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- Title
Vaginal biopsy goes beyond squamous epithelium: A case report of high-grade serous adenocarcinoma mimicking high grade squamous intraepithelial lesion.
- Authors
Qi Yang; Hongming Qiu
- Abstract
Background: High grade serous adenocarcinoma (HGSC) of mullerian origin is a well-documented entity with many different histologic features and cytological features. Making an accurate diagnosis is critical in-patient management, however these features can post significant challenges for practicing pathologists. Case reports: We describe a case of high-grade serous adenocarcinoma of mullerian origin from a vaginal biopsy mimicking high grade squamous intraepithelial lesion (HSIL). The patient is a 77-year-old female with history of uterine carcinoma treated with chemotherapy and radiation therapy. A recent vaginal biopsy 4 years after the original diagnosis was send to pathology for microscopic examination. On H&E section, it contains high grade carcinoma with solid and papillary growth pattern and slightly spindling in appearance, resembling those of less mature HSIL. No glandular differentiation is noted. Immunohistochemistry studies were performed due to her previous history of uterine carcinoma and confirmed that this is a HGSC morphologically mimicking HSIL. Conclusions: HGSC may have many different histological appearances that can post significant challenges for a busy practicing pathologist. Although the morphological diversity of this entity has been well recognized in the literature, signing out routine follow-up biopsy specimen without detailed history can be misleading and challenging. Careful reviewing patient's history and performing relevant immunohistochemistry studies can be very helpful in reaching correct diagnosis.
- Publication
Canadian Journal of Pathology, 2016, Vol 8, p40
- ISSN
1918-915X
- Publication type
Article