Anti-Mullerian hormone is a specific marker of Sertoli- and granulosa-cellorigin in gonadal tumors

Sex cord stromal tumors are gonadal neoplasms containing Sertoli, granulosa , Leydig, or thecal cells, which originate from cells derived from either t he sex cords (Sertoli and granulosa cell tumors) or the specific mesenchyma l stroma (Leydig and thecal cell tumors) of the embryonic gonad. Only granu losa and Sertoli cells produce anti-Mullerian hormone (AMH). Our purpose wa s to investigate whether AMH can be used as a specific marker of human gran ulosa or Sertoli fell origin in gonadal tumors, to distinguish them from ot her primary or metastatic neoplasms, using immunohistochemistry. We studied 7 juvenile and 6 adult-type granulosa cell tumors of ovarian localization and 3 extraovarian metastases, 20 other ovarian tumors, 6 testicular Sertol i cell tumors, 2 gonadoblastomas, and 13 extragonadal tumors. Granulosa cel l tumors, both juvenile- and adult-type of either ovarian or metastatic loc alization, showed an heterogeneous pattern of AMH immunoreactivity: Areas c ontaining intensely or weakly AMH-positive cells were intermingled with AMH -negative areas. Although in most cases AMH-positive areas represented a mi nor proportion of tumor cells, we found a positive reaction in all the case s examined, In testes, although normal prepubertal Sertoli cells were inten sely positive, testicular Sertoli cell tumors showed large areas of negativ e reaction, with few positive cells scattered throughout the tumor. AMH was also reactive in most of the cells of sex-cord origin in gonadoblastomas. No AMH immunoreaction was observed in other gonadal and extragonadal tumors . We conclude that AMH expression is conserved in only a small proportion o f tumor cells of granulosa or Sertoli fell origin; however, a positive reac tion in a few cells helps to distinguish between granulosa or Sertoli cell tumors or gonadoblastomas and other gonadal tumors of different origin, HUM PATHOL 31:1202-1208. Copyright (C) 2000 by W.B. Saunders Company.