Cyclin D1 and p16INK4 positive endometrial stromal sarcoma: A case report with new insights.
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Date
2014-10
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Abstract
Endometrial stromal sarcoma (ESS) has a wide histopathological spectrum with
CD10 as its diagnostic marker. Recently, few non-conventional ESSs have been
identifi ed that lack diffuse CD10 expression. A 46-year-old, perimenopausal
lady referred to us with history of vaginal bleeding. On clinical examination and
radiological imaging, a polypoid endometrial tumor was identifi ed. Hysterectomy
revealed a multinodular tumor in the myometrium. Microscopically, the tumor
composed of rather banal oval to spindle-shaped cells in a fi bromyxoid stroma.
Focal areas displayed compact cellular arrangement, unassociated with
signifi cant mitoses and necrosis. Immunohistochemically, tumor cells were focally
positive for CD10, estrogen receptor, progesterone receptor, p16INK4 and were
diffusely positive for cyclinD1. Diagnosis of cyclinD1 and p16INK4 positive ESS
was offered. This case highlights the value of additional IHC markers, especially
cyclinD1 and p16INK4 in order to identify certain ESSs that lack diffuse CD10
immunoexpression; are invariably misdiagnosed as undifferentiated sarcomas,
but actually form a relatively more aggressive subset of ESSs.
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Keywords
CD10, cyclinD1, endometrial stromal sarcoma, endometrial stromal tumors, p16INK4
Citation
Rekhi Bharat, Motghare Priyal. Cyclin D1 and p16INK4 positive endometrial stromal sarcoma: A case report with new insights. Indian Journal of Pathology & Microbiology. 2014 Oct-Dec 57 (4): 606-608.