case_images: PMC7290248_01
case_images: Computed tomography, cytological findings of the pericardial effusion, and histological findings of the surgical specimen of endometrium. (a) Computed tomography on admission showed pericardial effusion (left) and a mass measuring 8 cm in size from the pericardium to the liver surface (right). (b) Cytological examination of the pericardial effusion showed the presence of atypical glandular cells with foamy cytoplasm, enlarged nuclei, fine chromatin, and distinct nucleoli (Papanicolaou staining; original magnification, 400x). (c) Psammoma body (left) and mitosis (right) were partly observed in the cytological examination of the pericardial effusion (Papanicolaou staining; original magnification, 400x). (d) The surgical specimen of endometrial carcinoma dissected 7 years earlier had been diagnosed as moderately differentiated endometrioid adenocarcinoma (G2 > G1, pT3pN1cMX, pStageIIIC) (left) (HE staining; original magnification, 40x). On retrospective evaluation of this specimen, a partly included papillary serous carcinoma-like component was identified (right) (HE staining; original magnification, 100x).
case_images: 10.1177_2050313X20930919-fig1.jpg
case_images: PMC7290248_01_10.1177_2050313X20930919-fig1.jpg
case_images: fig1-2050313X20930919
case_images: Chest computed tomography revealed a large pericardial effusion (Figure 1(a), left) and a mass measuring 8 cm in size from the pericardium to the liver surface (Figure 1(a), right). Atypical glandular cells were observed to exhibit a foamy cytoplasm, enlarged nuclei, fine chromatin, and distinct nucleoli (Figure 1(b)). Psammoma bodies (Figure 1(c), left) and mitoses (Figure 1(c), right) were also partly observed. A surgical specimen from the endometrial carcinoma dissected 7 years earlier had been diagnosed as moderately differentiated endometrioid adenocarcinoma (G2 > G1, pT3pN1cMX, pStageIIIC; Figure 1(d), left). A retrospective evaluation of this surgical specimen showed the partial coexistence of papillary serous carcinoma-like components (Figure 1(d), right).
case_images: Immunohistochemical staining of a cell block of the pericardial effusion (top line), serous carcinoma (SC)-like components (middle line), and endometrioid carcinoma (EC) components (bottom line) of the surgical specimen dissected 7 years earlier. Staining of the cell block of the pericardial effusion revealed that adenocarcinoma cells were positive for p53, p16, and IMP-3, but negative for ER. The SC-like components were positive for p53 and IMP-3 and partially positive for p16, but negative for ER. In contrast, the endometrioid carcinoma components were positive for ER but negative for p53, p16, and IMP-3.
case_images: 10.1177_2050313X20930919-fig2.jpg
case_images: PMC7290248_01_10.1177_2050313X20930919-fig2.jpg
case_images: fig2-2050313X20930919
case_images: Immunohistochemistry of a cell block of the pericardial effusion showed that adenocarcinoma cells were positive for tumor protein p53 (p53), cyclin-dependent kinase inhibitor 2A (CDKN2A, also known as p16), and insulin-like growth factor II mRNA-binding protein-3 (IMP-3), but negative for estrogen receptor (ER; Figure 2, top line). IMP-3 and partially positive for p16, but negative for ER (Figure 2, middle line). In contrast, the endometrioid carcinoma components were observed to be positive for ER, but negative for p53, p16, and IMP-3 (Figure 2, bottom line).