Wick M R, Manivel J C
Virchows Arch A Pathol Anat Histopathol. 1987;410(4):309-16. doi: 10.1007/BF00711287.
Epithelioid sarcoma (ES) and epithelioid hemangioendothelioma (EH) both occur preferentially in the soft tissues, and may be confused with one another microscopically. We compared 8 examples of each tumor immunohistochemically, using formalin-fixed tissue, the ABC method, unconjugated Ulex europaeus I agglutinin (UEA), rabbit antibody to UEA, and monoclonal antibodies to epithelial membrane antigen (EMA), cytokeratin (CK), factor VIII-related antigen (FVIIIRAG), and blood group isoantigens A, B, and H (BGI). Six of 8 cases of ES, and 7 of 8 epithelioid hemangioendotheliomas bound UEA; similarly, 6 of 8 ES cases were reactive for BGI, as were 4 of 8 examples of EH. All epithelioid sarcomas were positive for CK, and 7 displayed EMA, whereas these antigens were lacking in EH. Conversely, 5 of 8 cases of EH contained FVIIIRAG, which was absent in all examples of ES. These findings underscore the nonspecificity of UEA-binding and BGI-expression as markers of endothelial differentiation. Moreover, they suggest that sole reliance upon these immunohistologic reactants for the identification of vascular tumors may result in diagnostic error. Inasmuch as ES and EH differ in biological behavior, such a mistake would be significant. Thus, we advocate the inclusion of immunostains for EMA, CK, and FVIIIRAG in the evaluation of histologically-similar cases of epithelioid sarcoma and epithelioid hemangioendothelioma.
上皮样肉瘤（ES）和上皮样血管内皮瘤（EH）均好发于软组织，在显微镜下可能相互混淆。我们使用福尔马林固定组织、ABC法、未结合的欧洲荆豆I凝集素（UEA）、抗UEA兔抗体以及上皮膜抗原（EMA）、细胞角蛋白（CK）、因子VIII相关抗原（FVIIIRAG）和血型同种抗原A、B和H（BGI）的单克隆抗体，对每种肿瘤的8个病例进行了免疫组织化学比较。8例ES中有6例、8例上皮样血管内皮瘤中有7例结合UEA；同样，8例ES病例中有6例对BGI呈反应性，8例EH中有4例也是如此。所有上皮样肉瘤的CK均呈阳性，7例显示EMA阳性，而EH中缺乏这些抗原。相反，8例EH中有5例含有FVIIIRAG，而所有ES病例均无此抗原。这些发现强调了UEA结合和BGI表达作为内皮分化标志物的非特异性。此外，它们表明仅依靠这些免疫组织学反应物来识别血管肿瘤可能会导致诊断错误。鉴于ES和EH在生物学行为上存在差异，这样的错误将具有重要意义。因此，我们主张在评估组织学上相似的上皮样肉瘤和上皮样血管内皮瘤病例时，加入EMA、CK和FVIIIRAG的免疫染色。
