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Cytokeratin expression in epithelioid vascular neoplasms
M H Gray1, A E Rosenberg, G R Dickersin
1Department of Pathology, Massachusetts General Hospital, Boston 02130.
Human Pathology
|February 1, 1990
Summary
Epithelioid vascular tumors like epithelioid hemangioendotheliomas (EHE) and epithelioid angiosarcomas (EAS) can express keratin, an epithelial marker. This finding is crucial for differentiating these tumors from carcinomas in soft-tissue neoplasm diagnostics.
Area of Science:
- Surgical pathology
- Soft tissue tumors
- Immunohistochemistry
Background:
- Epithelioid vascular tumors present diagnostic challenges due to their resemblance to carcinomas.
- Distinguishing between vascular neoplasms and carcinomas requires precise marker identification.
Purpose of the Study:
- To investigate the expression of endothelial and epithelial markers in epithelioid and non-epithelioid vascular tumors.
- To determine if keratin, an epithelial marker, is expressed in epithelioid vascular tumors.
Main Methods:
- Avidin-biotin-peroxidase method was used to stain 15 vascular tumors (7 epithelioid, 8 non-epithelioid).
- Markers included Ulex europaeus agglutinin-1 (UEA-1), factor VIII-related antigen (FVIII-RA), vimentin, keratin, carcinoembryonic antigen, and epithelial membrane antigen.
- Electron microscopy confirmed keratin-positive vascular tumors.
Main Results:
- All tumors stained positive for FVIII-RA, UEA-1, and vimentin.
- Epithelioid angiosarcoma (EAS) showed keratin positivity in both fixed and frozen sections.
- One epithelioid hemangioendothelioma (EHE) showed keratin positivity in frozen sections.
Conclusions:
- Epithelioid vascular tumors (EHE and EAS) can express the epithelial marker keratin, in addition to endothelial markers.
- This keratin expression can lead to misdiagnosis as carcinoma on routine light microscopy.
- A comprehensive panel of immunohistochemical markers is essential for accurate diagnosis of soft-tissue neoplasms.