Recognition of hereditary nonpolyposis colorectal cancer
)-related endometrial carcinoma
carcinoma by histologic features as compared with colonic cases.
Methods and Materials:
From the files of the Nijmegen Hereditary Cancer Clinic, HNPCC
-related (n = 6) endometrial and colorectal (n = 18) carcinomas were selected. For every HNPCC
-related tumor, 2 sporadic
control cases were included. The tumors were evaluated for the following 7 pathologic features: tumor differentiation, T-stage, growth pattern, presence of Crohn-like lymphoid reaction, mucinous differentiation, presence of lymphangioinvasive growth, and the amount of tumor-infiltrating lymphocytes.
-related endometrial carcinomas were significantly more often poorly differentiated (83% versus 27%), more often showed the presence of a Crohn-like lymphoid reaction (100% versus 13%) and lymphangioinvasive growth (67% versus 0%), and high number of tumor-infiltrating lymphocytes were more often present (100% versus 36%) compared with sporadic
endometrial carcinomas. The differences between HNPCC
and sporadic colorectal cancer
specimens were less discriminating.
-related endometrial carcinomas are characterized by poor differentiation, more frequent Crohn-like lymphoid reaction, lymphangioinvasive growth and more tumor-infiltrating lymphocytes. These features therefore might form the basis for selecting patients for counseling in a hereditary cancer clinic or testing for microsatellite instability or mutation analysis of mismatch repair genes, especially when they are of relatively young age.