Immunohistochemistry of endometrial stromal sarcoma

Utility of CD10 in Distinguishing between Endometrial Stromal Sarcoma and Uterine Smooth Muscle Tumors: An Immunohistochemical Comparison of 34 Cases

“…The staining differences among the tumor types were not apparent after use of antigen-retrieval immunohistochemistry methods, which were not used in the three cited reports. The value of ER and cytokeratins in the differential diagnosis of ESS versus uterine smooth muscle tumor is limited, because both ESSs and uterine smooth muscle tumors are usually ER positive and occasionally cytokeratin positive (8,10,11). Inhibin was positive only in cases of ESS with sex-cord-like elements, which can be found in 15 to 60% of ESS (39).…”

“…Oliva et al demonstrated that all highly uterine cellular leiomyomas were positive for desmin, whereas endometrial stromal nodules and ESSs were negative (38). In contrast, Farhood et al (8) found that 7 of 23 ESSs were positive for desmin, including three focally positive (Ͻ30% cells), three diffusely positive (30 to 70% cells), and one with generalized positivity (Ͼ70% cells). In addition, after studying 10 cases of normal endometrial stromal cells of proliferative or secretory phases and 14 cases of endometrial stromal neoplasms (12 ESSs and two stromal nodules), Franquemont et al (6) identified desmin positivity in nine cases of normal endometrial stromal cells (eight with rare cells staining and one with diffuse staining) and nine cases of endometrial stromal neoplasms (seven ESSs and two stromal nodules).…”

Endometrial sarcomas: an immunohistochemical and JAZF1 re-arrangement study in low-grade and undifferentiated tumors

“…Immunoreactivity for CD10, ER, PR, desmin, vimentin, smooth muscle actin, muscle-specific actin and beta-catenin have all been described. 5,[28][29][30][31][32][33][34][35] Of these, CD10 is the most sensitive for endometrial differentiation and rarely endometrial stromal sarcomas are negative for this marker. 7,23,30 However, CD10 may be expressed in other uterine mesenchymal tumors such as leiomyosarcoma, cellular leiomyomas, rhabdomyosarcomas and carcinosarcomas 5,7,30 as well as extra-uterine tumors like hemangiopericytoma and solitary fibrous tumor.…”

“…29 In distinguishing endometrial stromal sarcoma from uterine smooth muscle neoplasms, H-caldesmon has been touted as a more specific marker whereas desmin, smooth muscle actin, muscle-specific actin and calponin have all been variably shown to stain endometrial sarcomas. 7,10,30,31 There are few studies in the literature addressing immunohistochemical findings of undifferentiated endometrial sarcoma in relation to low-grade tumors. Interestingly, our results showed CD10 expression in undifferentiated endometrial sarcoma as well as low-grade endometrial stromal sarcoma.…”

Smooth Muscle, Endometrial Stromal, and Mixed Müllerian Tumors of the Uterus

“…Immunohistochemical techniques would, in principle, offer some hope of separating this group of ambiguously differentiated tumors into "smooth muscle" and "stromal" subsets because uterine smooth muscle tumor cells are likely to express desmin, as well as actin and vimentin, whereas nonmuscle mesenchymal cells more frequently express only actin and vimentin. This seemed to be the case in early studies, but subsequent studies have indicated that there is considerable overlap of stromal and uterine smooth muscle immunophenotypes (11,12). It is likely that we are dealing with an unresolvable morphologic continuum that represents the neoplastic counterpart of the transitions seen in the normal uterus between stromal differentiation and smooth muscle differentiation; over a certain range of conventional light microscopic appearances, to ask whether a given neoplastic cell is differentiating as a stromal or smooth muscle cell is analogous to asking whether a myofibroblast is truly a smooth muscle cell or a fibroblast: It is neither but has features of both.…”