Skip to main content
Journal of Clinical Pathology logoLink to Journal of Clinical Pathology
. 1990 Jul;43(7):554–559. doi: 10.1136/jcp.43.7.554

Adenoacanthoma of the endometrium: morphological changes induced by human papillomavirus.

W F Kealy 1, P G Annis 1, J A Barry 1, J M Hogan 1
PMCID: PMC502579  PMID: 2166095

Abstract

The observation of koilocyte-like features in the squamous epithelium of some endometrial adenoacanthomas prompted an investigation into a possible viral aetiology. These changes closely resemble those that occur in the ectocervical mucosa which are accepted as morphological evidence of human papillomavirus (HPV) infection. Sections of 87 hysterectomy specimens removed for endometrial carcinoma over 12 years, together with preoperative curettings, were reviewed for the presence of acanthomatous change and for appearances suggestive of HPV infection. The ages of the women ranged from 36 to 84 years, average age 62.6. Light microscopical examination showed koilocytosis, papillary formations, and intranuclear eosinophilic inclusions of both squamous and glandular epithelium in some tumours. Immunocytochemistry and DNA in situ hybridisation indicated the presence of HPV antigen in squamous and glandular cells, and perinuclear virus particles characteristic of HPV were seen on electron microscopical examination in those cells with nuclear inclusions. HPV probably infects endometrial adenocarcinomas directly from the cervix but it is unlikely that it has an aetiological role. It is possible, however, that in addition to being a "passenger," the virus may stimulate squamous metaplasia in some adenocarcinomas of the endometrium and may also exert some influence on their behaviour.

Full text

PDF
555

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aikawa M., Ng A. B. Mixed (adenosquamous) carcinoma of the endometrium: electron microscopic observations. Cancer. 1973 Feb;31(2):385–397. doi: 10.1002/1097-0142(197302)31:2<385::aid-cncr2820310217>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  2. Alberhasky R. C., Connelly P. J., Christopherson W. M. Carcinoma of the endometrium. IV. Mixed adenosquamous carcinoma. A clinical-pathological study of 68 cases with long-term follow-up. Am J Clin Pathol. 1982 Jun;77(6):655–664. doi: 10.1093/ajcp/77.6.655. [DOI] [PubMed] [Google Scholar]
  3. Badib A. O., Kurohara S. S., Vongtama V. Y., Selim M. A., Webster J. H. Biologic behavior of adenoacanthoma of endometrium. Am J Obstet Gynecol. 1970 Jan 15;106(2):205–209. doi: 10.1016/0002-9378(70)90264-4. [DOI] [PubMed] [Google Scholar]
  4. Barrowclough H., Jaarsma K. W. Adenoacanthoma of the endometrium: a separate entity or a histological curiosity? J Clin Pathol. 1980 Nov;33(11):1064–1067. doi: 10.1136/jcp.33.11.1064. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Blaustein A., Bigelow B., Demopoulos R. I. Association of carcinoma of the breast with adenosquamous carcinoma of endometrium. Cancer. 1978 Jul;42(1):326–329. doi: 10.1002/1097-0142(197807)42:1<326::aid-cncr2820420149>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  6. Bonney W. A., Jr, Glasser S. R., Clewe T. H., Noyes R. W., Cooper C. L. Endometrial response to the intrauterine device. Am J Obstet Gynecol. 1966 Sep 1;96(1):101–113. doi: 10.1016/s0002-9378(16)34648-8. [DOI] [PubMed] [Google Scholar]
  7. Drake M., Medley G., Mitchell H. Cytologic detection of human papillomavirus infection. Obstet Gynecol Clin North Am. 1987 Jun;14(2):431–450. [PubMed] [Google Scholar]
  8. Gupta J. W., Saito K., Saito A., Fu Y. S., Shah K. V. Human papillomaviruses and the pathogenesis of cervical neoplasia. A study by in situ hybridization. Cancer. 1989 Nov 15;64(10):2104–2110. doi: 10.1002/1097-0142(19891115)64:10<2104::aid-cncr2820641022>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  9. Haqqani M. T., Fox H. Adenosquamous carcinoma of the endometrium. J Clin Pathol. 1976 Nov;29(11):959–966. doi: 10.1136/jcp.29.11.959. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Hopkin I. D., Harlow R. A., Stevens P. J. Squamous carcinoma of the body of the uterus. Br J Cancer. 1970 Mar;24(1):71–76. doi: 10.1038/bjc.1970.10. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Kanbour A. I., Stock R. J. Squamous cell carcinoma in situ of the endometrium and fallopian tube as superficial extension of invasive cervical carcinoma. Cancer. 1978 Aug;42(2):570–580. doi: 10.1002/1097-0142(197808)42:2<570::aid-cncr2820420225>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  12. Lauchlan S. C. Metaplasias and neoplasias of Müllerian epithelium. Histopathology. 1984 Jul;8(4):543–557. doi: 10.1111/j.1365-2559.1984.tb02367.x. [DOI] [PubMed] [Google Scholar]
  13. Liu C. T. A study of endometrial adenocarcinoma with emphasis on morphologically variant types. Am J Clin Pathol. 1972 May;57(5):562–573. doi: 10.1093/ajcp/57.5.562. [DOI] [PubMed] [Google Scholar]
  14. MARCUS S. L. Adenoacanthoma of the endometrium. A report of 24 cases and a review of squamous metaplasia. Am J Obstet Gynecol. 1961 Feb;81:259–267. doi: 10.1016/s0002-9378(16)36363-3. [DOI] [PubMed] [Google Scholar]
  15. Martinez-Palomo A., Le Buis J., Bernhard W. Electron microscopy of adenovirus 12 replication. 1. Fine structural changes in the nucleus of infected KB cells. J Virol. 1967 Aug;1(4):817–829. doi: 10.1128/jvi.1.4.817-829.1967. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Morrison D. L. Adenoacanthoma of the uterine body. J Obstet Gynaecol Br Commonw. 1966 Aug;73(4):605–610. [PubMed] [Google Scholar]
  17. NOVAK E. R., NALLEY W. B. Uterine adenoacanthoma. Obstet Gynecol. 1957 Apr;9(4):396–402. [PubMed] [Google Scholar]
  18. Ng A. B., Reagan J. W., Storaasli J. P., Wentz W. B. Mixed adenosquamous carcinoma of the endometrium. Am J Clin Pathol. 1973 Jun;59(6):765–781. doi: 10.1093/ajcp/59.6.765. [DOI] [PubMed] [Google Scholar]
  19. Roberts P. F., Brown J. C. Condylomatous atypia of the endometrial cavity. Case report. Br J Obstet Gynaecol. 1985 May;92(5):535–538. doi: 10.1111/j.1471-0528.1985.tb01362.x. [DOI] [PubMed] [Google Scholar]
  20. Salazar O. M., DePapp E. W., Bonfiglio T. A., Feldstein M. L., Rubin P., Rudolph J. H. Adenosquamous carcinoma of the endometrium. An entity with an inherent poor prognosis? Cancer. 1977 Jul;40(1):119–130. doi: 10.1002/1097-0142(197707)40:1<119::aid-cncr2820400121>3.0.co;2-9. [DOI] [PubMed] [Google Scholar]
  21. Silverberg S. G., Bolin M. G., DeGiorgi L. S. Adenoacanthoma and mixed adenosquamous carcinoma of the endometrium. A clinicopathologic study. Cancer. 1972 Nov;30(5):1307–1314. doi: 10.1002/1097-0142(197211)30:5<1307::aid-cncr2820300524>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  22. zur Hausen H. Papillomaviruses in human cancer. Cancer. 1987 May 15;59(10):1692–1696. doi: 10.1002/1097-0142(19870515)59:10<1692::aid-cncr2820591003>3.0.co;2-f. [DOI] [PubMed] [Google Scholar]

Articles from Journal of Clinical Pathology are provided here courtesy of BMJ Publishing Group

RESOURCES