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2015, Volume 31, Number 1, Page(s) 080
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DOI: 10.5146/tjpath.2014.01287
CAMTA1 Immunostaining is not Useful in Differentiating Epithelioid Hemangioendothelioma from its Potential Mimickers
Viroj WIWANITKIT
Visiting Professor, Hainan Medical University, China
Introduction
Dear Editor,

The recent report on “CAMTA1 Immunostaining” is very interesting1. Yusıflı et al. concluded that “epithelioid hemangioendothelioma, its potential morphological mimickers and other benign or malignant vascular tumors showed strong and diffuse CAMTA1 expression, nullifying the potential use of CAMTA1 immunohistochemistry as an adjunct in the differential diagnosis1.” In fact, the diagnosis of epithelioid hemangioendothelioma is challenging. The use of immunohistochemistry is usually of limited use for the diagnosis. As Lee noted, histopathology alone is not adequate for diagnosis. Lee et al. suggested using “fluorescence in situ hybridization” that could help identify “the presence of CAMTA1 rearrangement” in epithelioid hemangioendothelioma2. A more complex diagnostic tool, FISH or RT-PCR analysis, can also be useful as a standard tool for the diagnosis of epithelioid hemangioendothelioma3. The “presence of WWTR1-CAMTA1 fusion” is the diagnostic hallmark from FISH or RT-PCR analysis3. Errani et al. also noted that it is necessary to use FISH or RT-PCR analysis for the diagnosis since it can help distinguish epithelioid hemangioendothelioma from other malignant epithelioid vascular tumors4.

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    1) Yusıflı Z, Kösemehmetoğlu K. CAMTA1 immunostaining is not useful in differentiating epithelioid hemangioendothelioma from its potential mimickers. Turk Patoloji Derg. 2014;30:159-65.

    2) Lee SE, Park HY, Kim S, Bang H, Min JH, Choi YL. Epithelioid hemangioendothelioma with extensive cystic change and CAMTA1 rearrangement. Pathol Int. 2013;63:502-5.

    3) Errani C, Zhang L, Sung YS, Hajdu M, Singer S, Maki RG, Healey JH, Antonescu CR. A novel WWTR1-CAMTA1 gene fusion is a consistent abnormality in epithelioid hemangioendothelioma of different anatomic sites. Genes Chromosomes Cancer. 2011;50:644-53.

    4) Errani C, Zhang L, Panicek DM, Healey JH, Antonescu CR. Epithelioid hemangioma of bone and soft tissue: A reappraisal of a controversial entity. Clin Orthop Relat Res. 2012;470:1498-506.

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