Annals of Diagnostic Pathology
Volume 12, Issue 6 , Pages 401-405 , December 2008

Epithelioid smooth muscle tumors of the uterus do not express CD1a: a potential immunohistochemical adjunct in their distinction from uterine perivascular epithelioid cell tumors

  • Oluwole Fadare, MD

      Affiliations

    • Department of Pathology, Wilford Hall Medical Center, Lackland AFB, San Antonio, TX 78236, USA
    • Department of Pathology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
    • Corresponding Author InformationCorresponding author. Department of Pathology, Wilford Hall Medical Center, Lackland AFB, TX 78236, USA.
    • ,
  • Sharon X. Liang, MD, PhD

      Affiliations

    • Department of Pathology, Stony Brook University Hospital, Stony Brook, NY 11794, USA

References 

  1. Bonetti F, Pea M, Martignoni G, Doglioni C, Zamboni G, Capelli P, et al. Clear cell (“sugar”) tumor of the lung is a lesion strictly related to angiomyolipoma—the concept of a family of lesions characterized by the presence of the perivascular epithelioid cells (PEC). Pathology. 1994;26:230–236
  2. Pea M, Bonetti F, Zamboni G, Martignoni G, Fiore-Donati L. Clear cell tumor and angiomyolipoma. Am J Surg Pathol. 1991;15:199–201[letter]
  3. Bonetti F, Pea M, Martignoni G, Zamboni G. PEC and Sugar. Am J Surg Pathol. 1992;16:307–308[letter]
  4. Fadare O, Parkash V, Yilmaz Y, Mariappan MR, Ma L, Hileeto D, et al. Perivascular epithelioid cell tumor (PEComa) of the uterine cervix associated with intraabdominal “PEComatosis”: a clinicopathological study with comparative genomic hybridization analysis. World J Surg Oncol. 2004;2:35
  5. Fadare O. Perivascular epithelioid cell tumors and smooth muscle tumors of the uterus. Am J Surg Pathol. 2007;31:1454–1455[letter]
  6. Fadare O, Hileeto D, Mariappan MR, Hui P. Perivascular epithelioid cell tumor not otherwise specified (PEComa-NOS)—a review of 43 reported cases. Am J Clin Pathol. 2004;122:625–661[abstract]
  7. Fadare O. Perivascular epithelioid cell tumor [PEComa] of the uterus: an outcome-based clinicopathologic analysis of 41 reported cases. Adv Anat Pathol. 2008;15:63–75
  8. Fadare O. Uterine PEComa: appraisal of a controversial and increasingly reported mesenchymal neoplasm. Int Semin Surg Oncol. 2008;5:7
  9. Folpe AL. Neoplasms with perivascular epithelioid cell differentiation (PEComas). In:  Fletcher CDM,  Unni KK,  Mertens F editor. World Health Organization classification of tumors: pathology and genetics of tumors of soft tissue and bone. Lyon: IARC Press; 2002;p. 221–222
  10. Martignoni G, Pea M, Reghellin D, Zamboni G, Bonetti F. Perivascular epithelioid cell tumor (PEComa) in the genitourinary tract. Adv Anat Pathol. 2007;14:36–41
  11. Hornick JL, Fletcher CD. PEComa: what do we know so far. Histopathology. 2006;48:75–82
  12. Folpe AL, Mentzel T, Lehr HA, Fisher C, Balzer BL, Weiss SW. Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol. 2005;29:1558–1575
  13. Bonetti F, Pea M, Martignoni G, Zamboni G, Manfrin E, Colombari R, et al. The perivascular epithelioid cell and related lesions. Adv Anat Pathol. 1997;4:343–358
  14. Martignoni G, Pea M, Reghellin D, Zamboni G, Bonetti F. PEComas: the past, the present and the future. Virchows Arch. 2008;452:119–132
  15. Apitz K. Die Geschwulste und Gewebsmissbildungen der Nierenrinde. II Midteilung. Die mesenchymalen Neubildungen. Virchows Arch. 1943;311:306–327
  16. Folpe AL, Goodman ZD, Ishak KG, Paulino AF, Taboada EM, Meehan SA, et al. Clear cell myomelanocytic tumor of the falciform ligament/ligamentum teres: a novel member of the perivascular epithelioid clear cell family of tumors with a predilection for children and young adults. Am J Surg Pathol. 2000;24:1239–1246
  17. Hendrickson MR, Tavassoli FA, Kempson RL, McCluggage WG, Haller U, Kubik-Huch RA. Mesenchymal tumors and related lesions. In:  Tavassoli FA,  Devilee P editor. World Health Organization classification of tumors. Pathology and genetics of tumors of the breast and female genital organs. Lyon: IARC Press; 2003;p. 233–244
  18. Pan CC, Jong YJ, Chai CY, Huang SH, Chen YJ. Comparative genomic hybridization study of perivascular epithelioid cell tumor: molecular genetic evidence of perivascular epithelioid cell tumor as a distinctive neoplasm. Hum Pathol. 2006;37:606–612
  19. Luo DL, Liu YH, Zhuang HG, Luo XL. Tumors showing perivascular epithelioid cell differentiation: a clinicopathologic study of 39 cases. Zhonghua Yi Xue Za Zhi. 2007;87:2909–2913
  20. Yang YP, Zhu YL, Wu WP, Wang ZM, Zhang JM. Perivascular epithelioid cell tumor of uterus: report of 5 cases and literature review. Zhonghua Bing Li Xue Za Zhi. 2007;36:302–306
  21. Pea M, Martignoni G, Zamboni G, Bonetti F. Perivascular epithelioid cell. Am J Surg Pathol. 1996;20:1149–1153
  22. Gan MF, Yu CK, Jin M, Lu HS, Li HM. Perivascular epithelioid cell tumor of the uterus: report of three cases. Chin Med J (Engl). 2007;120:526–528
  23. Rammeh Rommani S, Trabelsi A, Attia L, Msakni I, Koubaa A, Ben Jilani S, et al. Perivascular epithelioid cell tumor of the uterus: a case report. Pathologica. 2006;98:649–651
  24. Azad NS, Aziz AB, Pervez S, Kayani N. Uterine perivascular epithelioid cell tumour presenting as a cervical mass. J Pak Med Assoc. 2006;56:83–84
  25. Jeon IS, Lee SM. Multimodal treatment using surgery, radiotherapy, and chemotherapy in a patient with a perivascular epithelioid cell tumor of the uterus. J Pediatr Hematol Oncol. 2005;27:681–684
  26. Bosincu L, Rocca PC, Martignoni G, Nogales FF, Longa L, Maccioni A, et al. Perivascular epithelioid cell (PEC) tumors of the uterus: a clinicopathologic study of two cases with aggressive features. Mod Pathol. 2005;18:1336–1342
  27. Fukunaga M. Perivascular epithelioid cell tumor of the uterus: report of four cases. Int J Gynecol Pathol. 2005;24:341–346
  28. Fukunaga M. Perivascular epithelioid cell tumor of the uterus: a case report. Int J Gynecol Pathol. 2004;23:287–291
  29. Bernardo Vega R, Camino FV, Frenandez MDC, Segura GQ, Gonzalez JM, Gonzalez-Tejero C. The PEComa Tumor: could it be considered an independent neoplastic entity. J Gynecol Surg. 2005;21:161–166
  30. Gao Z, Bhuiya T, Anderson A. Perivascular epithelioid cell tumour (PEComa) of the uterus associated with malignant neoplasm of the female genital tract. J Obstet Gynaecol. 2004;24:600–604
  31. Darai E, Bazot M, Barranger E, Detchev R, Cortez A. Epithelioid angiomyolipoma of the uterus: a case report. J Reprod Med. 2004;49:578–581
  32. Greene LA, Mount SL, Schned AR, Cooper K. Recurrent perivascular epithelioid cell tumor of the uterus (PEComa): an immunohistochemical study and review of the literature. Gynecol Oncol. 2003;90:677–681
  33. Park SH, Ro JY, Kim HS, Lee ES. Perivascular epithelioid cell tumor of the uterus: immunohistochemical, ultrastructural and molecular study. Pathol Int. 2003;53:800–805
  34. Dimmler A, Seitz G, Hohenberger W, Kirchner T, Faller G. Late pulmonary metastasis in uterine PEComa. J Clin Pathol. 2003;56:627–628
  35. Vang R, Kempson RL. Perivascular epithelioid cell tumor (“PEComa”) of the uterus: a subset of HMB-45–positive epithelioid mesenchymal neoplasms with an uncertain relationship to pure smooth muscle tumors. Am J Surg Pathol. 2002;26:1–13
  36. Bonetti F, Martignoni G, Colato C, Manfrin E, Gambacorta M, Faleri M, et al. Abdominopelvic sarcoma of perivascular epithelioid cells. Report of four cases in young women, one with tuberous sclerosis. Mod Pathol. 2001;14:563–568
  37. Michal M, Zamecnik M. Hyalinized uterine mesenchymal neoplasms with HMB-45–positive epithelioid cells: epithelioid leiomyomas or angiomyolipomas? Report of four cases. Int J Surg Pathol. 2000;8:323–328
  38. D'Andrea V, Lippolis G, Biancari F, Ruco LP, Marzullo A, Wedard BM, et al. A uterine PEComa: a case report. G Chir. 1999;20:163–164
  39. Ruco LP, Pilozzi E, Wedard BM, Marzullo A, D'Andrea V, De Antoni E, et al. Epithelioid lymphangioleiomyomatosis-like tumour of the uterus in a patient without tuberous sclerosis: a lesion mimicking epithelioid leiomyosarcoma. Histopathology. 1998;33:91–93
  40. Hornick JL, Fletcher CD. Sclerosing PEComa: clinicopathologic analysis of a distinctive variant with a predilection for the retroperitoneum. Am J Surg Pathol. 2008;32:493–501
  41. Armah HB, Parwani AV. Malignant perivascular epithelioid cell tumor (PEComa) of the uterus with late renal and pulmonary metastases: a case report with review of the literature. Diagn Pathol. 2007;2:45
  42. Liang SX, Pearl M, Liu J, Hwang S, Tornos C. “Malignant” uterine perivascular epithelioid cell tumor, pelvic lymph node lymphangioleiomyomatosis, and gynecological PEComatosis in a patient with tuberous sclerosis: a case report and review of the literature. Int J Gynecol Pathol. 2008;27:86–90
  43. Kurman RJ, Norris HJ. Mesenchymal tumors of the uterus. VI. Epithelioid smooth muscle tumors including leiomyoblastoma and clear-cell leiomyoma: a clinical and pathologic analysis of 26 cases. Cancer. 1976;37:1853–1865
  44. Prayson RA, Goldblum JR, Hart WR. Epithelioid smooth-muscle tumors of the uterus: a clinicopathologic study of 18 patients. Am J Surg Pathol. 1997;21:383–391
  45. Oliva E, Nielsen PG, Clement PB, Young RH, Scully RE. Epithelioid smooth muscle tumors of the uterus. A clinicopathologic study of 80 cases. Mod Pathol. 1997;10:107A;[abstract]
  46. Atkins K, Bell S, Kempson R, Hendrickson M. Epithelioid smooth muscle tumors of the uterus. Mod Pathol. 2001;14:132A;[abstract]
  47. Silva EG, Deavers MT, Bodurka DC, Malpica A. Uterine epithelioid leiomyosarcomas with clear cells: reactivity with HMB-45 and the concept of PEComa. Am J Surg Pathol. 2004;28:244–249
  48. Kempson RL, Hendrickson MR. Smooth muscle, endometrial stromal, and mixed Müllerian tumors of the uterus. Mod Pathol. 2000;13:328–342
  49. Adachi Y, Horie Y, Kitamura Y, Nakamura H, Taniguchi Y, Miwa K, et al. CD1a expression in PEComas. Pathol Int. 2008;58:169–173
  50. Kaminski PF, Tavassoli FA. Plexiform tumorlet: a clinical and pathologic study of 15 cases with ultrastructural observations. Int J Gynecol Pathol. 1984;3:124–134
  51. Silva EG, Bodurka DC, Scouros MA, Ayala A. A uterine leiomyosarcoma that became positive for HMB45 in the metastasis. Ann Diagn Pathol. 2005;9:43–45
  52. Silva EG, Tornos C, Ordonez NG, Morris M. Uterine leiomyosarcoma with clear cell areas. Int J Gynecol Pathol. 1995;14:174–178
  53. Smolarek TA, Bejarano PA, Heffelfinger S, Menon AG. HMB-45 immunoreactivity is present in both uterine leiomyomas and normal myometrium. Mod Pathol. 1999;12:125;[abstract]
  54. Williams ME, Gainey TW, Lamb T, Bach D, Kornstein MJ, Burks RT. HMB-45 immunoreactivity in uterine mesenchymal tumors. Mod Pathol. 2000;13:120;[abstract]
  55. Oliva E, Wang WL, Branton P, Logani S, Zannoni GF, Linkov I, et al. Expression of melanocytic (“PEComa”) markers in smooth muscle tumors of the uterus: an immunohistochemical analysis of 86 cases. Mod Pathol. 2006;86:191A;[abstract]
  56. Simpson KW, Albores-Saavedra J. HMB-45 reactivity in conventional uterine leiomyosarcomas. Am J Surg Pathol. 2007;31:95–98
  57. Hurrell DP, McCluggage WG. Uterine leiomyosarcoma with HMB45+ clear cell areas: report of two cases. Histopathology. 2005;47:540–542
  58. Barcus ME, Williams RI, Gainey TW. HMB-45 immunoreactivity in uterine mesenchymal tumors. Mod Pathol. 2000;13:120A
  59. Adachi Y, Kitamura Y, Nakamura H, Taniguchi Y, Miwa K, Horie Y, et al. Benign clear (sugar) cell tumor of the lung with CD1a expression. Pathol Int. 2006;56:453–456

☆ The views expressed in this article are those of the authors and do not reflect the official policy of the Department of Defense or other Departments of the United States Government.

PII: S1092-9134(08)00044-0

doi: 10.1016/j.anndiagpath.2008.04.009

Annals of Diagnostic Pathology
Volume 12, Issue 6 , Pages 401-405 , December 2008

Article Tools

* Image Usage & Resolution