Sentinel Nodal Metastasis Detection in Endometrial Carcinoma with Microcystic, Elongated, and Fragmented (MELF) Pattern by Cytokeratin Immunostaining

Kimmie M. Rabe, Molly E. Klein, Sayak Ghatak, Irina Stout, Alexandra Schefter, Britt K. Erickson, Mahmoud A. Khalifa

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives: The microcystic, elongated, and fragmented (MELF) pattern of myoinvasion in endometrial carcinoma (EC) is associated with an increased risk of lymph node metastasis. Our aim is to assess the role of cytokeratin immunohistochemical (IHC) stains in detecting sentinel nodal metastasis in MELF pattern tumors. Methods: We recovered 19 MELF pattern EC hysterectomies with lymphadenectomy from our files. Negative nodes were subjected to cytokeratin AE1/AE3 IHC. Ten additional cases with sentinel lymph node (SLN) biopsies primarily assessed by IHC were also analyzed. Results: Of the 19 cases of EC, 6 had positive lymph nodes based on H&E-stained sections at the time of their initial diagnosis. With the addition of IHC stains, 8 previously negative cases were found to have node metastases, and 3 of these were SLNs. Among the 10 cases primarily assessed by IHC, 5 had malignant cells in their SLNs. Conclusions: Cytokeratin IHC staining detected malignant cells in 9 of 16 cases with SLNs in our sample of women with MELF pattern of myoinvasion. Immunohistochemical stains should be routinely performed on SLNs from all MELF-positive cases to detect occult lymph node metastases and isolated tumor cells.

Original languageEnglish (US)
Pages (from-to)846-852
Number of pages7
JournalAmerican Journal of Clinical Pathology
Volume156
Issue number5
DOIs
StatePublished - Nov 1 2021

Bibliographical note

Publisher Copyright:
© 2021 American Society for Clinical Pathology, 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Keywords

  • Cytokeratin
  • Endometrial cancer
  • Immunohistochemistry
  • MELF
  • Nodal metastases
  • Sentinel lymph nodes

PubMed: MeSH publication types

  • Journal Article

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