This primary endocervical lesion would express which biomarkers?

• A. Vimentin & ER
• B. GATA3 & PAX8
• C. p16 & CEA
• D. Pancytokeratin & p63

Answer: (C)

The main idea is that endocervical glandular lesions, especially HPV-associated adenocarcinomas, show strong p16 expression as a result of HPV-driven disruption of the cell cycle, and they commonly express CEA as a marker of mucin-producing adenocarcinomas. So a primary endocervical lesion would best fit a profile of diffuse p16 positivity along with CEA expression, reflecting its HPV-related origin and glandular nature.

Vimentin and ER would be less typical for a primary endocervical adenocarcinoma since this combination points away from a straightforward epithelial, HPV-driven glandular tumor. GATA3 is more associated with urothelial or breast lineage, and while PAX8 can be seen in Müllerian-derived tumors, the pairing with GATA3 isn’t characteristic for endocervical lesions. Pancytokeratin is a broad epithelial marker, but p63 indicates squamous differentiation, which is not a feature of endocervical adenocarcinoma.