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Volume 39, Issue 1, 2025
Online ISSN: 3042-3511
ISSN: 3042-3503
Volume 39 , Issue 1, (2025)
Published: 31.03.2025.
Open Access
Welcome to Issue 39, No. 1 – the first of our two annual publications for this year. Inside, you'll find a curated selection of articles. Start your year with the essential knowledge and perspectives offered in this timely edition
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01.04.2018.
Poster session
Lobular endocervical glandular hyperplasia vs. Minimal deviation adenocarcinoma: case report
Aim: Lobular endocervical glandular hyperplasia is very rare, differential diagnostic difficult entity, which often mimics more aggressive endocervical lesions, with worse prognosis. Introduction: Lobular glandular endocervical hyperplasia(LEGH) is benign lesion with lobular proliferation of endocervical glands and endocervical epithelium without or with minimal nuclear atypia. Lobular structure can be deep into the cervical tissue without stromal invasion, which is important difference between adenocarcinoma of minimal deviation(MDA), well-differentiated endocervical type of adenocarcinoma, similar to LEGH. Case report: The patient is 50 years, with demarcated, nodular, multicystic tumor, localized deep in cervical tissue. Microscopic analysis shows numerous cystically dilated endocervical glands with lobular presentation, surrounded by hyperplastic fibrous stroma. Glandular acini are diffusely localized, with centrally dilated acinus and peripheral smaller tubular structures. Glands are without the presence of architectural changes and cytonuclear atypia, with uniform, endocervical epithelium.Immunochemical analysis showed:CEA- /CA125focal /p16 focal /Er and Pr focal epithelium, diffusely in stroma. Because structures were described deep in the cervical tissue, MDA is considered diagnostically differential. However, glands do not show signs of distortion(architectural atypia), which is important feature of this entity, as well as no pronounced surrounding desmoplastic stromal reaction. Macroscopic tumor is well demarcated, and the CEA marker is negative, which also suggested LEGH. Conclusion: LEGH and MDA show a quiet clinical and histological similarity. Association of LEGH(50%) with MDA and 40% with cervical adenocarcinoma has been demonstrated, suggesting the possible precancerous potential of LEGH. Research of the lesion microenvironment could be an interesting subject for further research.
Ljubiša Jovanović, Simić Ljubica, Stefanović Radomir, Vrtikapa Jelena, Pajević Mila, Atanacković Jasmina, Milenković Svetlana
01.12.2011.
Review Article
Tumors of the uterus
The latest version of uterine tumors classification was done in 2003. According to WHO classification, endometrial cancers are divided into two groups, so called Type I and Type II. Endometrioid adenocarcinoma has a higher frequency and belongs to Type I. Serous and clear-cell adenocarcinoma, are forming Type II and by definition, they are high grade cancers with poor prognosis and no clearly defined precursors and predisposing risk factors. In Type I, there is a PTEN mutation and in Type II overexpression of p53. These two biomarkers are used in their differential diagnosis.WHO has defined a three-step system in determining the grade of endometrioid adenocarcinoma in which squamous component has no significance. There are other, two-step, grading systems which are not generally accepted.2009 FIGO classification is still in use for tumor staging and according to that tumors confined to the uterus body are divided into stages IA and IB. In the group of mesenchyme tumors, undifferentiated sarcoma was separated, due to different morphology and immunohistochemical profile compared to leiomyoma and endometrial stromal sarcoma. New terms, like UTROSCT, are accepted as well as new theory about the origin of carcinosarcoma. Common believe is that these tumors have epithelial origin and therefore sarcoma component showed positivity on epithelial and mesenchymal markers too. Large number of new antibodies was discovered which in the diagnosis and differential diagnosis of uterine tumors are only meaningful when used in correlation with the clinical picture and morphological data (endometrial carcinoma vs. ovarian carcinoma, adenosarcoma vs. adenofibroma).
Svetlana Milenkovic