Endometrial cysts within the liver: A rare entity and its differential diagnosis with mucinous cystic neoplasms of the liver

Maylee Hsu, Benoit Terris, Tsung Teh Wu, Yoh Zen, Hock Liew Eng, Wan Ting Huang, Matthew M. Yeh

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Endometrial cysts within the liver are rare but can present as diagnostic challenges on small biopsies or frozen sections and may mimic mucinous cystic neoplasms (MCN) of the liver. Five cases of endometrial cysts and 6 cases of MCNs within the liver were collected. The clinicopathological, imaging, and immunohistochemical features were systematically reviewed and compared. The average size of the endometrial cysts was 8.3 cm. Four patients had a prior pelvic operation and coexisting endometriosis at other sites. All 5 cases of endometrial cysts had positive ER staining within both the epithelium and the stroma. PR was also positive in both epithelial and stromal cells in 4 cases. Four cases had additional immunostains performed, which all showed cytokeratin 19 and cytokeratin 7 positivity (only in epithelium) and CD10 positivity (only in stroma). α-Inhibin and calretinin were negative for both the epithelium and the stroma in all 4 cases. All 6 MCN cases (mean size, 11.1 cm) had positive ER, PR, and α-inhibin staining only in the stroma. ER and PR were positive in both the epithelium and stromal cells in endometrial cysts, whereas they were positive only in the stromal cells of MCNs. The stromal cells were CD10 positive and α-inhibin negative in endometrial cysts as opposed to the opposite staining pattern in MCNs. Awareness of this distinct staining pattern and the possibility of endometrial cysts in the liver can lead to accurate diagnoses and appropriate treatment modalities.

Original languageEnglish (US)
Pages (from-to)761-767
Number of pages7
JournalHuman Pathology
Volume45
Issue number4
DOIs
StatePublished - 2014

Fingerprint

Liver Neoplasms
Cysts
Differential Diagnosis
Stromal Cells
Liver
Inhibins
Epithelium
Staining and Labeling
Keratin-7
Keratin-19
Calbindin 2
Frozen Sections
Endometriosis
Epithelial Cells
Biopsy
Neoplasms

Keywords

  • Endometrial cysts
  • Immunohistochemistry
  • Liver
  • Mucinous cystic neoplasm
  • Stroma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Endometrial cysts within the liver : A rare entity and its differential diagnosis with mucinous cystic neoplasms of the liver. / Hsu, Maylee; Terris, Benoit; Wu, Tsung Teh; Zen, Yoh; Eng, Hock Liew; Huang, Wan Ting; Yeh, Matthew M.

In: Human Pathology, Vol. 45, No. 4, 2014, p. 761-767.

Research output: Contribution to journalArticle

Hsu, Maylee ; Terris, Benoit ; Wu, Tsung Teh ; Zen, Yoh ; Eng, Hock Liew ; Huang, Wan Ting ; Yeh, Matthew M. / Endometrial cysts within the liver : A rare entity and its differential diagnosis with mucinous cystic neoplasms of the liver. In: Human Pathology. 2014 ; Vol. 45, No. 4. pp. 761-767.
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