CyclinD1 Positive High-Grade Endometrial Stromal Sarcoma: a Fascinating Entity!
Keywords:
CyclinD1, endometrial stromal sarcoma, high-grade
Abstract
The 2014 WHO classifies endometrial stromal tumours into endometrial stromal nodule(ESN), low-grade endometrial stromal sarcoma (LGESS), high-grade endometrial stromalsarcoma (HGESS), and undifferentiated uterine sarcoma (UUS). LGESS and HGESS are histomorphologically, immunohistochemically and genetically distinct from each other.A 51-year-old postmenopausal lady presented to us with vaginal bleeding. Radiological findings revealed a well defined heterogeneous lesion involving the whole of uterus.Hysterectomy revealed a large polypoidal tumour, occupying the entire uterine cavity.Microscopically, the tumor was predominantly composed of epithelioid cells with very fewintervening spindle cell areas. Immunohistochemically, epithelioid cells were diffusely positive for cyclinD1, while were negative for CD10, ER, PR.Diagnosis of cyclinD1 positive HGESS was rendered. This case highlights the importance of performing cyclinD1 immunostaining in diagnosing HGESS. DOI:10.21276/APALM.1530References
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2.Lee CH, Nucci MR. Endometrial stromal sarcoma–the new genetic paradigm. Histopathology 2015;67:1–19.
3.Ali RH, Rouzbahman M. Endometrial stromal tumours revisited: an update based on the 2014 WHO classification. J Clin Pathol 2015;68:325–332.
4.Norris HJ, Taylor HB. Mesenchymal tumors of the uterus. I. A clinical and pathological study of 53 endometrial stromal tumors. Cancer 1966;19:755–66.
5.Lee CH, Ali RH, Rouzbahman M, et al. Cyclin D1 as a diagnostic immunomarker for endometrial stromal sarcoma with YWHAE-FAM22 rearrangement. Am J Surg Pathol 2012;36:1562–70.
6.Marisa R Nucci. Practical issues related to uterine pathology: endometrial stromal tumors Modern Pathology (2016) 29, S92–S103.
7.Koontz JI, Soreng AL, Nucci M, Koontz JI, Soreng AL, Nucci M, et al. Frequent fusion of the JAZF1 and JJAZ1 genes in endometrial stromal tumors. Proc Natl Acad Sci U S A 2001;98:6348-53.
8. Lee CH, Marino-Enriquez A, Ou W, et al. The clinicopathologic features of YWHAE-FAM22 endometrial stromal sarcomas: a histologically high-grade and clinically aggressive tumor. Am J Surg Pathol 2012;36:641–53.
9. Kurihara S, Oda Y, Ohishi Y et al. Endometrial stromal sarcomas and related high- grade sarcomas: immunohistochemical and molecular genetic study of 31 cases. Am J Surg Pathol 2008;32:1228–1238.
10. Cyclin D1 does not distinguish YWHAE-NUTM2 high-grade endometrial stromal sarcoma from undifferentiated endometrial carcinoma. Am J Surg Pathol 2015;39(5):722-724.
Published
2017-10-27
Issue
Section
Case Report
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