Adenomatoid tumors of the female and male genital tracts are well characterized as mesothelial in origin, but a detailed histological and immunohistochemical analysis comparing both traditional and newer mesothelial markers across gender and site has not been formally conducted. A variety of morphologic features previously described as characteristic of
adenomatoid tumors were evaluated in 44
adenomatoid tumors from the male and female genital tracts. Immunohistochemical analysis with pankeratin (AE1/
CAM5.2), WT-1,
calretinin, CK5/6, D2-40, and
caldesmon was also performed. The extent and intensity of staining were scored semiquantitatively on one representative section per case and mean value for each parameter was calculated. All (n=44) the
adenomatoid tumors from both the female and male genital tracts demonstrated a distinctive thread-like bridging strand pattern. Lymphoid aggregates were seen in all 12
adenomatoid tumors of male patients, but in only 4 of 32 (13%)
tumors in female patients (P<0.0001). The remaining morphologic features were variably present with no clear sex predilection. Pankeratin,
calretinin, and D2-40 reactivity were identified in all female (n=32) and male (n=12) genital tract
adenomatoid tumors.
Adenomatoid tumors expressed WT-1 in 11/12 (92%) male patients and in 31/32 (97%) female patients. In male patients, reactivity for CK5/6 and
caldesmon was found in 1/12 (8%) and 0/12 (0%)
adenomatoid tumors (respectively), whereas reactivity in female patients was found in 5/32 (16%) and 1/32 (3%); respectively. Female
tumors differ from their male counterparts by the frequent absence of lymphoid aggregates and the presence of a circumscribed margin when occurring in the fallopian tube. Of the putative mesothelial markers evaluated,
calretinin, D2-40, and WT-1 show a similar immunoprofile and have a higher sensitivity than CK5/6 and
caldesmon in genital tract
adenomatoid tumors. However, the presence of additional, often strong expression of WT-1 in normal tissues of the female genital tract limits the utility of WT-1 in this setting.