Stains
Desmin

Author: Nat Pernick, M.D. (see Authors page)

Revised: 8 December 2015, last major update March 2012

Copyright: (c) 2002-2015, PathologyOutlines.com, Inc.

PubMed Search: Desmin [title]

Definition / General
  • 53 kDa intermediate filament first described in 1976 (Proc Natl Acad Sci USA 1976;73:4344), present near the Z line in sarcomeres, present in cardiac, smooth and striated muscle (Wikipedia)
  • Expressed before actin in myoblasts
  • Variable expression in myofibroblasts
Uses by Pathologists
  • Common stain used in panels for mesenchymal markers
  • Confirms myogenic origin of tissue / tumors
  • Helps differentiate smooth muscle tumors (desmin+) from GIST (c-kit+, almost always desmin-)
  • In serous effusion, more common in reactive mesothelial cells (84%) than mesothelioma (8%) or carcinoma (2%, Am J Surg Pathol 2001;25:1405)
Diagrams / Tables
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Molecular architecture

Micro Images

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Hear, leiomyosarcoma

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Heart, rhabdomyosarcoma

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Kidney, angiomyolipoma,

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Nasal cavity, angioleiomyoma

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Pancreas, desmoplastic small RCT

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Soft tissue, embryonal rhabdomyosarcoma, cross striations (L), rhabdoid cells (M), spindle cells (R)

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Testis, spindle cell variant

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Thyroid, rhabdomyoma

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Vulva-, ggressive angiomyxoma



Images hosted on Other servers:

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Adrenal gland

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Breast, spindle cell lipoma

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Heart, rhabdomyosarcoma

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Hepatorenal embryonal rhabdomyosarcoma

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Kidney, leiomyosarcoma

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Kidney, mixed epithelial stromal tumor

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Skin, angiomatoid fibrous histiocytoma

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Small bowel

Positive Staining - Normal
  • Cervix: decidual reaction, endometrium (focal), fallopian tube stroma
  • Liver: stellate cells
  • Mesothelial cells (reactive), myoblasts, myofibroblasts (variable), myometrium, smooth muscle cells
Positive Staining - Disease
  • Adenosarcoma (cervix, prostate, stomach), aggressive angiomyxoma, alveolar soft parts sarcoma (cervix)
  • Anaplastic sarcoma, kidney (usually), angioleiomyoma (Hum Pathol 2007;38:645)
  • Angiomatoid fibrous histiocytoma (Mod Pathol 2011;24:1560), angiomyofibroblastoma, angiomyolipoma (smooth muscle cells)
  • Atypical fibroxanthoma of skin (30%), atypical polypoid adenomyoma of uterus (variable)
  • Benign stromal spindle cell tumors (breast)
  • Chondrosarcoma, dedifferentiated
  • Desmoplastic small round cell tumor (dot-like perinuclear pattern)
  • Endometrial stromal sarcoma (50%), endometriosis (associated with desmin+ skeletal muscle regeneration, Am J Surg Pathol 2010;34:10), epithelioid sarcoma (proximal type has variable staining)
  • Fibroblastic reticulum cell tumor, fibroepithelial polyp, fibromatosis (usually negative, but may be focal), fibrous hamartoma of infancy (spindle cell areas), fibrous histiocytoma of skin, variable
  • Giant cell tumor of tendon sheath-localized type, granulosa cell tumor (variable)
  • Hemangiopericytoma (20% in CNS)
  • Inflammatory myofibroblastic tumor (variable, Hum Pathol 2008;39:846, epithelioid tumors are usually positive, Am J Surg Pathol 2011;35:135), ischemic fasciitis
  • Leiomyoma (Am J Surg Pathol 2001;25:455) and leiomyosarcoma (staining associated with more differentiated tumors, Hum Pathol 2010;41:663)
  • Low grade myofibroblastic sarcoma (variable), lymphangioleiomyomatosis, lymphangiomyoma
  • Malignant fibrous histiocytoma, malignant mixed Mullerian tumor (cervix-sarcomatous component), medullomyoblastoma, mesenchymal hamartoma
  • Mixed epithelial and stromal tumor of kidney (stroma), mycobacterial spindle cell pseudotumor in lymph nodes
  • Myofibroblastoma (variable, Hum Pathol 2012;43:243), myofibrosarcoma, myogenic sarcoma, myoid gonadal stromal tumor (Hum Pathol 2012;43:144)
  • Neuroblastoma, neuromuscular hamartoma of soft tissue
  • Ossifying fibromyxoid tumor (38%, Am J Surg Pathol 2011;35:1615), osteosarcoma (variable)
  • Paratesticular fibrous pseudotumor (31%, Am J Surg Pathol 2010;34:569), perivascular epithelioid cell tumors (sclerosing PEComa has diffuse staining, abdominopelvic sarcoma and tumors of falciform ligament / ligamentum teres are negative, other sites are predominantly negative)
  • Phyllodes tumor of breast (stroma), PNET (variable), prostatic stromal hyperplasia with atypia (moderate staining, Arch Pathol Lab Med 2008;132:1729)
  • Pseudoangiomatous stromal hyperplasia (PASH) of breast (variable), pseudosarcomatous fibroepithelial stromal polyp (cervix, vagina)
  • Reactive nodular fibrous pseudotumor (variable), rhabdomyoma, rhabdomyosarcoma (in more differentiated cells)
  • Sclerosing stromal tumor (ovary), smooth muscle tumor of pleura, spindle cell carcinoma (variable)
  • Spindle cell epithelioma of vagina, stromal sarcoma of prostate (variable), superficial cervicovaginal myofibroblastoma
  • Uterine tumors resembling ovarian sex cord tumor (Am J Surg Pathol 2010;34:1749)
Negative Staining
  • Angiofibroma (positive in 11%, Am J Surg Pathol 2012;36:500)
  • Calcifying fibrous tumor (Am J Surg Pathol 2010;34:271), carcinomas (usually), chondromyxoid fibroma, chondrosarcoma, mesenchymal
  • Choriocarcinoma, clear cell sarcoma
  • Dermatofibrosarcoma protuberans, desmoplastic fibroblastoma
  • Ectomesenchymal chondromyxoid tumor, elastofibroma
  • Fibroma, fibrosarcoma, follicular dendritic cell sarcoma
  • Gastrointestinal stromal tumor (epithelioid tumors may have focal staining), GANT
  • Giant cell fibroblastoma, glomus coccygeum, granular cell tumor
  • Hemosiderotic fibrohistiocytic lipomatous lesion
  • Inflammatory fibroid polyp, interdigitating dendritic cell tumor, intranodal palisaded myofibroblastoma
  • Histiocytic sarcoma
  • Lipoma (pleomorphic, spindle cell), liposarcoma (but dedifferentiated tumors may be desmin+, Am J Surg Pathol 2010;34:844), lipomatous hemangiopericytoma
  • Low grade fibromyxoid sarcoma, lymphoma
  • Mesothelioma (Mod Pathol 2012;25:689), metanephric adenoma / adenofibroma of kidney
  • Myoepithelioma, myofibroma, myopericytoma (rarely focal staining, Am J Surg Pathol 2009;33:1666), mxyoma
  • Neural tumors (chordoid glioma, neuroblastoma, neurofibroma, perineurioma, schwannoma)
  • Nodular fasciitis, nuchal fibrocartilaginous pseudotumor, nuchal type fibroma
  • Osteosarcoma
  • Pancreatic serous cystadenoma, pigmented villonodular synovitis, plexiform fibromyxoma (Am J Surg Pathol 2009;33:1624)
  • Post-operative spindle cell nodule (bladder), proliferative fasciitis / myositis, pseudomyogenic hemangioendothelioma (Am J Surg Pathol 2011;35:190), pseudosarcomatous fibromyxoid tumor of prostate
  • Rhabdoid tumor of heart
  • Sialadenoma papilliferum, solitary fibrous tumor
  • Superficial acral fibromyxoma / digital fibromyxoma (rare focal staining, Am J Surg Pathol 2012;36:789), synovial sarcoma
  • Vascular tumors (angiosarcoma, glomangioma, glomus tumor, hemangiopericytoma outside CNS, Kaposi's sarcoma)
  • Warthin tumor