Immunohistochemical Profile of Uterine Leiomyoma With Bizarre Nuclei; Comparison With Conventional Leiomyoma, Smooth Muscle Tumors of Uncertain Malignant Potential and Leiomyosarcoma

Tabrizi, Ali Dastranj; Ghojazadeh, Morteza; Anvar, Hanieh Thagizadeh; Vahedi, Amir; Naji, Siamak; Mostafidi, Elmira; Berenjian, Siamak

doi:10.15171/apb.2015.093

Cited by 6 publications

(5 citation statements)

References 15 publications

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“…Several studies, including that by Mittal et al, also examined p53 expression in uterine smooth-muscle tumors, with no consensus about its relevance in the subcategory of STUMPs. Authors agree with the evidence of increasing MIB-1 and p53 expression in LMS concurrently with progressive loss of steroid receptors (9,22,23).…”

Section: Immunohistochemical Patternssupporting

confidence: 83%

Recurrent Uterine Smooth-Muscle Tumors of Uncertain Malignant Potential (STUMP): State of The Art

et al. 2020

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The term 'uterine STUMP' (smooth-muscle tumors of uncertain malignant potential) is currently used to define a heterogeneous group of uterine tumors distinct from leiomyomas and leiomyosarcomas. This rare entity is often characterized by a slow growth and protracted patient survival when compared to leiomyosarcomas but few data are available about its clinical management and outcome. In this review, we summarize the current state of knowledge about uterine STUMP, with a particular focus on cases of recurrence.

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Section: Immunohistochemical Patternssupporting

confidence: 83%

Recurrent Uterine Smooth-Muscle Tumors of Uncertain Malignant Potential (STUMP): State of The Art

et al. 2020

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“…TP53 gene can be mutated frequently, and its protein, so called P53, acts as a tumor suppressor [18]. In the study of Tabrizi et al, none of STUMP cases had positive P53 that was in the same line with our study [41]. In another research, one out of 18 STUMP cases showed positive P53 [37].…”

Section: Discussionsupporting

confidence: 89%

Uterine smooth muscle tumors of uncertain malignant potential: a retrospective evaluation of clinical pathology and immunohistochemistry features

Akbarzadeh-Jahromi,

Todarbary,

Aslani

et al. 2024

Surg Exp Pathol

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Background Uterine smooth muscle tumor of uncertain malignant potential (STUMP) is a group of uterine smooth muscle tumors which cannot be classified as a subtype of leiomyoma or leiomyosarcoma. Diagnosis, prognosis, and treatment of these tumors are challenging due to recurrence, potential of malignancy, and metastasis. Methods A retrospective cohort study was conducted in southern Iran during 2011 to 2020. We included records of 21 patients with STUMP and 24 patients with leiomyoma by simple randomized sampling in the tertiary health care centers in Shiraz, southern Iran. Slides were reviewed by an expert pathologist for examining mitosis, necrosis, and atypia, and also proper blocks were selected for immunohistochemistry (IHC) staining. Results From 45 participants, 21 (46.7%) and 24 (53.3%) patients were in the STUMP and normal leiomyoma groups, respectively. Odds ratio and 95% confidence interval (OR (95% C.I)) of pathologic size in the range of 5–10 cm was significantly higher in the STUMP group compared with normal leiomyoma. (CI: 7.22 (1.44–36.22)). Additionally, hyaline necrosis 0.05 (0.0-0.91), mild to moderate atypia 0.02 (0.0-0.4), moderate to severe atypia 0.01 (0.0-0.22), focal atypia 0.01 (0-0.26) and diffuse atypia 0.01 (0-0.26) were significantly fewer in normal leiomyoma compared to the STUMP group. Negative P16 0.01 (0.0007-0.24) and negative Bcl2 0.22 (0.06–0.81) were significantly higher in the normal leiomyoma group compared with the STUMP group. The cut-off points for predicting STUMP were 2.5% (sensitivity = 62% and specificity = 100%) and 45% (sensitivity = 43% and specificity = 96%) for P16 and bcl2, respectively. Conclusion The category and management of STUMP continues to progress. The diagnosis for STUMP mainly depends on the histopathological manifestations. No single IHC marker such as P53, P16, and Bcl-2 has proved robust enough in separating STUMP from other leiomyoma variants; however, according to our study, we suggest combination use of P16 and Bcl-2 (cut off 2.5 and 45%, respectively) to distinguish equivocal cases of STUMP.

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“…The evidence may be found in studies by O’Neill et al (2007), and Chen et al (2008), who revealed that expression of p16, p53 and Ki-67 is stronger in uterine LMS as compared to normal LMs, LM variants, and STUMP [31,79]. Dastranj Tabrizi et al (2015), and Azimpouran et al (2016), confirmed the previous findings, even for separate p53 evaluation in differential diagnosis of uterine LMS vs. LM and STUMP [80,81]. Zhou et al (2015), confirmed the overexpression of the p53 protein in uterine LMS.…”

Section: Available Immunohistochemical Markersmentioning

confidence: 69%

“…Markers of cell proliferation such as Ki-67 [ 31 ], p53 protein [ 76 ], and ER and PR expression [ 144 ] have been successfully used in differential diagnosis for years. LMs are characterized by low expression of Ki-67 [ 68 , 69 , 70 , 74 , 145 ], p53 [ 31 , 74 , 80 , 81 ], and high expression of ER and PR receptors [ 69 , 74 , 145 ]. It is also a well-known fact that the risk for malignant transformation increases with higher expression of proliferation markers [ 145 , 161 ].…”

Section: Available Immunohistochemical Markersmentioning

confidence: 99%

The Usefulness of Immunohistochemistry in the Differential Diagnosis of Lesions Originating from the Myometrium

Rubisz

Ciebiera

Hirnle

et al. 2019

IJMS

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Uterine leiomyomas (LMs), currently the most common gynecological complaint around the world, are a serious medical, social and economic problem. Accurate diagnosis is the necessary prerequisite of the diagnostic-therapeutic process. Statistically, mistakes may occur more often in case of disease entities with high prevalence rates. Histopathology, based on increasingly advanced immunohistochemistry methods, is routinely used in the diagnosis of neoplastic diseases. Markers of the highest sensitivity and specificity profiles are used in the process. As far as LMs are concerned, the crux of the matter is to identify patients with seemingly benign lesions which turn out to be suspicious (e.g., atypical LM) or malignant (e.g., leiomyosarcoma (LMS)), which is not uncommon. In this study, we present the current state of knowledge about the use of immunohistochemical markers in the differential diagnosis of LM, atypical LM, smooth muscle tumors of uncertain malignant potential (STUMP), and LMS, as well as their clinical predictive value.

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Immunohistochemical Profile of Uterine Leiomyoma With Bizarre Nuclei; Comparison With Conventional Leiomyoma, Smooth Muscle Tumors of Uncertain Malignant Potential and Leiomyosarcoma

Cited by 6 publications

References 15 publications

Recurrent Uterine Smooth-Muscle Tumors of Uncertain Malignant Potential (STUMP): State of The Art

Recurrent Uterine Smooth-Muscle Tumors of Uncertain Malignant Potential (STUMP): State of The Art

Uterine smooth muscle tumors of uncertain malignant potential: a retrospective evaluation of clinical pathology and immunohistochemistry features

The Usefulness of Immunohistochemistry in the Differential Diagnosis of Lesions Originating from the Myometrium

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