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Bladder
Other tumors
Angiosarcoma
Author: Nat Pernick, M.D. (see Authors page)
Revised: 21 December 2009, last major update - December 2009
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Rare vascular tumor with anastomosing vascular channels
● Endothelial cells usually exhibit marked cytologic atypia
Terminology
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Epidemiology
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● Mean age 64 years, 89% occur in males
Sites
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Etiology
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● Due to radiation therapy for pelvic malignancy in 1/3; also exposure to arsenic, thorium dioxide, polyvinyl chloride or chemotherapeutic agents
Clinical features
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● Patients typically present with hematuria
● Traditionally considered to have a poor prognosis, but see Arch Pathol Lab Med 2006;130:1543
Prognostic factors
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Case reports
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● Survival 6 years after initial presentation (Urology 2007;69:575.e9)
Treatment
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Clinical images
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Gross description (Macroscopy)
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● Hemorrhagic, raised masses (mean 7 cm) of trigone or dome
Gross images
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Micro description (Histopathology)
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● Anastomosing channels lined by plump hyperchromatic cells
● Also solid growth and epithelioid cytology
● Typically invades the muscularis propria (Am J Surg Pathol 2008;32:1213)
Micro images
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Endothelial cells have marked atypia with prominent nucleoli
Cytology description
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Cytology images
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Positive stains
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● CD31, CD34
Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● Hemangioma: typically 1 cm or less, 80% are cavernous, no atypia, no anastomosing or solid areas
● Kaposi’s sarcoma: associated with HIV and HHV8; extravasated red blood cells present; usually less atypia than angiosarcoma
Additional references
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End of Bladder > Other tumors > Angiosarcoma
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