Angiosarcoma in FNA smears: diagnostic accuracy, morphology, immunocytochemistry and differential diagnoses

Abstract

Angiosarcomas are difficult to recognize on FNA smears when they lack the typical dual, spindle and epithelioid cell population and when they occur in internal organs where carcinomas are more common. Very few reliable data are available concerning specificity of CD31 on cytological material.

Cytologic Diagnosis of Intravascular Papillary Endothelial Hyperplasia: A Report of Two Cases and Review of Cytologic Literature

“…In angiosarcoma, aspirate is usually abundant and architectural patterns like pseudoacini, branching pseudopapillary structures, and rosettes can be seen [11]. The presence of admixture of anaplastic spindled and epithelioid tumor cells, mitotic figures, necrosis, erytrophagocytosis, and hemosiderin in tumor cells helps to clinch a diagnoses of angiosarcoma.…”

A Case of Metastatic Angiosarcoma Diagnosed by Liquid-Based Preparation: Peculiar Cytoplasmic Changes

“…However, this feature was a very focal finding, and therefore diligent search was required. Although the vasoformative features of angiosarcoma in cytology is characterized by variable arrangements such as microacinar lumen formation, pseudorosette formation, intracytoplasmic lumens/vacuoles, and a signet-ring cell-like feature, almost all angiosarcomas by CP tend to present with many dissociated cells with only a few vasoformative features, or even without them in some cases 2,3,4. In our case by LBP, a few microacinar lumenal formations and occasional intracytoplasmic vacuoles were also identified.…”

“…When angiosarcoma is predominantly or exclusively composed of large, rounded, so-called epithelioid cells, it can be classified as an epithelioid angiosarcoma variant. According to Pohar-Marinsek and Lamovec2 epithelioid angiosarcoma can be classified into the following three subgroups by CP: pleomorphic, carcinoma-like, and benign in appearance. The first pleomorphic subgroup has large tumor cells with large, hyperchromatic nuclei, coarse chromatin, and small to prominent nucleoli.…”

“…The reported cytopathologic findings of angiosarcoma, particularly those with epithelioid features by CP are variable nuclear atypia, intracellular red blood cells (RBCs), bloody background and vasoformative features such as intracytoplasmic lumen, microacinar arrangement or well-formed vessels 2,3. However, there have only been a few reports on LBP,4 and the cytopathologic findings by LBP are required for the correct diagnosis.…”

Needle biopsy of mesenchymal lesions of the head and neck: Evolving concepts and new strategies for diagnosis

“…The cytologic features of AS are rather nonspecific but are consistent with a high-grade sarcoma. 65 Cell morphology may be either spindled or epithelioid but is most often obviously malignant (Fig. 7C).…”