OVARIAN SEROUS BORDERLINE TUMORS WITH LYMPH-NODE INVOLVEMENT - CLINICOPATHOLOGICAL AND DNA CONTENT STUDY OF 7 CASES AND REVIEW OF THE LITERATURE

Although several studies have established the excellent prognosis of o varian serous borderline tumors (OSBTs) in general, the significance o f lymph node involvement has not been thoroughly addressed. In this ar ticle, we describe seven OSBTs with lymph node involvement and their D NA content and S-phase fraction. Lymph node involvement was identified at presentation in four cases (pelvic, paraaortic, and omental) and a fter 4, 5, and 7 years in the other three (omental, scalene, and cervi cal, respectively). In the first group, clusters of cells cytologicall y similar to those of the OSBT were identified in the nodal sinusoids in all four cases and focally in the lymph node parenchyma in three of them. In contrast, the involved lymph nodes of the three cases with d elayed nodal disease showed an almost complete replacement by tumor. I n one of them, the tumor in the lymph node was histologically similar to the OSBT, while in the other two cases the tumor was more solid and poorly differentiated, suggesting true metastatic disease. Flow cytom etric analysis of nuclear DNA content and S-phase fraction were perfor med on paraffin-embedded tissue of all of the primary OSBTs and of the involved lymph nodes in six cases; diploid DNA content and low S-phas e fraction were seen in all cases. All patients were alive and free of disease 2-9 years after initial diagnosis. While the clinical signifi cance of LN involvement in OSBT is still uncertain, DNA ploidy analysi s seems to be unable to identify those cases at risk for tumor progres sion.