Expression and sensitivity of immunohistochemical markers SMA, Desmin, CD10 for uterine leiomyomas - A tertiary care centre experience

Introduction: Leiomyoma is the most common benign tumor of the uterus which usually presents with menorrhagia, pain in abdomen or both. In extremely rare cases where uterine leiomyoma can be difficult to distinguish from other uterine smooth muscle tumors, immunohistochemistry is used. This study was aimed to study the expression and sensitivity of immunohistochemical markers SMA, Desmin, CD 10 for uterine leiomyomas and to find average number of mitosis in uterine leiomyomas using Ki 67. Materials and methods: The present study was carried out in the Department of Pathology, Dhiraj General Hospital and Smt. Bhikhiben Kanjibhai Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth, Piparia. A total 50 cases of uterine leiomyomas after its histological diagnosis were evaluated with immunohistochemical markers SMA, Desmin, CD 10 and Ki 67. Results: SMA expression was seen in all 50 cases of uterine leiomyomas with strong expression in 44 cases (88%). Strong SMA expression was seen more in usual leiomyomas as compared to leiomyomas with secondary changes. Desmin expression was also seen in all the 50 cases of uterine leiomyomas with moderate expression in 26 cases (52%). Weak CD 10 expression was seen in 15 cases of uterine leiomyomas (30%). Ki 67 was expressed very focally in only 3 cases of leiomyomas with mean value of only 0.3% tumor cells. Conclusions: Leimyomas was most frequently seen in the women in 4th decade. The most common clinical presentation was menorrhagia. SMA and Desmin expression was seen in all the cases with strong and moderate immunoreactivity respectively. SMA expression was found to be more specific than Desmin in uterine leiomyoma. Weak CD 10 and focal Ki 67 were expressed only in few cases and were found to be insignificant.

Low Grade Endometrial Stromal Sarcoma in 40 years old female – A rare case report

Endometrial uterine sarcoma is a very rare tumour of the uterine cavity with an incidence of 1-2 cases per 100,000 women. Low grade Endometrial stromal sarcoma (LGESS) is an occasional diagnosis in a patient presenting as leiomyoma uterus. The symptoms are nonspecific, mostly abnormal uterine bleeding in perimenopausal women. Clinically and radiologically it is difficult to diagnose this entity. Histopathological examination and immunohistochemistry confirmed the diagnosis of LGESS. In addition of surgery chemotherapy, radiotherapy and immunotherapy treatments will be quite useful in all cases of LGESS. This case report of Low grade Endometrial stromal sarcoma (LGESS) is presented here because of its rarity.