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Case Reports
. 2003 Mar;56(3):221-4.
doi: 10.1136/jcp.56.3.221.

Inhibin is more specific than calretinin as an immunohistochemical marker for differentiating sarcomatoid granulosa cell tumour of the ovary from other spindle cell neoplasms

V I Shah  1 , O N Freites, P Maxwell, W G McCluggage
Affiliations
Case Reports

Inhibin is more specific than calretinin as an immunohistochemical marker for differentiating sarcomatoid granulosa cell tumour of the ovary from other spindle cell neoplasms

V I Shah et al. J Clin Pathol. 2003 Mar.

Abstract

Aims: To describe a case of recurrent sarcomatoid adult granulosa cell tumour (AGCT) of the ovary and to evaluate the usefulness of two ovarian sex cord stromal markers (inhibin and calretinin) in separating sarcomatoid AGCT from true sarcomas.

Methods: A 72 year old woman presented with a recurrent sarcomatoid AGCT in the sigmoid colon mesentery, which histologically mimicked a malignant gastrointestinal stromal tumour (GIST). This index case and 79 sarcomas (32 GISTs, 28 leiomyosarcomas, 15 endometrial stromal sarcomas (ESSs), including one with sex cord-like areas, and four undifferentiated uterine sarcomas) were immunostained using antibodies to inhibin and calretinin.

Results: The recurrent sarcomatoid AGCT expressed diffuse, strong cytoplasmic immunoreactivity with inhibin and focal but strong nuclear and cytoplasmic positivity with calretinin. Focal, weak cytoplasmic inhibin expression limited to sex cord-like areas was present in one ESS. None of the other sarcomas expressed inhibin. Focal, strong calretinin immunoreactivity was identified in 11 leiomyosarcomas and one GIST. The case of ESS with sex cord-like areas showed strong immunoreactivity for calretinin limited to the sex cord-like areas.

Conclusions: Inhibin is a useful immunomarker to distinguish sarcomatoid AGCT from other spindle cell neoplasms that may enter into the differential diagnosis. Calretinin appears to be less specific than inhibin.

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Figures

Figure 1
Figure 1
Recurrent adult granulosa cell tumour. (A) Sarcomatoid area (haematoxylin and eosin stained). (B) Insular, ribbon-like and follicular patterns (haematoxylin and eosin stained). (C) Sarcomatoid area showing diffuse, strong cytoplasmic inhibin immunoreactivity. (D) Sarcomatoid area showing focal, strong nuclear and cytoplasmic calretinin immunoreactivity.
Figure 2
Figure 2
Calretinin immunoreactivity in spindle cell neoplasms. (A) Focal, strong positivity in a gastrointestinal stromal tumour. (B) Focal, strong positivity in uterine leiomyosarcoma. (C) Strong positivity in a sex cord-like area in endometrial stromal sarcoma.
See this image and copyright information in PMC

References

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