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Russell Vang - One of the best experts on this subject based on the ideXlab platform.
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SF-1 is a diagnostically useful immunohistochemical marker and comparable to other sex cord-stromal Tumor markers for the differential diagnosis of ovarian Sertoli Cell Tumor.
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists, 2008Co-Authors: Chengquan Zhao, Ross Barner, Tuyethoa N. Vinh, Kim Mcmanus, David J. Dabbs, Russell VangAbstract:Immunohistochemistry can be an important part of the diagnosis of Sertoli Cell Tumor of the ovary, including distinction from non-sex cord-stromal Tumors such as the Sertoliform variant of endometrioid carcinoma and carcinoid. Several good markers for this differential diagnosis have been identified, particularly inhibin, Wilms Tumor 1 gene product (WT1), epithelial membrane antigen, and chromogranin; however, many available markers have limitations to some degree. Steroidogenic factor 1 (SF-1; adrenal 4-binding protein; Ad4BP) is a nuclear transcription factor involved in gonadal and adrenal development. In the testes, SF-1 is expressed in Sertoli Cells. Immunohistochemical expression of this marker in ovarian sex cord-stromal Tumors, including utility for differential diagnosis, has not been rigorously evaluated. As an extension of our previous immunohistochemical studies of ovarian Sertoli Cell Tumor, expression of SF-1 and comparison with WT1 and inhibin were assessed in 111 primary ovarian Tumors: 27 Sertoli Cell Tumors, 60 endometrioid Tumors (including borderline Tumors, conventional well-differentiated carcinomas, and Sertoliform variants of carcinoma), and 24 carcinoids. SF-1 was expressed in 100% of Sertoli Cell Tumors but not in endometrioid Tumors or carcinoid. WT1 was expressed in 100% of Sertoli Cell Tumors and 17% of endometrioid Tumors; all carcinoids were negative. Inhibin was expressed in 96% of Sertoli Cell Tumors and 2% of endometrioid Tumors (4% of conventional well-differentiated carcinomas); all carcinoids were negative. The extent of expression of all 3 markers was similar in Sertoli Cell Tumor but greatest for WT1: 63%, 96%, and 78% of cases showed expression of SF-1, WT1, and inhibin, respectively, in more than 50% of Tumor Cells. Immunohistochemical composite scores combining both extent and intensity of staining in positive cases were calculated for Sertoli Cell Tumor (possible range: 1-12). Combined extent/intensity of immunostaining was similar for all 3 markers, but WT1 showed the most robust immunoreactivity in positive cases (mean immunohistochemical composite scores for SF-1, WT1, and inhibin: 6.1, 10.8, and 7.8, respectively). We conclude that for the differential diagnosis with endometrioid Tumors and carcinoid of the ovary, SF-1 is a sensitive and specific immunohistochemical marker for Sertoli Cell Tumor and that SF-1 is diagnostically comparable with other good sex cord-stromal markers.
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comparative analysis of alternative and traditional immunohistochemical markers for the distinction of ovarian Sertoli Cell Tumor from endometrioid Tumors and carcinoid Tumor a study of 160 cases
The American Journal of Surgical Pathology, 2007Co-Authors: Chengquan Zhao, Gary L. Bratthauer, Ross Barner, Russell VangAbstract:The main neoplasms in the differential diagnosis for primary ovarian Tumors with a tubule-rich pattern are pure Sertoli Cell Tumor, endometrioid Tumors (including borderline Tumor, well-differentiated carcinoma, and the Sertoliform variant of endometrioid carcinoma), and carcinoid Tumor. Because traditional immunohistochemical markers [pan-cytokeratin (pan-CK), low molecular weight cytokeratin (CK8/18), epithelial membrane antigen (EMA), inhibin, calretinin, CD99, chromogranin, and synaptophysin] can occasionally have diagnostic limitations, the goal of this study was to determine whether or not any alternative markers [cytokeratin 7 (CK7), estrogen receptor (ER), progesterone receptor (PR), CD10, and CD56] have better diagnostic utility when compared with traditional markers for this differential diagnosis. Immunohistochemical stains for alternative, as well as traditional, markers were performed on the following primary ovarian Tumors: pure Sertoli Cell Tumor (n = 40), endometrioid borderline Tumor (n = 38), Sertoliform endometrioid carcinoma (n = 13), well-differentiated endometrioid carcinoma (n = 27), and carcinoid Tumor (n = 42). Extent and intensity of immunostaining were semiquantitatively scored. In addition, immunohistochemical composite scores (ICSs) in positive cases were calculated on the basis of the combination of extent and intensity scores. Cytokeratin 7 (CK7) was positive in 97% of endometrioid Tumors, 13% of Sertoli Cell Tumors, and 24% of carcinoid Tumors. The differences in the mean ICSs for endometrioid Tumors versus Sertoli Cell Tumor or carcinoid Tumor were statistically significant (P values ranging from <0.001 to 0.018). ER and PR were positive in 87% and 86% of endometrioid Tumors, 8% and 13% of Sertoli Cell Tumors, and 2% each of carcinoid Tumors, respectively. The differences in the mean ICSs for endometrioid Tumors versus Sertoli Cell Tumor were statistically significant (P values ranging from <0.001 to 0.012). Among the epithelial markers, EMA seemed to be the most discriminatory but only slightly better than CK7, ER, or PR. Pan-CK and CK8/18 were not helpful. CD10 showed overlapping patterns of expression in all categories of Tumors. Among the sex cord markers, CD10 was markedly less useful than inhibin or calretinin; CD99 was not discriminatory. CD56 showed overlapping patterns of expression in all categories of Tumors. Among the neuroendocrine markers, CD56 was less useful than chromogranin or synaptophysin. When traditional immunohistochemical markers are problematic for the differential diagnosis of ovarian Sertoli Cell Tumor versus endometrioid Tumors versus carcinoid Tumor, adding CK7, ER, and/or PR to a panel of markers can be helpful. Endometrioid Tumors more frequently express CK7, ER, and PR and show a greater extent of immunostaining in contrast to Sertoli Cell Tumor and carcinoid Tumor. Compared with traditional epithelial markers, CK7, ER, and PR are nearly as advantageous as EMA. Inhibin is the most discriminatory sex cord marker, and CD10 is not helpful in the differential diagnosis. Chromogranin and synaptophysin are exCellent discriminatory markers for carcinoid Tumor, and CD56 is neither sufficiently sensitive nor specific enough for this differential diagnosis to warrant its use in routine practice.
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Diagnostic utility of WT1 immunostaining in ovarian Sertoli Cell Tumor.
The American journal of surgical pathology, 2007Co-Authors: Chengquan Zhao, Gary L. Bratthauer, Ross Barner, Russell VangAbstract:WT1, the Wilms Tumor gene product, can be expressed in various Tumors from different anatomic sites, including some types of ovarian Tumors. Regarding the latter, most studies have focused on surface epithelial-stromal Tumors in which serous carcinomas are usually positive and endometrioid carcinomas are negative. Very few studies have specifically investigated this marker in ovarian sex cord-stromal Tumors; however, limited data in the literature suggest that WT1 may be frequently expressed in sex cord-stromal Tumors. As pure Sertoli Cell Tumor can be in the histologic differential diagnosis of endometrioid Tumors (particularly borderline Tumor and carcinoma) and carcinoid, immunostaining for WT1 might be of diagnostic value. Immunohistochemical staining for WT1 was performed in 108 ovarian Tumors: pure Sertoli Cell Tumor (n=26), endometrioid borderline Tumor (n=25), classic well-differentiated endometrioid carcinoma (n=23), Sertoliform endometrioid carcinoma (n=12), and carcinoid (n=22). Additionally, inhibin and calretinin immunostaining were performed in all cases of Sertoli Cell Tumor for purposes of comparing expression with WT1. Extent of immunostaining was scored on a 0 to 4+ semiquantitative scale, and immunohistochemical composite scores based on a combination of extent and intensity of immunostaining were calculated in positive cases (possible range, 1 to 12). Nuclear expression of WT1 was present in 96% of Sertoli Cell Tumors, 16% of endometrioid borderline Tumors, 13% of classic well-differentiated endometrioid carcinomas, 25% of Sertoliform endometrioid carcinomas, and 0% of carcinoids. In Sertoli Cell Tumors, expression was diffuse (>50% of positive Cells) in all positive cases. When positive in the non-Sertoli Cell Tumors, the extent of expression tended to be focal to patchy (50% or less positive Cells). In Sertoli Cell Tumors, inhibin and calretinin were expressed in 96% and 54% of cases, respectively. The extent of expression of inhibin tended to be diffuse, similar to WT1; however, the extent of immunostaining for calretinin tended to be focal to patchy. The immunohistochemical composite scores for WT1, inhibin, and calretinin were 11.2, 7.6, and 4.8, respectively. Coordinate patterns for the extent of expression of WT1, inhibin, and calretinin in pure Sertoli Cell Tumor showed that all 3 markers were positive in 54% of cases; however, 42% were positive for WT1 and inhibin but negative for calretinin. In cases positive for both WT1 and inhibin, expression of both markers was diffuse in 84% of cases, but WT1 was diffuse while inhibin was focal to patchy in 16% of cases. We conclude that ovarian Sertoli Cell Tumor should be added to the growing list of WT1-positive Tumors. This marker is useful for the distinction of Sertoli Cell Tumor from endometrioid Tumors and carcinoid. The diagnostic utility of WT1 in Sertoli Cell Tumor is similar to inhibin but better than that of calretinin.
Debra L Zynger - One of the best experts on this subject based on the ideXlab platform.
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sclerosing Sertoli Cell Tumor without expression of typical sex cord stromal Tumor markers case report and literature review
Pathology Research and Practice, 2012Co-Authors: Christopher M Esber, Ahmad Shabsigh, Debra L ZyngerAbstract:Sertoli Cell Tumor is a potential histologic mimic of other Tumors, such as seminoma due to similar histology and overlapping clinical presentation. Sclerosing Sertoli Cell Tumor is a rare sex cord stromal Tumor variant, with 16 cases reported in the English literature. We present an unusual case of sclerosing Sertoli Cell Tumor in a 33-year-old Caucasian male, which was negative or weakly reactive using immunohistochemical markers typically positive in Sertoli Cell Tumors. The Tumor was positive for cytokeratin AE1/AE3, CAM 5.2, vimentin, CD56, CK8, synaptophysin and S100, and negative for inhibin, calretinin, WT1, CD99, CD117, CK5/6, CK7, chromogranin A, placental alkaline phosphatase, neuron specific enolase, D2-40, smooth muscle actin, Melan-A, epithelial membrane antigen and carbonic anhydrase IX. This is the second reported case of a Sertoli Cell Tumor with reactivity limited to neuroendocrine markers and the first such case of the sclerosing variant. A literature review of sclerosing Sertoli Cell Tumor, including English and non-English literature, is described. Our case highlights that expected immunohistochemical markers may be negative, and awareness of antigenically unreactive Tumors is needed to avoid confusion between Sertoli Cell Tumor and other entities.
Chengquan Zhao - One of the best experts on this subject based on the ideXlab platform.
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SF-1 is a diagnostically useful immunohistochemical marker and comparable to other sex cord-stromal Tumor markers for the differential diagnosis of ovarian Sertoli Cell Tumor.
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists, 2008Co-Authors: Chengquan Zhao, Ross Barner, Tuyethoa N. Vinh, Kim Mcmanus, David J. Dabbs, Russell VangAbstract:Immunohistochemistry can be an important part of the diagnosis of Sertoli Cell Tumor of the ovary, including distinction from non-sex cord-stromal Tumors such as the Sertoliform variant of endometrioid carcinoma and carcinoid. Several good markers for this differential diagnosis have been identified, particularly inhibin, Wilms Tumor 1 gene product (WT1), epithelial membrane antigen, and chromogranin; however, many available markers have limitations to some degree. Steroidogenic factor 1 (SF-1; adrenal 4-binding protein; Ad4BP) is a nuclear transcription factor involved in gonadal and adrenal development. In the testes, SF-1 is expressed in Sertoli Cells. Immunohistochemical expression of this marker in ovarian sex cord-stromal Tumors, including utility for differential diagnosis, has not been rigorously evaluated. As an extension of our previous immunohistochemical studies of ovarian Sertoli Cell Tumor, expression of SF-1 and comparison with WT1 and inhibin were assessed in 111 primary ovarian Tumors: 27 Sertoli Cell Tumors, 60 endometrioid Tumors (including borderline Tumors, conventional well-differentiated carcinomas, and Sertoliform variants of carcinoma), and 24 carcinoids. SF-1 was expressed in 100% of Sertoli Cell Tumors but not in endometrioid Tumors or carcinoid. WT1 was expressed in 100% of Sertoli Cell Tumors and 17% of endometrioid Tumors; all carcinoids were negative. Inhibin was expressed in 96% of Sertoli Cell Tumors and 2% of endometrioid Tumors (4% of conventional well-differentiated carcinomas); all carcinoids were negative. The extent of expression of all 3 markers was similar in Sertoli Cell Tumor but greatest for WT1: 63%, 96%, and 78% of cases showed expression of SF-1, WT1, and inhibin, respectively, in more than 50% of Tumor Cells. Immunohistochemical composite scores combining both extent and intensity of staining in positive cases were calculated for Sertoli Cell Tumor (possible range: 1-12). Combined extent/intensity of immunostaining was similar for all 3 markers, but WT1 showed the most robust immunoreactivity in positive cases (mean immunohistochemical composite scores for SF-1, WT1, and inhibin: 6.1, 10.8, and 7.8, respectively). We conclude that for the differential diagnosis with endometrioid Tumors and carcinoid of the ovary, SF-1 is a sensitive and specific immunohistochemical marker for Sertoli Cell Tumor and that SF-1 is diagnostically comparable with other good sex cord-stromal markers.
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comparative analysis of alternative and traditional immunohistochemical markers for the distinction of ovarian Sertoli Cell Tumor from endometrioid Tumors and carcinoid Tumor a study of 160 cases
The American Journal of Surgical Pathology, 2007Co-Authors: Chengquan Zhao, Gary L. Bratthauer, Ross Barner, Russell VangAbstract:The main neoplasms in the differential diagnosis for primary ovarian Tumors with a tubule-rich pattern are pure Sertoli Cell Tumor, endometrioid Tumors (including borderline Tumor, well-differentiated carcinoma, and the Sertoliform variant of endometrioid carcinoma), and carcinoid Tumor. Because traditional immunohistochemical markers [pan-cytokeratin (pan-CK), low molecular weight cytokeratin (CK8/18), epithelial membrane antigen (EMA), inhibin, calretinin, CD99, chromogranin, and synaptophysin] can occasionally have diagnostic limitations, the goal of this study was to determine whether or not any alternative markers [cytokeratin 7 (CK7), estrogen receptor (ER), progesterone receptor (PR), CD10, and CD56] have better diagnostic utility when compared with traditional markers for this differential diagnosis. Immunohistochemical stains for alternative, as well as traditional, markers were performed on the following primary ovarian Tumors: pure Sertoli Cell Tumor (n = 40), endometrioid borderline Tumor (n = 38), Sertoliform endometrioid carcinoma (n = 13), well-differentiated endometrioid carcinoma (n = 27), and carcinoid Tumor (n = 42). Extent and intensity of immunostaining were semiquantitatively scored. In addition, immunohistochemical composite scores (ICSs) in positive cases were calculated on the basis of the combination of extent and intensity scores. Cytokeratin 7 (CK7) was positive in 97% of endometrioid Tumors, 13% of Sertoli Cell Tumors, and 24% of carcinoid Tumors. The differences in the mean ICSs for endometrioid Tumors versus Sertoli Cell Tumor or carcinoid Tumor were statistically significant (P values ranging from <0.001 to 0.018). ER and PR were positive in 87% and 86% of endometrioid Tumors, 8% and 13% of Sertoli Cell Tumors, and 2% each of carcinoid Tumors, respectively. The differences in the mean ICSs for endometrioid Tumors versus Sertoli Cell Tumor were statistically significant (P values ranging from <0.001 to 0.012). Among the epithelial markers, EMA seemed to be the most discriminatory but only slightly better than CK7, ER, or PR. Pan-CK and CK8/18 were not helpful. CD10 showed overlapping patterns of expression in all categories of Tumors. Among the sex cord markers, CD10 was markedly less useful than inhibin or calretinin; CD99 was not discriminatory. CD56 showed overlapping patterns of expression in all categories of Tumors. Among the neuroendocrine markers, CD56 was less useful than chromogranin or synaptophysin. When traditional immunohistochemical markers are problematic for the differential diagnosis of ovarian Sertoli Cell Tumor versus endometrioid Tumors versus carcinoid Tumor, adding CK7, ER, and/or PR to a panel of markers can be helpful. Endometrioid Tumors more frequently express CK7, ER, and PR and show a greater extent of immunostaining in contrast to Sertoli Cell Tumor and carcinoid Tumor. Compared with traditional epithelial markers, CK7, ER, and PR are nearly as advantageous as EMA. Inhibin is the most discriminatory sex cord marker, and CD10 is not helpful in the differential diagnosis. Chromogranin and synaptophysin are exCellent discriminatory markers for carcinoid Tumor, and CD56 is neither sufficiently sensitive nor specific enough for this differential diagnosis to warrant its use in routine practice.
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Diagnostic utility of WT1 immunostaining in ovarian Sertoli Cell Tumor.
The American journal of surgical pathology, 2007Co-Authors: Chengquan Zhao, Gary L. Bratthauer, Ross Barner, Russell VangAbstract:WT1, the Wilms Tumor gene product, can be expressed in various Tumors from different anatomic sites, including some types of ovarian Tumors. Regarding the latter, most studies have focused on surface epithelial-stromal Tumors in which serous carcinomas are usually positive and endometrioid carcinomas are negative. Very few studies have specifically investigated this marker in ovarian sex cord-stromal Tumors; however, limited data in the literature suggest that WT1 may be frequently expressed in sex cord-stromal Tumors. As pure Sertoli Cell Tumor can be in the histologic differential diagnosis of endometrioid Tumors (particularly borderline Tumor and carcinoma) and carcinoid, immunostaining for WT1 might be of diagnostic value. Immunohistochemical staining for WT1 was performed in 108 ovarian Tumors: pure Sertoli Cell Tumor (n=26), endometrioid borderline Tumor (n=25), classic well-differentiated endometrioid carcinoma (n=23), Sertoliform endometrioid carcinoma (n=12), and carcinoid (n=22). Additionally, inhibin and calretinin immunostaining were performed in all cases of Sertoli Cell Tumor for purposes of comparing expression with WT1. Extent of immunostaining was scored on a 0 to 4+ semiquantitative scale, and immunohistochemical composite scores based on a combination of extent and intensity of immunostaining were calculated in positive cases (possible range, 1 to 12). Nuclear expression of WT1 was present in 96% of Sertoli Cell Tumors, 16% of endometrioid borderline Tumors, 13% of classic well-differentiated endometrioid carcinomas, 25% of Sertoliform endometrioid carcinomas, and 0% of carcinoids. In Sertoli Cell Tumors, expression was diffuse (>50% of positive Cells) in all positive cases. When positive in the non-Sertoli Cell Tumors, the extent of expression tended to be focal to patchy (50% or less positive Cells). In Sertoli Cell Tumors, inhibin and calretinin were expressed in 96% and 54% of cases, respectively. The extent of expression of inhibin tended to be diffuse, similar to WT1; however, the extent of immunostaining for calretinin tended to be focal to patchy. The immunohistochemical composite scores for WT1, inhibin, and calretinin were 11.2, 7.6, and 4.8, respectively. Coordinate patterns for the extent of expression of WT1, inhibin, and calretinin in pure Sertoli Cell Tumor showed that all 3 markers were positive in 54% of cases; however, 42% were positive for WT1 and inhibin but negative for calretinin. In cases positive for both WT1 and inhibin, expression of both markers was diffuse in 84% of cases, but WT1 was diffuse while inhibin was focal to patchy in 16% of cases. We conclude that ovarian Sertoli Cell Tumor should be added to the growing list of WT1-positive Tumors. This marker is useful for the distinction of Sertoli Cell Tumor from endometrioid Tumors and carcinoid. The diagnostic utility of WT1 in Sertoli Cell Tumor is similar to inhibin but better than that of calretinin.
Ross Barner - One of the best experts on this subject based on the ideXlab platform.
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SF-1 is a diagnostically useful immunohistochemical marker and comparable to other sex cord-stromal Tumor markers for the differential diagnosis of ovarian Sertoli Cell Tumor.
International journal of gynecological pathology : official journal of the International Society of Gynecological Pathologists, 2008Co-Authors: Chengquan Zhao, Ross Barner, Tuyethoa N. Vinh, Kim Mcmanus, David J. Dabbs, Russell VangAbstract:Immunohistochemistry can be an important part of the diagnosis of Sertoli Cell Tumor of the ovary, including distinction from non-sex cord-stromal Tumors such as the Sertoliform variant of endometrioid carcinoma and carcinoid. Several good markers for this differential diagnosis have been identified, particularly inhibin, Wilms Tumor 1 gene product (WT1), epithelial membrane antigen, and chromogranin; however, many available markers have limitations to some degree. Steroidogenic factor 1 (SF-1; adrenal 4-binding protein; Ad4BP) is a nuclear transcription factor involved in gonadal and adrenal development. In the testes, SF-1 is expressed in Sertoli Cells. Immunohistochemical expression of this marker in ovarian sex cord-stromal Tumors, including utility for differential diagnosis, has not been rigorously evaluated. As an extension of our previous immunohistochemical studies of ovarian Sertoli Cell Tumor, expression of SF-1 and comparison with WT1 and inhibin were assessed in 111 primary ovarian Tumors: 27 Sertoli Cell Tumors, 60 endometrioid Tumors (including borderline Tumors, conventional well-differentiated carcinomas, and Sertoliform variants of carcinoma), and 24 carcinoids. SF-1 was expressed in 100% of Sertoli Cell Tumors but not in endometrioid Tumors or carcinoid. WT1 was expressed in 100% of Sertoli Cell Tumors and 17% of endometrioid Tumors; all carcinoids were negative. Inhibin was expressed in 96% of Sertoli Cell Tumors and 2% of endometrioid Tumors (4% of conventional well-differentiated carcinomas); all carcinoids were negative. The extent of expression of all 3 markers was similar in Sertoli Cell Tumor but greatest for WT1: 63%, 96%, and 78% of cases showed expression of SF-1, WT1, and inhibin, respectively, in more than 50% of Tumor Cells. Immunohistochemical composite scores combining both extent and intensity of staining in positive cases were calculated for Sertoli Cell Tumor (possible range: 1-12). Combined extent/intensity of immunostaining was similar for all 3 markers, but WT1 showed the most robust immunoreactivity in positive cases (mean immunohistochemical composite scores for SF-1, WT1, and inhibin: 6.1, 10.8, and 7.8, respectively). We conclude that for the differential diagnosis with endometrioid Tumors and carcinoid of the ovary, SF-1 is a sensitive and specific immunohistochemical marker for Sertoli Cell Tumor and that SF-1 is diagnostically comparable with other good sex cord-stromal markers.
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comparative analysis of alternative and traditional immunohistochemical markers for the distinction of ovarian Sertoli Cell Tumor from endometrioid Tumors and carcinoid Tumor a study of 160 cases
The American Journal of Surgical Pathology, 2007Co-Authors: Chengquan Zhao, Gary L. Bratthauer, Ross Barner, Russell VangAbstract:The main neoplasms in the differential diagnosis for primary ovarian Tumors with a tubule-rich pattern are pure Sertoli Cell Tumor, endometrioid Tumors (including borderline Tumor, well-differentiated carcinoma, and the Sertoliform variant of endometrioid carcinoma), and carcinoid Tumor. Because traditional immunohistochemical markers [pan-cytokeratin (pan-CK), low molecular weight cytokeratin (CK8/18), epithelial membrane antigen (EMA), inhibin, calretinin, CD99, chromogranin, and synaptophysin] can occasionally have diagnostic limitations, the goal of this study was to determine whether or not any alternative markers [cytokeratin 7 (CK7), estrogen receptor (ER), progesterone receptor (PR), CD10, and CD56] have better diagnostic utility when compared with traditional markers for this differential diagnosis. Immunohistochemical stains for alternative, as well as traditional, markers were performed on the following primary ovarian Tumors: pure Sertoli Cell Tumor (n = 40), endometrioid borderline Tumor (n = 38), Sertoliform endometrioid carcinoma (n = 13), well-differentiated endometrioid carcinoma (n = 27), and carcinoid Tumor (n = 42). Extent and intensity of immunostaining were semiquantitatively scored. In addition, immunohistochemical composite scores (ICSs) in positive cases were calculated on the basis of the combination of extent and intensity scores. Cytokeratin 7 (CK7) was positive in 97% of endometrioid Tumors, 13% of Sertoli Cell Tumors, and 24% of carcinoid Tumors. The differences in the mean ICSs for endometrioid Tumors versus Sertoli Cell Tumor or carcinoid Tumor were statistically significant (P values ranging from <0.001 to 0.018). ER and PR were positive in 87% and 86% of endometrioid Tumors, 8% and 13% of Sertoli Cell Tumors, and 2% each of carcinoid Tumors, respectively. The differences in the mean ICSs for endometrioid Tumors versus Sertoli Cell Tumor were statistically significant (P values ranging from <0.001 to 0.012). Among the epithelial markers, EMA seemed to be the most discriminatory but only slightly better than CK7, ER, or PR. Pan-CK and CK8/18 were not helpful. CD10 showed overlapping patterns of expression in all categories of Tumors. Among the sex cord markers, CD10 was markedly less useful than inhibin or calretinin; CD99 was not discriminatory. CD56 showed overlapping patterns of expression in all categories of Tumors. Among the neuroendocrine markers, CD56 was less useful than chromogranin or synaptophysin. When traditional immunohistochemical markers are problematic for the differential diagnosis of ovarian Sertoli Cell Tumor versus endometrioid Tumors versus carcinoid Tumor, adding CK7, ER, and/or PR to a panel of markers can be helpful. Endometrioid Tumors more frequently express CK7, ER, and PR and show a greater extent of immunostaining in contrast to Sertoli Cell Tumor and carcinoid Tumor. Compared with traditional epithelial markers, CK7, ER, and PR are nearly as advantageous as EMA. Inhibin is the most discriminatory sex cord marker, and CD10 is not helpful in the differential diagnosis. Chromogranin and synaptophysin are exCellent discriminatory markers for carcinoid Tumor, and CD56 is neither sufficiently sensitive nor specific enough for this differential diagnosis to warrant its use in routine practice.
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Diagnostic utility of WT1 immunostaining in ovarian Sertoli Cell Tumor.
The American journal of surgical pathology, 2007Co-Authors: Chengquan Zhao, Gary L. Bratthauer, Ross Barner, Russell VangAbstract:WT1, the Wilms Tumor gene product, can be expressed in various Tumors from different anatomic sites, including some types of ovarian Tumors. Regarding the latter, most studies have focused on surface epithelial-stromal Tumors in which serous carcinomas are usually positive and endometrioid carcinomas are negative. Very few studies have specifically investigated this marker in ovarian sex cord-stromal Tumors; however, limited data in the literature suggest that WT1 may be frequently expressed in sex cord-stromal Tumors. As pure Sertoli Cell Tumor can be in the histologic differential diagnosis of endometrioid Tumors (particularly borderline Tumor and carcinoma) and carcinoid, immunostaining for WT1 might be of diagnostic value. Immunohistochemical staining for WT1 was performed in 108 ovarian Tumors: pure Sertoli Cell Tumor (n=26), endometrioid borderline Tumor (n=25), classic well-differentiated endometrioid carcinoma (n=23), Sertoliform endometrioid carcinoma (n=12), and carcinoid (n=22). Additionally, inhibin and calretinin immunostaining were performed in all cases of Sertoli Cell Tumor for purposes of comparing expression with WT1. Extent of immunostaining was scored on a 0 to 4+ semiquantitative scale, and immunohistochemical composite scores based on a combination of extent and intensity of immunostaining were calculated in positive cases (possible range, 1 to 12). Nuclear expression of WT1 was present in 96% of Sertoli Cell Tumors, 16% of endometrioid borderline Tumors, 13% of classic well-differentiated endometrioid carcinomas, 25% of Sertoliform endometrioid carcinomas, and 0% of carcinoids. In Sertoli Cell Tumors, expression was diffuse (>50% of positive Cells) in all positive cases. When positive in the non-Sertoli Cell Tumors, the extent of expression tended to be focal to patchy (50% or less positive Cells). In Sertoli Cell Tumors, inhibin and calretinin were expressed in 96% and 54% of cases, respectively. The extent of expression of inhibin tended to be diffuse, similar to WT1; however, the extent of immunostaining for calretinin tended to be focal to patchy. The immunohistochemical composite scores for WT1, inhibin, and calretinin were 11.2, 7.6, and 4.8, respectively. Coordinate patterns for the extent of expression of WT1, inhibin, and calretinin in pure Sertoli Cell Tumor showed that all 3 markers were positive in 54% of cases; however, 42% were positive for WT1 and inhibin but negative for calretinin. In cases positive for both WT1 and inhibin, expression of both markers was diffuse in 84% of cases, but WT1 was diffuse while inhibin was focal to patchy in 16% of cases. We conclude that ovarian Sertoli Cell Tumor should be added to the growing list of WT1-positive Tumors. This marker is useful for the distinction of Sertoli Cell Tumor from endometrioid Tumors and carcinoid. The diagnostic utility of WT1 in Sertoli Cell Tumor is similar to inhibin but better than that of calretinin.
Christopher M Esber - One of the best experts on this subject based on the ideXlab platform.
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sclerosing Sertoli Cell Tumor without expression of typical sex cord stromal Tumor markers case report and literature review
Pathology Research and Practice, 2012Co-Authors: Christopher M Esber, Ahmad Shabsigh, Debra L ZyngerAbstract:Sertoli Cell Tumor is a potential histologic mimic of other Tumors, such as seminoma due to similar histology and overlapping clinical presentation. Sclerosing Sertoli Cell Tumor is a rare sex cord stromal Tumor variant, with 16 cases reported in the English literature. We present an unusual case of sclerosing Sertoli Cell Tumor in a 33-year-old Caucasian male, which was negative or weakly reactive using immunohistochemical markers typically positive in Sertoli Cell Tumors. The Tumor was positive for cytokeratin AE1/AE3, CAM 5.2, vimentin, CD56, CK8, synaptophysin and S100, and negative for inhibin, calretinin, WT1, CD99, CD117, CK5/6, CK7, chromogranin A, placental alkaline phosphatase, neuron specific enolase, D2-40, smooth muscle actin, Melan-A, epithelial membrane antigen and carbonic anhydrase IX. This is the second reported case of a Sertoli Cell Tumor with reactivity limited to neuroendocrine markers and the first such case of the sclerosing variant. A literature review of sclerosing Sertoli Cell Tumor, including English and non-English literature, is described. Our case highlights that expected immunohistochemical markers may be negative, and awareness of antigenically unreactive Tumors is needed to avoid confusion between Sertoli Cell Tumor and other entities.
