandular hyperplasias including non-specific-type (NEGH) (n = 3) and lobular-type (LEGH) (n = 8), and minimal deviation adenocarcinoma (MDA) (n = 11), well-differentiated endocervical adenocarcinoma of usual-type (WDA) (n = 11), and adenocarcinoma in situ (AIS) (n = 6) of the cervix, by double immunostaining for oestrogen receptor (ER) and α-smooth muscle actin (α-SMA) using peroxidase- and alkaline phosphatase-polymer methods, respectively. Glands in NEGH invariably showed nuclear staining for ER, with surrounding ER+/α-SMA- stromal cells, whereas LEGH also harboured ER+/α-SMA- spindle cells, but lacked nuclear staining for ER in constituent glands. In contrast, both WDA and MDA displayed accompanying stroma rich in α-SMA+ spindle cells in close vicinity to the infiltrating neoplastic glands, with only occasional weakly ER+ stromal cells. WDA tended to contain more α-SMA+ cells. The distribution of α-SMA+ cells was periglandular (6/11), patchy (6/11), and/or diffuse (4/11) in WDA, whereas in MDA it was periglandular (11/11) and/or patchy (8/11). AIS was surrounded by ER+/α-SMA- stromal cells. All cases of WDA, MDA, and AIS lacked nuclear staining for ER. Conclusions: Both MDA and WDA can be distinguished from LEGH and NEGH by identifying surrounding α-SMA+ stromal cells and the absence or decreased number of ER+ cells, possibly as a result of the desmoplastic reaction with myofibroblasts replacing pre-existing ER+ stromal cells. In particular, the periglandular distribution of these α-SMA+ stromal cells can be a clue suggesting destructive stromal invasion in cases of MDA, although occasional glands may lack these cells.
AB - Aims: To define the phenotypic alteration of the stromal component in association with destructive invasion which is a crucial feature in distinguishing minimal deviation adenocarcinoma (MDA) from benign endocervical glandular lesions. Methods and results: We studied endocervical glandular hyperplasias including non-specific-type (NEGH) (n = 3) and lobular-type (LEGH) (n = 8), and minimal deviation adenocarcinoma (MDA) (n = 11), well-differentiated endocervical adenocarcinoma of usual-type (WDA) (n = 11), and adenocarcinoma in situ (AIS) (n = 6) of the cervix, by double immunostaining for oestrogen receptor (ER) and α-smooth muscle actin (α-SMA) using peroxidase- and alkaline phosphatase-polymer methods, respectively. Glands in NEGH invariably showed nuclear staining for ER, with surrounding ER+/α-SMA- stromal cells, whereas LEGH also harboured ER+/α-SMA- spindle cells, but lacked nuclear staining for ER in constituent glands. In contrast, both WDA and MDA displayed accompanying stroma rich in α-SMA+ spindle cells in close vicinity to the infiltrating neoplastic glands, with only occasional weakly ER+ stromal cells. WDA tended to contain more α-SMA+ cells. The distribution of α-SMA+ cells was periglandular (6/11), patchy (6/11), and/or diffuse (4/11) in WDA, whereas in MDA it was periglandular (11/11) and/or patchy (8/11). AIS was surrounded by ER+/α-SMA- stromal cells. All cases of WDA, MDA, and AIS lacked nuclear staining for ER. Conclusions: Both MDA and WDA can be distinguished from LEGH and NEGH by identifying surrounding α-SMA+ stromal cells and the absence or decreased number of ER+ cells, possibly as a result of the desmoplastic reaction with myofibroblasts replacing pre-existing ER+ stromal cells. In particular, the periglandular distribution of these α-SMA+ stromal cells can be a clue suggesting destructive stromal invasion in cases of MDA, although occasional glands may lack these cells.
KW - Adenoma malignum
KW - Oestrogen receptor
KW - Stroma
KW - α-smooth muscle actin
UR - http://www.scopus.com/inward/record.url?scp=14344264910&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=14344264910&partnerID=8YFLogxK
U2 - 10.1111/j.1365-2559.2005.02057.x
DO - 10.1111/j.1365-2559.2005.02057.x
M3 - Article
C2 - 15693884
AN - SCOPUS:14344264910
VL - 46
SP - 130
EP - 136
JO - Histopathology
JF - Histopathology
SN - 0309-0167
IS - 2
ER -