A helpful clue for serous morphology is the irregular luminal border (micropapillae or tuftings of cells). In this example, the archetecture raises the possibility of serous carcinoma but the cytology does not; as serous carcinoma cytology are high grade which means if you are looking at a FIGO2 or FIGO3 endometrioid carcinoma, high grade cytology is expected (marked nuclear pleomorphism, macronucleoli, and conspicuous mitotic activity), otherwise, it's reasonable to think about serous carcinoma with this architecture.
A review study by Dr. Fadare in 2018 showed that 259 serous carcinoma cases were sequenced whole-exome in 5 studies. TP53 mutations were only found in 75% of endometrial serous carcinomas (range, 60 to 88). The number of studies reporting an aberrant p53 rate of less than 80% in endometrial serous carcinomas totaled 12 (33%) of 36. Thus, neither mutated pattern p53 or wild-type p53 can be 100% in this setting.
References: Fadare O, Roma AA, Parkash V, Zheng W, Walavalkar V. Does a p53 "Wild-type" Immunophenotype Exclude a Diagnosis of Endometrial Serous Carcinoma? Adv Anat Pathol. 2018 Jan;25(1):61-70. doi: 10.1097/PAP.0000000000000171. PMID: 28945609.
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