Endometrial stromal sarcoma
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Endometrial stromal sarcoma, abbreviated ESS, is a rare malignant mesenchymal tumour of the uterus.
| Endometrial stromal sarcoma | |
|---|---|
| Diagnosis in short | |
 Endometrial stromal sarcoma. H&E stain. | |
|
| |
| LM | highly cellular islands of (tumour) cells with a wavy irregular border -- benign uterine smooth muscle between; tumour cells: high NC ratio and epithelioid, pallisade around thin blood vessels within the tumour |
| LM DDx | leiomyoma (cellular), endometrial stromal nodule, uterine leiomyosarcoma |
| IHC | CD10 +ve, H-caldesmin -ve, PR +/-ve, ER +/-ve |
| Molecular | t(7;17) |
| Site | uterus - see uterine tumours |
|
| |
| Prevalence | rare |
| Prognosis | good |
| Clin. DDx | other uterine tumours |
It is also known as low-grade endometrial stromal sarcoma, abbreviated LGESS.
General
Note:
- Extrauterine endometrial stromal sarcoma is known as endometrioid stromal sarcoma.[4]
Microscopic
Features:
- Highly cellular islands with a wavy irregular border.
- Border has finger-like projections/tongue-like projections.
- Benign uterine smooth muscle between islands of tumour cells.
- Epithelioid cells.
- High NC ratio.
- Thin blood vessels within islands of cells.
- Tumour cells pallisade around the vessels.
Notes:
- Vaguely resembles the stroma of proliferative endometrium.
- Low mitotic rate - predictive of good outcome.[2]
DDx:
- Leiomyoma.
- Endometrial stromal nodule.
- Uterine leiomyosarcoma.
- Undifferentiated endometrial sarcoma (previously known as high-grade endometrial stromal sarcoma) - necrosis and nuclear atypia.[2]
Images
ESS - low mag. (WC/Nephron)
ESS - low mag. (WC/Nephron)
ESS - intermed. mag. (WC/Nephron)
ESS - high mag. (WC/Nephron)
ESS - very high mag. (WC/Nephron)
ESS. (WC)
Endometrial stromal sarcoma - low grade. (WC)
www:
IHC
Features:[6]
- CD10 +ve.
- H-caldesmin -ve.
- Leiomyomas +ve.
- PR +/-ve.
- ER +/-ve.
- CD117 +ve (~80%).[7]
Molecular
May be associated a recurrent translocation:[8]
See also
References
- ↑ Chew, I.; Oliva, E. (Mar 2010). "Endometrial stromal sarcomas: a review of potential prognostic factors.". Adv Anat Pathol 17 (2): 113-21. doi:10.1097/PAP.0b013e3181cfb7c2. PMID 20179433.
- ↑ 2.0 2.1 2.2 Cite error: Invalid
<ref>tag; no text was provided for refs namedpmid24146786 - ↑ Yoon, A.; Park, JY.; Park, JY.; Lee, YY.; Kim, TJ.; Choi, CH.; Bae, DS.; Kim, BG. et al. (Oct 2013). "Prognostic factors and outcomes in endometrial stromal sarcoma with the 2009 FIGO staging system: A multicenter review of 114 cases.". Gynecol Oncol. doi:10.1016/j.ygyno.2013.10.029. PMID 24184602.
- ↑ Masand, RP.; Euscher, ED.; Deavers, MT.; Malpica, A. (Nov 2013). "Endometrioid stromal sarcoma: a clinicopathologic study of 63 cases.". Am J Surg Pathol 37 (11): 1635-47. doi:10.1097/PAS.0000000000000083. PMID 24121169.
- ↑ Baker, P.; Oliva, E. (Mar 2007). "Endometrial stromal tumours of the uterus: a practical approach using conventional morphology and ancillary techniques.". J Clin Pathol 60 (3): 235-43. doi:10.1136/jcp.2005.031203. PMID 17347285. http://jcp.bmj.com/content/60/3/235.full.
- ↑ Zhu, XQ.; Shi, YF.; Cheng, XD.; Zhao, CL.; Wu, YZ. (Jan 2004). "Immunohistochemical markers in differential diagnosis of endometrial stromal sarcoma and cellular leiomyoma.". Gynecol Oncol 92 (1): 71-9. PMID 14751141.
- ↑ Park, JY.; Kim, KR.; Nam, JH. (Jan 2013). "Immunohistochemical analysis for therapeutic targets and prognostic markers in low-grade endometrial stromal sarcoma.". Int J Gynecol Cancer 23 (1): 81-9. doi:10.1097/IGC.0b013e3182738361. PMID 23221606.
- ↑ Amant, F.; Moerman, P.; Cadron, I.; Hagemeijer, A.; Vergote, I.; Debiec-Rychter, M. (Mar 2003). "Endometrial stromal sarcoma with a sole t(X;17) chromosome change: report of a case and review of the literature.". Gynecol Oncol 88 (3): 459-62. PMID 12648605.
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 606246
- ↑ Online 'Mendelian Inheritance in Man' (OMIM) 606245