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Use of Immunohistochemical Markers (HNF-1β, Napsin A, ER, CTH, and ASS1) to Distinguish Endometrial Clear Cell Carcinoma From Its Morphologic Mimics Including Arias-Stella Reaction.
Int J Gynecol Pathol
July 2020
Department of Pathology and Laboratory Medicine, University of British Columbia (J.X.J., B.T.-C, B.G., D.G.H., L.N.H.) Department of Molecular Oncology, British Columbia Cancer Research Centre (D.R.C.) Genetic Pathology Evaluation Centre (S.L., A.S.C., C.C.) Department of Pathology, Vancouver General Hospital (B.G., L.N.H.), Vancouver, British Columbia, Canada.
The diagnosis of clear cell (CC) carcinoma of the endometrium can be challenging, especially when endometrioid (EC) and serous (SC) endometrial cancers exhibit nonspecific clear cell changes, in carcinomas with mixed histology and in the setting of Arias-Stella reaction (ASR). In this study, classic CC immunohistochemical markers (Napsin A, HNF-1β, and ER) and 2 recent novel markers, cystathionine gamma-lyase (CTH) and arginosuccinate synthase (ASS1), are assessed for their utility in distinguishing CC from its morphologic mimics. Tissue microarrays containing 64 CC, 128 EC, 5 EC with clear cell change, 16 SC, 5 mixed carcinomas, and 11 whole ASR sections were stained, with 12 additional examples of ASR stained subsequently.
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