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Updated: Feb 21, 2026
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Multiplexed Fluorescent Immunohistochemical Staining of Four Endometrial Immune Cell Types in Recurrent Miscarriage
Published on: August 4, 2021
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Despite Diagnostic Morphology, Many Mixed Endometrial Carcinomas Show Unexpected Immunohistochemical Staining
Cathleen E Matrai1, Edyta C Pirog, Lora Hedrick Ellenson
1Department of Pathology and Laboratory Medicine, New York Presbyterian Hospital-Weill Cornell Medicine, New York, New York.
Summary
Mixed endometrial carcinomas often show unexpected immunohistochemical patterns, challenging clinical diagnosis. Biomarker evaluation is crucial, as these tumors may not reflect the typical features of their constituent cell types.
Area of Science:
- Gynecologic Pathology
- Oncology
- Molecular Diagnostics
Background:
- Endometrial carcinomas traditionally classified by histology.
- Immunohistochemistry is increasingly vital for complex cases.
- Mixed endometrial carcinomas present diagnostic challenges.
Purpose of the Study:
- Evaluate mixed endometrial carcinomas using a biomarker panel.
- Assess the consistency and clinical utility of immunohistochemical stains.
- Investigate immunohistochemical patterns in mixed histology tumors.
Main Methods:
- Analyzed 18 mixed endometrial carcinoma cases (serous, endometrioid, clear cell).
- Utilized immunohistochemistry for p53, p16, Ki67, ER, PR, and Napsin A.
- Quantified staining intensity and extent.
Main Results:
- Only 3 of 18 cases showed typical immunostaining patterns.
- 15 cases exhibited unexpected patterns with at least one marker.
- Common unexpected findings included diffuse p16/ER/PR positivity in EC/SC and diffuse p53 in SC/CC.
Conclusions:
- Components of mixed endometrial carcinomas may lack expected immunohistochemical features.
- Tumor heterogeneity may arise from a single clone with divergence.
- Diagnostic approach should account for atypical immunohistochemical presentations.
