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Inhibin (2)

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. Inhibin (2).

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Inhibin (2)

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  1. 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

  2. Inhibin (2) • An important paracrine/autocrine regulator 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

  3. 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. Anderson Cancer Center

  4. Background(1) • Ovarian sex cord-stromal tumors( SCSTs) 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

  5. Background(2) • Variable markers have been applied • Inhibin: most useful to date, but not expressed by all SCSTs • Calretinin • WT1: found in in both ovarian surface epithelium and ovarian serous carcinoma • CK, EMA, CK5/6, CD10

  6. Material and method(1) • Department of pathology at the university 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+

  7. Discussion(1) • SCSTs are morphologically heterogeneous groups • D/D: ca, sa, germ cell tumor, melanoma • Inhibin( a-inbibina): most useful immunomarker to date for SCSTs

  8. Discussion(2) inhibin Sensitive marker, in particular for granulosa cell tumors and SLCTs • Fibroma and FTs were focal or negative

  9. Discussion (3) Caretinin • 29 Kda calcium binding protein • Neuronal tissue, mesothelial cells and ovary • McCluggage and Maxwell: 36/37, Cao et al : 20/26 • In our report: better than inhibin • Superior in identifying the fibroma and FTs

  10. Discussion(4) Caretinin • The greater sensitivity of calretinin for fibromas 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

  11. Discussion(5) • In problematic cases, calretinin and inhibin 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

  12. Discussion(6) WT1 • Consistently found in ovarian surface epithelium and in ovarian serous ca • In granulosa cells, a role in repressing the activity of the a inhibin promoter and thus arrest follicle development • Do not correlate the calretinin and inhibin • Little diagnostic utility

  13. Discussion(7) • CK 5/6 is consistently present in mesothelioma, 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

  14. Inhibin Alpha Distinguish Hemagnioblastoma From Clear Cell Renal Cell Carcinoma ~2003 AJSP

  15. Background(1) • Hemangioblastoma: the endothelial and 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

  16. 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 mdeulla, 1 in occipital lobe, 5 in spinal cord

  17. Material and method(2) • 19 RCC from 17 p’t • A-inhibin, grade 0~3+ • 10 cases from 8 p’t with VHL, 5 sporadic, 4 brain meta RCC • NSE, EMA

  18. Immunohistochemical finding(1) • Inhibin A: predominantly cytoplasmic • Stromal cells of all 25 hemangioblastoma expressed inhibin A • No RCC expressed inhibin in this study • NSE: positive in 9/9 hemangioblastoma • EMA: negative in 6/6 hemagnioblastoma

  19. Discussion(1) • Histogenesis of the stromal cell of HAB remains unclarified due to broad immunohistochemical expression that includes vit, S-100, NSE, PR, LeuM1, Leu 7, actin, GFAP, renin and erythropoietin

  20. Discussion(2) • ? Modified or abnormal differentiated endothelial 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

  21. 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

  22. Discussion(4) • The pathophysiology of inhibin expression remains 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

  23. Discussion(5) • Serum level of activin A and inhibin A have also 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

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