Table of Contents
Definition / general | Terminology | Pathophysiology | Uses by pathologists | Microscopic (histologic) images | Positive staining - normal | Positive staining - disease | Negative staining | Flow cytometry imagesCite this page: Pernick N. CD10. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/cdmarkerscd10.html. Accessed January 30th, 2023.
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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Contributed by Jijgee Munkhdelger, M.D., Ph.D. and Andrey Bychkov, M.D., Ph.D.
Images hosted on other servers:
Bladder:
Breast:
Kidney:
Lung:
Lymph node:
Skin:
Small intestine:
Positive staining - normal
-
Hematopoietic cells:
- PreB cells, preT cells; some T cells, follicular center (germinal center) cells, granulocytes
- 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
Other cells:
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
- 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)
Other: