Cytokeratin-positive epithelioid angiosarcoma presenting in the tonsil: a diagnostic challenge

Agaimy, Abbas; Kirsche, Hanspeter; Semrau, Sabine; Iro, Heinrich; Hartmann, Arndt

doi:10.1016/j.humpath.2011.10.018

Cited by 19 publications

(17 citation statements)

References 17 publications

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“…Because ERG expression is generally retained, even in malignant endothelial cells, ERG is a good diagnostic marker for angiosarcoma and other malignant vascular tumours . Illustrative case reports and small series have supported the diagnostic value of ERG in the differential diagnosis of cutaneous and soft tissue tumours of endothelial origin . A monoclonal antibody generated by the Center of Prostate Disease Research and now made commercially available is an excellent diagnostic reagent .…”

Section: Ten Key Markers For the Diagnosis Of Soft Tissue Tumoursmentioning

confidence: 99%

Immunohistochemistry of soft tissue tumours – review with emphasis on 10 markers

Miettinen

2013

Histopathology

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Immunohistochemistry is an integral component in the proper analysis of soft tissue tumours, and a simple panel of six markers is useful in practical triage: CD34, desmin, epithelial membrane antigen (EMA), keratin cocktail AE1/AE3, S100 protein and alpha smooth muscle actin (SMA). These markers frequently assist in the differential diagnosis of fibroblastic, myoid, nerve sheath and perineurial cell tumours, synovial and epithelioid sarcoma and others. However, they all are multispecific, so that one has to be cognizant of their distribution in normal and neoplastic tissues. Four additional useful markers for specific tumour types are discussed here: CD31 and ERG for vascular endothelial tumours, and KIT and DOG1/Ano-1 for gastrointestinal stromal tumours (GISTs). However, hardly any marker is totally monospecific for any one type of tumour. Furthermore, variably lineage-specific markers do not usually distinguish between benign and malignant proliferations, so that this distinction has to be made on histological grounds. Immunohistochemical evaluation is most useful, efficient and cost-effective when used in the context of careful histological evaluation by an experienced pathologist, aware of all diagnostic entities and their histological spectra. Additional diagnostic steps that must be considered in difficult cases include clinicoradiological correlation and additional sampling of remaining wet tissue, if possible.

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Section: Ten Key Markers For the Diagnosis Of Soft Tissue Tumoursmentioning

confidence: 99%

Immunohistochemistry of soft tissue tumours – review with emphasis on 10 markers

Miettinen

2013

Histopathology

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“…Unlike the conventional appearance, a particular morphological subtype of angiosarcoma, in which the neoplastic endothelial cells have a predominantly epithelioid character, has been termed epithelioid angiosarcoma (EAS) (1). EAS most often arises in the deep soft tissues of the extremities (2), but a variety of primary sites, including the thyroid gland, skin, adrenal glands, gallbladder (3), uterus (4), tonsil (5) and bone, have been reported (6). The pathological features of primary renal EAS have been previously described in a study which used fine-needle aspiration cytology (7).…”

Section: Introductionmentioning

confidence: 99%

Epithelioid angiosarcoma of the kidney: A case report and literature review

Liu¹,

Huang²,

Chen³

et al. 2014

Oncology Letters

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Epithelioid angiosarcoma (EAS) is a rare disease which presents a great diagnostic challenge. The present study reports a case of EAS in the kidney in a 75-year-old male who presented with gross hematuria. An abdominal computed tomography scan revealed space-occupying lesions of the right kidney and renal cell carcinoma was suspected. Histological examination of the resected specimens showed pleomorphic epithelioid cells with vesicular nuclei, prominent nucleoli and eosinophilic cytoplasm that lined irregular vascular spaces. Immunohistochemical staining revealed that the tumor cells were positive for AE1/AE3, cytokeratin (CK) 7, vimentin, cluster of differentiation (CD) 31 and E-cadherin, but showed no staining for CD10, CD34, factor VIII, CK20, carcinoembryonic antigen or desmin. Based on the histopathological and immunohistochemical findings, the patient was diagnosed with epithelioid angiosarcoma. Postoperative radiation therapy was administered and no recurrence was observed six months after surgery.

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“…Les angiosarcomes de la muqueuse buccale peuvent être primitifs ou secondaires [7,8]. Les lésions métastatiques se développent préférentiellement dans les tissus mous, et les récidives sont fréquentes au-delà de 5 ans [6,9]. Dans le cas rapporté, la présence d'une adénopathie secondaire était en faveur d'une atteinte buccale primitive.…”

Section: Commentairesunclassified

“…Dans les formes indifférenciées, le marqueur vasculaire CD31 est utile au diagnostic. D'autres marqueurs moins spécifiques ou sensibles peuvent être utilisés (facteur Willebrand, CD34, lectines) [9]. Les formes épithélioïdes posent le problème du diagnostic différentiel avec les carcinomes épidermoides peu différenciés, d'autant plus qu'il existe une forte expression des cytokératines AE1/AE3 dans l'angiosarcome.…”

Section: Commentairesunclassified

“…Les formes épithélioïdes posent le problème du diagnostic différentiel avec les carcinomes épidermoides peu différenciés, d'autant plus qu'il existe une forte expression des cytokératines AE1/AE3 dans l'angiosarcome. Dans le cas présenté, la mise en évidence de marqueurs vasculaires sur les cellules endothéliales atypiques, isolées ou situées dans des fentes ou des ramifications vasculaires, a permis de poser le diagnostic d'angiosarcome à cellules fusiformes [9]. Le bilan d'extension général a comporté un CT-scan pulmonaire.…”

Section: Commentairesunclassified

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