Exploring the Histogenesis of Ovarian Mucinous and Transitional Cell (Brenner) Neoplasms and Their Relationship With Walthard Cell Nests: A Study of 120 Tumors

Archives of Pathology and Laboratory Medicine - Tập 132 Số 11 - Trang 1753-1760 - 2008
Jeffrey D. Seidman1, Fatemeh Khedmati1
1From the Department of Pathology and Laboratory Medicine, Washington Hospital Center, Washington, DC

Tóm tắt

Abstract Context.—The origin of and relationship between ovarian mucinous and transitional cell (Brenner) neoplasms are enigmatic. The reported association ranges from 1% to 16%, and whether there is an association with Walthard cell nests is unknown. Objective.—To clarify the histologic relationship between mucinous and Brenner tumors. Design.—A total of 40 mucinous cystadenomas, 67 Brenner tumors, and 13 combined tumors were studied. Peritoneal surfaces were examined for Walthard nests in 83 patients compared with 272 controls. Results.—A total of 25% of tumors with a mucinous component contained a Brenner component, and 16% of tumors with a Brenner component contained a mucinous component. Most calcifications were spiculated (nonpsammomatous). In 6 combined tumors, the relative volume of the 2 components was less than 1:3000 (transitional-mucinous). Walthard nests were found in 50% of patients with Brenner tumors and 59% of patients with mucinous tumors. This was significantly higher than the 28% found in controls (P = .002 and P < .001, respectively). The number of fallopian tube blocks examined was correlated with the likelihood of finding Walthard nests, and accordingly, sampling accounted for 39% of the increase with Brenner tumors but strengthened the association with mucinous tumors. Conclusions.—The strong association of mucinous and transitional cell components, similar type of calcification, complementary size distributions, and frequent identification of a transitional component in the face of an exceedingly small estimated proportion of that component suggest that this association has been underestimated. The association of Brenner tumors with Walthard nests, although significant, appears weak and not strongly supportive of a histogenetic relationship. The stronger association of Walthard nests with mucinous tumors remains unexplained.

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Tài liệu tham khảo

Ball, 1990, Intestinal differentiation in ovarian mucinous tumours., Virchows Arch A Pathol Anat Histopathol, 417, 197, 10.1007/BF01600134

Cariker, 1954, Mucinous cystadenomas and mucinous cystadenocarcinomas of the ovary: a clinical and pathological study of 355 cases., Cancer, 7, 302, 10.1002/1097-0142(195403)7:2<302::AID-CNCR2820070214>3.0.CO;2-9

Guerreri, 1994, Mucinous borderline and malignant tumors of the ovary: a clinicopathologic and DNA ploidy study of 92 cases., Cancer, 74, 2329, 10.1002/1097-0142(19941015)74:8<2329::AID-CNCR2820740818>3.0.CO;2-G

Hart, 1973, Borderline and malignant mucinous tumors of the ovary: histologic criteria and clinical behavior., Cancer, 31, 1031, 10.1002/1097-0142(197305)31:5<1031::AID-CNCR2820310501>3.0.CO;2-7

Hertig, Tumors of the Female Sex Organs, Part 3.

Hoerl, 1998, Primary ovarian mucinous cystadenocarcinomas: a clinicopathologic study of 49 cases with long-term follow-up., Am J Surg Pathol, 22, 1449, 10.1097/00000478-199812000-00002

Lee, 2000, Mucinous tumors of the ovary: a clinicopathologic study of 196 borderline tumors (of intestinal type) and carcinomas, including an evaluation of 11 cases with ‘pseudomyxoma peritonei.’., Am J Surg Pathol, 24, 1447, 10.1097/00000478-200011000-00001

Nomura, 1997, A histogenetic consideration of ovarian mucinous tumors based on an analysis of lesions associated with teratomas or Brenner tumors., Pathol Int, 47, 862, 10.1111/j.1440-1827.1997.tb03718.x

Riopel, 1999, Evaluation of diagnostic criteria and behavior of ovarian intestinal-type mucinous tumors: atypical proliferative (borderline) tumors and intraepithelial, microinvasive, invasive, and metastatic carcinomas., Am J Surg Pathol, 23, 617, 10.1097/00000478-199906000-00001

Rodriguez, 2002, Mucinous tumors of the ovary: a clinicopathologic analysis of 75 borderline tumors (of intestinal type) and carcinomas., Am J Surg Pathol, 26, 139, 10.1097/00000478-200202000-00001

Russell, 1979, The pathological assessment of ovarian neoplasms, I: introduction to the common ‘epithelial’ tumours and analysis of benign ‘epithelial’ tumours., Pathology, 11, 5, 10.3109/00313027909063533

Woodruff, 1960, Mucinous tumors of the ovary., Obstet Gynecol, 16, 699

Ehrlich, 1971, The Brenner tumor: a clinicopathologic study of 57 cases., Cancer, 27, 332, 10.1002/1097-0142(197102)27:2<332::AID-CNCR2820270213>3.0.CO;2-L

Greene, 1952, The diverse origins of Brenner tumors., Am J Obstet Gynecol, 64, 878, 10.1016/S0002-9378(16)38802-0

Jondahl, 1950, Brenner tumor of the ovary: a clinicopathologic study of 31 cases., Am J Obstet Gynecol, 60, 160, 10.1016/S0002-9378(16)39052-4

Santini, 1989, Brenner tumor of the ovary: a correlative histologic, histochemical, immunohistochemical, and ultrastructural investigation., Hum Pathol, 20, 787, 10.1016/0046-8177(89)90074-9

Shevchuk, 1980, Histogenesis of Brenner tumors, I: histology and ultrastructure., Cancer, 46, 2607, 10.1002/1097-0142(19801215)46:12<2607::AID-CNCR2820461213>3.0.CO;2-Q

Silverberg, 1971, Brenner tumor of the ovary: a clinicopathologic study of 60 tumors in 54 women., Cancer, 28, 588, 10.1002/1097-0142(197109)28:3<588::AID-CNCR2820280310>3.0.CO;2-J

Tighe, 1961, Brenner tumours of the ovary: a clinico-pathological study., J Obstet Gynaecol Br Commonw, 68, 292, 10.1111/j.1471-0528.1961.tb02727.x

Waxman, 1979, Pure and mixed Brenner tumors of the ovary: clinicopathologic and histogenetic observations., Cancer, 43, 1830, 10.1002/1097-0142(197905)43:5<1830::AID-CNCR2820430536>3.0.CO;2-C

Yoonessi, 1979, Brenner tumors of the ovary., Obstet Gynecol, 54, 90, 10.1097/00006250-197907000-00021

Russell, Transitional cell (Brenner) tumors.

Seidman, Surface epithelial tumors of the ovary., 10.1007/978-1-4419-0489-8_14

Seidman, 2004, Borderline ovarian tumors: diverse contemporary viewpoints on terminology and diagnostic criteria with illustrative images., Hum Pathol, 35, 918, 10.1016/j.humpath.2004.03.004

Chapman, 2001, Developments in the pathology of ovarian tumours., Curr Opin Obstet Gynecol, 13, 53, 10.1097/00001703-200102000-00008

Feeley, 2001, Precursor lesions of ovarian epithelial malignancy., Histopathology, 38, 87, 10.1046/j.1365-2559.2001.01042.x

Barzilai, Atlas of Ovarian Tumors., 10.1097/00000441-194307000-00032

Roth, 1985, Ovarian Brenner tumors, I: metaplastic, proliferating, and of low malignant potential., Cancer, 56, 582, 10.1002/1097-0142(19850801)56:3<582::AID-CNCR2820560327>3.0.CO;2-E

Roth, 1993, Ovarian Brenner tumors and transitional cell carcinoma: recent developments., Int J Gynecol Pathol, 12, 128, 10.1097/00004347-199304000-00007

Clement, Non-neoplastic lesions of the ovary.

Karseladze, 2001, On the site of origin of epithelial tumors of the ovary., Eur J Gynaecol Oncol, 22, 110

Seidman, 2005, Benign ovarian serous tumors: a re-evaluation and proposed reclassification of serous “cystadenomas” and “cystadenofibromas.”., Gynecol Oncol, 96, 395, 10.1016/j.ygyno.2004.10.014

Arey, 1961, The origin and form of the Brenner tumor., Am J Obstet Gynecol, 81, 743, 10.1016/S0002-9378(15)33523-7

Raab, 1997, Mucinous tumors of the ovary: interobserver diagnostic variability and utility of sectioning protocols., Arch Pathol Lab Med, 121, 1192

Scully, Tumors of the Ovary and Maldeveloped Gonads.

Resta, 1993, Morphologic precursors of ovarian epithelial tumors., Obstet Gynecol, 82, 181

Salazar, 1996, Microscopic benign and invasive malignant neoplasms and a cancer-prone phenotype in prophylactic oophorectomies., J Natl Cancer Inst, 88, 1810, 10.1093/jnci/88.24.1810

Towers, 1956, Note on the origin of the pseudomucinous cystadenoma of the ovary., J Obstet Gynecol Brit Emp, 63, 253, 10.1111/j.1471-0528.1956.tb05477.x

Pejovic, 1999, Well-differentiated mucinous carcinoma of the ovary and a coexisting Brenner tumor both exhibit amplification of 12q14-21 by comparative genomic hybridization., Gynecol Oncol, 74, 134, 10.1006/gyno.1999.5402

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Archives of Pathology and Laboratory Medicine

Tập 132 Số 11

1753-1760

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