A Case of Epithelioid Angiosarcoma Diagnosed From Gross Examination of a Pulmonary Tumor Utilizing Imprint Cytology and Immunocytochemistry

Cancer Rep (Hoboken). 2024 Oct;7(10):e70014. doi: 10.1002/cnr2.70014.

Abstract

Background: Angiosarcoma, a very rare malignant tumor constituting 2%-4% of soft tissue sarcomas, manifest in diverse organs including skin, soft tissues, and bones. Histologically, angiosarcoma presents a wide range of morphologies, with epithelioid angiosarcoma (EAS) resemblance to carcinoma. The difficulty arises from the shared epithelial-like morphology and expression of epithelial markers in immunohistochemistry.

Case: This study reports a case where EAS diagnosis was achieved through a combination of gross findings in a lung resection sample, imprint cytology, and immunocytochemistry. Imprint cytology revealed clusters of epithelioid cells, while immunocytochemistry showed positive results for CD31, ERG, Fli-1, and AE1/AE3, proving instrumental in diagnosing EAS. The described immunocytochemical protocol facilitates prompt diagnosis exclusively through cytology samples.

Conclusion: This report emphasizes the potential for diagnosing EAS using cytological specimens, which is especially useful in cases where obtaining tissue samples proves challenging.

Keywords: angiosarcoma; cytopathology; epithelioid; immunocytochemistry; touch‐imprint.

Publication types

  • Case Reports

MeSH terms

  • Biomarkers, Tumor* / analysis
  • Biomarkers, Tumor* / metabolism
  • Cytodiagnosis / methods
  • Epithelioid Cells / pathology
  • Female
  • Hemangiosarcoma* / diagnosis
  • Hemangiosarcoma* / pathology
  • Humans
  • Immunohistochemistry*
  • Lung Neoplasms* / diagnosis
  • Lung Neoplasms* / pathology
  • Male
  • Proto-Oncogene Protein c-fli-1
  • Transcriptional Regulator ERG / analysis
  • Transcriptional Regulator ERG / metabolism

Substances

  • Biomarkers, Tumor
  • Proto-Oncogene Protein c-fli-1
  • Transcriptional Regulator ERG
  • ERG protein, human