Immunophenotypic alteration of the stromal component in minimal deviation adenocarcinoma ('adenoma malignum') and endocervical glandular hyperplasia: a study using oestrogen receptor and α-smooth muscle actin double immunostaining

• Published in: Histopathology Vol. 46; no. 2; pp. 130 - 136
• Main Authors: Mikami, Y, Kiyokawa, T, Moriya, T, Sasano, H
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Science Ltd 01.02.2005; Blackwell
• Subjects: Actins - analysis; Adenocarcinoma - metabolism; Adenocarcinoma - pathology; adenoma malignum; Biological and medical sciences; Cervix Uteri - chemistry; Cervix Uteri - pathology; Female; Humans; Hyperplasia; Immunohistochemistry - methods; Investigative techniques, diagnostic techniques (general aspects); Medical sciences; Metaplasia; Muscle, Smooth - chemistry; Neoplasm Invasiveness; oestrogen receptor; Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques; Receptors, Estrogen - analysis; stroma; Uterine Cervical Neoplasms - metabolism; Uterine Cervical Neoplasms - pathology; α-smooth muscle actin; Adenocarcinoma; Immunohistochemistry; α-smooth muscle actin; Immunophenotype; Hyperplasia; Estrogen; Contractile protein; Stroma; Smooth muscle; adenoma malignum; Malignant tumor; Adenoma; Uterine cervix; oestrogen receptor; Ovarian hormone; Anatomic pathology; Actin; Benign neoplasm; Sex steroid hormone; Deviation; Hormonal receptor
• ISSN: 0309-0167; 1365-2559
• DOI: 10.1111/j.1365-2559.2005.02057.x

Aims : To define the phenotypic alteration of the stromal component in association with destructive invasion which is a crucial feature in distinguishing minimal deviation adenocarcinoma (MDA) from benign endocervical glandular lesions. Methods and results : We studied endocervical glandular hyperplasias including non‐specific‐type (NEGH) (n = 3) and lobular‐type (LEGH) (n = 8), and minimal deviation adenocarcinoma (MDA) (n = 11), well‐differentiated endocervical adenocarcinoma of usual‐type (WDA) (n = 11), and adenocarcinoma in situ (AIS) (n = 6) of the cervix, by double immunostaining for oestrogen receptor (ER) and α‐smooth muscle actin (α‐SMA) using peroxidase‐ and alkaline phosphatase‐polymer methods, respectively. Glands in NEGH invariably showed nuclear staining for ER, with surrounding ER+/α‐SMA– stromal cells, whereas LEGH also harboured ER+/α‐SMA– spindle cells, but lacked nuclear staining for ER in constituent glands. In contrast, both WDA and MDA displayed accompanying stroma rich in α‐SMA+ spindle cells in close vicinity to the infiltrating neoplastic glands, with only occasional weakly ER+ stromal cells. WDA tended to contain more α‐SMA+ cells. The distribution of α‐SMA+ cells was periglandular (6/11), patchy (6/11), and/or diffuse (4/11) in WDA, whereas in MDA it was periglandular (11/11) and/or patchy (8/11). AIS was surrounded by ER+/α‐SMA− stromal cells. All cases of WDA, MDA, and AIS lacked nuclear staining for ER. Conclusions : Both MDA and WDA can be distinguished from LEGH and NEGH by identifying surrounding α‐SMA+ stromal cells and the absence or decreased number of ER+ cells, possibly as a result of the desmoplastic reaction with myofibroblasts replacing pre‐existing ER+ stromal cells. In particular, the periglandular distribution of these α‐SMA+ stromal cells can be a clue suggesting destructive stromal invasion in cases of MDA, although occasional glands may lack these cells.