Melan-A (A103) and inhibin expression in ovarian neoplasms.

Department of Pathology, New York Presbyterian Hospital-Weill Medical College of Cornell University, New York, New York, U.S.A.
Applied immunohistochemistry & molecular morphology: AIMM / official publication of the Society for Applied Immunohistochemistry (Impact Factor: 2.06). 10/2003; 11(3):244-9. DOI: 10.1097/00129039-200309000-00007
Source: PubMed

ABSTRACT A103 is a melanocyte-associated monoclonal antibody that recognizes the Melan-A/MART-1 antigen in melanomas. The Melan-A/MART-1 antigen is also expressed in Leydig cells, adrenal tissue, and steroid-secreting tumors. A103 immunoreactivity in ovarian neoplasms, specifically sex cord stromal tumors (SCSTs), has not been well studied. Inhibin is known to be expressed in SCSTs but is also expressed in some carcinomas and other tumors. We sought to explore the usefulness of both antibodies in the diagnosis of ovarian neoplasms. Using conventional tissue sections and a tissue microarray, we studied the immunoreactivities of 131 ovarian tumors for A103 and inhibin: 30 SCSTs, including fibrothecoma, luteoma, hilus cell tumor, granulosa cell tumor, Sertoli-Leydig cell tumor, and sex cord tumor with annular tubules, and a control group of 96 surface epithelial tumors. A few other rare ovarian tumors including 1 small cell carcinoma, 1 adenocarcinoid tumor, 1 ovarian tumor of probable wolffian origin, 1 Krukenberg tumor, and 1 desmoplastic small round cell tumor were also studied. Inhibin staining was generally strong and diffuse in the majority of SCSTs (83%) and at least focally positive in the small cell carcinoma, ovarian tumor of probable wolffian origin, Krukenberg tumor, and desmoplastic small round cell tumor. Variable immunoreactivities were also present in 7 of 96 (7.3%) surface epithelial tumors. In comparison, A103 expression was usually weaker and more focal than that of inhibin and was present in a smaller proportion of SCSTs (37%) and negative in all the surface epithelial tumors. A103 was typically positive in the lipid-containing cells (both neoplastic and normal components) of these tumors (fibrothecomas, luteomas, Sertoli-Leydig cell tumors, hilus cell tumors, and granulosa cell tumors), and in some cases, moderate positivity was noted in these cells. Weak A103 positivity was identified in the single case of ovarian tumor of probable wolffian origin. A103 is relatively less sensitive than inhibin for recognizing SCSTs but does not appear to be expressed by ovarian surface epithelial tumors. It is therefore more specific than inhibin for SCSTs and is a useful marker for specifically identifying lipid-containing cells in tumors. Thus, adding A103 to a panel of markers including inhibin may be a valuable adjunct in the differential diagnoses of SCSTs and their distinction from other ovarian neoplasms.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Adult testicular granulosa cell tumors are rare sex cord- stromal tumors of which only 45 have been previously reported. As compared with their ovarian counterparts, these tumors may follow a more aggressive course because the proportion of malignant cases is higher. We report here a unique case of a 78-year Caucasian with a left sided adult type granulosa cell tumor with a heterologous sarcomatous tumor component. A heterologous sarcomatous component has occasionally been observed in ovarian tumors but never in testicular granulosa cell tumors. The sarcomatous component showed a higher number of mitotic figures (1/Hpf) and a marked proliferation rate (up to 50% Ki 67 positive cells) compared with the granulosa type tumor component. CD 99 and the progesterone receptor were positive in both tumor components, inhibin and calretinin only in the granulosa cells, and pancytokeratin only in the sarcomatouse one. Key words: testis - ovary - granulosa cells - sarcoma - inhibin Runing title: testicular sarcomatous granulosa tumor.Virtual Slides: The virtual slide(s) for this article can be found here:
    Diagnostic Pathology 06/2014; 9(1):107. · 2.41 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Zu den Keimstrangmarkern gehören Proteine und Hormone, die in den Keimstrangderivaten normaler Ovarien und Hoden sowie in gonadalen Keimstrang-Stroma-Tumoren produziert werden. Klinisch können Keimstrangmarker (vor allem Inhibin-α) als Serumtumormarker eingesetzt werden. Der immunhistochemische Nachweis von Keimstrangmarkern ist hilfreich bei der differenzialdiagnostischen Abgrenzung ovarieller Keimstrang-Stroma-Tumoren von Oberflächenepithel-Stroma-Tumoren, Keimzelltumoren, anderen Ovarialtumoren und Ovarialmetastasen. Inhibin-α ist der spezifischste momentan verfügbare Keimstrangmarker. Calretinin gilt im Vergleich als noch etwas sensitiver bei jedoch reduzierter Spezifität. Ein Markerpanel bestehend aus Inhibin-α und Calretinin wird derzeit als optimal für die Differenzialdiagnose der ovariellen Keimstrang-Stroma-Tumoren angesehen. CD99, MIS (,,Müllerian inhibiting substance“, Anti-Müller-Hormon), Melan-A und CD10 sind weitere Keimstrangmarker von begrenzter Sensitivität und Spezifität. Ihr Einsatz sollte in der Diagnostik von Ovarialtumoren nur gezielt und als Teil eines Markerpanels erfolgen. Als sinnvolle mögliche Ergänzung eines immunhistochemischen Markerpanels in der Differenzialdiagnose ovarieller Keimstrang-Stroma-Tumoren gelten EMA, CK7 und Chromogranin.
    Der Pathologe 01/2007; 28(3). · 0.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Sertoliform endometrioid carcinoma (SEC) of the ovary is an uncommon variant of endometrioid carcinoma of the ovary resembling sex cord-stromal tumor of pure Sertoli and Sertoli-Leydig cell type (SLCT). This entity was first described by Young et al. (1982). Since then only a few cases of this entity have been reported (Roth et al. 1982; Guerrieri et al. 1998; Remadi et al. 1995). SEC occurs in peri- and post menopausal women with an age range of 41–89 years (mean, 60 years). Abdominal enlargement secondary to a unilateral ovarian mass is the most common presentation. Up to 10% cases show bilaterality (Young et al. 1982). The patients very rarely present with androgenic symptoms such as virulization and, to date estrogenic manifestations have been reported in one case in a series of 13 cases (Young et al. 1982). Adequate sampling, a careful search for areas of conventional endometrioid carcinoma and immunohistochemical stains is helpful in the evaluation of SEC from true ovarian sex cord stromal tumors. It is important to recognize this variant of endometrioid carcinoma and especially differentiate it from a sex cord stromal tumor. SEC as it behaves, is a low grade malignancy and displays a good prognosis if confined to the ovary.


Available from