High-grade Serous Carcinoma

Epidemiology and Etiology:

Common sites:

Gross features:

Histologic features:

• Architecture:
• Solid masses of cells with slit-like spaces typically
• Papillary areas common
• Glandular areas common
• Cribriform areas common
• Thick undulating bands of epithelial cells resembling urothelial carcinoma maybe
• Well-sampled “transitional cell carcinoma” usually shows areas of typical serous carcinoma, not actually a distinct entity
• Intracystic, lacking apparent invasion (very small proportion)
• Necrosis frequent
• Nuclei:
• Large, hyperchromatic, pleomorphic
• Often large bizarre or multinucleated forms
• Nucleoli usually prominent, may be very large and eosinophilic
• Mitoses numerous and often atypical
• Psammoma bodies variably inconspicuous (less conspicuous than in LGSC)

Immunophenotype:

Marker:

Sensitivity:

Specificity:

CK7
WT1	Most	Absent in most endometrial serous carcinomas Usually negative in breast, GI, and pancreatobiliary CA
CA 125	Most
p53 (strong diffuse / > 60%, or total lack of staining)	Correlates with a mutated TP53 gene, which is present in virtually all HGSC	Can be useful in distinction from LGSC

Molecular features:

Other features:

References:

• Kurman RJ, Carcangiu ML, Herrington CS, Young RH (eds.) WHO Classification of Tumours of Female Reproductive Organs. (2014)