Diagnostic Utility of Fli-1 and D2-40 in distinguishing atypical fibroxanthoma from angiosarcoma

Jonathan Cuda, Neda Mirzamani, Ramya Kantipudi, Jason Robbins, Micheal Jude Welsch, Uma N. Sundram

Research output: Contribution to journalArticle

Abstract

Although in most cases one can easily distinguish between atypical fibroxanthomas and angiosarcomas, hemorrhagic atypical fibroxanthomas can pose a diagnostic problem. In rare cases, the large atypical cells of atypical fibroxanthoma can stain with CD31, leading to the erroneous diagnosis of angiosarcoma. We elected to further study this conundrum with 2 additional markers of lymphatic and vascular elements, namely D2-40 (podoplanin) and Fli-1, respectively. We studied 26 cases of atypical fibroxanthoma and 20 cases of angiosarcoma with Fli-1 and D2-40. We found that both Fli-1 and D2-40 stained a majority of cases of angiosarcoma (16/20 and 12/20, respectively), although only staining a minority of cases of atypical fibroxanthoma (8/26 for both). In addition, D2-40 staining of atypical fibroxanthoma was usually weak when positive, whereas Fli-1 staining of angiosarcomas was mostly strong and nuclear. Thus, both D2-40 and Fli-1 seem to be useful in distinguishing between atypical fibroxanthomas and angiosarcomas.

Original languageEnglish (US)
Pages (from-to)316-318
Number of pages3
JournalAmerican Journal of Dermatopathology
Volume35
Issue number3
DOIs
StatePublished - May 1 2013

Keywords

  • Angiosarcoma
  • Atypical fibroxanthoma
  • D2-40
  • Fli-1
  • Immunohistochemistry

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Dermatology

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