Marisa R. Nucci, M.D., Brigham and Women's Hospital, Boston, MA and Esther Oliva, M.D., Massachusetts General Hospital, Boston, MA
This course has been designed to discuss problematic aspects in the differential diagnosis of glandular lesions of the cervix and mesenchymal tumors of the uterus in which the correct diagnosis is important for patient management.
The following topics regarding glandular lesions of the cervix will be discussed with an emphasis on diagnostic problems and pitfalls: 1) criteria for diagnosis of in situ and invasive endocervical adenocarcinoma including variants; 2) pseudoneoplastic lesions and their distinction from invasive adenocarcinoma and adenocarcinoma in situ; 3) the concept of microinvasion; 4) distinction of endocervical vs. endometrial carcinoma, particularly in biopsy/curettage specimens.
In the presentation of mesenchymal tumors of the uterus special emphasis will be given to common benign subtypes of smooth muscle tumors, including highly cellular leiomyomas, mitotically active leiomyomas and leiomyomas with bizarre nuclei. Criteria for the categorization of epithelioid and myxoid smooth muscle tumors will be discussed as will criteria for classification of smooth muscle tumors into their main three prognostic categories: benign, of uncertain malignant potential and malignant. Conventional prognostic factors of leiomyosarcomas and information that may be garnered from new techniques will be considered. Recently emphasized aspects of the pathology and varied differential diagnosis of endometrial stromal tumors will be discussed in detail. The significance and utility of immunohistochemical markers in the differential diagnosis of endometrial stromal tumors and smooth muscle tumors as well as cytogenetics will be considered.
This course will be of interest to general pathologists, those with special interest in gynecologic pathology, and pathology residents and fellows. A set of transparencies/glass slides will be available for advanced mailing and a detailed syllabus will be distributed at the course.