Difference between revisions of "Angiosarcoma"
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'''Angiosarcoma''' is an uncommon malignant [[vascular tumour]]. | |||
==General== | |||
*Malignant tumour - general has a poor prognosis.<ref name=pmid20537949>{{cite journal |author=Young RJ, Brown NJ, Reed MW, Hughes D, Woll PJ |title=Angiosarcoma |journal=Lancet Oncol |volume= |issue= |pages= |year=2010 |month=May |pmid=20537949 |doi=10.1016/S1470-2045(10)70023-1 |url=}}</ref> | |||
Epidemiology: | |||
*May arise secondary to chronic lymphedema related to [[invasive breast cancer|breast carcinoma]]. | |||
**Known as ''Stewart–Treves syndrome''.<ref name=pmid18753651>{{Cite journal | last1 = Pincus | first1 = LB. | last2 = Fox | first2 = LP. | title = Images in clinical medicine. The Stewart-Treves syndrome. | journal = N Engl J Med | volume = 359 | issue = 9 | pages = 950 | month = Aug | year = 2008 | doi = 10.1056/NEJMicm071344 | PMID = 18753651 | url=http://www.nejm.org/doi/full/10.1056/NEJMicm071344}}</ref> | |||
*[[Hepatic angiosarcoma|Liver angiosarcoma]]s are associated with vinyl chloride exposure.<ref>{{Ref PCPBoD8|212}}</ref> | |||
*Cutaneous angiosarcomas are classically seen on the head and neck of whites over 60 years old.<ref name=pmid>{{Cite journal | last1 = Albores-Saavedra | first1 = J. | last2 = Schwartz | first2 = AM. | last3 = Henson | first3 = DE. | last4 = Kostun | first4 = L. | last5 = Hart | first5 = A. | last6 = Angeles-Albores | first6 = D. | last7 = Chablé-Montero | first7 = F. | title = Cutaneous angiosarcoma. Analysis of 434 cases from the Surveillance, Epidemiology, and End Results Program, 1973-2007. | journal = Ann Diagn Pathol | volume = 15 | issue = 2 | pages = 93-7 | month = Apr | year = 2011 | doi = 10.1016/j.anndiagpath.2010.07.012 | PMID = 21190880 }}</ref> | |||
==Microscopic== | |||
Features: | |||
*Very many small capillaries of irregular shape lined with: | |||
**Pleomorphic nuclei. | |||
***May have hobnail morphology. | |||
*Mitoses. | |||
*Cytoplasmic vacuoles. | |||
**Cells trying to form lumina - embryologic. | |||
Notes: | |||
*Epithelioid variant (with abundant cytoplasm & sheeting architecture) may resemble ''[[melanoma]]'' or ''[[hepatocellular carcinoma]]''. | |||
DDx: | |||
*[[Atypical vascular lesion]]. | |||
*[[Kaposi sarcoma]]. | |||
*Poorly differentiated carcinoma. | |||
===Images=== | |||
<gallery> | |||
Image:Epithelioid_angiosarcoma_-_very_low_mag.jpg | Epithelioid angiosarcoma - very low mag. (WC/Nephron) | |||
Image:Epithelioid_angiosarcoma_-_intermed_mag.jpg | Epithelioid angiosarcoma - intermed mag. (WC/Nephron) | |||
Image:Epithelioid_angiosarcoma_-_very_high_mag.jpg | Epithelioid angiosarcoma - very high mag. (WC/Nephron) | |||
Image:Epithelioid_angiosarcoma_-_CD31_-_intermed_mag.jpg | Epithelioid angiosarcoma - CD31 - intermed. mag. (WC/Nephron) | |||
</gallery> | |||
==IHC== | |||
*CD34 +ve. | |||
*CD31 +ve. | |||
*FLI-1 +ve.<ref name=pmid15001993>{{Cite journal | last1 = Rossi | first1 = S. | last2 = Orvieto | first2 = E. | last3 = Furlanetto | first3 = A. | last4 = Laurino | first4 = L. | last5 = Ninfo | first5 = V. | last6 = Dei Tos | first6 = AP. | title = Utility of the immunohistochemical detection of FLI-1 expression in round cell and vascular neoplasm using a monoclonal antibody. | journal = Mod Pathol | volume = 17 | issue = 5 | pages = 547-52 | month = May | year = 2004 | doi = 10.1038/modpathol.3800065 | PMID = 15001993 }}</ref> | |||
*D2-40 +ve/-ve.<ref name=pmid11950918>{{Cite journal | last1 = Kahn | first1 = HJ. | last2 = Bailey | first2 = D. | last3 = Marks | first3 = A. | title = Monoclonal antibody D2-40, a new marker of lymphatic endothelium, reacts with Kaposi's sarcoma and a subset of angiosarcomas. | journal = Mod Pathol | volume = 15 | issue = 4 | pages = 434-40 | month = Apr | year = 2002 | doi = 10.1038/modpathol.3880543 | PMID = 11950918 | URL = http://www.nature.com/modpathol/journal/v15/n4/full/3880543a.html }}</ref> | |||
*HHV-8 -ve. | |||
==See also== | |||
*[[Kaposi sarcoma]]. | |||
*[[Vascular tumours]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Vascular tumours]] |
Revision as of 20:13, 9 October 2013
Angiosarcoma is an uncommon malignant vascular tumour.
General
- Malignant tumour - general has a poor prognosis.[1]
Epidemiology:
- May arise secondary to chronic lymphedema related to breast carcinoma.
- Known as Stewart–Treves syndrome.[2]
- Liver angiosarcomas are associated with vinyl chloride exposure.[3]
- Cutaneous angiosarcomas are classically seen on the head and neck of whites over 60 years old.[4]
Microscopic
Features:
- Very many small capillaries of irregular shape lined with:
- Pleomorphic nuclei.
- May have hobnail morphology.
- Pleomorphic nuclei.
- Mitoses.
- Cytoplasmic vacuoles.
- Cells trying to form lumina - embryologic.
Notes:
- Epithelioid variant (with abundant cytoplasm & sheeting architecture) may resemble melanoma or hepatocellular carcinoma.
DDx:
- Atypical vascular lesion.
- Kaposi sarcoma.
- Poorly differentiated carcinoma.
Images
IHC
See also
References
- ↑ Young RJ, Brown NJ, Reed MW, Hughes D, Woll PJ (May 2010). "Angiosarcoma". Lancet Oncol. doi:10.1016/S1470-2045(10)70023-1. PMID 20537949.
- ↑ Pincus, LB.; Fox, LP. (Aug 2008). "Images in clinical medicine. The Stewart-Treves syndrome.". N Engl J Med 359 (9): 950. doi:10.1056/NEJMicm071344. PMID 18753651. http://www.nejm.org/doi/full/10.1056/NEJMicm071344.
- ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 212. ISBN 978-1416054542.
- ↑ Albores-Saavedra, J.; Schwartz, AM.; Henson, DE.; Kostun, L.; Hart, A.; Angeles-Albores, D.; Chablé-Montero, F. (Apr 2011). "Cutaneous angiosarcoma. Analysis of 434 cases from the Surveillance, Epidemiology, and End Results Program, 1973-2007.". Ann Diagn Pathol 15 (2): 93-7. doi:10.1016/j.anndiagpath.2010.07.012. PMID 21190880.
- ↑ Rossi, S.; Orvieto, E.; Furlanetto, A.; Laurino, L.; Ninfo, V.; Dei Tos, AP. (May 2004). "Utility of the immunohistochemical detection of FLI-1 expression in round cell and vascular neoplasm using a monoclonal antibody.". Mod Pathol 17 (5): 547-52. doi:10.1038/modpathol.3800065. PMID 15001993.
- ↑ Kahn, HJ.; Bailey, D.; Marks, A. (Apr 2002). "Monoclonal antibody D2-40, a new marker of lymphatic endothelium, reacts with Kaposi's sarcoma and a subset of angiosarcomas.". Mod Pathol 15 (4): 434-40. doi:10.1038/modpathol.3880543. PMID 11950918.