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PubMed1986

Minimal deviation adenocarcinoma of the uterine cervix ("adenoma malignum"). An immunohistochemical comparison with microglandular endocervical hyperplasia and conventional endocervical adenocarcinoma.

In an effort to obtain objective information that would be useful in separating minimal deviation adenocarcinoma (MDA) or "adenoma malignum" of the endocervix from benign endocervical glandular proliferations, four cases of MDA were studied immunocytochemically, and compared with seven cases of microglandular endocervical hyperplasia (MEH) and six cases of conventional endocervical adenocarcinoma (ACA). Monoclonal antibodies to carcinoembryonic antigen (CEA) and blood group isoantigens A, B, and H (BGI) were used in these analyses. All MDA and ACA were CEA-positive, whereas none of the cases of MEH stained for the presence of this substance. Six of seven examples of MEH expressed appropriate BGI; the remaining case failed to stain for blood group substances. In contrast, six of ten cases of malignant endocervical glandular tumors manifested "inappropriate" expression of BGI, based on the patients' known blood types. These data suggest that immunostains for CEA may be helpful in the diagnostic separation of MDA and MEH. The close biochemical similarity between CEA and BGI is postulated as an explanation for "inappropriate" expression of blood group antigens by malignant endocervical lesions.

Adenocarcinoma↗
PubMed1990

Human papillomavirus type 16/18 in uterine cervical adenocarcinoma in situ and adenocarcinoma. A study by in situ hybridization with biotinylated DNA probes.

The distribution of human papillomavirus (HPV) DNA type 16/18 in the paraffin sections of 11 adenocarcinomas (AC), 4 adenocarcinomas in situ (AIS), and 2 adenosquamous carcinomas (AC/SCC) of the cervix was examined by in situ hybridization (ISH) with biotinylated DNA probes (B-probes). Four AC, four AIS, and one AC/SCC were positive. These results show that B-probes are an acceptable alternative to both ISH with radiolabeled probes and Southern blot hybridization (SBH), which are difficult to apply in routine pathologic laboratories. Cervical tissues infiltrated with endometrial AC were negative for HPV DNA 16/18, and it is suggested that the presence of HPV DNA 16/18 in uterine AC may be helpful in discriminating cervical AC from endometrial AC.

Adenocarcinoma↗
PubMed1994

Endobronchial adenocarcinoma with endometrioid features and prominent neuroendocrine differentiation. A variant of fetal adenocarcinoma.

An endobronchial tumor, resected from a 77-year-old man, had an endometrioid histologic pattern consistent with fetal adenocarcinoma. A distinctive feature of the neoplasm was prominent neuroendocrine differentiation, including single, discrete neuroendocrine cells; aggregates of neuroendocrine cells resembling miniature carcinoid tumors; and a single focus of undifferentiated small cell carcinoma. Immunohistochemical staining of neuroendocrine cells revealed the presence of neuron-specific enolase, chromogranin, somatostatin, insulin, and serotonin. The heterogeneous cell populations caused problems in differential diagnosis and histologic classification. This case demonstrates that fetal adenocarcinoma may occur as a central endobronchial mass and express a variable degree of neuroendocrine differentiation.

Adenocarcinoma↗
PubMed2003

The prognostic impact of cyclin dependent kinase inhibitors p21WAF1, p27Kip1, and p16INK4/MTS1 in adenocarcinomas of the uterine cervix: an immunohistochemical evaluation of expression patterns in population-based material from 142 patients with international federation of gynecology and obstetrics stage I and II adenocarcinoma.

BACKGROUND: The authors assessed the prognostic significance of abnormal cyclin dependent kinase inhibitor (CDKI) expression in adenocarcinomas of the uterine cervix. METHODS: Population-based, archival material from patients with International Federation of Gynecology and Obstetrics (FIGO) Stage I and II cervical adenocarcionmas from 2 5-year periods (1976-1980, n = 82 patients; 1986-1990, n = 142 patients) was examined for expression of p21(WAF1), p27(Kip1), and p16(INK4/MTS1) using immunohistochemical techniques. RESULTS: Rates of tumors with low levels of nuclear expression of p27 and p16 were lower during the period 1976-1980 (P < 0.01), suggesting bias due to unbuffered formalin. Analyses that were restricted to patients from 1986-1990 showed positive associations between all three CDKIs (P < 0.05). Low p16 expression was associated with higher FIGO stage (P = 0.01), age older than 55 years (P = 0.01), and deep invasion (P = 0.003). No significant associations with stage, age, or histopathologic parameters were found for p21 or p27. Significant associations with tumor differentiation were not seen for any CDKI. Kaplan-Meier plots showed diverging survival curves for p21 and p27 expression, but the differences were not significant. In multivariate analysis, low p27 expression and high p16 expression were strong predictors of a poor prognosis (p27: < 40% nuclear staining; P = 0.001; hazard ratio, 3.18; p16: < 40% nuclear staining; P < 0.001; hazard ratio, 0.16). Low p27 expression was of prognostic significance only if it was analyzed together with p16 expression. Further evaluation indicated that patients with different phenotypic p27/p16 combinations may have different outcomes. CONCLUSIONS: Aberrant expression patterns of CDKIs were predictors of prognosis for patients with FIGO Stage I or II cervical adenocarcinoma. Analysis of CDKI expression in this patient group may prove clinically useful.

Adenocarcinoma↗
PubMed2006

Comparison of DNA hypermethylation patterns in different types of uterine cancer: cervical squamous cell carcinoma, cervical adenocarcinoma and endometrial adenocarcinoma.

The incidence of cervical adenocarcinoma (CA) is rising, whereas the incidence of cervical squamous cell carcinoma (CSCC) continues to decrease. However, it is still unclear whether different molecular characteristics underlie these 2 types of cervical carcinoma. To better understand the epigenetic characteristics of cervical carcinoma, we investigated the DNA promoter hypermethylation profiles in CA and CSCC. In addition, we investigated whether DNA hypermethylation patterns might be used for the molecular diagnosis of CA and endometrial adenocarcinoma (EA). Using the bisulfite-modification technique and methylation-specific PCR, we examined the aberrant promoter hypermethylation patterns of 9 tumor suppressor genes (APC, DAPK, CDH1, HLTF, hMLH1, p16, RASSF1A, THBS1 and TIMP3) in 62 CSCCs, 30 CAs and 21 EAs. After Bonferroni correction adjustment (statistically significant at p < 0.0055), we found that the aberrant hypermethylations of CDH1 and DAPK were more frequent in CSCCs than in CAs (80.6% vs. 43.3%, p = 0.001; 77.4% vs. 46.7%, p = 0.005), whereas HLTF and TIMP3 were more frequently methylated in CAs (3.2% vs. 43.3%, p < 0.001; 8.1% vs. 53.3%, p = 0.001). The hypermethylations of RASSF1A and APC were more frequent in CAs than in CSCCs, but this was not significant (9.7% vs. 33.3%, p = 0.008; and 14.5% vs. 40.0%, respectively, p = 0.009). In addition, RASSF1A hypermethylation was significantly more frequent in EAs than in CAs (81.0% vs. 33.3%, p = 0.001). In conclusion, the existence of these unique methylation patterns in these cancers suggests that their tumorigenesis may involve different epigenetic mechanisms.

Adenocarcinoma↗
PubMed1976

Adenocarcinoma-associated antigen: enhancement of tumor growth with serum from animals bearing adenocarcinoma.

Why do tumors continue to grow in the presence of cell-mediated immune reactions? When inoculated subcutaneously, 10(5) viable spontaneous mammary adenocarcinoma cells produced solid tumors that progressively proliferated and eventually killed all the recipient mice. During the first 10 days after inoculation, the mice developed antibody titers, and the serum acquired toxic activity against the tumor cells. As the tumor gained in size these two activities ceased. Serum of normal mice had no effect on the tumor; the serum of mice immunized with an adenocarcinoma-associated antigen (a glycoprotein) inhibited growth, but that of mice with progressive tumors enhanced proliferation of the tumors.

Adenocarcinoma↗
PubMed2003

The presence of high-risk HPV combined with specific p53 and p16INK4a expression patterns points to high-risk HPV as the main causative agent for adenocarcinoma in situ and adenocarcinoma of the cervix.

Adenocarcinoma in situ (ACIS) and adenocarcinoma (AdCA) of the cervix are frequently missed in population-based screening programmes. Adding high-risk HPV (hrHPV) testing to cervical cancer screening might improve the detection rate of ACIS and AdCA. Since the exact proportion of AdCAs of the cervix that can be attributed to hrHPV infection is still a matter of debate, a comprehensive study was performed of hrHPV presence in ACIS and AdCA of the cervix. Archival formalin-fixed specimens of indisputable ACIS (n=65) and AdCA (n=77) of the cervix were tested for hrHPV DNA by GP5+/6+ PCR-enzyme immunoassay (EIA) and type-specific E7 PCR for 14 hrHPV types. Further immunostaining for p16INK4A and p53 was performed to assess alternative pathways of carcinogenesis potentially unrelated to HPV. hrHPV DNA was found in all (100%) ACISs and 72 (94%) cervical AdCAs, whereas none of 20 endometrial AdCAs scored hrHPV-positive. HPV 18 was most prevalent and found as single or multiple infection in 68% of ACISs and 55% of cervical AdCAs. Diffuse immunostaining for p16INK4a, a potential marker of hrHPV E7 function, was significantly more frequent in hrHPV-positive cervical AdCAs (19/20; 95%) than in those without hrHPV (1/5; 20%; p<0.001). Immunostaining for p53, pointing to stabilized wild-type or mutant p53 protein, was significantly more frequent in hrHPV cervical AdCAs negative for hrHPV (p=0.01). No difference in p16INK4a and p53 immunostaining was found between hrHPV-negative cervical AdCAs and endometrial AdCAs. Hence, only a minority of cervical AdCAs displayed absence of HPV DNA and immunostaining profiles suggestive of an aetiology independent of HPV. Since all ACISs and nearly all cervical AdCAs were hrHPV-positive, the incorporation of hrHPV testing in cervical cancer screening programmes is likely to decrease markedly the incidence of cervical AdCA.

Adenocarcinoma↗
PubMed1995

Invasive adenocarcinoma of the cervix following LLETZ (large loop excision of the transformation zone) for adenocarcinoma in situ.

Adenocarcinoma in situ (AIS) of the cervix is a controversial entity which is being encountered with increasing frequency. Current critical issues in its management are the safety of uterine preservation in younger patients and the use of LLETZ conization. A 28-year-old patient was diagnosed with AIS and managed with LLETZ. Despite apparently negative margins of resection in the initial conizations, the patient was found to have invasive adenocarcinoma 1 year later. It is concluded, after review of the pathologic features of AIS, that if conservative management of AIS is elected, then standard cold knife conization should be performed and not LLETZ. Further study is required to establish the overall safety of conservative treatment of cervical AIS, including the use of LLETZ.

Adenocarcinoma↗
PubMed1995

Combined choriocarcinoma, hepatoid adenocarcinoma, small cell carcinoma and tubular adenocarcinoma in the oesophagus.

We describe an oesophageal tumour composed of choriocarcinoma, hepatoid adenocarcinoma, small cell carcinoma and tubular adenocarcinoma. The choriocarcinomatous areas and hepatoid adenocarcinomatous areas contained beta human chorionic gonadotropin-positive cells and alpha fetoprotein-positive cells, respectively. The small cell carcinomatous areas contained cells positive for serotonin or adrenocorticotrophic hormone, while the tubular adenocarcinomatous areas contained cells positive for carcinoembryonic antigen. Non-neoplastic gastric type columnar epithelium was found directly adjoing the tumour at the oral side. This tumour, with its unprecedented histology combination of tissues may have originated in Barrett's oesophagus, although we could not confirm a history of chronic gastro-oesophageal reflux.

Adenocarcinoma↗
PubMed1995

Metastatic adenocarcinoma of the ethmoids in a patient with previous gastric adenocarcinoma: a case report.

Metastatic carcinoma of the ethmoids is very rare. Of the few cases reported in the literature, the majority are renal in origin. Although metastases from the gastrointestinal tract have been reported, there are no known cases of metastases from the stomach. We present a rare case of metastatic adenocarcinoma of the ethmoids in a patient previously treated for adenocarcinoma of the stomach and describe the possible mechanisms of spread. The patient had a craniofacial resection of the tumour but unfortunately died four weeks post-operatively from acute liver failure probably caused by a liver metastasis.

Adenocarcinoma↗
PubMed2000

Mucin histochemistry in primary adenocarcinoma of the urinary bladder (of urachal or vesicular origin) and metastatic adenocarcinoma originating in the colorectum.

In order to evaluate the mucin histochemistry of primary adenocarcinomas (PA) of the urinary bladder and metastatic adenocarcinoma (MA) originating in the colorectum, 52 PA and nine MA were examined. It was determined that the percentage of cases in which more than 25% of the tumor was stained by each of the following: (i) Alcian blue pH 2.5 periodic acid-Schiff (AB-PAS); (ii) high iron diamine-AB (HID-AB); (iii) periodic acid-sodium borohydride-potassium hydroxide-PAS (PA-SB-PH-PAS); (iv) galactose oxidase- Schiff (GOS); and (v) paradoxical concanavalin A stain (PCS). For PA, the values obtained were: 75% of cases (blue, AB-PAS), 85% (magenta, AB-PAS), 71% (black, HID-AB), 75% (blue, HID-AB), 0% (PA-SB-PH-PAS), 19% (GOS), 8% (class II concanavalin A (Con A)-reactive mucin)), and 0% (class III Con A-reactive mucin). For MA, the corresponding values were 33, 22, 0, 11, 0, 0, 11, and 0%, respectively. A higher percentage of PA than MA cases showed staining in AB-PAS for acidic and neutral mucins, in HID-AB for sialo- and sulfomucins, and in GOS for terminal beta-galactose and beta-N-acetylgalactosamine. PA and MA were significantly different in terms of both frequency of staining with AB-PAS and frequency of staining with HID-AB. However, the overlap was such that in practice, it might be difficult, if not impossible, to use mucin histochemistry to inform a differential diagnosis. In view of the differences in AB-PAS and HID-AB positivity between PA and MA, we speculate that MA (originating in the colorectum) may have undergone structural distortion affecting the production and/or secretion of neutral mucins and acidic mucins (sialo- and sulfomucins) during metastasis or invasion.

Adenocarcinoma↗
PubMedDate not supplied

Invasive adenocarcinoma of the vagina following surgery for adenocarcinoma in situ of the cervix--recurrence or implantation?

A 51-year-old woman underwent cervical conization for severe glandular abnormal cells. Histology noted adenocarcinoma in situ (AIS) with incomplete excision margins. Four months later, hysterectomy revealed no residual disease. Six months subsequently she developed invasive adenocarcinoma of the upper vagina. This report documents the unusual behavior of AIS and its management difficulties.

Adenocarcinoma↗
PubMedDate not supplied

Cervical implant from villoglandular endometrial adenocarcinoma masquerading as cervical villoglandular adenocarcinoma.

This is an unusual presentation of a rare subtype of endometrial adenocarcinoma (villoglandular papillary carcinoma, VGPC) in a 71-year-old woman, which was initially diagnosed on cervical biopsy as being primary cervical VGPC. Loop excision failed to show any evidence of residual disease. Subsequent hysterectomy revealed a localized villoglandular carcinoma involving the uterine fundus and invading the inner one-third of the myometrium, the background endometrium was atrophic. The remaining cervix contained a focus of papillary forming endometrial type adenocarcinoma involving the surface epithelium and the superficial subepithelial glands. In conclusion, VGPC of cervix occurs mainly in young women and can be treated conservatively, pathologists should be cautious in making such a diagnosis in a postmenopausal woman before ruling out a primary endometrial origin.

Adenocarcinoma, Papillary↗
PubMed2002

Cytometric features of cell nuclei of adenocarcinoma in situ and invasive adenocarcinoma of the cervix.

OBJECTIVE: The goal of this study was to characterize adenocarcinoma in situ (ACIS) and invasive adenocarcinoma (AdCa) of the cervix by using image histometric measurements of nuclear morphometric features. STUDY DESIGN: Archival pathology slides and tissue blocks from 37 patients with ACIS, 18 with invasive AdCa, and 13 with normal cervical epithelial and glandular histology were reviewed by two pathologists. The controls were matched for age and menstrual status and as closely as possible for the age of the slides; this limited the number of normal cases available. Morphometric, photometric, and textural measurements were made on 4-microm sections of tissue stained with a thionin-SO(2) Feulgen reaction. A mixed analysis of covariance model was used for analysis. RESULTS: The Integrated Optical Density Index was found between the mean value for normal cells and that for ACIS and invasive AdCa (P <.001). Twenty-two other morphometric features were identified that exhibited differences in their means between at least two of the three tissue types. CONCLUSION: In the cell populations studied, certain nuclear image features were found to correlate with histologic diagnosis. The features can be measured objectively and could be useful to pathologists in differentiating lesions, although a larger study should be evaluated to confirm these findings. Further, these features may be important as optical technologies are developed that make diagnoses in real time.

Adenocarcinoma↗
PubMed1990

Expression of a multidrug resistance gene in esophageal adenocarcinoma. Correlation with response to chemotherapy and comparison with gastric adenocarcinoma.

The resistance of malignant tumors to chemotherapy is often associated with overexpression of the multidrug resistance gene MDR. Its gene product, P-glycoprotein, acts as a drug efflux pump for chemotherapeutic agents. The authors studied MDR expression in 28 adenocarcinomas arising in Barrett's esophagus (EAs) using a monoclonal antibody directed against this gene product. The results were compared with MDR expression in 27 gastric adenocarcinomas (GAs). P-glycoprotein was detected in both tumor and normal mucosa in 7 of 27 GAs and in 6 of 10 EAs that were resected without prior chemotherapy. Chemotherapy was given before surgical resection in 18 of the EAs studied. Five patients had a partial response to chemotherapy, and one had a complete eradication of his carcinoma; all of these tumors were negative for P-glycoprotein. Of 12 patients without chemotherapy response, 6 had tumors that expressed P-glycoprotein. The authors conclude that P-glycoprotein is present in EAs and GAs before exposure to chemotherapy. The presence of P-glycoprotein in tumors usually correlates with its presence in the adjacent mucosa. Its presence in tumor cells may be an indicator of lack of sensitivity to chemotherapy.

ATP Binding Cassette Transporter, Subfamily B, Mem↗
PubMed1990

An immunohistologic study of the feto-acinar pancreatic protein (FAP) in the normal pancreas, chronic pancreatitis, pancreatic adenocarcinoma, and intraabdominal metastases of adenocarcinomas.

The immunohistologic distribution of the feto-acinar pancreatic protein (FAP), detected by the monoclonal antibody (MoAb) J28 using an indirect immunoperoxidase technique, is described. Tests were carried out on normal adult pancreas (n = 10), chronic pancreatitis (n = 14), pancreatic adenocarcinoma (n = 17), intraabdominal metastases of pancreatic and nonpancreatic origin (n = 22), metastatic tumors invading the pancreas (n = 3), nonpancreatic fetal (n = 39) and adult (n = 65) normal organs (n = 104), and nonpancreatic malignancies (n = 145). All sections were formalin fixed and paraffin embedded. In the normal pancreas, only a few positive acinar cells were found around some islets of Langerhans. In pancreatitis there was an increased expression of FAP protein in the acinar tissue in relation to inflammatory changes. In cases of primary pancreatic adenocarcinoma and metastatic tumors in the pancreas, a strong expression of FAP protein in the peritumoral acinar area was found. The tumors themselves were FAP protein negative, as were the nonpancreatic tumors and normal organs. It can be concluded that FAP protein, detected by MoAb J28 in tissue sections, is specific for pancreatic exocrine tissue with reactive changes.

Adenocarcinoma↗
PubMed2001

Adenocarcinoma in situ and early invasive adenocarcinoma of the uterine cervix.

As data continue to accumulate, the clinical characteristics of preinvasive and early invasive glandular cervical neoplasia are becoming progressively better defined. Cytologic screening for these lesions is imprecise; however, modifications to current classification systems may improve the overall accuracy. All glandular abnormalities on the Papanicolaou smear, nevertheless, require judicious evaluation and careful follow-up. Cervical conization is the most definitive means of diagnosing adenocarcinoma in situ (ACIS). Because ACIS has been thought to represent a multifocal process, with negative conization margins having limited predictive value, conservative management protocols have been difficult to endorse. Several large studies now indicate that the surgical margin status may be a more reliable indicator of true disease clearance than previously thought. For young patients desiring to maintain reproductive capacity, ACIS appears to be safely managed by cold-knife conization combined with diligent surveillance. Early invasive adenocarcinoma of the uterine cervix is associated with an excellent prognosis, and recent data suggest that radical surgery may be unnecessary.

Adenocarcinoma↗