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Inhibin, dimetric 32-kDa peptide hormone that belongs to the transforming growth factor beta family, it is produced by ovarian granulosa cells and testicular Sertoli cells
It inhibits the release of FSH from the pituitary gland
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Inhibin (2) An important paracrine/autocrine regul
ator of differentiation and proliferation of various tissue
inhibin mRNA:ovary, testis, placenta, pituitary gland, adrenal cortex, BM, kidney, spinal cord, pancreas
IHC: Leydig, granulosa, thecal and pituitary somatotrophs
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Ovarian Sex Cord-Stromal Tumor: An Immunohistochemical study Including a Comparison Of Calretinin and Inhibin
~ 2003 Modern pathology department of Pathology, the university of Texas M.D. A
nderson Cancer Center
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Background(1) Ovarian sex cord-stromal tumors( SCST
s) account for about 8% of ovarian tumors
Composed of cells derived from gonadal sex cords, specialized gonadal stroma and fibroblasts
Morphology range from entirely glandular to entirely spindled
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Background(2) Variable markers have been applied Inhibin: most useful to date, but not exp
ressed by all SCSTs Calretinin WT1: found in in both ovarian surface e
pithelium and ovarian serous carcinoma
CK, EMA, CK5/6, CD10
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Material and method(1) Department of pathology at the univers
ity of Texas M.D. Anderson cancer center
53 SCSTs: 17 AGCTs, 4 JGCTs, 3 SCTATs, 9 SLCTs, 10 fibromas, 5 fibrothecoma and 5 thecomas
8 cases were from metastatic sites Grade:0~4+
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Discussion(1) SCSTs are morphologically heterogene
ous groups D/D: ca, sa, germ cell tumor, melanoma Inhibin( a-inbibina): most useful immun
omarker to date for SCSTs
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Discussion(2) inhibin Sensitive marker, in particular for granul
osa cell tumors and SLCTs Fibroma and FTs were focal or negative
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Discussion (3) Caretinin 29 Kda calcium binding protein Neuronal tissue, mesothelial cells and o
vary McCluggage and Maxwell: 36/37, Cao et
al : 20/26 In our report: better than inhibin Superior in identifying the fibroma and
FTs
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Discussion(4) Caretinin The greater sensitivity of calretinin for fibrom
as and FTs could be useful in cases in which the differential diagnosis includes ESS with a fibroma-like appearance
The combination of calretinin and CD10 may be useful in helping to distinguish
The two markers also could play a complementary role in meta SCSTs
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Discussion(5) In problematic cases, calretinin and inhi
bin are best used part of a large of antibodies
Keratin can be found in both CA and SCSTs, EMA may be useful distinguish between the two entities
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Discussion(6) WT1 Consistently found in ovarian surface epitheli
um and in ovarian serous ca In granulosa cells, a role in repressing the acti
vity of the a inhibin promoter and thus arrest follicle development
Do not correlate the calretinin and inhibin Little diagnostic utility
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Discussion(7) CK 5/6 is consistently present in mesoth
elioma, it was not found in any of the SCSTs tested
Calretinin comprares favorably to inhibin as a marker of SCSTs, at least as sensitive as inhibin in most categories and more sensitive for fibromas and FTs
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Inhibin Alpha Distinguish Hemagnioblastoma From Clear Cell Renal Cell Carcinoma
~2003 AJSP
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Background(1) Hemangioblastoma: the endothelial an
d pericytic components are vascular, the origin of the stromal elements has not been elucidated
Cerebellum, spinal cord Distinguish hemgioblastoma from meta
RCC continues to be a diagnostic challenge
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Material and method(1) 1990~2002 university of Texas Southwestern
Medical Center and Veterans Affairs Medical Center, Dallas, Texas
25 hemangioblastoma from 22 p’t, 11 cases from 8 p’t with VHL dx 18 in the cerebellum/posterior fossa, 1 in mde
ulla, 1 in occipital lobe, 5 in spinal cord
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Material and method(2) 19 RCC from 17 p’t A-inhibin, grade 0~3+ 10 cases from 8 p’t with VHL, 5 sporadi
c, 4 brain meta RCC NSE, EMA
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Immunohistochemical finding(1) Inhibin A: predominantly cytoplasmic Stromal cells of all 25 hemangioblastoma exp
ressed inhibin A No RCC expressed inhibin in this study NSE: positive in 9/9 hemangioblastoma EMA: negative in 6/6 hemagnioblastoma
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Discussion(1) Histogenesis of the stromal cell of HAB r
emains unclarified due to broad immunohistochemical expression that includes vit, S-100, NSE, PR, LeuM1, Leu 7, actin, GFAP, renin and erythropoietin
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Discussion(2) ? Modified or abnormal differentiated e
ndothelial cells and pericytes or neuroendocrine feature or originate form embryonal plexus epi or histiocytic origin
Since p’t with WHL are predioposed to develop both HAB and RCC, distinguish the two tumors is of clinical importance
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Discussion(3) NSE, EMA, CAM5.2 Inhibin seems to be a helpful marker in
distinguish HAB and RCC, similar to previous study
In our study, no difference in the inhibin A staining pattern between sporadic and VHL associated HAB
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Discussion(4) The pathophysiology of inhibin expression re
mains unknown One possibility: endodermally derived epi and
primitive mesenchyme Serum inhibin level has been used as an early
marker of tumor growth and recurrent dx in p’t with granulosa cell tumor
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Discussion(5) Serum level of activin A and inhibin A have als
o recently been described as potential markers for hydatidiform mole
The consistent expression of inhibin A by HAB raise the potential diagnostic value of serum inhibin A in monitoring either tumor development or recurrence in the VHL