h-Caldesmon

Immunohistochemical expression

Caldesmon, originally purified from gizzard smooth muscle6, is a cytoskeleton-associated protein present in smooth and non-smooth muscle cells. Binding to actin, tropomyosin, calmodulin, myosin and phospholipids, it counteracts actin-tropomyosin activated myosin-adenosine triphosphatase, thereby inhibiting calcium-dependent contraction of smooth muscle5. It exists in low and high molecular weight forms. The low molecular weight form (l-Caldesmon) is present in many cell types. The high molecular weight isoforms (89 to 93 kD, h-caldesmon) are thought to be restricted to visceral and vascular smooth muscle and myoepithelial cells. (Myoepithelial cells show variable staining while the limited number of tumours of myoepithelial cells studied by Watanabe were all negative2.) Anti-h-caldesmon appears to be a more specific identifier of smooth muscle differentiation than are desmin, muscle specific actin and alpha smooth muscle actin. A commercially available monoclonal antibody (h-CD) works on paraffin sections.

 

h-caldesmon

desmin (D33)

muscle specific actin (HHF-35)

smooth muscle actin

Myometrium

40/404

40/404

 

 

Leiomyoma

6/62, 10/104

6/62, 10/104

6/62

6/62

Uterine cellular leiomyoma

8/113, 14/144

10/113, 14/144

 

10/113

Uterine highly cellular leiomyoma

8/84

8/84

 

 

Angioleiomyoma

2/22

2/22

2/22

2/22

Leiomyosarcoma

19/261,2,3, 29/294

24/261,2,3, 28/294

17/171,2,3

26/261,2,3

Gastric stromal tumour

2/82

0/82

6/82

1/82

Glomus tumour

3/32

0/32

3/32

3/32

Rhabdomyosarcoma

0/82

8/82

8/82

2/82

MFH

0/341,2

5/341,2

11/341,2

11/341,2

Synovial sarcoma

0/41

0/41

0/41

0/41

MPNST

0/51

0/51

0/51

2/51

Endometrium

0/254

8/254

 

 

Endometrial stromal neoplasm

0/123, 0/244

1/123, 12/244

 

1/123

Fibromatosis

0/151,2

10/151,2

13/151,2

14/151,2

Nodular fasciitis

0/41

0/41

2/41

4/41

Cellular cutaneous fibrous histiocytoma

0/111

3/111

1/111

6/111

Salivary pleomorphic adenoma

0/22

0/22

1/22

1/22

Salivary myoepithelioma

0/12

0/12

1/12

1/12

Salivary epithelial-myoepithelial carcinoma

0/12

0/12

1/12

1/12

Chondroid syringoma

0/22

0/22

2/22

0/22

Desmoplastic stroma

0/51

0/51

4/51

5/51

Inflammatory pseudotumour

0/22

1/22

2/22

2/22

Myofibroblastic reaction

0/51

0/51

4/51

5/51

 

Fibrous capsule of thyroid lesions: h-caldesmon-positive spindle cells are present in the fibrous capsule of hyperplastic nodules and follicular neoplasms, but not encapsulated papillary carcinomas.

 

h-caldesmon positive spindle cells

  

hyperplastic nodule

20/216

follicular adenoma

29/296

minimally invasive follicular carcinoma

5/56

widely invasive follicular carcinoma

4/66

encapsulated papillary carcinoma

0/96
 

 

Diagnostic utility

 

References

1 KM Ceballos et at. Is anti-h-caldesmon useful for distinguishing smooth muscle and myofibroblastic tumors? Am J Clin Pathol 2000;114:746-753.

2 K Watanabe et al. h-Caldesmon in leiomyosarcoma and tumors with smooth muscle cell-like differentiation: its specific expression in the smooth muscle cell. Hum Pathol 2000;30:392-396.

3 DS Rush et al. h-Caldesmon, a novel smooth muscle-specific antibody, distinguishes between cellular leiomyoma and endometrial stromal sarcoma. Am J Surg Pathol 2001;25:253-258.

4 MR Nucci et al. h-Caldesmon expression effectively distinguishes endometrial stromal tumors from uterine smooth muscle tumors. J Pathol 2001;25:455-463.

5 Diagnostic Immunohistochemistry edited by Professor D. J. Dabbs, page 70.

6 Nakayama, H., Enzan, H., Miyazaki, E., Moriki, T., Kiyoku, H., Toi, M., Kuroda, N. and Hiroi, M. High molecular weight caldesmon positive stromal cells in the capsule of thyroid follicular tumours and tumour-like lesions. J Clin Pathol 2002;55:917-20.

7 Comin CE, Dini S, Novelli L, et al. h-Caldesmon, a useful positive marker in the diagnosis of pleural malignant mesothelioma, epithelioid type. Am J Surg Pathol 2006; 30:463-9

This page last revised 5.9.2007.

©SMUHT/PW Bishop