Pathology Outlines

CD Markers
CD10

Topic Completed: 1 September 2013

Revised: 24 July 2019

Revised: 13 December 2018, last major update September 2013

Copyright: (c) 2002-2018, PathologyOutlines.com, Inc.

PubMed Search: CD10[title]

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Table of Contents

Cite this page: Pernick N. CD10. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cdmarkerscd10.html. Accessed February 23rd, 2020.

Definition / general

Cell membrane metallopeptidase widely distributed in hematopoietic cells and their neoplasms
Important in diagnosis of preB-ALL (OMIM #120520)
Useful in diagnosis of other entities (see below), but must be used with caution, as staining is nonspecific

Terminology

Also called Common Acute Lymphoblastic Leukemia Antigen (CALLA), neutral endopeptidase 24.11, neprilysin, enkephalinase

Pathophysiology

90-110 kDa cell membrane metallopeptidase at 3q21-27 which inactivates bioactive peptides, including bombesin
In epithelial cells, CD10 loss from methylation leads to increased cell migration, cell growth and cell survival, contributing to neoplastic development and progression (J Pediatr Hematol Oncol 2010;32:2)

Uses by pathologists

Apical surface staining only: well differentiated carcinoma of colon, pancreas, prostate (Am J Clin Pathol 2000;113:374)
Diffuse cytoplasmic or membranous / Golgi staining pattern: adenocarcinoma (poorly differentiated), endometrial stromal sarcoma, melanoma, renal cell carcinoma, urothelial carcinoma

Acute lymphoblastic leukemia (ALL):

One of first markers to identify leukemic cells in children (hence its name)
Found on ALL cells which derive from pre-B lymphocytes

Bladder:

Present in 40%, strongly correlates with grade and stage (Diagn Pathol 2009;4:38, Am J Clin Pathol 2005;124:371)

Breast:

Marker of myoepithelial cells (Mod Pathol 2002;15:397), mammary myofibroblastoma (Virchows Arch 2007;450:727); but also rarely invasive ductal carcinoma, papilloma (J Clin Pathol 2007;60:958), benign stroma, sarcoma NOS (Diagn Pathol 2013 Jan 28;8:14)
Values may change post-chemotherapy (Indian J Cancer 2013;50:46)
Helps differentiate collagenous spherulosis (CD10+, HHF35+) from adenoid cystic carcinoma (CD10-, HHF35-, Pathol Res Pract 2012;208:405)

Ectopic prostate:

Used with PSA, PSAP to confirm diagnosis in uterus and vagina (Am J Surg Pathol 2006;30:209)

Endometrial stromal tumors:

May differentiate CD10+ endometrial stromal tumors from smooth muscle tumors, which are usually CD10- (Mod Pathol 2001;14:465), but not always (Mod Pathol 2002;15:923)

Endometriosis:

May be useful in diagnosis, except in cervix (Adv Anat Pathol 2004;11:310)

Gynecologic tumors:

Mesonephric remnants and tumors are CD10+
CD10 differentiates metastatic renal cell carcinoma (CD10+, Am J Surg Pathol 2003;27:178) from primary clear cell carcinoma (CD10-)

Hepatocellular carcinoma vs. non-hepatocellular carcinoma:

CD10+ is 52 - 68% sensitive and > 95% specific with canalicular pattern (Am J Surg Pathol 2001;25:1297, Am J Surg Pathol 2002;26:978), although another study recommends use of HepPar1, MOC31 and pCEA, but not CD10 (Mod Pathol 2002;15:1279)

Kidney

Distinguish renal cell carcinoma, clear cell type, eosinophilic variant (CD10+) from chromophobe carcinoma, eosinophilic variant or oncocytoma (both CD10-, Appl Immunohistochem Mol Morphol 2012;20:454)

Lymphoma: angioimmunoblastic T cell (AITL):

Distinguish AITL (CD10+, Mod Pathol 2011;24:993) at nodal and extranodal sites other than bone marrow from other T cell lymphomas (CD10-, Am J Surg Pathol 2004;28:54, Hum Pathol 2005;36:784), but benign T cells may also be CD10+ (Mod Pathol 2003;16:879)

Lymphoma: Burkitt:

CD10+ confirms diagnosis, but must exclude CD10+ diffuse large B cell lymphoma (Am J Clin Pathol 2012;137:665, Am J Clin Pathol 2010;133:718)

Lymphoma: diffuse large B cell:

Marker for germinal center phenotype (also HGAL, bcl6, CD38), usually considered a favorable prognostic factor (Mod Pathol 2005;18:1113, J Hematop 2009;2:187), but see Am J Clin Pathol 2001;116:183 (CD10+bcl2+ tumors have poorer survival), Virchows Arch 2004;445:545 (no difference in survival)

Lymphoma: follicular:

CD10+ may confirm diagnosis of primary (Am J Clin Pathol 2002;117:291), or secondary spread (Hum Pathol 2013;44:1328), but:
- high grade follicular lymphomas and interfollicular infiltrates may be CD10- (Am J Clin Pathol 2001;115:862)
- other lymphomas may be CD10+, including angioimmunoblastic T cell (see above), Burkitt (see above), diffuse large B cell lymphoma (see above), mantle cell (Appl Immunohistochem Mol Morphol 2010;18:103), marginal zone (J Clin Pathol 1999;52:849), rare CD5+ CD10+ lymphomas (Am J Clin Pathol 2003;119:218, Arch Pathol Lab Med 2001;125:951)

Microvillous inclusion disease:

Strong CD10+ cytoplasmic staining in enterocytes (Am J Surg Pathol 2002;26:902, Orphanet J Rare Dis 2006 Jun 26;1:22) or colonic biopsies (Am J Surg Pathol 2010;34:970 ) vs. linear brush border staining of enterocytes and negative colonic staining in normals

Pancreas:

Confirm diagnosis of solid and papillary neoplasm (CD10+, Am J Surg Pathol 2000;24:1361)
Differentiates mucinous cystic neoplasms (CD10+ / CK20+) from intraductal papillary mucinous neoplasm of branch duct type (CD10- / CK20-, Pancreas 2009;38:558)

Skin tumors:

Staining patterns may differentiate basal cell carcinoma-epithelial staining, trichoblastoma-peritumoral stromal staining (Int J Dermatol 2009;48:713), squamous cell carcinoma-strong stromal staining (Iran J Med Sci 2013;38:100)
Differentiates atypical fibroxanthoma (diffuse membranocytoplasmic staining) from spindle cell melanoma and sarcomatoid squamous cell carcinoma (CD10-, J Cutan Pathol 2010;37:744)

Vascular tumors:

Differentiates metastatic renal cell carcinoma (CD10+, Mod Pathol 2005;18:788) from hemangioblastoma (usually CD10-, rarely focal staining-Diagn Pathol 2012 Apr 12;7:39)
Epithelioid hemangioendothelioma can have strong / diffuse CD10+ and mimic metastatic renal cell carcinoma (Arch Pathol Lab Med 2009;133:1965)

Microscopic (histologic) images

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Bladder:

Noninvasive and invasive urothelial carcinoma

Bladder urothelial carcinoma

Breast:

Myoepithelium (fig B, F)

Normal and DCIS

DCIS

Stromal staining in invasive ductal carcinoma

Malignant phyllodes tumor

Adenosis (fig B)

Kidney:

Kidney hemangioblastoma (fig D)

Leukemia / lymphoma:

Diffuse large B cell lymphoma

Pre-T ALL

Lung:

COPD

Lymph node:

Metastatic prostate carcinoma

Metastatic seminoma

Pleura:

Epithelioid hemangioendothelioma

Skin:

Basal cell carcinoma (fig B)

Squamous cell carcinoma (fig B)

Trichoepithelioma

Small intestine:

Microvillous inclusion disease

Uterus - benign:

Endometriosis

CD10- stromal cells

Uterus - endometrial stromal sarcoma:

Extrauterine (fig 4, inset ER)

Myxoid-fibrous (fig 4)

Positive staining - normal

Hematopoietic cells:

PreB cells, preT cells; some T cells, follicular center (germinal center) cells, granulocytes

Other cells:

Adrenal cortex, brain, choroid plexus
Endometrial stroma, endothelial cells (some, Hypertension 1995;26:230), fibroblasts
GU (male) epithelium, hepatocytes, kidney microvilli
Liver, mesonephric remnants, myoepithelial cells (breast, Mod Pathol 2002;15:397, J Clin Pathol 2004;57:625)
Ovary, placenta (cytotrophoblast, intermediate trophoblast, syncytiotrophoblast), prostate basal and secretory cells
Small intestine (linear brush border staining, variable loss with active enteritis, Mod Pathol 2011;24:1627), Wolffian (but not Müllerian) type epithelium

Positive staining - disease

Leukemia / lymphoma:
- PreB ALL (75%, preT ALL (63%, Arch Pathol Lab Med 2000;124:704)
- Angioimmunoblastic T cell, Burkitt, CML in blast crisis (90%)
- Diffuse large B cell (variable), follicular center cell (70%), hairy cell leukemia (10%, Am J Clin Pathol 2003;120:228)
- Myeloma (some), plasmablastic (variable), primary cutaneous diffuse large B cell (variable), primary mediastinal B cell (32%, Am J Surg Pathol 2001;25:1277)
Other:
- Breast cancer associated stroma, breast metaplastic carcinoma, breast myofibroblastoma (Virchows Arch 2007;450:727), choriocarcinoma
- Colonic carcinoma and high grade dysplasia associated stroma (Hum Pathol 2002;33:806), dermatofibroma, dermatofibrosarcoma
- Epithelioid hemangioendothelioma (Arch Pathol Lab Med 2009;133:1965), Ewing sarcoma, gastric carcinoma associated stroma (Jpn J Clin Oncol 2005;35:245), glioma
- Hepatocellular carcinoma (canalicular pattern similar to polyclonal CEA, Am J Pathol 2001;159:1415)
- Malignant fibrous histiocytoma, malignant mixed Müllerian tumors
- Mediastinal germ cell tumors, melanoma (40%, Mod Pathol 2004;17:1251)
- Mesonephric tumors (Am J Surg Pathol 2001;25:1540), mesothelioma (malignant, Arch Pathol Lab Med 2006;130:823)
- Microvillous inclusion disease (strong cytoplasmic staining), Müllerian adenosarcoma
- Pancreatic adenocarcinoma (50%), pancreatic solid-papillary neoplasm
- Placental site trophoblastic tumor, prostate carcinoma (some Gleason pattern 4 and 5 cases)
- Renal cell carcinoma (most clear cell, variable papillary, variable chromophobe, Am J Surg Pathol 2000;24:203, Mod Pathol 2005;18:535, Mod Pathol 2004;17:1455)
- Renal cell sarcoma, rhabdomyosarcoma (60%) and other sarcomas
- Schwannoma (45%), seminoma (87-92%, Int J Clin Exp Pathol 2013;6:498, Histol Histopathol 2013 Jul 16 [Epub ahead of print]), spindle cell lipoma (Virchows Arch 2007;450:727)
- Tumor of wolffian origin of broad ligament and ovary, urothelial carcinoma (54%)
- Uterus: adenomyosis, cellular leiomyoma (50%), endometrial adenocarcinoma (may also be present in desmoplastic stroma, Am J Surg Pathol 2003;27:786), endometrial stromal tumor, leiomyosarcoma, other sarcomas
- Yolk sac tumor

Negative staining

Leukemia / lymphomas:

AML, Burkitt-like, CLL, EBV+ lymphoproliferative disorders
Lymphoplasmacytic, mantle cell, marginal zone, pyothorax associated

Other:

Atypical polypoid adenomyoma (stromal cells), clear cell carcinoma of female genital tract, CNS hemangioblastoma
Colon (normal, diseased), erythroid and myeloid precursors, prostatic high grade PIN and basal cell hyperplasia (Hum Pathol 2003;34:450), prostate adenocarcinoma (all Gleason patterns 2 and 3, some 4 and 5)

Flow cytometry images

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CD10+ vs. CD10- diffuse large B cell lymphoma