Needle aspiration cytology and lmmunocytochemical study in a case of angiosarcoma of the breast

Abstract

A case of angiosarcoma of breast diagnosed by needle aspiration cytology (NAC) is documented. The significant features which enabled the NAC diagnosis included presence of spindly to polygonal malignant endothelial lining cells appearing as papillary tufts merging with solid areas, branching effects, and presence of microacinar structures lined with abnormal spindly to polygonal cells indicative of vasoformative structures. Immunostaining for factor VIII and vimentin was strongly positive in the malignant spindly polygonal endothelial cells and further supported the NAC diagnosis. Similar findings were also seen in sections of cell blocks from aspirate and excised biopsy tissue from the breast tumor in hematoxylin-eosin stained sections and on immunostaining. Despite the rarity of occurrence of angiosarcoma in the breast it was felt that its cytologic diagnosis is possible especially in cases in which the lesion is extensive because of a good chance of getting a cellular sample on aspiration. This can be of considerable value for deciding an appropriate management and as a possible guide to prognosis.

Fine Needle Aspiration Cytodiagnosis of Leiomyosarcoma of the Breast

“…13,30 In malignant fibrous histiocytoma of the breast, apart from spindle cells, pleomorphic giant cells are usually found, 26,29 and in angiosarcoma, papillary clusters, spindle cells and microacini reflecting vasoformation are said to be characteristic features for diagnosis. 14,20,29 Hemangiopericytomas of the breast consist of oval and spindle-shaped cells with irregular contours, lobulation and occasional perithelial arrangement, similar to their counterpart in the head and neck. 1 In fibromatosis of the breast, spindle-shaped cells with enlarged, ovoid and elongated nuclei with minimal atypia have been described 31 and may rarely result in diagnostic confusion.…”

Angiosarcoma of the Breast

“…The significant features which enabled the NAC diag nosis included presence of spindly to polygonal malignant endothelial lining cells appearing as papillary tufts merging with solid areas, branching effects, and presence of microacinar structures lined with abnormal spindly to polygonal cells indicative of vasoformative structures. Immunostaging for fac tor VIII and vimentin was strongly positive in the malignant spindly polygonal endothelial cells and further supported the NAC diagnosis [13]. Four patients from the study of Salvadori et al [12] underwent NAC and in 3 of them malignant cells of Fig.…”

“…The role of MR breast imaging for the diag nosis for angiosarcoma of the breast remains to be explored. Gupta et al [13] described in their report a case of angiosarco ma of the breast diagnosed by needle aspiration cytology (NAC). The significant features which enabled the NAC diag nosis included presence of spindly to polygonal malignant endothelial lining cells appearing as papillary tufts merging with solid areas, branching effects, and presence of microacinar structures lined with abnormal spindly to polygonal cells indicative of vasoformative structures.…”

Cytologic Evaluation of Primary Malignant Vascular Tumors of the Liver

“…[7][8][9] There is no more than a brief case report about FNA of hepatic EH. 10 FNA cytologic characterization of angiosarcoma has been described as variable findings, such as papillary clusters lacking cohesion at the periphery, 1 a branching, papillary pattern with occasional microacinar pattern [2][3][4] and small clusters composed …”

“…In the neighborhood of each syncytium many polymorphonuclear cells were frequently lodged; they were also identified in the biopsy. The shape of tumor cells in AS has been described predominantly as spindle [2][3][4]6 and sometimes polygonal 3 or oval. [5][6] The tumor cells in our case were predominantly oval or spindle.…”