D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans
D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans
复制标题
D2-40，一种区分皮肤纤维瘤和隆突性皮肤纤维肉瘤的新型免疫组织化学标记物
作者：
B. Bandarchi;Linglei Ma;C. Marginean;S. Hafezi;J. Zubovits;G. Rasty
切除活检时，皮肤纤维瘤，特别是细胞变异型和隆起性皮肤纤维肉瘤之间的区别通常是直接的。然而，两者之间的分离有时可能是具有挑战性的，特别是在浅表活检中。尽管因子XIIIA和CD34免疫染色在大多数情况下有助于鉴别皮肤纤维瘤和隆突性皮肤纤维肉瘤，但在细胞性纤维组织细胞瘤中也可见局灶性CD34阳性。一些病例显示免疫染色结果重叠。D2-40鉴定了一种存在于多种组织中的40 kDa O连接唾液糖蛋白，包括睾丸生殖细胞肿瘤以及淋巴管内皮细胞。在这项研究中，我们研究了D2-40在分离隆起皮肤纤维肉瘤和皮肤纤维肉瘤中的应用，并与其他常用的免疫染色结果进行了比较。从多伦多大学桑尼布鲁克健康科学中心解剖病理教研室检索56例皮肤纤维瘤(包括6例细胞变异型)和29例隆突性皮肤纤维肉瘤。我们将因子XIIIA、CD34和鼠抗D2-40单抗免疫染色应用于福尔马林固定、石蜡包埋的组织切片。56例(100%)皮肤纤维瘤的梭形细胞和间质D2-40呈强阳性和弥漫性免疫反应。同样，XIIIA因子在梭形细胞中呈强阳性和弥漫性阳性。除1例局部阳性外，几乎所有皮肤纤维瘤CD34均为阴性。无1例隆突性皮肤纤维肉瘤被D2-40标记，但有4例背景染色较弱，呈斑块状，与皮肤纤维瘤的弥漫性、强、脆性染色相反。我们的结果表明D2-40似乎是皮肤纤维瘤的一个敏感的免疫组织化学标记物，包括细胞变异型。隆突性皮肤纤维肉瘤间质中可见局灶性和淡淡的D2-40染色。我们的发现表明，D2-40可以作为XIIIA和CD34因子的补充免疫染色，用于有问题和具有挑战性的浅表活检病例。
The distinction between dermatofibroma, particularly cellular variant, and dermatofibrosarcoma protuberans in excisional biopsies is usually straightforward. However, a separation between the two may be sometimes challenging, especially in superficial biopsies. Although factor XIIIa and CD34 immunostains are useful in differentiating dermatofibroma and dermatofibrosarcoma protuberans in most instances, focal CD34 positivity may be seen in cellular fibrous histiocytoma. Some cases reveal overlapping immunostain results. D2-40 identifies a 40-kDa O-linked sialoglycoprotein present on a variety of tissues including testicular germ cell tumors as well as lymphatic endothelium. In this study, we investigated the utility of D2-40 in separating dermatofibroma from dermatofibrosarcoma protuberans and compared the results with other commonly used immunostains. Fifty-six cases of dermatofibroma (including six cellular variant) and 29 cases of dermatofibrosarcoma protuberans were retrieved from the archives of Department of Anatomic Pathology at Sunnybrook Health Sciences Center in University of Toronto. We applied factor XIIIa, CD34, and monoclonal mouse anti-D2-40 immunostains to formalin-fixed, paraffin-embedded tissue sections. All 56 (100%) cases of dermatofibroma demonstrated strong and diffuse immunoreactivity to D2-40 in the spindle cells and stroma. Similarly, factor XIIIa showed strong and diffuse positivity in the spindle cells. Nearly all dermatofibromas were negative for CD34 except one case revealing focal positivity. None of dermatofibrosarcoma protuberans cases were labeled by D2-40, although four cases showed weak and patchy background staining in contrary to diffuse, strong, and crisp staining seen in dermatofibromas. Our results indicate that D2-40 seems to be a sensitive immunohistochemical marker for dermatofibromas, including cellular variant. Focal and faint D2-40 staining may be seen in the stroma of dermatofibrosarcoma protuberans. Our findings suggest that D2-40 can be used as a complementary immunostain to factor XIIIa and CD34 in problematic and challenging cases on superficial biopsies.
影响因子：
6
作者：
Hirakawa, S;Hong, YK;Detmar, M
通讯作者：
Detmar, M