Inconsistent immunohistochemical expression of lymphatic and blood endothelial cell markers in cutaneous lymphangiomas

Authors


Jag Bhawan,

Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA, USA

Tel: 617-638-5570

Fax: 617-638-5575

e-mail: jbhawan@bu.edu

Abstract

Purpose

We sought to describe expression of the immunohistochemical markers, CD31, D2-40 and LYVE-1 (lymphatic vessel hyaluronan receptor-1), that may assist in differentiating cutaneous lymphangioma and cutaneous hemangioma.

Methods

Immunohistochemical staining of lymphangioma and hemangioma specimens was completed with CD31, D2-40 and LYVE-1 antibodies.

Results

Thirty-three examples of lymphangioma and 13 examples of hemangioma were evaluated. CD31 was positive in 91% of lymphangioma and 100% of hemangioma (sensitivity 0.91, 95% confidence interval 0.75-0.98; specificity 0, 95% confidence interval 0-0.28). D2-40 was positive in 54% of lymphangioma and 23% in hemangioma (sensitivity 0.50 95% confidence interval 0.32-0.68; specificity 0.50 95% confidence interval 0.28-0.72). LYVE-1 was positive in 6% in lymphangioma and 15% hemangioma (sensitivity 0.06 95% confidence interval 0.01-0.22, specificity 0.85 95% confidence interval 0.54-0.97).

Conclusions

Due to the similar embryonic origins, it is unlikely that a single marker may accurately differentiate the lymphangioma from hemangioma. A combination of immunohistochemical stains such CD31, D2-40 and LYVE-1 testing may potentially increase the diagnostic accuracy in differentiating lymphangioma from hemangioma. However, our findings suggest that there is no advantage in performing immunohistochemical staining to differentiate lymphangioma from hemangioma.

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