Pleomorphic and dedifferentiated leiomyosarcoma: clinicopathologic and immunohistochemical study of 41 cases

Marlo M. Nicolas, Pheroze Tamboli, Jose A. Gomez, Bogdan A. Czerniak

Research output: Contribution to journalArticle

32 Citations (Scopus)

Abstract

In this article, we supplement the few published articles by describing the clinical and pathologic features of pleomorphic and dedifferentiated leiomyosarcoma from 41 patients (27 women and 14 men) with an age range of 25 to 75 years (mean, 56.5 years), representing the largest cohort reported to date. The typical leiomyosarcoma component accounted for <5% to 60% (mean, 15%) of the tumor. The pleomorphic sarcoma component was composed of polygonal cells in 57% of cases, spindle cells in 21%, a combination of polygonal, epithelioid, rhabdoid, and/or spindle cells in 18%, and predominantly epithelioid cells in 3%. The classical leiomyosarcoma component was positive for at least one myogenic immunohistochemical marker in 29 tumors tested; smooth muscle actin in 100% (27/27), calponin in 90% (9/10), muscle-specific actin in 90% (10/11), desmin in 86% (23/27), smooth muscle myosin heavy chain (SMMS-1) in 67% (4/6), and caldesmon in 57% (4/7). The pleomorphic sarcoma component was reactive for at least one muscle marker in 77% (23/30) of cases; smooth muscle actin in 63% (17/27), calponin in 60% (6/10), SMMS-1 in 60% (3/5), desmin in 59% (16/27), muscle-specific actin in 40% (4/10), and caldesmon in 29% (2/7). The classical leiomyosarcoma component was often strongly positive for myogenic markers, and the pleomorphic sarcoma component usually showed focal and less intense immunoreactivity. Based on staining for muscle markers in the pleomorphic component, twenty-three cases were designated as pleomorphic leiomyosarcoma, and 7 cases were designated as dedifferentiated leiomyosarcoma (negative for all muscle markers used). Eleven cases, in which tissue was not available for immunhistochemical stains, the question of pleomorphic versus dedifferentiated leiomyosarcoma could not be answered. The incidence of metastasis was 89% (32/36) and the mortality rate was 50% (18/36) at last follow-up (3-104 months; mean, 27.5 months).

Original languageEnglish (US)
Pages (from-to)663-671
Number of pages9
JournalHuman Pathology
Volume41
Issue number5
DOIs
StatePublished - May 2010
Externally publishedYes

Fingerprint

Leiomyosarcoma
Actins
Muscles
Sarcoma
Calmodulin-Binding Proteins
Desmin
Smooth Muscle
Smooth Muscle Myosins
Epithelioid Cells
Myosin Heavy Chains
Neoplasms
Coloring Agents
Staining and Labeling
Neoplasm Metastasis
Mortality
Incidence

Keywords

  • Dedifferentiated
  • Immunohistochemical
  • Leiomyosarcoma
  • Pleomorphic
  • Retroperitoneum

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Pleomorphic and dedifferentiated leiomyosarcoma : clinicopathologic and immunohistochemical study of 41 cases. / Nicolas, Marlo M.; Tamboli, Pheroze; Gomez, Jose A.; Czerniak, Bogdan A.

In: Human Pathology, Vol. 41, No. 5, 05.2010, p. 663-671.

Research output: Contribution to journalArticle

Nicolas, Marlo M. ; Tamboli, Pheroze ; Gomez, Jose A. ; Czerniak, Bogdan A. / Pleomorphic and dedifferentiated leiomyosarcoma : clinicopathologic and immunohistochemical study of 41 cases. In: Human Pathology. 2010 ; Vol. 41, No. 5. pp. 663-671.
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