Chu P G, Arber D A, Weiss L M, Chang K L
Division of Pathology, City of Hope National Medical Center, Duarte, California 91010, USA.
Mod Pathol. 2001 May;14(5):465-71. doi: 10.1038/modpathol.3880335.
Endometrial stromal sarcoma (ESS), uterine cellular leiomyoma (UCL), and uterine leiomyosarcoma (ULS) are composed mainly of spindle cells that express similar antigens such as desmin, smooth muscle actin (SMA), and muscle-specific actin (MSA). The differential diagnosis of an ESS versus a uterine smooth muscle tumor or an extrauterine spindle cell sarcoma can be problematic based solely on clinical presentation, histologic assessment, or routine immunohistochemistry. Recently, we reported that normal endometrium, but not myometrium, as well as five cases of ESS, were positive for CD10. We now report the results of CD10 immunohistochemistry in an additional 11 cases of ESS (total 16 cases), 10 cases of UCL, and nine cases of ULS. CD10 immunoreactivity was detected in 16 of 16 cases of ESS (100%) as compared to only 2 of 10 cases of UCL (20%) and none of nine cases of ULS (0%). We compared the utility of CD10 immunoreactivity with that of desmin, SMA, MSA, estrogen receptor (ER), and inhibin in these tumors. Although the majority of cases of UCL and ULS were positive for SMA, MSA, and desmin, a substantial portion of cases of ESS were also positive for SMA, MSA, and desmin. We conclude that in combination with SMA, MSA, and desmin, CD10 is a useful immunohistochemical marker in the differential diagnosis of ESS versus UCL or ULS.
子宫内膜间质肉瘤（ESS）、子宫细胞性平滑肌瘤（UCL）和子宫平滑肌肉瘤（ULS）主要由表达相似抗原（如结蛋白、平滑肌肌动蛋白[SMA]和肌肉特异性肌动蛋白[MSA]）的梭形细胞组成。仅基于临床表现、组织学评估或常规免疫组化，鉴别ESS与子宫平滑肌肿瘤或子宫外梭形细胞肉瘤可能存在问题。最近，我们报道正常子宫内膜而非子宫肌层以及5例ESS对CD10呈阳性。我们现在报告另外11例ESS（共16例）、10例UCL和9例ULS的CD10免疫组化结果。16例ESS中有16例（100%）检测到CD10免疫反应性，相比之下，10例UCL中只有2例（20%）呈阳性，9例ULS中无一例（0%）呈阳性。我们比较了这些肿瘤中CD10免疫反应性与结蛋白、SMA、MSA、雌激素受体（ER）和抑制素的效用。尽管大多数UCL和ULS病例对SMA、MSA和结蛋白呈阳性，但相当一部分ESS病例对SMA、MSA和结蛋白也呈阳性。我们得出结论，与SMA、MSA和结蛋白联合使用时，CD10是鉴别ESS与UCL或ULS的一种有用的免疫组化标志物。
