CD10 is a Marker for Normal and Neoplastic Endometrial Stromal Cells

Abstract

Using the immunohistochemical technique, we investigated the expression of CD10 in normal female genital tissues, chorionic villi and decidua of early gestation, endometriotic lesions, and uterine mesenchymal tumors. The cytoplasm of normal endometrial stromal cells was consistently positive for CD10. During early gestation, decidualized endometrial stromal cells were negative or only focally positive for CD10, whereas nondecidualized stromal cells were diffusely positive. Syncytiotrophoblast was positive for CD10 on the apical surface, whereas chorionic mesenchymal cells were diffusely positive within the cytoplasm. Cytotrophoblast and intermediate trophoblast were negative for CD10. Groups of stromal cells surrounding cervical glands were often positive for CD10. Myometrium, endometrial and cervical glands, cervical squamous epithelia, and tubal epithelia and stroma exhibited no reactivity for CD10. In endometriosis and adenomyosis, ectopic endometrial stromal cells were usually positive for CD10. Endometrial stromal tumors, including undifferentiated uterine sarcomas, mostly showed diffuse immunoreactivity for CD10. Leiomyomas and leiomyosarcomas were negative or focally (< 5% of cells staining) positive (8/12 leiomyomas and 4/8 leiomyosarcomas) for CD10, except for 1 myxoid leiomyosarcoma that showed CD10 staining in the myxoid areas. These data suggest that diffuse CD10 staining is characteristic of normal and neoplastic endometrial stromal cells, unless they are decidualized.

Diagnostic use of nuclear Β-catenin expression for the assessment of endometrial stromal tumors

“…9,15,16 Although CD10 is a useful immunohistochemical marker for the differential diagnosis of endometrial stromal sarcomas from uterine cellular leiomyomata, CD10 may also be detected in uterine cellular leiomyomata. 9,11 In this study, we demonstrated that b-catenin nuclear expression is frequently found in endometrial stromal tumors, but not in normal endometrial stroma and uterine cellular leiomyomata. Nuclear reactivity for b-catenin was noted in both of the 2 endometrial stromal nodules evaluated in this study, in 11 (92%) of the 12 low-grade endometrial stromal sarcomas evaluated and in 6 (75%) of the 8 undifferentiated endometrial sarcomas evaluated.…”

“…Immunohistochemical studies of endometrial stromal sarcomas have shown that they are usually positive for CD10 and both estrogen and progesterone receptors, and that they may also be positive for smooth muscle markers (such as actin and desmin). [10][11][12]14 Although diffuse strong immunoreactivity for CD10 favors the diagnosis of endometrial stromal sarcomas, 9 it is important to note that this diagnosis is not always straightforward. For example, the staining may be focal or weak, which could result in a false negative.…”

“…[3][4][5][6][7] Although nuclear accumulation of b-catenin has recently been demonstrated in endometrial stromal sarcomas, these studies included only a small sample size and immunostaining produced variable results. 3,8 It has been reported that CD10 is expressed by normal and neoplastic endometrial stromal cells, as well as stromal cells involved in endometriosis and adenomyosis, [9][10][11] and diffuse CD10 immunoreactivity is a very useful positive predictive marker for endometrial stromal sarcomas. 9 However, a study conducted by McCluggage et al 10 showed that 38% of low-grade endometrial stromal sarcomas expressed focally weak CD10 positivity.…”

Distinction of endometrial stromal sarcomas from ‘hemangiopericytomatous’ tumors using a panel of immunohistochemical stains

“…19 Furthermore, CD10 was identified as a sensitive and diagnostically useful marker of normal endometrial stroma and of endometrial stromal neoplasms. [20][21][22][23] In this study, antibodies against CD10 stained a majority of endometrial stromal sarcomas in a diffuse pattern, but in some cases the staining pattern was focal or patchy cytoplasmic and membranous. A similar patchy cytoplasmic and membranous pattern of staining was also observed in many solitary fibrous tumors and hemangiopericytomas.…”

Small cell carcinoma in endometrium on the base of extensive adenomyosis: differential diagnosis with immunochemistry

“…Furthermore, endometrial stromal sarcomas commonly occur in premenopausal women in contrast to the aforementioned tumors. CD10 has been considered as a specific marker for both neoplastic and non-neoplastic endometrial stromal cells [21], and probably distinguishes endometrial stromal neoplasms from others. However, there has been a report stressing CD10 positivity both in MMMT and Mullerian adenosarcoma, and indicating that CD10 is a characteristic of Mullerian system-derived neoplastic mesenchymal cells [22].…”