{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:28:29Z","timestamp":1780964909330,"version":"3.54.1"},"reference-count":73,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2013,11,12]],"date-time":"2013-11-12T00:00:00Z","timestamp":1384214400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2014,2]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Lymph node involvement affects prognosis\/treatment in endometrial carcinoma patients. We assessed various histological features associated with nodal metastasis in patients with grade <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content>, stage <jats:styled-content style=\"fixed-case\">I<\/jats:styled-content> endometrial endometrioid carcinoma (<jats:styled-content style=\"fixed-case\">EEC<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>Eighteen stage <jats:styled-content style=\"fixed-case\">I EEC<\/jats:styled-content>s with occult positive lymph nodes and 36 controls were assessed for depth of myoinvasion; microcystic, elongated and fragmented (<jats:styled-content style=\"fixed-case\">MELF<\/jats:styled-content>) pattern of myometrial invasion; lymphovascular invasion (<jats:styled-content style=\"fixed-case\">LVI<\/jats:styled-content>); and epithelial metaplasia. Nodal metastases were subclassified as isolated tumour cells (<jats:styled-content style=\"fixed-case\">ITC<\/jats:styled-content>s; \u22640.2\u00a0mm), micrometastasis (&gt;0.2\u00a0mm and &lt;2\u00a0mm), or macrometastasis (\u22652\u00a0mm). Node\u2010positive cases had significantly higher rates of <jats:styled-content style=\"fixed-case\">LVI<\/jats:styled-content> (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>&lt;<jats:italic>\u00a0<\/jats:italic>0.001) and <jats:styled-content style=\"fixed-case\">MELF<\/jats:styled-content> invasion (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.003) on univariate analysis. Only <jats:styled-content style=\"fixed-case\">LVI<\/jats:styled-content> was associated significantly with nodal metastasis on multivariate analysis (<jats:italic><jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.002). Tumours with <jats:styled-content style=\"fixed-case\">MELF<\/jats:styled-content> invasion demonstrated reduced <jats:styled-content style=\"fixed-case\">E<\/jats:styled-content>\u2010cadherin expression. Macrometastases were identified in seven cases (39%) with or without micrometastasis\/<jats:styled-content style=\"fixed-case\">ITC<\/jats:styled-content>s. Eight (44%) contained only <jats:styled-content style=\"fixed-case\">ITC<\/jats:styled-content>s. Eleven (61%) had histiocyte\u2010like nodal metastases. Biopsy material from four of six (67%) and five of 17 (29%) cases with and without nodal metastasis showed detached eosinophilic tumour cell buds. Of the former, three were associated with histiocyte\u2010like nodal metastases\u00a0\u2013\u00a0a feature absent in biopsies without tumour budding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lymph nodes from grade <jats:styled-content style=\"fixed-case\">I EEC<\/jats:styled-content> exhibiting cellular budding or <jats:styled-content style=\"fixed-case\">LVI<\/jats:styled-content> should be examined for occult metastases, especially in the form of histiocyte\u2010like cells.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.12254","type":"journal-article","created":{"date-parts":[[2013,8,14]],"date-time":"2013-08-14T07:08:21Z","timestamp":1376464101000},"page":"389-398","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Histological features associated with occult lymph node metastasis in <scp>FIGO<\/scp> clinical stage <scp>I<\/scp>, grade <scp>I<\/scp> endometrioid carcinoma"],"prefix":"10.1111","volume":"64","author":[{"given":"Guangming","family":"Han","sequence":"first","affiliation":[{"name":"Department of Pathology Sunnybrook Health Sciences Centre University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Pathology National University Health System Singapore Singapore"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Mario M","family":"Leitao","sequence":"additional","affiliation":[{"name":"Gynecology Service Department of Surgery Memorial Sloan\u2010Kettering Cancer Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadeem R","family":"Abu\u2010Rustum","sequence":"additional","affiliation":[{"name":"Gynecology Service Department of Surgery Memorial Sloan\u2010Kettering Cancer Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A","family":"Soslow","sequence":"additional","affiliation":[{"name":"Department of Pathology Memorial Sloan\u2010Kettering Cancer Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,11,12]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djn397"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61766-3"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19920315)69:6<1424::AID-CNCR2820690620>3.0.CO;2-5"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(92)90296-U"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0028-2243(94)90294-1"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1997.4788"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19901015)60:8 <2035::AID-CNCR2820601515>3.0.CO;2-8"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0090-8258(91)90334-2"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19850415)55:8<1753::AID-CNCR2820550823>3.0.CO;2-P"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19961001)78:7<1447::AID-CNCR11>3.0.CO;2-#"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1994.1158"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.2001.6550"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1067\/mob.2000.107335"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.1987.tb02275.x"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19920815)70:4<790::AID-CNCR2820700413>3.0.CO;2-8"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1006\/gyno.1995.1148"},{"key":"e_1_2_5_18_1","first-page":"73","article-title":"Endometrial adenocarcinoma associated with subtle lymph\u2010vascular space invasion and lymph node metastasis: a histologic pattern mimicking intravascular and sinusoidal histiocytes","volume":"24","author":"McKenney JK","year":"2005","journal-title":"Int. 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