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Mural nodules in mucinous ovarian tumors represent a morphologic spectrum of clonal neoplasms: a morphologic, immunohistochemical, and molecular analysis of 13 cases.
- Source :
-
Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc [Mod Pathol] 2021 Mar; Vol. 34 (3), pp. 613-626. Date of Electronic Publication: 2020 Aug 05. - Publication Year :
- 2021
-
Abstract
- Mucinous ovarian tumors rarely harbor mural nodules, which have historically been classified as sarcoma-like, anaplastic carcinomatous, or sarcomatous on the basis of predominant morphologic features. The molecular relationship between mural nodules and associated mucinous ovarian tumors remains poorly characterized, as does the molecular pathogenesis of these mural nodules. Thus, we analyzed the morphological, immunohistochemical, and genetic features of 13 mucinous ovarian tumors and associated mural nodule(s). Three harbored sarcoma-like mural nodules and ten contained anaplastic carcinomatous nodules, including 1 tumor with spatially discrete anaplastic carcinomatous and sarcomatous nodules. Twelve of 13 cases showed genetic evidence of clonality between the mural nodule(s) and associated mucinous ovarian tumor, including all three tumors with sarcoma-like morphology. Mural nodules were genetically identical in the five cases in which there were multiple discrete mural nodules that were sequenced separately. MTAP and p53 immunohistochemistry confirmed the distribution of neoplastic cells in a subset of sarcoma-like and anaplastic carcinomatous nodules. No single recurrent genetic alteration was associated with mural nodule development. No recurrent genetic differences were identified between mural nodules with sarcoma-like, anaplastic carcinomatous, and sarcomatous morphology. Of 11 patients with clinical follow-up, three died of disease 3, 8, and 9 months after diagnosis, but no recurrent genetic events were associated with poor outcome. These molecular data suggest that sarcoma-like, anaplastic carcinomatous, and sarcomatous nodules represent a morphologic spectrum of clonal neoplasms arising in mucinous ovarian tumors rather than three discrete biological entities.
- Subjects :
- Adolescent
Adult
Aged
Biopsy
Female
Humans
Microtubule-Associated Proteins analysis
Microtubule-Associated Proteins genetics
Middle Aged
Predictive Value of Tests
Prognosis
Tumor Suppressor Protein p53 analysis
Tumor Suppressor Protein p53 genetics
Biomarkers, Tumor analysis
Biomarkers, Tumor genetics
High-Throughput Nucleotide Sequencing
Immunohistochemistry
Neoplasms, Cystic, Mucinous, and Serous chemistry
Neoplasms, Cystic, Mucinous, and Serous genetics
Neoplasms, Cystic, Mucinous, and Serous pathology
Neoplasms, Cystic, Mucinous, and Serous therapy
Ovarian Neoplasms chemistry
Ovarian Neoplasms genetics
Ovarian Neoplasms pathology
Ovarian Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1530-0285
- Volume :
- 34
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
- Publication Type :
- Academic Journal
- Accession number :
- 32759977
- Full Text :
- https://doi.org/10.1038/s41379-020-0642-9