Endometrioid-like Carcinoma



Endometrioid-like Carcinoma











Gross photograph of an endometrioid-like carcinoma of the lung shows a well-circumscribed but not encapsulated mass. The tumor is light tan and slightly lobulated.






Endometrioid adenocarcinoma shows a malignant glandular proliferation destroying lung parenchyma. Note the tumor mass is well circumscribed and a rim of normal lung parenchyma is present image.


TERMINOLOGY


Synonyms



  • Endometrioid adenocarcinoma


Definitions



  • Malignant epithelial neoplasms that mimics secretory endometrium


CLINICAL ISSUES


Presentation



  • Cough


  • Hemoptysis


  • Difficulty breathing


  • Chest pain


Treatment



  • Surgical approaches



    • Lobectomy or pneumonectomy


  • Adjuvant therapy



    • Radiation or chemotherapy depending on clinical stage


Prognosis



  • Depends on clinical and pathological stage


MACROSCOPIC FEATURES


General Features



  • Tumor mass is light tan to brown


  • From 1 cm to > 10 cm in greatest diameter


  • Hemorrhage or necrosis may be seen


  • Tumor may be central or peripheral


MICROSCOPIC PATHOLOGY


Histologic Features



  • Glands composed of cells with clear cytoplasm mimicking secretory phase of endometrium


  • Absence of morular component


  • Neoplastic cells with intracellular mucin


Predominant Pattern/Injury Type



  • Glandular


Predominant Cell/Compartment Type



  • Epithelial, glandular


DIFFERENTIAL DIAGNOSIS


Pulmonary Blastoma



  • Endometrioid adenocarcinoma



    • Lacks morular component between glandular structures


    • Lacks primitive glands that recapitulate lung development of approximately weeks 11-16


    • Shows intracellular mucin while blastoma lacks it


Metastatic Endometrioid Adenocarcinoma from Gynecologic Primary



  • Differential diagnosis more important in female patients


  • Clinical history &/or complete physical examination are of utmost importance


  • Use of immunohistochemical stains may help in some cases


  • TTF-1 may be positive in a small number of primary endometrial adenocarcinomas

Jul 9, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Endometrioid-like Carcinoma

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