Difference between revisions of "Angiosarcoma"
Jump to navigation
Jump to search
(tweak) |
|||
| Line 10: | Line 10: | ||
| IHC = CD31 +ve, FLI-1 +ve, CD34 +ve, HHV-8 -ve | | IHC = CD31 +ve, FLI-1 +ve, CD34 +ve, HHV-8 -ve | ||
| EM = | | EM = | ||
| Molecular = | | Molecular = +/-MYC amplification | ||
| IF = | | IF = | ||
| Gross = red lesion{{fact}} | | Gross = red lesion{{fact}} | ||
| Line 73: | Line 73: | ||
*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> | *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. | *HHV-8 -ve. | ||
==Molecular== | |||
*Amplification of MYC<ref name=pmid25374893>{{Cite journal | last1 = Kurisetty | first1 = V. | last2 = Bryan | first2 = BA. | title = Aberrations in Angiogenic Signaling and MYC Amplifications are Distinguishing Features of Angiosarcoma. | journal = Angiol Open Access | volume = 1 | issue = | pages = | month = Apr | year = 2013 | doi = 10.4172/2329-9495.1000102 | PMID = 25374893 }}</ref> - esp. in secondary angiosarcoma.<ref name=pmid24983371>{{Cite journal | last1 = Styring | first1 = E. | last2 = Seinen | first2 = J. | last3 = Dominguez-Valentin | first3 = M. | last4 = Domanski | first4 = HA. | last5 = Jönsson | first5 = M. | last6 = von Steyern | first6 = FV. | last7 = Hoekstra | first7 = HJ. | last8 = Suurmeijer | first8 = AJ. | last9 = Nilbert | first9 = M. | title = Key roles for MYC, KIT and RET signaling in secondary angiosarcomas. | journal = Br J Cancer | volume = 111 | issue = 2 | pages = 407-12 | month = Jul | year = 2014 | doi = 10.1038/bjc.2014.359 | PMID = 24983371 }}</ref> | |||
==See also== | ==See also== | ||
Revision as of 06:12, 9 November 2014
| Angiosarcoma | |
|---|---|
| Diagnosis in short | |
 Epithelioid angiosarcoma. H&E stain. | |
|
| |
| LM | atypical cells - usu. spindle cells, occasionally epithelioid; vascular differentiation (abundant capillaries - "red" at low power, +/-cytoplasmic vacuolization, +/-hobnail endothelial cells) |
| LM DDx | Kaposi sarcoma, other vascular tumours |
| IHC | CD31 +ve, FLI-1 +ve, CD34 +ve, HHV-8 -ve |
| Molecular | +/-MYC amplification |
| Gross | red lesion[citation needed] |
| Site | skin, head and neck, elsewhere |
|
| |
| Syndromes | Stewart–Treves syndrome |
|
| |
| Clinical history | +/-chronic lymphedema, vinyl chloride exposure (liver angiosarcoma) |
| Prevalence | uncommon |
| Prognosis | poor |
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:
- Spindle cell lesion.
- Occasionally an epithelioid lesion.
- Very many small capillaries of irregular shape lined with:
- Pleomorphic nuclei - important.
- May have hobnail morphology.
- Usually "red" at low power - due to many RBCs - important.
- Pleomorphic nuclei - important.
- 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
Epithelioid angiosarcoma - very low mag. (WC/Nephron)
Epithelioid angiosarcoma - intermed mag. (WC/Nephron)
Epithelioid angiosarcoma - very high mag. (WC/Nephron)
Epithelioid angiosarcoma - CD31 - intermed. mag. (WC/Nephron)
IHC
Molecular
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.
- ↑ Kurisetty, V.; Bryan, BA. (Apr 2013). "Aberrations in Angiogenic Signaling and MYC Amplifications are Distinguishing Features of Angiosarcoma.". Angiol Open Access 1. doi:10.4172/2329-9495.1000102. PMID 25374893.
- ↑ Styring, E.; Seinen, J.; Dominguez-Valentin, M.; Domanski, HA.; Jönsson, M.; von Steyern, FV.; Hoekstra, HJ.; Suurmeijer, AJ. et al. (Jul 2014). "Key roles for MYC, KIT and RET signaling in secondary angiosarcomas.". Br J Cancer 111 (2): 407-12. doi:10.1038/bjc.2014.359. PMID 24983371.