Journal article
Clonal X-chromosome inactivation suggests that splenic cord capillary hemangioma is a true neoplasm and not a subtype of splenic hamartoma
Modern pathology, Vol.24(1), pp.108-116
01/2011
DOI: 10.1038/modpathol.2010.168
PMID: 20852592
Abstract
Splenic hamartoma is a rare tumor-like lesion composed of structurally disorganized red pulp elements. It has been hypothesized that two other splenic lesions, cord capillary hemangioma and myoid angioendothelioma, may fall within the spectrum of splenic hamartoma, simply representing morphological variants. In this study, we compared the vascular and stromal composition of cord capillary hemangioma and myoid angioendothelioma with those of classical hamartoma. In addition, we assessed the clonal vs polyclonal nature of the lesions in nine female cases by performing clonality analysis for X-chromosome inactivation at the human androgen receptor locus (HUMARA) on laser-assisted microdissected samples. In 15 of 17 cases, increased reticulin and/or collagen content was observed. The classical hamartoma cases showed a vasculature predominantly composed of CD8+ CD31+ CD34- splenic sinuses, whereas cases of cord capillary hemangioma and myoid angioendothelioma contained many CD8- CD31+ CD34+ cord capillaries, but very little CD8+ vasculature. All cases lacked expression of D2-40 and Epstein Barr virus-encoded RNA. All cases showed a proliferation index of ≤5% by Ki-67. Cases of classical hamartoma lacked significant perisinusoidal expression of collagen IV and low-affinity nerve growth factor receptor. Both markers were variably expressed in the other lesions. Increased CD163-positive histiocytes were found in four cases (three cord capillary hemangiomas and one myoid angioendothelioma). HUMARA analysis was informative in all nine tested cases, of which three cases showed a non-random X-chromosome inactivation pattern, indicating clonality. All three clonal cases were cord capillary hemangiomas. Our study has shown that in spite of considerable morphologic heterogeneity and overlapping features, classical hamartoma and cord capillary hemangioma and myoid angioendothelioma are different in terms of their vascular and stromal composition. Clonality analysis supports a true neoplastic origin for the cord capillary hemangioma. A larger study using additional immunohistochemical and molecular studies is necessary to further evaluate the biological significance of the current findings.
Details
- Title: Subtitle
- Clonal X-chromosome inactivation suggests that splenic cord capillary hemangioma is a true neoplasm and not a subtype of splenic hamartoma
- Creators
- A Chiu - Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065, USAM CzaderL Cheng - Indiana University School of MedicineR P HasserjianM WangS BhagavathiE M HyjekH Al-AhmadieD M KnowlesA Orazi
- Resource Type
- Journal article
- Publication Details
- Modern pathology, Vol.24(1), pp.108-116
- DOI
- 10.1038/modpathol.2010.168
- PMID
- 20852592
- NLM abbreviation
- Mod Pathol
- ISSN
- 0893-3952
- eISSN
- 1530-0285
- Publisher
- United States
- Language
- English
- Date published
- 01/2011
- Academic Unit
- Pathology
- Record Identifier
- 9984047613002771
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