Kristen M Paral1, Jerome B Taxy2, Mark W Lingen3. 1. Resident, Department of Pathology, University of Chicago, Chicago, IL, USA. 2. Professor, Department of Pathology, NorthShore University Health System, Evanston, IL, USA. 3. Professor, Department of Pathology, University of Chicago, Chicago, IL, USA. Electronic address: mark.lingen@uchospitals.edu.
Abstract
OBJECTIVE: This study evaluated the use of stromal biomarkers CD34 and α smooth muscle actin (α-SMA) to distinguish verrucous carcinoma (VC) from verrucous hyperplasia (VH). STUDY DESIGN: Thirteen VH, 15 VC, 20 squamous cell carcinoma (SCC), and 16 of uninvolved adjacent stroma specimens were analyzed for α-SMA and CD34 expression by immunohistochemistry. RESULTS: Stromal α-SMA positivity was observed in 100% (20 of 20) of the SCC and in 93% (14 of 15) of the VC, whereas none of the VH (0 of 13) or adjacent uninvolved stroma (0 of 16) demonstrated α-SMA reactivity. Stromal CD34 positivity was observed in 100% (13 of 13) of VH and adjacent stroma (16 of 16), while 20% (3 of 15) of VC and 11% (2 of 18) of SCC stroma expressed CD34. The SCC and VC groups differed significantly from the VH and uninvolved stroma groups for both α-SMA and CD34 expression (P < .0001). CONCLUSIONS: Stromal CD34 and α-SMA protein expression patterns may aid in distinguishing between VC and VH in challenging cases.
OBJECTIVE: This study evaluated the use of stromal biomarkers CD34 and α smooth muscle actin (α-SMA) to distinguish verrucous carcinoma (VC) from verrucous hyperplasia (VH). STUDY DESIGN: Thirteen VH, 15 VC, 20 squamous cell carcinoma (SCC), and 16 of uninvolved adjacent stroma specimens were analyzed for α-SMA and CD34 expression by immunohistochemistry. RESULTS: Stromal α-SMA positivity was observed in 100% (20 of 20) of the SCC and in 93% (14 of 15) of the VC, whereas none of the VH (0 of 13) or adjacent uninvolved stroma (0 of 16) demonstrated α-SMA reactivity. Stromal CD34 positivity was observed in 100% (13 of 13) of VH and adjacent stroma (16 of 16), while 20% (3 of 15) of VC and 11% (2 of 18) of SCC stroma expressed CD34. The SCC and VC groups differed significantly from the VH and uninvolved stroma groups for both α-SMA and CD34 expression (P < .0001). CONCLUSIONS: Stromal CD34 and α-SMA protein expression patterns may aid in distinguishing between VC and VH in challenging cases.