title: The utility of ERG, CD31 and CD34 in the cytological diagnosis of angiosarcoma: an analysis of 25 cases.
abstract: OBJECTIVE
  Erythroblast transformation specific related gene (ERG), a proto-oncogene member of the erythroblast transformation specific transcription factor family, is a sensitive marker of endothelial differentiation and is expressed in vascular tumours, including angiosarcomas (AS). Immunohistochemistry is necessary for the diagnosis of AS in fine needle aspirates where low cellularity and lack of preserved tissue architecture impedes diagnosis. The aim of this study was to assess the utility of an ERG-enriched immunohistochemistry panel in the cytological diagnosis of AS.
  
  
  METHODS
  25 AS diagnosed on fine needle aspirates were stained for ERG, CD31, CD34, and AE1/AE3. Staining intensity and percentage tumour cell positivity were evaluated. Spearman's correlation was assessed for significant correlations between antibodies.
  
  
  RESULTS
  Sensitivities for ERG, CD31, CD34 and AE1/AE3 were 100%, 100%, 60% and 21%, respectively. Spearman's analysis revealed that ERG and CD31 staining correlated significantly; there was no significant correlation between CD31 and CD34 staining.
  
  
  CONCLUSIONS
  With equal sensitivity to, and strong correlation with CD31, ERG staining is highly suitable for the cytological diagnosis of AS. ERG and CD31 are more sensitive vascular markers than CD34. ERG, a nuclear stain, complements the cytoplasmic/membranous staining of CD31. Used in conjunction with CD31, ERG can corroborate the diagnosis of AS.
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
authors.forename: Harold C
authors.initials: HC
authors.lastname: Sullivan
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Edgar
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Cohen
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
authors.forename: Charles K
authors.initials: CK
authors.lastname: Kovach
authors.affiliation: Department of Pathology, Louisiana State University Health Sciences Center, Shreveport, Louisiana, USA.
authors.forename: Kim
authors.initials: K
authors.lastname: HooKim
authors.affiliation: Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA.
authors.forename: Michelle D
authors.initials: MD
authors.lastname: Reid
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018952:Antigens, CD34 / Q000032:analysis*; D014408:Biomarkers, Tumor / Q000032:analysis*; D001707:Biopsy, Needle; D002675:Child, Preschool; D003581:Cytodiagnosis / Q000379:methods; D005260:Female; D006394:Hemangiosarcoma / Q000737:chemistry / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000032:analysis*; D000090063:Proto-Oncogene Mas; D012680:Sensitivity and Specificity; D015534:Trans-Activators / Q000032:analysis*; D000071230:Transcriptional Regulator ERG
chemical_list: D018952:Antigens, CD34; D014408:Biomarkers, Tumor; C072312:ERG protein, human; C000715470:MAS1 protein, human; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D000090063:Proto-Oncogene Mas; D015534:Trans-Activators; D000071230:Transcriptional Regulator ERG
keywords: CYTOLOGY; IMMUNOHISTOCHEMISTRY; VASCULAR TUMOURS