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Int J Clin Exp Pathol 2011;4(2):175-182

Original Article
D2-40: an additional marker for myoepithelial cells of breast and the precaution in
interpreting tumor lymphovascular invasion

Shuyue Ren, Mohammed Abuel-Haija, Jasvir S. Khurana, Xinmin Zhang

Department of Pathology and Laboratory Medicine, Temple University Hospital, Temple University School of Medicine, Philadelphia, PA 19140,

Received January 12, 2011; accepted January 29, 2011; Epub January 30, 2011; published February 15, 2011

Abstract: D2-40 is a recently available mouse monoclonal antibody specifically recognized human podoplanin and has been used in
identifying lymphovascular invasion (LVI) of tumors. Although its expression has been evaluated in other tissues, as a marker of the
myoepithelial cells (MEC) of breast it has not been studied. To explore its expression in the MEC of breast, histological materials of 48 patients
with breast diseases were reviewed and paraffin embedded tissue blocks were selected to include usual ductal hyperplasia ( UDH, 41 cases),
atypical ductal hyperplasia (ADH, 4 cases) and ductal carcinoma in situ (DCIS, 17 cases). Normal breast parenchyma and invasive carcinoma
coexisting in the tissue sections were also included in the study. Immunohistochemistry for D2-40, calponin and p63 was performed and the
staining patterns were reviewed and compared. D2-40 immunohistochemical staining is positive in the cytoplasm of MEC at UDH, ADH, and
majority of DCIS. The staining pattern of D2-40 is compatible with that of calponin, however D2-40 staining of MEC is weaker than that of
calponin and with less background. In addition, myoepithelial cells and myofibroblasts at the edge of retraction space of DCIS are also stained
by D2-40 that could be misinterpreted as tumor LVI. In conclusion, D2-40 immunohistochemistry reliably identifies the MEC of breast in a
variety of lesions in a pattern similar to that of calponin and p63, and can be used as an additional MEC marker. Precaution should be excised
when interpreting the staining of cells surrounding DCIS and carcinoma with retraction artifact. (IJCEP1101001).

Keywords: D2-40, myoepithelial cells, breast, lymphovascular invasion

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Address all correspondence to:
Xinmin Zhang, MD
Department of Pathology and Laboratory Medicine
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Philadelphia, PA 19140, USA.
Tel: 215 -707-8273