title: High-grade endometrial stromal sarcoma with smooth muscle and skeletal muscle differentiation: report of a case with cytomorphologic and immunocytologic analysis.
abstract: We report a case of high-grade endometrial stromal sarcoma with cytological and immunocytochemical findings. Cytologically, major tumor cells showed round-to-short spindle shapes with round- to oval-shaped nuclei and moderately abundant delicate cytoplasm. Tumor cells with tapered shapes and eccentric nuclei were also observed. A few spindle cells having enlarged cigar-shaped nuclei with conspicuous nucleoli and delicate wispy cytoplasm, which resembled leiomyosarcoma, were intermingled. One rhabdomyoblast cell with both α-sarcomeric muscle actin and myoglobin was also observed. Most of the tumor cells, including the leiomyosarcomatous spindle cells, were positive for CD10, and negative for desmin and h-caldesmon. Accordingly, when relatively monotonous round-to-short spindle tumor cells and taper-shaped tumor cells are observed in the female genital tract, high-grade endometrial stromal sarcoma should be considered in the differential diagnosis. Immunocytochemistry contributed to the correct diagnosis. This case was high-grade endometrial stromal sarcoma with smooth muscle and skeletal muscle differentiation.
authors: Department of Pathology, Showa University Northern Yokohama Hospital, Kanagawa, Japan. yomareko@cmed.showa-u.ac.jp
authors: Yoshiki
authors: Y
authors: Ohta
authors: Takao
authors: T
authors: Suzuki
authors: Tomoko
authors: T
authors: Kojima
authors: Tetsuya
authors: T
authors: Mikogami
authors: Mutsuko
authors: M
authors: Omatsu
authors: Shigeharu
authors: S
authors: Hamatani
authors: Akira
authors: A
authors: Shiokawa
authors: Miki
authors: M
authors: Kushima
authors: Hidekazu
authors: H
authors: Ota
mesh_terms: D000328:Adult; D000943:Antigens, Differentiation / Q000378:metabolism; D014408:Biomarkers, Tumor / Q000378:metabolism; D002454:Cell Differentiation; D002467:Cell Nucleus / Q000473:pathology; D048430:Cell Shape; D002843:Chromatin / Q000473:pathology; D016889:Endometrial Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D018482:Muscle, Skeletal / Q000473:pathology*; D009130:Muscle, Smooth / Q000473:pathology*; D015260:Neprilysin / Q000378:metabolism; D018203:Sarcoma, Endometrial Stromal / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery
chemical_list: D000943:Antigens, Differentiation; D014408:Biomarkers, Tumor; D002843:Chromatin; D015260:Neprilysin