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Low-grade endometrial stromal sarcoma with an extensive epithelial-like element
Yoshiki Ohta1, Takao Suzuki, Motohiro Kojima
1Department of Pathology, Showa University Northern Yokohama Hospital, 35-1 Chigasaki-chuo, Tsuzuki-ku, Yokohama, Kanagawa 224-8503, Japan. yomareko@cmed.showa-u.ac.jp
Pathology International
|April 5, 2003
Summary
This study reports a rare endometrial stromal sarcoma case with abundant epithelial-like elements (ELE). These ELEs show smooth muscle differentiation and CD10 positivity, suggesting a CESS origin and impacting clinical prognosis.
Area of Science:
- Gynecologic Pathology
- Tumor Biology
- Immunohistochemistry
Background:
- Endometrial stromal sarcoma (ESS) is a rare uterine malignancy.
- Tumors with extensive epithelial-like elements (ELE) may exhibit distinct clinical behaviors.
- Understanding the differentiation of ELE is crucial for accurate diagnosis and prognosis.
Observation:
- A case of low-grade ESS with approximately 72% ELE is presented.
- Immunohistochemistry revealed ELE was negative for sex-cord markers but positive for myogenic markers, including alpha-smooth muscle actin.
- ELE also showed CD10 positivity, supporting derivation from classical endometrial stromal sarcoma (CESS).
Findings:
- The epithelial-like elements (ELE) demonstrated smooth muscle differentiation, not sex-cord differentiation.
- CD10 positivity in ELE suggests a common origin with classical endometrial stromal sarcoma (CESS).
- The Ki-67 labeling index was significantly higher in CESS compared to ELE.
Implications:
- ELE in ESS may represent smooth muscle differentiation rather than sex-cord differentiation.
- The proliferative activity difference between CESS and ELE might influence the clinical behavior and prognosis of these tumors.
- Further research into ESS with abundant ELE is warranted to refine diagnostic and therapeutic strategies.