title: Diagnostic utility of WT-1 cytoplasmic stain in variety of vascular lesions.
abstract: Vascular lesions are commonly encountered in routine pathologic practice and often pose diagnostic challenges owing to their morphologic diversity. Although WT-1 expression was reported in some vascular tumors, little is known about its staining patterns in a spectrum of vascular lesions from various locations. We examined WT-1 immunostain in 95 cases of vascular lesions including angiosarcomas (AS, 19 cases), hemangioendotheliomas (HE, 5), Kaposi's sarcomas (KS, 4), cavernous hemangiomas (CVH, 12), capillary hemangiomas (CPH, 7), pyogenic granulomas (PG, 4), lymphangiomas (LA, 4), hemangiopericytomas (HP, 5), glomus tumors (GT, 8), vascular malformation (VM, 13) and granulation tissue (GRT, 14). Strong WT-1 cytoplasmic stain was invariably observed in all cases of malignant and borderline vascular tumors including AS (19/19), KS (4/4) and HE (5/5). WT-1 was also consistently expressed in CPH (7/7), PG (4/4), and GRT (14/14), while it became weaker in VM (10/13) and often negative in CVH (2/12) and LA (0/4). WT1 stain was not demonstrated in HP (0/5) and rarely in GT (2/8). We conclude that consistent and diffuse WT-1 cytoplasmic stain in AS, HE and KS can be useful in distinguishing these tumors from poorly differentiated tumors with mimicking features. On the other hand, reliable WT-1 stain in CPH, PG and GRT may help in differential diagnosis with non-endothelial vascular tumors such as GT and HP. Recognizing the WT-1 cytoplasmic stain in a broad spectrum of benign and neoplastic tissues is critical in formulating appropriate immunohistochemical panels and avoiding misinterpretation of results.
authors: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University Houston, TX, USA.
authors: Sarah K
authors: SK
authors: Galfione
authors: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University Houston, TX, USA.
authors: Jae Y
authors: JY
authors: Ro
authors: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University Houston, TX, USA.
authors: Alberto G
authors: AG
authors: Ayala
authors: Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Weill Medical College of Cornell University Houston, TX, USA.
authors: Yimin
authors: Y
authors: Ge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D003593:Cytoplasm / Q000737:chemistry*; D003937:Diagnosis, Differential; D005260:Female; D006097:Granulation Tissue / Q000737:chemistry* / Q000473:pathology; D017789:Granuloma, Pyogenic / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008202:Lymphangioma / Q000737:chemistry* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009383:Neoplasms, Vascular Tissue / Q000737:chemistry* / Q000473:pathology; D009389:Neovascularization, Pathologic; D011237:Predictive Value of Tests; D054079:Vascular Malformations / Q000378:metabolism* / Q000473:pathology; D025721:WT1 Proteins / Q000032:analysis*; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D025721:WT1 Proteins; C583751:WT1 protein, human
keywords: WT-1; angiogenesis; endothelial proliferation; immunohistochemistry; vascular tumor