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Published on: May 1, 2015
Inconsistent immunohistochemical expression of lymphatic and blood endothelial cell markers in cutaneous
Jag Bhawan1, Claudine Silva, Wirach Matt Taungjaruwinai
1Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA, USA. jbhawan@bu.edu
Insights
Immunohistochemical markers CD31, D2-40, and LYVE-1 (lymphatic vessel hyaluronan receptor-1) show limited utility in distinguishing cutaneous lymphangioma from hemangioma. Combined marker testing did not improve diagnostic accuracy, suggesting no benefit from immunohistochemistry for differentiation.
Area of Science:
- Dermatopathology
- Immunohistochemistry
- Tumor Biology
Background:
- Cutaneous lymphangioma and hemangioma are distinct vascular tumors.
- Accurate differentiation is crucial for appropriate clinical management.
- Immunohistochemical markers are often used to aid in tumor diagnosis.
Purpose of the Study:
- To evaluate the expression of CD31, D2-40, and LYVE-1 (lymphatic vessel hyaluronan receptor-1) in cutaneous lymphangioma and hemangioma.
- To determine the utility of these markers in differentiating between these two conditions.
Main Methods:
- Immunohistochemical staining was performed on 33 lymphangioma and 13 hemangioma specimens.
- Antibodies used included CD31, D2-40, and LYVE-1.
- Expression patterns and diagnostic accuracy metrics were analyzed.
Main Results:
- CD31 was positive in 91% of lymphangiomas and 100% of hemangiomas.
- D2-40 showed positivity in 54% of lymphangiomas and 23% of hemangiomas.
- LYVE-1 was positive in only 6% of lymphangiomas and 15% of hemangiomas, with high specificity (85%).
Conclusions:
- No single marker reliably differentiates lymphangioma from hemangioma due to shared embryonic origins.
- While combined testing may offer some diagnostic improvement, the overall findings suggest immunohistochemistry provides no significant advantage.
- Further research may be needed to identify more specific markers for differentiating these cutaneous lesions.
Purpose:
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.
