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low-grade endometrial stromal tumor

Tuesday 1 November 2016

endometrial stromal tumors; low-grade ESS




- smooth muscle differentiation in low-grade endometrial stromal sarcoma


- benign endometrial stromal tumor
- endometrial stromal sarcoma (malignant endometrial stromal tumor )


- haphazard arrangement (not fascicular) of uniform small cells resembling endometrial stroma

- Tumors cells resemble proliferative-phase endometrial stroma

  • Numerous thin-walled arterioles
  • Myometrial and/or vascular invasion “Tongue-like growth”
  • I HC: CD10 (strong), ER, PR and WT1 +, h-caldesmon -
  • t(7;17)(p15;q21) JAZF1-JJAZ1 gene fusion

- stromal cells circle small vessels / thin vessels that resemble spiral arterioles
- collagen hyalinization
- foamy cells
- may have prominent vasculature resembling hemangiopericytoma




- CD10 in endometrial stromal tumors (ESTs) / endometrial stromal sarcoma (ESS) / endometrial stromal nodule (ESN)

  • CD10 have a positive staining in a small number of endometrial stromal sarcomas as well as in normal endometrial stroma.
  • CD10 is a reliable and sensitive immunohistochemical marker of normal endometrial stroma.
  • Positivity, which is often strong and/or diffuse is found in endometrial stromal nodules and low-grade ESS. (11532038)
  • Positive staining with CD10, when strong and diffuse, may be useful in distinguishing these tumours from histological mimics, especially cellular leiomyoma and AGCT which are generally negative.
  • CD10 should be used as part of a panel which might include desmin and alpha-inhibin depending on the differential diagnosis considered.
  • Positive staining with CD10 in a high-grade uterine sarcoma which is negative with muscle markers might indicate endometrial stromal differentiation and identify a group of neoplasms which it is correct to diagnose as high-grade ESS rather than undifferentiated uterine sarcoma. (11532038)

See also

- uterine tumors

  • uterine mesenchymal tumros