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Extrauterine mixed mesodermal tumors. An immunohistochemical study.

E A Dellers1, P T Valente, P R Edmonds

  • 1Department of Pathology, Temple University Hospital, Philadelphia, PA.

Archives of Pathology & Laboratory Medicine
|September 1, 1991
PubMed
Summary

Extrauterine mixed mesodermal tumors, rare malignancies, were studied using histochemical and immunoperoxidase methods. These techniques aid in distinguishing epithelial and mesenchymal components, despite occasional cross-reactivity, for accurate diagnosis.

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Area of Science:

  • Oncology
  • Pathology

Background:

  • Mixed mesodermal tumors (MMTs) are rare, particularly outside the uterus.
  • Extrauterine MMTs present diagnostic challenges due to their mixed epithelial and mesenchymal components.

Purpose of the Study:

  • To evaluate the utility of histochemical and immunoperoxidase staining in characterizing extrauterine MMTs.
  • To differentiate between epithelial and mesenchymal elements in these uncommon neoplasms.

Main Methods:

  • Nine extrauterine MMTs (eight ovarian, one extragenital) underwent histochemical staining (Periodic Acid-Schiff) and immunoperoxidase analysis.
  • Antibodies used included those for alpha 1-antitrypsin, myoglobin, keratin, vimentin, muscle-specific actin, and alpha 1-antichymotrypsin.
  • Avidin-biotin-immunoperoxidase method was employed for all immunohistochemical stains.

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Main Results:

  • Both epithelial and mesenchymal elements were malignant in eight cases, with diverse differentiation (chondroid, rhabdomyoid, osteoid).
  • Keratin effectively highlighted epithelial areas in most cases.
  • Myoglobin confirmed rhabdomyoid differentiation in four cases, though squamous elements showed false positivity in one instance.
  • Periodic Acid-Schiff-positive droplets exhibited peripheral alpha 1-antitrypsin positivity.

Conclusions:

  • Immunoperoxidase staining is valuable for distinguishing epithelial and mesenchymal components in extrauterine MMTs.
  • Careful interpretation is necessary due to potential cross-reactivity of certain markers.
  • These methods aid in the accurate diagnosis of rare mixed mesodermal tumors.