title: Inconsistent immunohistochemical expression of lymphatic and blood endothelial cell markers in cutaneous lymphangiomas.
abstract: OBJECTIVE
  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.
authors.affiliation: Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA, USA. jbhawan@bu.edu
authors.forename: Jag
authors.initials: J
authors.lastname: Bhawan
authors.forename: Claudine
authors.initials: C
authors.lastname: Silva
authors.forename: Wirach Matt
authors.initials: WM
authors.lastname: Taungjaruwinai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000096:biosynthesis*; D042783:Endothelial Cells / Q000378:metabolism / Q000473:pathology; D004729:Endothelium, Lymphatic / Q000378:metabolism / Q000473:pathology; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006391:Hemangioma; D006801:Humans; D008297:Male; D008875:Middle Aged; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000096:biosynthesis*; D012878:Skin Neoplasms / Q000378:metabolism / Q000473:pathology; D033921:Vesicular Transport Proteins / Q000096:biosynthesis*
chemical_list: D014408:Biomarkers, Tumor; C119248:LYVE1 protein, human; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D033921:Vesicular Transport Proteins
keywords: D2-40; LYVE-1; hemangioma; immunohistochemistry; lymphangioma