title: Immunohistochemical distinction of endometrial stromal sarcoma and cellular leiomyoma.
abstract: Distinguishing low grade endometrial stromal sarcoma (ESS) from benign smooth muscle proliferations like cellular leiomyoma (CL) can be problematic; because of differing treatments and prognosis, this distinction is important. The authors tested the hypothesis that low grade ESS could be distinguished from CL by immunohistochemistry using a panel of antibodies that have not previously been used in this setting. Antibodies to calponin, smooth muscle myosin heavy chain (SMM-HC), the Wilms tumor gene product (WT-1), and CD10 were applied to 14 cases of ESS (10 low grade, 4 high grade) and 9 CL. Among low grade ESS, 3 of 10, 3 of 10, 9 of 10, and 10 of 10 were positive for expression of calponin, SMM-HC, WT-1, and CD10, respectively. Of CL, all 9 were positive for calponin, SMM-HC, and WT-1, whereas 3 of 9 marked with antibodies to CD10. Overall, SMM-HC and calponin were expressed strongly in CL but weakly expressed in ESS; the converse was true for CD10. Expression of WT-1 and the reticulin-staining pattern do not discriminate between these two tumors. Antibodies to SMM-HC, CD10, and calponin can reliably distinguish ESS from CL.
authors.affiliation: Department of Cytopathology, University of Washington Medical Center, Seattle, USA. agoff@u.washington.edu
authors.forename: S N
authors.initials: SN
authors.lastname: Agoff
authors.forename: V S
authors.initials: VS
authors.lastname: Grieco
authors.forename: R
authors.initials: R
authors.lastname: Garcia
authors.forename: A M
authors.initials: AM
authors.lastname: Gown
mesh_terms: D002135:Calcium-Binding Proteins / Q000032:analysis; D003937:Diagnosis, Differential; D016889:Endometrial Neoplasms / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000175:diagnosis* / Q000473:pathology; D008840:Microfilament Proteins; D009130:Muscle, Smooth / Q000737:chemistry; D018995:Myosin Heavy Chains / Q000032:analysis; D015260:Neprilysin / Q000032:analysis; D012155:Reticulin / Q000032:analysis; D018203:Sarcoma, Endometrial Stromal / Q000737:chemistry / Q000175:diagnosis* / Q000473:pathology; D025721:WT1 Proteins / Q000032:analysis; D000096985:Calponins
chemical_list: D002135:Calcium-Binding Proteins; D008840:Microfilament Proteins; D018995:Myosin Heavy Chains; D015260:Neprilysin; D012155:Reticulin; D025721:WT1 Proteins; D000096985:Calponins