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
Article first published online: 5 FEB 2005
Volume 46, Issue 2, pages 130–136, February 2005
How to Cite
Mikami, Y., Kiyokawa, T., Moriya, T. and Sasano, H. (2005), 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. Histopathology, 46: 130–136. doi: 10.1111/j.1365-2559.2005.02057.x
- Issue published online: 5 FEB 2005
- Article first published online: 5 FEB 2005
- Date of submission 6 January 2004 Accepted for publication 29 March 2004
- α-smooth muscle actin;
- adenoma malignum;
- oestrogen receptor;
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.