What does the CD10 immunohistochemical marker test for?

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CD10 Immunohistochemical Marker: Diagnostic Applications

Primary Diagnostic Role: Lymphoma Immunophenotyping

CD10 is an essential component of first-line immunohistochemistry panels for lymphoma diagnosis and must be included in both paraffin-section and flow cytometry workups. 1

Core Panel Requirements

  • Paraffin immunohistochemistry panel: CD10 is required alongside CD45, CD20, CD3, Ki-67, BCL2, BCL6, and TdT for comprehensive lymphoma evaluation 2, 1

  • Flow cytometry panel: CD10 is essential in the B-cell panel with kappa/lambda light chains, CD45, CD20, CD3, CD5, CD19, and TdT 2, 1

  • Consensus recommendation: CD10 appears in 42% of lymphoproliferative disorder panels and is part of the eight-marker consensus panel (CD19, CD5, κ, λ, CD20, CD10, CD45, CD23) 1

Specific Lymphoma Subtypes Where CD10 is Diagnostic

  • Follicular lymphoma: CD10 positivity (along with BCL2+, CD20+, BCL6+) is the characteristic immunophenotype; CD10 markedly improves classification accuracy for follicular lymphoma and germinal-center type diffuse large B-cell lymphoma 2, 1

  • Burkitt lymphoma: Typical immunophenotype includes CD10+, surface immunoglobulin+, CD20+, Ki-67 ≈100%, BCL2-, BCL6+; CD10 is essential for distinguishing Burkitt lymphoma from other aggressive B-cell lymphomas 2, 1

  • Bone marrow assessment: Antibodies to CD10 are useful for recognizing subtle bone marrow involvement in follicular lymphoma, particularly when combined with cyclin D1, CD23, CD5, and kappa/lambda light chains 2, 3

Critical Interpretation Caveats

  • Post-rituximab specimens: CD10 surface epitopes may be masked for several months after rituximab therapy, leading to false-negative results; use CD79a as an alternative pan-B-cell marker in this setting 2, 1

  • Tissue adequacy: Fine-needle aspiration or core-needle biopsy alone is generally insufficient for initial lymphoma diagnosis; excisional or incisional biopsy provides the architecture needed for comprehensive CD10 assessment 2, 1

Secondary Diagnostic Role: Hepatocellular Carcinoma

CD10 demonstrates superior specificity and sensitivity for hepatocellular carcinoma (HCC) diagnosis compared to traditional markers like HepPar-1 and glypican-3. 2

HCC Diagnostic Panel

  • Hepatocellular differentiation markers: CD10, pCEA, and BSEP show higher performance than HepPar-1 and glypican-3 for HCC diagnosis 2

  • Staining pattern: CD10 exhibits canalicular (cytoplasmic and membranous) staining in HCC, which helps distinguish it from cholangiocarcinoma 2

  • Differential diagnosis approach: Combine CD10 with pCEA and BSEP to support hepatocellular differentiation, while using cytokeratin 7 and cytokeratin 19 to identify cholangiocytic differentiation 2, 1

Additional Non-Hematologic Applications

Renal Cell Carcinoma

  • High sensitivity: 89% (41/46) of renal cell carcinomas express CD10, showing diffuse cytoplasmic or membranous patterns 4

  • Diagnostic utility: CD10 expression in renal cell carcinoma is useful because these tumors otherwise lack specific markers 4

Endometrial Stromal Tumors

  • Strong marker: CD10 is a reliable and sensitive marker of normal endometrial stroma and endometrial stromal neoplasms 5, 4

  • Differential diagnosis: Strong and diffuse CD10 positivity distinguishes endometrial stromal nodules and low-grade endometrial stromal sarcoma from cellular leiomyoma and adult granulosa cell tumor (which are generally negative) 5

  • High-grade tumors: CD10 positivity in high-grade uterine sarcoma negative for muscle markers may indicate endometrial stromal differentiation 5

Breast Myoepithelial Cells

  • Myoepithelial marker: CD10 consistently highlights normal breast myoepithelial cells on paraffin sections, comparable to smooth muscle actin (SMA) 6

  • Advantage over SMA: CD10 is negative in vessels (unlike SMA), making it useful for differentiating myoepithelial cells from thin vascular walls in intracystic lesions 6

  • Invasive carcinoma: Absence of myoepithelial cells in invasive ductal carcinomas is more clearly highlighted by CD10 than SMA 6

Other Tumor Types with CD10 Expression

  • Prostatic adenocarcinoma: 61% (11/18) show CD10 positivity, typically restricted to apical surface in well-differentiated tumors 4

  • Transitional cell carcinoma: 54% (13/24) express CD10 with diffuse cytoplasmic or membranous patterns 4

  • Pancreatic adenocarcinoma: 50% (7/14) are CD10-positive 4

  • Malignant melanoma: 40% (12/30) show CD10 positivity with diffuse cytoplasmic or membranous/Golgi patterns 4

Practical Diagnostic Algorithm

For Suspected Lymphoma

  1. Initial workup: Include CD10 in first-line immunophenotyping using either paraffin IHC (CD45, CD20, CD3, CD10, Ki-67, BCL2, BCL6, TdT) or flow cytometry (κ/λ, CD45, CD20, CD3, CD5, CD19, CD10, TdT) 2, 1

  2. Interpretation of CD10+ B-cell population: Suggests follicular lymphoma, Burkitt lymphoma, or germinal-center type diffuse large B-cell lymphoma; correlate with BCL2, BCL6, Ki-67 and cytogenetic/FISH studies for t(14;18), MYC, and BCL6 rearrangements 2, 1

  3. Post-treatment evaluation: If patient received rituximab within several months, add CD79a to avoid false-negative CD10 results 2, 1

For Liver Tumors

  1. Hepatocellular differentiation panel: Use CD10, pCEA, and BSEP (superior to HepPar-1 and glypican-3) 2, 1

  2. Cholangiocytic differentiation panel: Use cytokeratin 7 and cytokeratin 19 2

  3. Pattern recognition: Look for canalicular (cytoplasmic and membranous) CD10 staining characteristic of HCC 2

References

1
Guideline

CD10 Marker: Evidence‑Based Diagnostic Recommendations

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

2
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Guideline

Bone Marrow Lymphoid Aggregates Diagnosis

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

6
Research

Availability of CD10 immunohistochemistry as a marker of breast myoepithelial cells on paraffin sections.

Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2002

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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