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dc.contributor.authorMurali, Rajmohan
dc.contributor.authorDavidson, Ben
dc.contributor.authorFadare, Oluwole
dc.contributor.authorCarlson, Joseph A.
dc.contributor.authorCrum, Christopher
dc.contributor.authorGilks, C. Blake
dc.contributor.authorIrving, Julie A.
dc.contributor.authorMalpica, Anais
dc.contributor.authorMatias-Guiu, Xavier
dc.contributor.authorMcCluggage, W. Glenn
dc.contributor.authorMittal, Khush
dc.contributor.authorOliva, Esther
dc.contributor.authorParkash, Vinita
dc.contributor.authorRutgers, Joanne
dc.contributor.authorStaats, Paul
dc.contributor.authorStewart, Colin
dc.contributor.authorTornos, Carmen
dc.contributor.authorSoslow, Robert A.
dc.description.abstractThis review of challenging diagnostic issues concerning high-grade endometrial carcinomasisderivedfromtheauthors’ reviewoftheliteraturefollowedbydiscussionsatthe Endometrial Cancer Workshop sponsored by the International Society of Gynecological Pathologists in 2016. Recommendations presented are evidence-based, insofar as this is possible,giventhatthelevelsofevidenceareweakormoderateduetosmallsamplesizesand nonuniform diagnostic criteria used in many studies. High-grade endometrioid carcinomas include FIGO grade 3 endometrioid carcinomas, serous carcinomas, clear cell carcinomas, undifferentiated carcinomas, and carcinosarcomas. FIGO grade 3 endometrioid carcinoma is diagnosed when an endometrioid carcinoma exhibits >50% solid architecture (excluding squamousareas), orwhenan architecturallyFIGOgrade2endometrioid carcinomaexhibits marked cytologic atypia, provided that a glandular variant of serous carcinoma has been excluded. The most useful immunohistochemical studies to make the distinction between these 2 histotypes are p53, p16, DNA mismatch repair proteins, PTEN, and ARID1A. Endometrial clear cell carcinomas must display prototypical architectural and cytologic features for diagnosis. Immunohistochemical stains, including, Napsin A and p504s can be used as ancillary diagnostic tools; p53 expression is aberrant in a minority of clear cell carcinomas. Of note, clear cells are found in all types of high-grade endometrial carcinomas, leading to a tendency to overdiagnose clear cell carcinoma. Undifferentiated carcinoma (which when associated with a component of low-grade endometrioid carcinoma is termed “dedifferentiated carcinoma”) is composed of sheets of monotonous, typically dyscohesive cells, which can have a rhabdoid appearance; they often exhibit limited expression of cytokeratins and epithelial membrane antigen, are usually negative for PAX8 and hormone receptors, lack membranous e-cadherin and commonly demonstrate loss of expression of DNA mismatch repair proteins and SWI-SNF chromatin remodeling proteins. Carcinosarcomas must show unequivocal morphologic evidence of malignant epithelial and mesenchymal differentiation.ca_ES
dc.description.sponsorshipThis work was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.ca_ES
dc.publisherLippincott, Williams & Wilkinsca_ES
dc.relation.isformatofReproducció del document publicat a
dc.relation.ispartofInternational Journal of Gynecological Pathology, 2019, vol. 38, p. S40–S63ca_ES
dc.rightscc-by (c) Rajmohan Murali et al., 2019ca_ES
dc.subjectClear cell carcinomaca_ES
dc.subjectDedifferentiated carcinomaca_ES
dc.subjectEndometrioid carcinomaca_ES
dc.titleHigh-grade Endometrial Carcinomas: Morphologic and Immunohistochemical Features, Diagnostic Challenges and Recommendationsca_ES

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