Cytokeratin Expression Profile Study in Malignant Ovarian Tumors
A Retrospective Study in Teaching Institution
AbstractBackground: Expression of cytokeratin is seen in varied ovarian tumors including primary surface epithelial tumors, Granulosa cell tumors, Sertoli – Leydig cell tumors, non dysgerminomatous germ cell tumors and metastatic carcinomas. The aim of the study is to demonstrate various patterns of cytokeratin expression in epithelial and non-epithelial malignant ovarian tumors. Methods: Materials for the present study of 39 cases of malignant ovarian tumors obtained from the patients admitted during the period of two years. For histopathological examination, 10% formalin fixed embedded representative tissue sections were studied with Haematoxylin and Eosin. Detailed microscopic examination was carried out. Application of IHC for cytokeratin expression study was carried by streptavidin – biotin complex method. The details of clinical history and relevant investigations were obtained. Results: The total number of malignant ovarian tumors studied during two year period was 39 cases. Among that, serous tumors was the most common [25 cases (64.6%)], followed by Sex cord stromal tumors [6 cases (15.3%)], metastatic tumors [4 cases (10.2%)] and Germ cell tumors [4 cases (10.2%). Cytokeratin was positive in >50% of serous epithelial cells, followed by krukenberg tumor and showed focal positivity in non-epithelial tumors. Conclusion: Evaluation for pancytokeratin (AE 1 / AE 3) in the context of ovarian tumors is useful only in specific instances including identification of epithelial differentiation in an apparently undifferentiated neoplasms and distinction of dysgerminoma from non dysgerminomatous germ cell tumors. Non dysgerminomatous germ cell tumors characteristically express cytokeratin diffusely and strongly, whereas in dysgerminoma it shows only focal and weak expression.
Kumar, V., Abbas, A., Aster, J., Cotran, R. and Robbins, S. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Philadelphia: Elsevier, 2015. p.11.
Rosai, J. and Ackerman, L. Rosai and Ackerman's surgical pathology. 10th ed. Edinburgh: Mosby/ Elsevier, 2011 pp.43-45.
Miettinen M: Keratin immunohistochemistry. Update of applications and pitfalls. Pathol Annu 1993; 28:113-143.
Basu, P., De, P., Mandal, S., Ray, K. and Biswas, J. Study of 'patterns of care' of ovarian cancer patients in a specialized cancer institute in Kolkata, eastern India. Indian Journal of Cancer, 2009;46(1),28.
Suslow, R. and Tornos, C. DIAGNOSTIC PATHOLOGY OF OVARIAN TUMORS. [S.l.]: SPRINGER-VERLAG NEW YORK, 2011;47.
Tavassoli, F. and Devilee, P. Pathology and genetics of tumours of the breast and female genital organs. Lyon: International Agency for Research on Cancer, 2003; p.117.
Wick, M. Immunohistochemical approaches to the diagnosis of undifferentiated malignant tumors. Annals of Diagnostic Pathology, 2008;12(1), 72-84.
Underwood, J. and Lowe, D. Recent advances in histopathology 20. London: Royal Society of Medicine, 2003;17-28.
Weidner, N. Modern surgical pathology. 2nd ed. Philadelphia, PA: Saunders/ Elsevier, 2009; pp.51-52.
Clement, P. and Young, R. Atlas of gynecologic surgical pathology. 3rd ed. Philadelphia: Saunders, 2014; pp.289-290.
Deka, P., Ben, D. and Dawka, S. A rare case of pancreatic adenocarcinoma mimicking an early ovarian tumour. Obstetrics and Gynecology Today, 2007;12(2), 558-562.
Crum and Koapar. Differential diagnosis of Gynecologic Disorders. Arch pathol Lab Med, 2015;139:48.
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