Microscopic Description -- An Ovarian Mass
MICROSCOPIC DESCRIPTION:
Legends:
- Figure 1 Ovary, focal lobulation of stromal cells with alternate myxoid and edematous areas and occasional tubules
- Figure 2 Ovary, spindle to small round-oval cells with occasional tubular and trabecular pattern
- Figure 3 Ovary, round to oval cells in vague trabecular pattern with angular hyperchromatic nuclei and high mitotic activity. Note frequent atypical and abnormal mitotic figures
- Figure 4 Immunoperoxidase stain. The neoplastic cells stain with Inhibin.
- Figures 5 & 6 Recurrent omental lesion. The cells in diffuse to vague storiform and fascicular pattern with alternate myxoid and edematous areas. Neoplastic cells are round or elongated with hyperchromatic nuclei. Significant mitotic activity (>10 / 10 HPF) is evident. Sertoli-like tubular structures or Leydig cell nests are not seen, as seen in original ovarian tumor.
The ovarian neoplasm showed monotonous arrangement of spindle to small round-oval cells. This pattern was interrupted by ill-defined masses of tall columnar Sertoli cells with round to oval and angular nuclei in occasional tubular and trabecular pattern (Fig. 1). The cells were round or elongated with hyperchromatic nuclei. Nuclear grooves were not present. Mitotic activity was brisk (>10 / 10 HPF) , with frequent atypical and abnormal mitotic figures. The cells were decorated with Inhibin and focally with cytokeratin (AE1/AE3) and S-100. The tumor cells did not stain with NSE, Synaptophysin, GFAP, Actin and Vimentin antibodies.
Peritoneal fluid cytology was positive for malignant cells.
The recurrent tumor was less differentiated than the original ovarian neoplasm. The cells were arranged in diffuse to vague storiform and fascicular pattern. Focal lobulation of stromal cells was also seen with alternate myxoid and edematous areas. Neoplastic cells were round or elongated with hyperchromatic nuclei. Nuclear grooves were not present. Significant mitotic activity (>10 / 10 HPF) was evident, suggesting fibrosarcoma. Sertoli-like tubular structures or Leydig cell nests were not seen, as in the original ovarian tumor. The tumor was focally positive for cytokeratin (AE1/AE3 and Cam 5.2) and diffusely positive for Vimentin. The cells did not stain with Inhibin or Alpha Fetoprotein (AFP).
FINAL DIAGNOSIS
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