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. 2011 Dec;35(12):1759-65.
doi: 10.1097/PAS.0b013e318233b0f7.

Fallopian tube correlates of ovarian serous borderline tumors

Anna R Laury  1 , Gang Ning, Charles M Quick, Jonathan Bijron, Mana M Parast, Rebeca A Betensky, Sara O Vargas, Frank D McKeon, Wa Xian, Marisa R Nucci, Christopher P Crum
Affiliations

Fallopian tube correlates of ovarian serous borderline tumors

Anna R Laury et al. Am J Surg Pathol. 2011 Dec.

Abstract

Ovarian serous borderline tumors (SBTs) are presumed to originate in the ovarian cortex or peritoneal surface. The pathogenetic role of the fallopian tube (FT) is unclear; however, recently, secretory cell outgrowths (SCOUTs) lacking PAX2 expression were described in benign FTs. This study addressed (1) the differentiation characteristics of SBTs and (2) the frequency of SCOUTs lacking PAX2 expression in the FTs of patients with SBTs and compared (3) SCOUT morphology and (4) PAX2 expression with SBTs. SBTs and FT epithelium shared both ciliated (p73) and secretory (HMFG2) differentiation. PAX2-null SCOUT frequency in FT cross-sections from patients with SBTs was 0.28 (110 of 398) versus 0.112 in benign hysterectomies and nearly 0 in pediatric and postpartum sterilization specimens (P = < 0.001). When adjusted for age, the differences narrowed but remained significant (P = 0.010). SCOUTs were heterogeneous, some displaying ciliated differentiation and papillary architecture. Two cases of discrete multifocal papillary SCOUTs in the FTs were associated with SBTs. All SBTs had heterogeneous PAX2 staining with areas of PAX2 loss. This study shows for the first time that PAX2-null SCOUTs are more common in the oviducts of women with SBTs and that loss of PAX2 expression occurs in most SBTs. These discoveries link both morphologic and functional gene (PAX2) alterations in the oviduct to SBTs, similar to that reported in high-grade serous carcinoma. Further study is warranted to clarify the relationship of the oviduct to serous neoplasia.

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Figures

Figure 1
Figure 1
Immunophenotype of serous borderline tumor (A), displaying ciliated (p73 staining nuclei, panel B) and secretory cell (HFMG2 staining cytoplasm, panel C) differentiation.
Figure 2
Figure 2
Secretory cell outgrowths (SCOUTs) of the fallopian tube composed of low columnar secretory cells (A), pseudostratified epithelium (B) and prominent ciliated cell differentiation (C). Corresponding PAX2-null areas are denoted by arrows in panels D, E, and F.
Figure 3
Figure 3
Multifocal oviductal papillary SCOUTs from two cases, associated with SBTs; Case 1 (A, B) and Case 2 (C–F).
Figure 4
Figure 4
Graphical depiction of average PAX2-null SCOUT frequency per tubal section in pediatric autopsies, postpartum sterilization specimens (PPS), benign salpingooophorectomies (SO) and serous borderline tumors (SBTs).
Figure 5
Figure 5
A SBTs (A) with heterogeneous PAX2 immunostaining (B); at higher power showing positive (upper right) and negative (lower left) negative staining in a single field (C).
See this image and copyright information in PMC

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