3.c.iv Mesonephric Remnants, Hyperplasia and Carcinoma
Click to enlarge image
Mesonephric remnants can be found laterally in the cervix along the path of the mesonephric (Wolffian) ducts. They can be easily recognized because they are composed of small tubular glands lined by bland low cuboidal cells and many of these glands show characteristic densely eosinophilic luminal secretions (Fig. 1). The diagnostic of mesonephric remnants can be challenging when they become hyperplastic. Mesonephric hyperplasia can consist of an increased number of otherwise typical small bland mesonephric glands or of larger glandular structures with intraluminal papillary growth (Fig. 2). The bland nuclear morphology of mesonephric hyperplasia is helpful in distinguishing it from endocervical adenocarcinoma. Positive immunostaining for CD10 and calretinin along with a negative immunostaining for CEA are also helpful in proving their mesonephric origin (see table below). Rarely, a mesonephric carcinoma can arise within hyperplastic remnants and the diagnosis of malignancy is based on the infiltrative and confluent pattern of growth, along with the presence of a cervical mass or barrel-shaped cervix.
Immunohistochemical staining profile:
Mesonephric Adenocarcinoma |
Endocervical Adenocarcinoma |
Endometrial Adenocarcinoma |
|
Calretinin |
+ | - | - |
mCEA |
- | + | - |
CD10 |
+ | - | - |
ER/PR | - | - | + |
p16 | - (or focal) | + | - (or focal) |
Contact Information
Gynecologic Pathology
Room E-436,
2075 Bayview Avenue,
Toronto, Ontario
M4N 3M5
Admin. Assistant/Clerical Supervisor
Lesley Nicholson
lesley.nicholson@
sunnybrook.ca
Tel: 416-480-4009