Abstract：
Mesonephric-like adenocarcinomas rarely occur in the uterus and the ovary. Benign mesonephric-like (ML) proliferations and hyperplasia have been described solely within the ovary. Pathogenetic data are very limited. We report a case with microscopic focus of benign ML-proliferation in association with mucinous cystadenoma in the ovary. The immunophenotype was distinct (mucinous tumor: focal weak nuclear positivity for PAX-8, CK 7, patchy cytoplasmic positivity for p16 and negativity for estrogen receptor, CD 10, TTF-1, p53 wildtype; mesonephric component: diffusely positive for PAX-8, CK 7, luminal CD 10, TTF-1, focal staining for estrogen receptor, patchy cytoplasmic for p16, p53 wildtype). On NGS-analysis there was clonal mutation of KRAS p.G12C. The data provide additional evidence for the concept of transdifferentiation (Müllerian tissue representing Wolffian/mesonephric features on histology and immunostaining) within the pathogenesis of mesonephric proliferation of the female genital tract and demonstrate the clonal relationship between these distinct morphologic components.
摘要：
中肾样腺癌很少发生在子宫和卵巢。仅在卵巢内描述了良性中肾样（ML）的增殖和增生。致病数据非常有限。我们报告了一例与卵巢粘液性囊腺瘤相关的良性ML增殖的微观病灶。免疫表型不同（粘液性肿瘤：PAX-8，CK7的局灶性弱核阳性，p16的斑片状细胞质阳性和雌激素受体阴性，CD10，TTF-1，p53野生型；中肾成分：PAX-8，CK7，腔CD10，TTF-1，雌激素受体局灶性染色，p16，p53野生型的斑片状细胞质）。在NGS分析中，KRASp.G12C存在克隆突变。数据为女性生殖道中肾增生的发病机理中的转分化概念（在组织学和免疫染色上代表沃尔夫/中肾特征的穆勒组织）提供了更多证据，并证明了这些不同形态成分之间的克隆关系。
