Ovarian Signet-ring Stromal Tumor: A Morphologic, Immunohistochemical, and Molecular Study of 7 Cases With Discussion of the Differential Diagnosis.

Autor:	Tchrakian N; Department of Laboratory Medicine and Pathobiology, University of Toronto, University Health Network, Toronto, ON., Oliva E; Pathology Division of Women's and Perinatal Pathology, Department, Massachusetts General Hospital.; Harvard Medical School., Chong AS; Cancer Research Program, Research Institute, McGill University Health Centre., Rivera-Polo B; Cancer Research Program, Research Institute, McGill University Health Centre.; Gerald Bronfman Institute of Oncology, McGill University, Montreal, QC, Canada.; Bellvitge Institute for Biomedical Research (IDIBELL), Barcelona, Spain., Bennett JA; Department of Pathology, University of Chicago Medical Center, Chicago, IL., Nucci MR; Department of Pathology, Brigham and Women's Hospital, Boston, MA., Sah S; Department of Histopathology, University Hospitals Coventry and Warwickshire NHS Trust, Walsgrave, Coventry., Schoolmeester JK; Department of Laboratory Medicine and Pathology, Mayo Clinic, Jacksonville, FL., van der Griend RA; Canterbury Health Labs, Christchurch, New Zealand., Foulkes WD; Cancer Research Program, Research Institute, McGill University Health Centre., Clarke BA; Department of Laboratory Medicine and Pathobiology, University of Toronto, University Health Network, Toronto, ON., Young RH; Pathology Division of Women's and Perinatal Pathology, Department, Massachusetts General Hospital.; Harvard Medical School., McCluggage WG; Department of Pathology, Belfast Health and Social Care Trust, Belfast, UK.
Jazyk:	angličtina
Zdroj:	The American journal of surgical pathology [Am J Surg Pathol] 2022 Dec 01; Vol. 46 (12), pp. 1599-1610. Date of Electronic Publication: 2022 Aug 29.
DOI:	10.1097/PAS.0000000000001954
Abstrakt:	Signet-ring stromal tumor (SRST) is a rare ovarian stromal neoplasm characterized by a population of bland signet-ring cells, devoid of mucin or lipid, in a generally cellular fibromatous stroma. Previous reports have described heterogenous immunohistochemical and molecular genetic findings, including occasional nuclear β-catenin expression and/or CTNNB1 mutations. We report 10 ovarian stromal neoplasms originally diagnosed as SRST. All but 1 tumor underwent detailed immunohistochemical analysis (including β-catenin) and 5 of 10 had CTNNB1 mutation analysis performed. All tumors contained a population of morphologically bland signet-ring cells that ranged from 15% to 95% of the neoplasm, characterized by a single large empty intracytoplasmic vacuole, mostly with nuclear indentation. Six of the 10 tumors contained cellular fibroma-like areas, comprising from 10% to 85% of the neoplasm. Three of the 10 tumors were reclassified as microcystic stromal tumor with signet-ring cells on the basis of the microcyst formation and hyalinized stroma, beta-catenin and cyclin D1 nuclear expression and/or CTNNB1 mutation, CD10 staining and largely absent expression of inhibin and calretinin. In the remaining 7 tumors, the diagnosis of SRST remained, constituting the largest series of SRST reported in the literature to date. The results of our study suggest that a subset of tumors diagnosed as ovarian SRST, especially those which show β-catenin nuclear positivity and/or CTNNB1 mutation, likely represent microcystic stromal tumor with variant morphology. We also suggest that at least a subset of SRSTs without evidence of Wnt/β-catenin pathway abnormalities may be related to ovarian fibromas. We discuss the differential diagnosis of ovarian neoplasms containing signet-ring cells. Competing Interests: Conflicts of Interest and Source of Funding: The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article. (Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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