The spectrum of rare morphological variants of cutaneous epithelioid angiosarcoma

Abstract

Our findings outline the morphological spectrum of cytoplasmic change in cutaneous angiosarcoma. Awareness and a high degree of suspicion in the context of tumours affecting sun-damaged skin of the elderly are necessary to direct appropriate immunohistochemical work-up with inclusion of the endothelial cell markers CD31 and ERG.

Cutaneous angiosarcoma mimicking xanthoma: a challenging histopathologic diagnosis with important consequences

“…As in the previous cases, the authors were able to found areas with typical histopathologic features of angiosarcoma. Finally, two of the six peculiar cases of cutaneous angiosarcoma reported by Wood et al also showed foamy cells. Table lists the main features of previously reported cases of cutaneous angiosarcoma with xanthomatous areas.…”

“…Cutaneous angiosarcoma is a malignant endothelial neoplasm that may be classified into idiopathic, Stewart‐Treves type arising in association with chronic lymphedema, and post‐radiation type . Clinically, cutaneous angiosarcoma often resembles a hematoma or a port wine stain, but this neoplasm usually spreads rapidly to cover large areas of the skin.…”

“…Histopathologically, the entity ranges from well‐differentiated vasoformative cutaneous angiosarcoma to poorly differentiated tumors with spindle or epithelioid neoplastic cells, and in the latter context angiosarcoma may present deceptively in some histopathologic sections and may be overlooked because it may mimic inflammatory processes, carcinoma, melanoma or lymphoma . Moreover, cutaneous angiosarcoma has a broad spectrum of histopathologic appearances, with marked variation even within different areas of the same tumor .…”

Index report of cutaneous angiosarcomas with strong positivity for tyrosinase mimicking melanoma with further evaluation of melanocytic markers in a large angiosarcoma series

“…Cutaneous angiosarcomas with foamy or granular cytoplasm have been reported to show reactivity for CD68 20,21 and CD163. 20 Synaptophysin positivity has been reported in 3 cases including 1 with co-expression of chromogranin A. 22 Interestingly, positivity for CD30 in a poorly differentiated angiosarcoma can raise the possibility of anaplastic large cell lymphoma.…”

“…For example, epithelioid angiosarcomas frequently show positivity for cytokeratin as well as EMA, thus raising the differential diagnosis of carcinoma. Cutaneous angiosarcomas with foamy or granular cytoplasm have been reported to show reactivity for CD68 and CD163 . Synaptophysin positivity has been reported in 3 cases including 1 with co‐expression of chromogranin A .…”