Case 112 - Revision history

Michael at 05:07, 29 September 2015

2015-09-29T05:07:51Z

← Older revision		Revision as of 05:07, 29 September 2015
Line 289:		Line 289:


	[[Category:Cases in ~~gynecological~~ pathology]]		[[Category:Cases in gynecologic pathology]]
	[[Category:Cases in ~~gynecological~~ pathology - junior]]		[[Category:Cases in gynecologic pathology - junior]]

	[[Category:Cases difficulty 2]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level -->		[[Category:Cases difficulty 2]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level -->

Michael at 05:06, 29 September 2015

2015-09-29T05:06:39Z

← Older revision		Revision as of 05:06, 29 September 2015
Line 288:		Line 288:
	[[Category:Cases]]		[[Category:Cases]]

	~~<!-- SELECT A CATEGORY~~
	[[Category:Cases in gynecological pathology]]		[[Category:Cases in gynecological pathology]]
	-->		[[Category:Cases in gynecological pathology - junior]]

	[[Category:Cases difficulty 2]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level -->		[[Category:Cases difficulty 2]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level -->

Michael: /* Diagnosis */ tweak

2015-09-27T04:03:37Z

Diagnosis: tweak

← Older revision		Revision as of 04:03, 27 September 2015
Line 273:		Line 273:
	===Diagnosis===		===Diagnosis===
	{{hidden\|Diagnosis\|<center>[[serous borderline tumour of the ovary\|BORDERLINE SEROUS TUMOR OF THE OVARY]] WITH MICROINVASION.</center>		{{hidden\|Diagnosis\|<center>[[serous borderline tumour of the ovary\|BORDERLINE SEROUS TUMOR OF THE OVARY]] WITH MICROINVASION.</center>
	<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or ~~10mm2~~). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. <ref name=pmid25188864>{{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}</ref>		<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm<sup>2</sup>). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are [[p16]] positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis.<ref name=pmid25188864>{{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}</ref>

	====References====		====References====

Michael at 16:44, 25 September 2015

2015-09-25T16:44:30Z

← Older revision		Revision as of 16:44, 25 September 2015
Line 3:		Line 3:

	===Site===		===Site===
	ovary		Left ovary

	===Primary image===		===Primary image===
	[[Image: Gross of borderline serous tumor of the ovary 01.jpg\|500px\|link=\|center\|]]		[[Image: Gross of borderline serous tumor of the ovary 01.jpg\|500px\|link=\|center\|]]
	<center>Gross image.</center>		<center>Gross image.</center>
			<br>
	[[Image: Low maginification of borderline serous tumor of the ovary.jpg\|500px\|link=\|center\|]]		[[Image: Low maginification of borderline serous tumor of the ovary.jpg\|500px\|link=\|center\|]]
	<center>Low magnification. [[H&E stain]].</center>		<center>Low magnification. [[H&E stain]].</center>

Michael: tweak

2015-09-25T16:43:59Z

tweak

← Older revision		Revision as of 16:43, 25 September 2015
Line 3:		Line 3:

	===Site===		===Site===
	~~ZZZ~~		ovary

	===Primary image===		===Primary image===
	[[Image: Gross of borderline serous tumor of the ovary 01.jpg\|500px\|link=\|center\|]]		[[Image: Gross of borderline serous tumor of the ovary 01.jpg\|500px\|link=\|center\|]]
			<center>Gross image.</center>

			[[Image: Low maginification of borderline serous tumor of the ovary.jpg\|500px\|link=\|center\|]]
	<center>Low magnification. [[H&E stain]].</center>		<center>Low magnification. [[H&E stain]].</center>

	~~{{hidden\|Intermediate magnification\|[[Image: Low maginification of borderline serous tumor of the ovary.jpg \|500px\|link=\|center\|]]~~
	~~<center>Intermediate magnification. [[H&E stain]].</center>}}~~

	{{hidden\|High magnification\|[[Image: Intermediate magnification of a borderline serous tumor showing eosiniophilic cells.jpg \|500px\|link=\|center\|]]		{{hidden\|High magnification\|[[Image: Intermediate magnification of a borderline serous tumor showing eosiniophilic cells.jpg \|500px\|link=\|center\|]]
	<center>High magnification. [[H&E stain]].</center>}}		<center>High magnification. [[H&E stain]].</center>}}


	{{hidden\|High magnification\|[[Image: Microinvasion in a borderline serous tumor of the ovary.jpg \|500px\|link=\|center\|]]		{{hidden\|High magnification\|[[Image: Microinvasion in a borderline serous tumor of the ovary.jpg \|500px\|link=\|center\|]]
	<center>High magnification. [[H&E stain]].</center>}}		<center>High magnification. [[H&E stain]].</center>}}


	===Differential diagnosis===		===Differential diagnosis===

Michael: /* Diagnosis */

2015-09-24T18:35:42Z

Diagnosis

← Older revision		Revision as of 18:35, 24 September 2015
Line 274:		Line 274:

	===Diagnosis===		===Diagnosis===
	{{hidden\|Diagnosis\|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>		{{hidden\|Diagnosis\|<center>[[serous borderline tumour of the ovary\|BORDERLINE SEROUS TUMOR OF THE OVARY]] WITH MICROINVASION.</center>
	<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. <ref name=pmid25188864>{{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}</ref>		<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. <ref name=pmid25188864>{{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}</ref>

Rudolf: /* Diagnosis */

2015-09-24T18:32:58Z

Diagnosis

← Older revision		Revision as of 18:32, 24 September 2015
Line 275:		Line 275:
	===Diagnosis===		===Diagnosis===
	{{hidden\|Diagnosis\|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>		{{hidden\|Diagnosis\|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>
	<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. <ref name=~~PMID 25188864~~> {{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}</ref>		<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. <ref name=pmid25188864>{{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}</ref>

	====References====		====References====

Rudolf at 18:32, 24 September 2015

2015-09-24T18:32:34Z

← Older revision		Revision as of 18:32, 24 September 2015
Line 275:		Line 275:
	===Diagnosis===		===Diagnosis===
	{{hidden\|Diagnosis\|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>		{{hidden\|Diagnosis\|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>
	<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. <ref name=PMID 25188864> {{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}<ref>		<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. <ref name=PMID 25188864> {{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}</ref>

	====References====		====References====

Vinita at 18:30, 24 September 2015

2015-09-24T18:30:49Z

← Older revision		Revision as of 18:30, 24 September 2015
Line 275:		Line 275:
	===Diagnosis===		===Diagnosis===
	{{hidden\|Diagnosis\|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>		{{hidden\|Diagnosis\|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>
	<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. {{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}		<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. <ref name=PMID 25188864> {{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}<ref>

	====References====		====References====

Vinita at 18:28, 24 September 2015

2015-09-24T18:28:26Z

← Older revision		Revision as of 18:28, 24 September 2015
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	===Diagnosis===		===Diagnosis===
	{{hidden\|Diagnosis\|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>		{{hidden\|Diagnosis\|<center>BORDERLINE SEROUS TUMOR OF THE OVARY WITH MICROINVASION.</center>
	<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. (Am J Surg Pathol 2014~~;38:1603–1611)~~		<br>The characteristic feature of borderline serous tumor is the hierarchical branching of the papillae, where the papillae progressively branch from larger ones to smaller one and finally into tufts of epithelial cells. The cells show only mild to moderate atypia. A cytadenofibroma may have similar proliferation, but by convention should be less than 5% of the tumor. Focal mucinous change may also occur. Papillary clear cell carcinoma simulating borderline tumor will show a WT1-ve, ER-ve, PR-ve immunoprofile in contrast to the positive profile of the serous tumor. Often clusters of cells with abundant eosinophilic cytoplasm are seen at the surface of papillae (star, image 2; oval image 3) or in lymphatic like spaces either as single cells or small papillary clusters. This theoretically represents microinvasion which is variably defined by different authors (<3 or 5 mm or 10mm2). However, recent evidence suggests that the two patterns of invasion have vastly different prognosis. The AEC (abundant eosinophilic cells) are p16 positive and reflect a terminally differentiated senescent phenotype. If invasion is exclusively composed of this cell type, then these do not portend a poor prognosis.<ref name=pmid24441661>{{Cite journal \| last1 = Maniar \| first1 = KP. \| last2 = Wang \| first2 = Y. \| last3 = Visvanathan \| first3 = K. \| last4 = Shih \| first4 = IeM. \| last5 = Kurman \| first5 = RJ. \| title = Evaluation of microinvasion and lymph node involvement in ovarian serous borderline/atypical proliferative serous tumors: a morphologic and immunohistochemical analysis of 37 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 6 \| pages = 743-55 \| month = Jun \| year = 2014 \| doi = 10.1097/PAS.0000000000000155 \| PMID = 24441661 }}</ref> These cells are significantly more often seen in BRAF mutated tumors, and are perhaps associated with a better prognosis. {{Cite journal \| last1 = Zeppernick \| first1 = F. \| last2 = Ardighieri \| first2 = L. \| last3 = Hannibal \| first3 = CG. \| last4 = Vang \| first4 = R. \| last5 = Junge \| first5 = J. \| last6 = Kjaer \| first6 = SK. \| last7 = Zhang \| first7 = R. \| last8 = Kurman \| first8 = RJ. \| last9 = Shih \| first9 = IeM. \| title = BRAF mutation is associated with a specific cell type with features suggestive of senescence in ovarian serous borderline (atypical proliferative) tumors. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 12 \| pages = 1603-11 \| month = Dec \| year = 2014 \| doi = 10.1097/PAS.0000000000000313 \| PMID = 25188864 }}

	====References====		====References====