2022-6-15病例

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1084-70ish F with persistent HPV+ ASCH cervical cytology and unsatisfactory colposcopy who underwent LEEP.

Adenoid Basal-like Tumor in Cervical LEEP

Differential Diagnosis

·HPV-associated cervical carcinoma

· Mixed squamous cell carcinoma and adenocarcinoma (”adenosquamous”)

· Adenocarcinoma with areas of stratified mucinous carcinoma (iSMILE)

 · Adenoid basal tumor

·HPV-independent cervical carcinoma

· Mesonephric carcinoma (although these usually arise deep in the cervical wall where mesonephric remnants exist)

· Direct extension of endometrial carcinoma into cervix

Adenoid Basal-Like Tumors of the Cervix

· Rare finding in cervix

· Usually incidental when pure; 

but often admixed with usualtype HPV-associated cervical carcinomas

· Resembles basal cell hyperplasia in the prostate

· Biphasic, nested growth pattern

· Peripheral cells = basaloid with palisading 

· Central cells = glandular

Key Points – Adenoid Basal Tumor

· Rare cervical tumors with a prostatic phenotype 

· Biphasic tumors resembling basal cell hyperplasia of prostate

· NKX3.1+ and HRHPV+ is an unusual IHC combination, unique to this entity

· Adenoid basal tumors are often admixed with traditional HPVassociated adenocarcinoma / squamous cell carcinoma with a minor adenoid basal component 

· Pure adenoid basal tumor is very rare, but have benign behavior thus far

· Must recommend further excision if lesion extends to the margin to 

exclude a component of conventional HPV-associated carcinoma

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References

· Stewart CJR, Moses J. NKX3.1 expression in cervical 'adenoid basal cell carcinoma': another gynaecological lesion with prostatic differentiation? Pathology. 2021 Feb;53(2):193-198. Epub 2020 Oct 5. PMID: 33032811.

· Russell MJ, Fadare O. Adenoid basal lesions of the uterine cervix: evolving terminology and clinicopathological concepts. Diagn Pathol. 2006 Aug 15;1:18.. PMID: 16911774; PMCID: PMC1564042.

1085-永不厌倦经典肿瘤类型

女性，30多岁，大腿有肿块。

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病变的两个组成部分突然转变为边界清晰的结节。高级别成分较深，看起来是假包膜的

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低级和高级梭形细胞成分

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CD34

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高级别成分的过渡和高倍镜HE

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低级是CD34阳性，高级几乎完全失去CD34。

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这是DFSP的纤维肉瘤样变。

FISH证实了COL1A1-PDGFB重排。