Table of Contents
Definition / general | Uses by pathologists | Diagrams / tables | Microscopic (histologic) images | Positive staining - normal | Positive staining - disease | Negative stainingCite this page: Pernick N. Desmin. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stainsdesmin.html. Accessed January 20th, 2021.
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)
Microscopic (histologic) images
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 Müllerian 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)
- Postoperative 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