IJCEP Copyright © 2007-All rights reserved.
Int J Clin Exp Pathol 1(3):276-284;2008

Original Article
Podoplanin (D2-40): A New Immunohistochemical Marker for Reactive Follicular
Dendritic Cells and Follicular Dendritic Cell Sarcomas

Qingmei Xie, Lugen Chen, Kai Fu, Josephine Harter, Ken H. Young, Jaya Sunkara, Deborah Novak, Esperanza Villanueva-Siles and Howard

Department of Pathology, Creighton University Medical Center, Omaha, NE; Department of Pathology, Montefiore Medical Center/Albert
Einstein College of Medicine, Bronx. NY; Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE;
Department of Pathology and Laboratory Medicine, University of Wisconsin School of Medicine and Public Health, UW Paul P. Carbone
Comprehensive Cancer Center, Madison, WI

Received 1 Aug 2007; accepted with revision 19 Aug 2007; available online 1 January 2008

Abstract: The diagnosis of follicular dendritic cell (FDC) sarcoma can be challenging because of its morphologic overlaps with many other
spindle cell neoplasms and, therefore, new phenotypic markers will be helpful in its differential diagnosis. Podoplanin is a mucin-type
transmembrane glycoprotein that has recently been detected in reactive FDCs. In this study, we investigated the expression patterns of
podoplanin using a new mouse monoclonal antibody D2-40, and compared them with CD21, a well-established FDC marker, in a
comprehensive panel of cases. The panel included 4 FDC sarcomas, 38 spindle cell neoplasms of other types, 25 reactive lymphoid
hyperplasia, and 117 lymphoid and 5 myeloid malignant hematopoietic neoplasms. Our study revealed that D2-40 strongly stained 3 of 4 FDC
sarcomas. In contrast, D2-40 stained only 2/38 other spindle cell neoplasms tested. Furthermore, we observed that D2-40 highlighted more
FDC meshworks than CD21 in Castleman’s disease, follicular lymphoma, nodular lymphocyte predominance Hodgkin lymphoma, and
residual reactive germinal centers in a variety of lymphoma types. D2-40 and CD21 stained an equal number of cases of reactive lymphoid
hyperplasia, progressively transformed germinal centers and angioimmunoblastic T-cell lymphoma. No expression of podoplanin was
detected in normal or neoplastic lymphoid and myeloid cells. We conclude that podoplanin (D2-40) is a sensitive and specific FDC marker,
which is superior or equal to CD21 in evaluating both reactive and neoplastic FDCs. In addition, our results suggest that podoplanin (D2-40)
can be used to support the diagnosis of FDC sarcoma. (IJCEP708002).

Key words: Podoplanin, D2-40, follicular dendritic cell, follicular dendritic cell sarcoma

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Address all correspondence to: Qingmei Xie, MD, Department of Pathology, Creighton University Medical Center, 601 N. 30th St., Omaha, NE
68131-2197, USA. Tel: 402-449-4630; Fax: 402-449-5252; Email: