Immunohistochemical study of a case of malignant Müllerian mixed tumor in comparison with the activity of normal uterine tissue

Abstract

A case of rnalignant Müllerian rnixed tumor of the uterus, exhibiting a histology of heterologous osteosarcornatous differentiation, is presented. Special ernphasis is placed on the characteristic irnrnunohistochernical reactivity of the tumor tissue in cornparison with that of normal uterine tissue in the proliferative phase. Keratin, cytokeratin, epithelial rnernbrane antigen (EMA), carcinoernbryonic antigen (CEA), and hurnan chorionic gonadotropin (HCG) were found only in the carcinornatous elernent. However, neuron specific enolase (NSE), S-100 protein (S 100) and virnentin were identified in alrnost al1 tumor tissue elernents. Desrnin and actin were not stained in any elernents. Myoglobin was only detected weakly in the squamous carcinornatous elernent. Undifferentiated cell elernent, cornposed of srnall, round, spindle, or polygonal cells showed positive reactions to NSE and S 100, but not to any other antibodies. As cornpared to the reactivities of the normal proliferative endornetriurn, the glandular epithelial cells were positive with NSE, S 100, virnentin and CEA, but the strornal cells were only positive with vimentin. Such a rnultitudinous and concornitant expression of antigenicity to the different tumor elernents indicates a close relationship to its rnesoderrnal Müllerian origin, and NSE, S 100 and virnentin rnight be rnost adequate indicators of these types of turnors.