Currently, the immunohistochemical evaluation of smooth muscle differentiation is usually based on
desmin, which also reacts with skeletal muscle and is not present in all
smooth muscle tumors, and alpha-smooth muscle actin, which reacts with myoepithelial cells. Neither marker typically reacts with
gastrointestinal stromal tumors (GISTs), previously classified as
smooth muscle tumors or presently often classified as smooth muscle/stromal
tumors. Two cytoskeleton-associated
actin-binding proteins,
calponin (CALP) and h-
caldesmon (HCD), are putative smooth muscle markers that also react with myoepithelia. These markers are of particular interest in the immunohistochemical analysis of
tumors; neither of them has been extensively documented in soft tissue
tumors. In this study, we evaluated selected normal and reactive tissues and more than 250 mesenchymal
tumors for CALP and HCD. Both markers were expressed in parenchymal and vascular smooth muscle cells in various organs and in myoepithelial cells. CALP also reacted with myofibroblasts of desmoplastic stroma. All of our 25 benign
smooth muscle tumors from various locations were positive for CALP and HCD, as were most of the retroperitoneal and uterine
leiomyosarcomas. HCD was more specific, because CALP also reacted with myofibroblastic lesions. The common reactivity of
malignant fibrous histiocytomas with CALP and HCD suggests a combination of myofibroblastic and smooth muscle differentiation in these
tumors. The GISTs (c-kit positive, usually actin negative) showed nearly consistent HCD reactivity, suggesting traits of smooth muscle differentiation. GISTs were usually CALP negative and showed a CALP expression pattern similar to that of alpha-smooth muscle actin. Although nonmuscle, nonmyofibroblastic
tumors were negative for CALP and HCD,
synovial sarcomas showed streaks of CALP-positive cells of unknown significance. CALP and HCD should be explored as markers to identify myofibroblastic and smooth muscle cell differentiation in mesenchymal
tumors.