On the discriminatory value of anti-HPCA-1 (CD-34) in the differential diagnosis of benign and malignant cutaneous vascular proliferations.
The staining pattern of monoclonal antibody anti-HPCA-1 (CD-34) was studied in 95 cases of benign and malignant cutaneous vascular proliferations and compared with other vascular endothelium-associated antigenic markers in paraffin-embedded tissues. The proliferating vessels in 22 cutaneous capillary hemangiomas, 8 lobular capillary hemangiomas, and 1 case of papillary intravascular endothelial hyperplasia stained strongly positively for anti-HPCA-1, and the intensity of the reaction was paralleled by that of factor VIII-related antigen (FVIII), Ulex europaeus lectin-1 (UEA), and vimentin (VIM). The vessels in 10 cases of granulation tissue, 6 cases of cavernous hemangioma, 6 cases of angiokeratoma, 5 cases of angiolymphoid hyperplasia with eosinophilia (epithelioid hemangioma), and 3 cases of bacillary angiomatosis showed a lack of reactivity with anti-HPCA-1 and staining of variable intensity with the other markers. Twenty cases of Kaposi's sarcoma (seven patch, five plaque, eight nodular stage) showed strong labeling with anti-HPCA-1 in small, well-formed vessels scattered among the spindle-cell proliferation, and four of these cases showed focal positivity of scattered spindle cells. Nine cases of cutaneous angiosarcoma, two cases of low-grade epithelioid angiosarcoma, and one case of spindle-cell hemangioendothelioma were negative for anti-HPCA-1 and showed variable reactivity for FVIII and UEA; all cases stained strongly positively for VIM. The results of this study indicate that although anti-HPCA-1 shows a high sensitivity for the staining of normal vascular endothelium, its specificity may be restricted to mature, well-formed vessels, therefore rendering its discriminatory value very limited for the identification of poorly differentiated vascular endothelial neoplasms.
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Arkadi M. Rywlin Department of Pathology & Laboratory Medicine, Mount Sinai Medical Center, Miami Beach, FL 33140.
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D000794:Angiokeratoma / Q000098:blood supply / Q000175:diagnosis; D016917:Angiomatosis, Bacillary / Q000175:diagnosis / Q000473:pathology; D000911:Antibodies, Monoclonal; D015703:Antigens, CD / Q000032:analysis*; D018952:Antigens, CD34; D014408:Biomarkers, Tumor / Q000032:analysis*; D003937:Diagnosis, Differential; D004730:Endothelium, Vascular / Q000473:pathology; D006097:Granulation Tissue / Q000098:blood supply; D017789:Granuloma, Pyogenic / Q000175:diagnosis; D018323:Hemangioendothelioma, Epithelioid / Q000098:blood supply / Q000175:diagnosis; D006391:Hemangioma / Q000098:blood supply / Q000175:diagnosis; D018324:Hemangioma, Capillary / Q000098:blood supply / Q000175:diagnosis; D006392:Hemangioma, Cavernous / Q000098:blood supply / Q000175:diagnosis; D006394:Hemangiosarcoma / Q000098:blood supply / Q000175:diagnosis; D006801:Humans; D006965:Hyperplasia; D037102:Lectins / Q000032:analysis; D016612:Paraffin Embedding; D037121:Plant Lectins; D012514:Sarcoma, Kaposi / Q000098:blood supply / Q000175:diagnosis; D017445:Skin Diseases, Vascular / Q000175:diagnosis* / Q000473:pathology; D012878:Skin Neoplasms / Q000098:blood supply* / Q000175:diagnosis*; D013194:Staining and Labeling; D014746:Vimentin / Q000032:analysis; D014841:von Willebrand Factor / Q000032:analysis
D000911:Antibodies, Monoclonal; D015703:Antigens, CD; D018952:Antigens, CD34; D014408:Biomarkers, Tumor; D037102:Lectins; D037121:Plant Lectins; C036850:Ulex europaeus lectins; D014746:Vimentin; D014841:von Willebrand Factor