ECP 2022 Abstract Book
Virchows Archiv (2022) 481 (Suppl 1):S1–S364 13 by immunohistochemistry were expressing CD20, CD79a, CD3, PAX5, CD23, CIg, CD10, bcl-2, bcl-6 with Ki-67 proliferation rate 30-40% in the nodular areas and 0-5 centroblasts per high power field. No lymph nodal or bone marrow involvement was detected. Tumour markers were unremarkable. The final diagnosis was of a primary low-grade follicular lymphoma. Standardized first-line therapy for follicular lymphoma, with R-CHOP chemotherapy, was introduced. Conclusion: Most ovarian lymphomas represent secondary involvement by a systemic disease. In comparison, primary ovarian lymphomas are rare and incidental but ovary is the most common site in the female genital tract to be involved by haematological malignancies. This case exemplifies the need to consider NHL in the differential diagnosis of unusual large solid ovarian tumours. Their prognosis is better than secondary lymphomas, which have to be excluded clinically. In our case the patient is free of disease one year later. E-PS-09-013 Immunohistochemical markers for uterine fibroids recurrence prediction A. Magnaeva*, A. Asaturova, N. Tonoyan, I. Kozachenko, V. Kometova, L. Adamyan *National Medical Research Center for Obstetrics, Gynaecology and Perinatology named after Academician V.I.Kulakov, Russia Background & objectives: Uterine leiomyoma is the most common neoplasms in the female reproductive tract. Myomectomy is selected to preserve the uterus, however, this neoplasm can recur after this surgical treatment. Consequently, we aimed to identify immunohistochemical markers of recurrent uterine fibroids. Methods: Samples of 13 patients with primary diagnosed leio- myoma and 18 patients with recurrent one, who had been provided lapascopic reconstructive plastic surgery were recruited. Pathomor- phological and immunohistochemical examination was carried out for leiomyoma. The expression of the proliferation marker (Ki-67), vascular endothelial growth factor (VEGF), progesterone (PgR) and oestrogen (ER) receptors, proto-oncogene p16 and anti-oncogene p53 was evaluated. Results: It was found that Ki-67 level was higher in reccurent fibroids as to primary diagnosed tumours (p = 0.031), which may reflect the proliferative potential of the tumour most prone to recurrence. In studied groups there was significant difference between ER, PgR, p16 biomarkers. Increased VEGF expression was revealed in both leiomyomas compared to internal control (normal myometrium), but expression level in each group was not found to differ. Apparently, changes in p53 expression are not lead- ing in the pathogenesis of uterine fibroids, since there were no statistically significant differences in the expression of this protein between patients groups. Conclusion: Pathogenetic factors of recurrent uterine fibroids are high rates of Ki-67, VEGF, p16, ER and PgR in leiomyoma. These tissue-based markers seem to be usefull in routine practice to pre- dict the recurrent potential of uterine fibroids. Funding: State Assignment number 121032300216-3 E-PS-09-014 Endometrial stromal nodule in pregnancy - an unsual presenta- tion of exceedingly rare tumour D. Tapoi*, A. Dumitru, A. Iliesiu, M. Sajin, M. Costache, O. Munteanu *University Emergency Hospital, Romania Background & objectives: Endometrial stromal nodule is an exceed- ingly rare benign tumour, most often diagnosed in perimenopausal women, who complain of abnormal bleeding and local pain. In such cases, hysterectomy is recommended as clinical and imaging investiga- tions cannot rule out malignancy. Methods: We report the case of a pregnant 32 year old woman who a healthy, full-term baby by C-section. During the surgery, a well circumscribed, solid, yellow nodule measuring 6x4x3 cm was incidentally observed located on the maternal surface of the placenta. The tumour was surgically removed and underwent ample histopathological and immunohistochemical analysis. Results: Microscopic examination revealed a well demarcated proliferation of polygonal to spindle cells with abundant eosino- philic cytoplasm and large nuclei with conspicous nucleoli, consist- ent with decidual reaction. The cells were arranged in fascicles, within a myxoid stroma. The mitotic activity was about 15/10 HPF. Immunohistochemical analysis demonstrated that the tumour cells stain intensely for CD10, SMA and WT1 and moderately for PLAP. Ki67 (MIB1) proliferation index was about 20%, which could be explained by the hormonal stimuli. Based on these results, the diagnosis of endometrial stromal nodule was established with decidualization. Conclusion: Endometrial stromal nodules are among the rarest benign tumours of the uterus. Since these tumours usually affect perimenopausal women and preoperative investigations cannot establish the benign nature, hysterectomy is considered the standard treatment. The case we present is unique because, to our knowledge, there are only two reported cases of an endometrial stromal nodule associated with pregnancy. This association renders the histopathological diagnosis particularly difficult due to the unusual morphological features, reflecting hormonal changes. E-PS-09-015 Combined small cell and large cell neuroendocrine tumour of uterine cervix - a case report C. Valavanis*, N. Novkovic, G. Stanc, G. Vorgias, M. Papazian, M. Sevastiadou, E. Souka *Molecular Pathology Unit Metaxa Cancer Hospital, Greece Background & objectives: Neuroendocrine tumours of the female genital tract are aggressive neoplasms, developing most often in the uterine cervix (NECC) and accounting for 1.4% of all cervical cancers. The prognosis of NECC is poor and there is no standardized therapy. Methods: A 39-year-old patient presented to our hospital for vaginal bleeding. She had a previous core needle biopsy from omentum who showed endometrioid carcinoma of ovary/ endometrium (ER and PgR positive, WT-1 negative). Imaging showed frozen pelvis with a large right parametrial mass. Cervical and endometrial biopsies were performed in order to define the type and origin of the neoplasm. Results: In both specimens the histoplathological examination revealed a high-grade neoplasm with neuroendocrine features, with a mixture of small cells and large cells, with cellular necrosis and brisk mitotic figures. Both specimens had the same immunophe- notype. All the neoplastic cells were positive for Synaptophysin, Chromogranin A, CD56, ISL-1, p16 and CK7 and negative for ER, PgR, PAX-8, CDX-2, WT-1 and p40. The Ki-67 was positive in 80-90% of neoplastic cells. The endometrioid component was absent in both specimens. The diagnosis of high-grade neuroendo- crine carcinoma with small and large cell morphology was made. The absence of tumour elsewhere based on MRI concluded that the primary tumour is from the cervix. S259
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