D2-40 is a sensitive and specific marker in differentiating primary adrenal cortical tumours from both metastatic clear cell renal cell carcinoma and phaeochromocytoma

Browning, Lisa; Bailey, Denis; Parker, Andrew

doi:10.1136/jcp.2007.049544

Cited by 29 publications

(13 citation statements)

References 14 publications

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“…The thin-walled vascular spaces around the cysts expressed CD34 only. The normal adrenal cortical cells were stained negative for D2-40 contrary to previous studies [14]. The discrepancy may be owing to different conditions in specimen fixation and immunohistochemical procedure.…”

Section: Diagnosis and Pathological Findingscontrasting

confidence: 56%

Adrenal Cystic Lesions: A Clinicopathological Analysis of 25 Cases with Proposed Histogenesis and Review of the Literature

Chien¹,

Chang

Hsu³

et al. 2008

Endocr Pathol

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Adrenal cystic lesions are uncommon and we analyzed clinical and pathologic features of 25 such cases from a single institute over 23 years. There were 16 pseudocysts, eight endothelial cysts, and one epithelial cyst. Seven of eight endothelial cysts were confirmed to be lymphangiomatous by D2-40 immunostaining. We suggest that pseudocysts and endothelial cysts may have different histogenesis. The proposed mesothelial origin of adrenal epithelial cyst cannot be confirmed in our example. Seven adrenal pseudocysts were associated with tumor, including two pheochromocytomas, one neuroblastoma, one adrenal cortical carcinoma, one adrenal cortical adenoma, one myelolipoma, and one schwannoma. The distinction of true cystic lesion from cystic neoplasm is important and requires thorough sampling of the specimens.

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Section: Diagnosis and Pathological Findingscontrasting

confidence: 56%

Adrenal Cystic Lesions: A Clinicopathological Analysis of 25 Cases with Proposed Histogenesis and Review of the Literature

Chien¹,

Chang

Hsu³

et al. 2008

Endocr Pathol

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“…In addition, one study has reported 100% specificity of the antibody D2-40 (anti-podoplanin) for adrenal cortical lesions, 3 but we were unable to achieve satisfactory staining and it was therefore excluded from further evaluation.…”

Section: Discussionmentioning

confidence: 94%

Immunohistochemical Distinction of Primary Adrenal Cortical Lesions From Metastatic Clear Cell Renal Cell Carcinoma

Sangoi

Fujiwara

West

et al. 2011

American Journal of Surgical Pathology

117

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The diagnosis of metastatic clear cell renal cell carcinoma (CC-RCC) can be difficult because of its morphologic heterogeneity and the increasing use of small image-guided biopsies that yield scant diagnostic material. This is further complicated by the degree of morphologic and immunophenotypic overlap with non-renal neoplasms and tissues, such as adrenal cortex. In this study, a detailed immunoprofile of 63 adrenal cortical lesions, which included 54 cortical neoplasms, was compared with 185 metastatic CC-RCC using traditional [anti-calretinin, CD10, anti-chromogranin, anti-EMA, anti-inhibin, anti-melanA, anti-cytokeratins (AE1/AE3 and AE1/CAM5.2), anti-renal cell carcinoma marker (RCCma), and anti-synaptophysin)] and novel [anti-carbonic anhydrase-IX (CAIX), anti-hepatocyte nuclear factor-1b (HNF-1b), anti-human kidney injury molecule-1 (hKIM-1), anti-PAX-2, anti-PAX-8, anti-steroidogenic factor-1 (SF-1), and anti-T cell immunoglobulin mucin-1 (TIM-1)] antibodies. Tissue microarray methodology was used to simulate small image-guided biopsies. Staining extent and intensity were scored semiquantitatively for each antibody. In comparing different intensity thresholds required for a ‘‘positive’’ result, ≥2+ was identified as optimal for diagnostic sensitivity/specificity. For the distinction of adrenal cortical lesions from metastatic CC-RCC, immunoreactivity for the adrenal cortical antigens SF-1 (86% adrenal; 0% CC-RCC), calretinin (89% adrenal; 10% CC-RCC), inhibin (86% adrenal; 9% CC-RCC), and melanA (86% adrenal; 10% CC-RCC) and the renal epithelial antigens hKIM-1 (0% adrenal; 83% CC-RCC), PAX-8 (0% adrenal; 83% CC-RCC), HNF-1b (0% adrenal; 76% CC-RCC), EMA (0% adrenal; 78% CC-RCC), and CAIX (3% adrenal; 87% CC-RCC) had the most potential utility. The use of the novel renal epithelial markers hKIM-1 (clone AKG7) and/or PAX-8, and the adrenocortical marker SF-1 in an immunohistochemical panel for distinguishing adrenal cortical lesions from metastatic CC-RCC offers improved diagnostic sensitivity and specificity.

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“…[22][23][24][25][26][27] Schacht et al 27 also demonstrated the expression of D2-40 in some other nonendothelial cells beyond the above-mentioned cells To date, there are controversies and uncertainties regarding the histiogenesis of dermatofibromas and dermatofibrosarcoma protuberans. [28][29][30][31] For dermatofibroma, various cells of origin, including fibroblast, histiocyte, and endothelial cell, have been hypothesized.…”

Section: Resultsmentioning

confidence: 99%

D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans

Bandarchi

Marginean

et al. 2010

Modern Pathology

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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.

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D2-40 is a sensitive and specific marker in differentiating primary adrenal cortical tumours from both metastatic clear cell renal cell carcinoma and phaeochromocytoma

Abstract: D2-40 may be a useful marker for distinguishing primary adrenal cortical neoplasms from both metastatic CCRCC and phaeochromocytoma.

Cited by 29 publications

References 14 publications

Adrenal Cystic Lesions: A Clinicopathological Analysis of 25 Cases with Proposed Histogenesis and Review of the Literature

Adrenal Cystic Lesions: A Clinicopathological Analysis of 25 Cases with Proposed Histogenesis and Review of the Literature

Immunohistochemical Distinction of Primary Adrenal Cortical Lesions From Metastatic Clear Cell Renal Cell Carcinoma

D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans

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