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The Korean Journal of Pathology 2006;40(5): 361-367.
Immunohistochemical Characteristics of Kaposi Sarcoma and its Mimicries.
Kyoung Bun Lee, Hye Seung Lee, Hee Eun Lee, So Yeon Park, Jin Haeng Chung, Gheeyoung Choe, Woo Ho Kim, Kye Yong Song
1Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
2Department of Pathology, Seoul National University Bundang Hospital, 300 Gumi-dong, Bundang-gu, Sungnam, Korea. mw9195@snubh.org
3Department of Pathology, Chung-Ang University College of Medicine, Seoul, Korea.
ABSTRACT
BACKGROUND: The differential diagnosis of Kaposi sarcoma includes many disease that range from benign disease to malignant tumors. However, little information is available about the immunohistochemical characteristics of Kaposi sarcoma. METHODS: The expressions of 13 various proteins (HHV-8 LNA-1, Ki-67, bcl-2, p53, CD31, CD34, factor VIII, D2-40, vimentin, SMA, S-100, EMA, and c-kit) were evaluated immunohistochemically in 49 vascular tumors including 16 Kaposi sarcomas, 8 angiosarcomas, 2 hemangioendotheliomas, and 23 benign vascular tumors with using the tissue array method. RESULTS: All 16 cases of Kaposi sarcoma showed nuclear staining for HHV-8 LNA-1, whereas all the cases of angiosarcoma and benign vascular lesions were negative for HHV-8 LNA-1 (p<0.001). All Kaposi sarcoma were positive for D2-40, which is a marker of lymphatic differentiation, but 25% of the benign vascular lesions and 30.4% of the angiosarcoma were positive for D2-40 (p<0.001). The mean proliferation index as assessed by Ki-67 immunostaining revealed no difference between the benign and malignant vascular lesions (p>0.05). No Kaposi sarcoma showed a bcl-2 expression, but 62.5% of the angiosarcomas and 21.7% of the benign vascular tumors had bcl-2 expressions (p=0.005). CONCLUSIONS: Immunohistochemical detection of HHV-8 LNA-1 and D2-40 are useful tools to differentiate Kaposi sarcoma from other vascular tumors.
Key Words: Sarcoma, Kaposi; Herpesvirus 8, human; Latent nuclear antigen; Monoclonal antibody D2-40; Immunohistochemistry