Apolipoprotein D in CD34-positive and CD34-negative cutaneous neoplasms: A useful marker in differentiating superficial acral fibromyxoma from dermatofibrosarcoma protuberans

Mikhail Lisovsky, Mai P. Hoang, Karen A. Dresser, Payal Kapur, Jag Bhawan, Meera Mahalingam

Research output: Contribution to journalArticle

33 Scopus citations

Abstract

More recent techniques to characterize the genetic profile of soft-tissue tumors include the use of gene arrays. Using this technique, Apolipoprotein D (Apo D), a 33-kDa glycoprotein component of high-density lipoprotein, has been found to be highly expressed in dermatofibrosarcoma protuberans. To corroborate these results, we sought to ascertain the utility of Apo D by investigating its sensitivity and specificity in a variety of CD34-positive and CD34-negative cutaneous neoplasms including superficial acral fibromyxoma, sclerotic fibromas, and cellular dermatofibromas. Of interest, we found absence of Apo D expression in all four cases of superficial acral fibromyxoma. Of the remaining CD34-positive lesions, Apo D expression was noted in 35/36 (97%) cases of dermatofibrosarcoma protuberans, 3/5 (60%) giant-cell fibroblastomas, 4/4 (100%) sclerotic fibromas, 8/8 (100%) neurofibromas, and 1/1 (100%) solitary fibrous tumor. Of the CD34-negative lesions, Apo D expression was noted in 2/22 (9%) regular dermatofibroma, 23/45 (51%) cellular dermatofibroma, 10/10 (100%) malignant fibrous histiocytoma, 9/10 (90%) atypical fibroxanthoma, 7/8 (86%) cellular neurothekeoma, 9/9 (100%) malignant melanoma, 8/8 (100%) melanocytic nevi (100%), 0/2 superficial angiomyxoma, 0/15 fibromatosis, 0/1 nodular fasciitis, and 1/2 (50%) desmoplastic fibroblastomas. In summary, our findings indicate that Apo D expression is not specific to dermatofibrosarcoma protuberans. Its principal use as an immunohistochemical adjunct lies in its utility in differentiating superficial acral fibromyxoma from dermatofibrosarcoma protuberans. Although strong positive staining of Apo D in a markedly atypical fibrohistiocytic lesion is suggestive of atypical fibroxanthoma and/or malignant fibrous histiocytoma, further studies with the inclusion of other atypical spindled cell neoplasms are required to conclusively prove the same.

Original languageEnglish (US)
Pages (from-to)31-38
Number of pages8
JournalModern Pathology
Volume21
Issue number1
DOIs
StatePublished - Jan 1 2008

Keywords

  • Apo D
  • Apolipoprotein D
  • CD34
  • Dermatofibrosarcoma protuberans
  • Superficial acral fibromyxoma

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Fingerprint Dive into the research topics of 'Apolipoprotein D in CD34-positive and CD34-negative cutaneous neoplasms: A useful marker in differentiating superficial acral fibromyxoma from dermatofibrosarcoma protuberans'. Together they form a unique fingerprint.

  • Cite this