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J Clin Pathol 2003;56:221-224 doi:10.1136/jcp.56.3.221
  • Original article

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

  1. V I Shah1,
  2. O N Freites2,
  3. P Maxwell3,
  4. W G McCluggage3
  1. 1Department of Histopathology, Singleton Hospital, Sketty, Swansea SA2 8QA, Wales, UK
  2. 2Department of Gynaecology and Obstetrics, Singleton Hospital
  3. 3Department of Histopathology, Royal Groups of Hospitals Trust, Belfast, Northern Ireland, UK
  1. Correspondence to:
 Dr V Shah, Department of Histopathology, Singleton Hospital, Sketty, Swansea SA2 8QA, Wales, UK; 
 varsha.shah{at}swansea-tr.wales.nhs.uk
  • Accepted 31 October 2002

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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