Which immunohistochemistry findings are characteristic of vascular sarcomas of the pleura?

Updated: Dec 25, 2019
  • Author: Joseph F Tomashefski, Jr, MD; more...
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Answer

Both EHE and angiosarcoma stain strongly for vimentin and are either negative or variably positive for cytokeratin. [40, 45, 78] Keratin expression is usually weak or spotty. [40] The tumor cells also express one or more vascular marker such as CD31, CD34, or factor VIII–related antigen. Mesothelial markers such as calretinin are negative, as are standard epithelial markers such as EMA, CEA, and CD15. CD10, a marker often associated with renal cell carcinoma, has been shown to be positive in most EHEs. [79] Accompanying spindle cells may stain positively for keratin consistent with submesothelial reactive mesenchymal cells. [40]

Pathology of nonmesothelial cancers of the pleura. Pathology of nonmesothelial cancers of the pleura. Serosal angiosarcoma demonstrating strong immunostaining for vimentin.
Pathology of nonmesothelial cancers of the pleura. Pathology of nonmesothelial cancers of the pleura. Serosal angiosarcoma demonstrating weak equivocal immunostaining for pankeratin.
Pathology of nonmesothelial cancers of the pleura. Pathology of nonmesothelial cancers of the pleura. Serosal angiosarcoma. The tumor stains strongly for the endothelial marker CD34.
Pathology of nonmesothelial cancers of the pleura. Pathology of nonmesothelial cancers of the pleura. Serosal angiosarcoma. Focal expression of the endothelial marker factor VIII. Factor VIII immuno-staining is frequently less intense and more focally distributed than that for CD31 or CD34.

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