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Gastrointestinal cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Stomach cancers usually form discrete ulcerating lesions, but can be nodular or polypoid. They are occasionally diffusely infiltrating leading to obliteration of the stomach lumen. Fifty percent arise in the pyloric region while, of those arising in the body, most are found along the lesser curvature; 90% are adenocarcinomas, subclassified into intestinal (well differentiated) and diffuse (undifferentiated). Around 5% are squamous carcinoma or adenoacanthoma (adenocarcinoma with areas of squamous metaplasia). There is, sometimes, evidence of prior intestinal metaplasia and carcinoma in situ in the surrounding mucosa.
Female Reproductive System
Published in Joseph Kovi, Hung Dinh Duong, Frozen Section In Surgical Pathology: An Atlas, 2019
Adenoacanthoma is a morphologic variant of adenocarcinoma of the endometrium. The squamous epithelium associated with the neoplastic glandular elements is composed of mature, differentiated squamous epithelial cells (Figure 91).
Skin
Published in Pritam S. Sahota, James A. Popp, Jerry F. Hardisty, Chirukandath Gopinath, Page R. Bouchard, Toxicologic Pathology, 2018
Zbigniew W. Wojcinski, Lydia Andrews-Jones, Daher Ibrahim Aibo, Rie Kikkawa, Robert Dunstan
SCC is a malignant tumor of the epidermis characterized by variable squamous differentiation, nuclear atypia, loss of intercellular bridges, penetration of the basal lamina, and invasion of the dermis or underlying striated muscles by cords or nests of neoplastic cells. Keratinizing forms of SCCs have cells arranged in cords or whorls with central keratinization, often referred to as “lamellated horn pearls” (Figure 21.6a). There is dyskeratosis and hyperkeratosis with variable degrees of keratinization. Occasionally, nests of cells may be present without keratinization. In the pseudoglandular form of SCC, a tubular or alveolar pseudoglandular pattern may be evident as a result of acantholysis, with the lumen occupied by desquamated acantholytic cells and debris. The lumen may be lined by one or several layers of epithelial cells with varying degrees of keratinization. In the non-keratinizing form of SCC, there is little evidence of keratinization. Cells appear atypical, polygonal, or spindle shaped with eosinophilic cytoplasm. There are numerous mitotic figures that may appear atypical or bizarre. Nuclear atypia is evident and the nuclei may be giant, fragmented, or multiple. Inflammation and ulceration may be evident. Differential diagnoses include squamous cell papilloma, keratoacanthoma, basal cell carcinoma, and malignant mammary adenoacanthoma (adenosquamous carcinoma) (Bruner et al. 2001; goRENI 2012; INHAND 2012). SCC has been associated with chronic dermatosis in beagle dogs (Hargis et al. 1977). SCC of the lip has been described in cynomolgus monkeys (Chamanza et al. 2010).
The prognostic value of squamous differentiation in endometrioid type endometrial cancer: a matched analysis
Published in Journal of Obstetrics and Gynaecology, 2022
Koray Aslan, Murat Öz, Burak Ersak, Hakan Kamil Müftüoğlu, Özlem Moraloğlu Tekin, Mehmet Mutlu Meydanli
Endometrioid histologic subtype constitutes 70–80% of all endometrial cancers (Kurman et al. 2014). A focus of squamous differentiation is recognised in 12.8–25% of women with endometrioid adenocarcinoma (Zaino and Kurman 1988; Abeler and Kjørstad 1992). The foci of squamous differentiation may exhibit either benign or malign cytological pattern, which was previously named as adenoacanthoma and adenosquamous carcinoma, respectively (Silverberg et al. 1972). However, more recent studies revealed that women with adenoacanthoma and adenosquamous carcinoma have a similar prognosis (Zaino et al. 1991). Therefore, the terminology of endometrioid carcinoma with squamous differentiation was proposed to refer both entities. The prognostic significance of the squamous differentiation was investigated in various studies (Zaino et al. 1991; Abeler and Kjørstad 1992; Jiang et al. 2017; De Andrade et al. 2019), but it still remained controversial. Some of the previous studies suggest that the squamous differentiation in endometrioid endometrial cancer was associated with poor prognosis (Jiang et al. 2017; De Andrade et al. 2019). In contrast, others reported similar (Abeler and Kjørstad 1992) or better outcomes for women with squamous differentiation (Zaino et al. 1991). Therefore, the prognostic significance of squamous differentiation in endometrioid endometrial cancer has not been delineated yet.
Extensive squamous metaplasia (morulosis) of the endometrium as a clinical and pathological problem: a case report and literature study
Published in Gynecological Endocrinology, 2020
Monika Kujdowicz, Tomasz Milewicz, Dariusz Adamek
The mechanism of the formation of morules remains a mystery. The prevailing pathogenetic theory is that hormonal changes in the blood influence the endometrial receptor status, which leads to extensive squamous metaplasia. Terada [1] presented one case (32-year-old) and Dutra [2] three (44-, 45- and 41-year-old) cases of morulosis in patients with abnormal uterine bleeding. Crum et al. [3] reported 10 cases of morulosis in women in the age range 19–45, presented with abnormal bleeding or infertility. Most of them were sent for consultation with a diagnosis of atypical hyperplasia of adenoacanthoma. Finally, Blaunstein [4] reported five cases of polycystic disease of ovaries with uterine morulosis (age range 24–37) which primary had been called ‘atypical glandular hyperplasia’. In some cases the hysterectomy (with or without salpingoophorectomy) was performed. Miranda and Mazur [5] reported two cases (49- and 34-year-old women), with endometrial hyperplasia without squamous metaplasia, who had been treated with progestin and later developed morules, however, without evidence of concomitant hyperplasia. Houghton et al. investigated genetic background of 18 cases of morules in patients with different endometrial lesions of uterus and ovary [6]. Okada et al. [7] showed a case of ovarian sex-cord tumor coexisting with endometrial adenoacanthoma (adenocarcinoma with squamous metaplasia), which may indicate correlation between higher level of testosterone and squamous metaplasia.