Atypical (carcinoma-like) and simple glandular inclusions in retroperitoneal lymph nodes

Glandular inclusions in pelvine and retroperitoneal lymph nodes are rare. Most of them are of endosalpingiotic origin. We studied 34 cases of glandular inclusions, which we found among 1.039 patients with cervical cancer. All tumors were squamous cell cancer with or without keratinization on histology. The cases were screened for the occurrence of signs of cellular and architectural atypia. Additionally, antibodies for immunohistochemistry were used (HEA 125, Ber EP-4, vimentin and CEA). Eleven out of 34 cases showed cellular or architectural atypias. In one fifth of all specimens, we found atypical and simple glands in the same node. There was no correlation to the extent, distribution, and immunohistochemical staining pattern and the kind of glandular inclusion. The mean follow up was 7.3 years (1.2 to 18 years), and none of the women showed any signs of adenocarcinoma elsewhere. In most case, the distinction between glandular inclusions and metastatic adenocarcinoma is not difficult using conventional light microscopic criteria. Signs of atypia are increased high of the cells, enlarged nuclei, occurrence of nucleoli, epithelial infoldings, papillary pattern, cribriform or back-to-back formation of the glands, and multilayered cells.