epithelioid angiosarcoma
Epithelioid angiosarcoma may have a broad morphological spectrum, raising interpretive challenges on microscopy.
Localization
cutaneous epithelioid angiosarcoma
Microscopically
packed polygonal cells with focal evidence of endothelial differentiation
+/- syncytial growth of large cells with clear nuclei and prominent nucleoli,
+/- discohesive plasmacytoid polygonal cells with abundant bright eosinophilic cytoplasm
+/- sheets of clear cells with coarse granular cytoplasm
trabecular and cord arrangement of tumor cells
+/- pseudoglandular appearance owing to clear cell tubular arrangement with open lumina
Differential diagnosis
lymphoma
melanoma
lymphoepithelioma-like carcinoma
adnexal carcinoma
neuroendocrine carcinoma
Immunochemistry
positivity for CD31 and CD34;
no immunoreactivity for other antigens including cytokeratins, S100 protein, melanocytic antigens, leukocyte common antigen, and desmin.
Therapeutics
local excision
chemotherapy
radiotherapy
Variants
epithelioid angiosarcoma arising in a deep-seated plexiform schwannoma (#17574948#)
See also
angiosarcomas
References
Epithelioid angiosarcoma of the skin: a study of 18 cases with emphasis on its clinicopathologic spectrum and unusual morphologic features. Bacchi CE, Silva TR, Zambrano E, Plaza J, Suster S, Luzar B, Lamovec J, Pizzolitto S, Falconieri G. Am J Surg Pathol. 2010 Sep;34(9):1334-43. PMID: #20697249#
Epithelioid angiosarcoma arising in a deep-seated plexiform schwannoma: a case report and literature review. Lee FY, Wen MC, Wang J. Hum Pathol. 2007 Jul;38(7):1096-101. PMID: #17574948#