Cytologic findings of malignant vascular neoplasms: A study of twenty‐four cases

Abstract

Cytologic characterization of malignant vascular neoplasms (MVN) is difficult due to the wide range of differential diagnoses and sampling errors. The objective of this study was to identify criteria helpful in the cytologic diagnosis of MVN. The clinical presentation and cytomorphologic features of 22 angiosarcomas and two hemangioendotheliomas were analyzed. The criteria evaluated included cellularity, cellular arrangement, cell shape and size, pleomorphism, cytoplasmic borders, nuclear shape and number, chromatin pattern, nucleoli, background, and presence of angioformative structures. A previous history of MVN was noted in 18 of 24 patients. Specimens with epithelioid morphology were more cellular and pleomorphic and contained multinucleated cells. Specimens with spindle morphology were usually less cellular and less pleomorphic. Angioformative structures were identified in 11 of 24 cases. Awareness of features suggestive of MVN is necessary to raise the possibility of vascular origin, which can be confirmed with appropriate immunocytochemical studies.

Binucleated HeLa cells are formed by cytokinesis failure in starvation and keep the potential of proliferation

“…In normal tissues, such as liver parenchyma, a relationship between binucleated cells and cell survival was reported (Morizur et al 2010). Many cytological studies have found elevated numbers of binucleated cells in various tumors (Bollmann et al 2005;Kimura et al 2009;Minimo et al 2002;Morin et al 2000;Stelow et al 2006;Stoll et al 2011). However, binucleated cells are observed in not only malignant tumors but also normal tissues (Mizoguchi and Ishikawa 1994;Morizur et al 2010).…”

“…Many cytological studies have reported that the numbers of binucleated cells were elevated in various tumors, including malignant mesothelioma, pancreatic endocrine tumor, cervical squamous lesion, angiosarcoma, and acute myeloid leukemia (Bollmann et al 2005;Kimura et al 2009;Minimo et al 2002;Morin et al 2000;Stelow et al 2006;Stoll et al 2011). However, binucleated cells are observed in not only malignant tumors but also normal tissues such as those of the heart, muscle cells, platelet progenitor-megakaryocytes, liver parenchyma, and bladder (Mizoguchi and Ishikawa 1994;Morizur et al 2010).…”

Pulmonary Metastasis of a Postradiation Breast Epithelioid Angiosarcoma Mimicking Adenocarcinoma

“…[6][7][8] Necrosis in the background is unusual. 8 Typically, the lesional cells of AS are spindle or ovoid, exhibit noticeable atypia, may have intracytoplasmic lumens with or without red blood cells and show microacinar formation.…”

“…However, these features are not consistently found in every tumor, making these cytologic characteristics insufficient for a definitive diagnosis. [6][7][8] EAS presents as round to polygonal cells with eosinophilic cytoplasm that may be mistaken in both cytologic and histologic biopsies for carcinoma, melanoma, mesothelioma, lymphoma and other mesenchymal tumors with epithelial differentiation, including epithelioid sarcoma, synovial sarcoma and malignant peripheral nerve sheath tumor (MPNST). [9][10][11][12][13][14][15]20 In the 3 histologically confirmed cases of EAS described by Boucher et al, 7 the neoplastic cells were round, ovoid or polygonal, with variable nuclear pleomorphism and nucleolar prominence.…”

“…Aspiration biopsy findings of AS have been well described based on series of cases and a number of single case reports. [4][5][6][7][8][9][10][11][12][13][14] A recognized variant of AS is composed of epithelial-looking cellular components designated epithelioid angiosarcoma (EAS). 15 Very few cases of EAS have been described as originating in the breast, 11,[16][17][18][19] and cytologically evaluated cases of EAS are infrequently reported.…”