title: Diagnostic utility of Fli-1 and D2-40 in distinguishing atypical fibroxanthoma from angiosarcoma.
abstract: Although in most cases one can easily distinguish between atypical fibroxanthomas and angiosarcomas, hemorrhagic atypical fibroxanthomas can pose a diagnostic problem. In rare cases, the large atypical cells of atypical fibroxanthoma can stain with CD31, leading to the erroneous diagnosis of angiosarcoma. We elected to further study this conundrum with 2 additional markers of lymphatic and vascular elements, namely D2-40 (podoplanin) and Fli-1, respectively. We studied 26 cases of atypical fibroxanthoma and 20 cases of angiosarcoma with Fli-1 and D2-40. We found that both Fli-1 and D2-40 stained a majority of cases of angiosarcoma (16/20 and 12/20, respectively), although only staining a minority of cases of atypical fibroxanthoma (8/26 for both). In addition, D2-40 staining of atypical fibroxanthoma was usually weak when positive, whereas Fli-1 staining of angiosarcomas was mostly strong and nuclear. Thus, both D2-40 and Fli-1 seem to be useful in distinguishing between atypical fibroxanthomas and angiosarcomas.
authors.affiliation: Department of Pathology, Stanford University Medical Center, Stanford, CA, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Cuda
authors.forename: Neda
authors.initials: N
authors.lastname: Mirzamani
authors.forename: Ramya
authors.initials: R
authors.lastname: Kantipudi
authors.forename: Jason
authors.initials: J
authors.lastname: Robbins
authors.forename: Micheal Jude
authors.initials: MJ
authors.lastname: Welsch
authors.forename: Uma N
authors.initials: UN
authors.lastname: Sundram
mesh_terms: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor / Q000032:analysis*; D003937:Diagnosis, Differential; D006394:Hemangiosarcoma / Q000737:chemistry* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008562:Membrane Glycoproteins / Q000032:analysis*; D011237:Predictive Value of Tests; D051789:Proto-Oncogene Protein c-fli-1 / Q000032:analysis*; D012878:Skin Neoplasms / Q000737:chemistry* / Q000473:pathology; D014973:Xanthomatosis / Q000378:metabolism* / Q000473:pathology; D000098853:Podoplanin
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D014408:Biomarkers, Tumor; D008562:Membrane Glycoproteins; D051789:Proto-Oncogene Protein c-fli-1; C078433:FLI1 protein, human; C117468:PDPN protein, human; D000098853:Podoplanin; C500987:monoclonal antibody D2-40