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Immunohistochemistry as an adjunct for challenging histological patterns of borderline Brenner tumors: An illustrative study of 4 cases.
- Source :
-
Annals of diagnostic pathology [Ann Diagn Pathol] 2024 Oct; Vol. 72, pp. 152324. Date of Electronic Publication: 2024 May 08. - Publication Year :
- 2024
-
Abstract
- Borderline Brenner tumors (BBT) have a range of morphology that shows considerable overlap with that of malignant Brenner tumors (MBT). In particular, two histological patterns of BBT can be particularly challenging: 1) BBT with intraepithelial carcinoma (BBT-IEC) and 2) BBT with a small nested pattern (BBT-SNP). BBT-IEC is characterized by a tumor with the low-power non-infiltrative silhouette of a conventional BBT, but with increased cytological atypia and mitotic activity similar to that of MBT. Conversely, BBT-SNP is characterized by a complex proliferation of small tumor nests that closely resemble the infiltrative growth pattern of MBT, but without the obligate cytologic atypia and mitotic activity of MBT. We suggest that the combination of p16, p53 and Ki-67 may be helpful in distinguishing these 2 patterns of BBT from both conventional BBT and from MBT. While both conventional BBT and BBT-IEC show a null pattern of p16 expression, our case of BBT-IEC showed aberrant p53 overexpression, albeit with a maturation pattern similar to that described for TP53 mutant mucinous ovarian carcinoma and differentiated vulvar intraepithelial neoplasia (dVIN). Similarly, while BBT-SNP shows an infiltrative-like growth pattern similar to that of MBT, our case also showed a wild-type pattern of p53 expression and a Ki-67 proliferative index similar to areas with conventional BBT histology. In conclusion, in our small case series, we show that the use of immunohistochemistry for p53 and Ki-67 may help to distinguish challenging patterns of BBT from MBT. Further studies are needed to validate this finding in a larger case cohort.<br />Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare.<br /> (Copyright © 2024 Elsevier Inc. All rights reserved.)
- Subjects :
- Humans
Female
Middle Aged
Ovarian Neoplasms pathology
Ovarian Neoplasms metabolism
Tumor Suppressor Protein p53 metabolism
Aged
Adult
Cyclin-Dependent Kinase Inhibitor p16 metabolism
Carcinoma in Situ pathology
Carcinoma in Situ metabolism
Carcinoma in Situ diagnosis
Immunohistochemistry methods
Brenner Tumor pathology
Brenner Tumor metabolism
Brenner Tumor diagnosis
Biomarkers, Tumor metabolism
Ki-67 Antigen metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 1532-8198
- Volume :
- 72
- Database :
- MEDLINE
- Journal :
- Annals of diagnostic pathology
- Publication Type :
- Academic Journal
- Accession number :
- 38733672
- Full Text :
- https://doi.org/10.1016/j.anndiagpath.2024.152324