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Skin - Nonmelanocytic tumors

Vascular tumors

Angiosarcoma


Reviewer: Christopher Hale, M.D. (see Reviewers page)
Revised: 16 July 2012, last major update July 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
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● Also called malignant hemangioendothelioma
● Skin cases are in head and neck of elderly, not young patients, unless also associated with chronic lymphedema or radiotherapy (these lesions are often called lymphangiosarcomas)
● Slow growing but highly aggressive with frequent recurrences that involve extensive areas of face and scalp
● Metastasize to regional lymph nodes, lungs, other organs

Case reports
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● 54 year old woman with “rash” on breast (Proc Bayl Univ Med Center 25;1:70)

Gross description
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● Violet elevated nodules on flat lesion with ill defined margins
● May be verrucoid

Gross images
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Scalp, neck and breast lesions

Micro description
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● Infiltrating, freely anastomosing channels lined by spindled to epithelioid endothelial cells with marked atypia, surrounding adnexae and dissecting dermal collagen
● Intracytoplasmic vacuoles represent lumina
● Also areas resembling Kaposi’s sarcoma and undifferentiated foci resembling melanoma or carcinoma
● May have focal granular cell features
● May extend into scalp aponeurosis

Micro images
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Various images

Electron microscopy description
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● Features of endothelial cells

Positive stains
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● CD31, CD34

Negative stains
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● HHV8

Molecular
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● Not diploid by flow cytometry

Differential diagnosis
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● Epithelioid variants resemble epithelioid hemangioendothelioma or epithelioid hemangioma
● Squamous cell carcinoma
● Epithelioid sarcoma
● Hamartoma of scalp with ectopic meningothelial elements
● Kaposi sarcoma

End of Skin - Nonmelanocytic tumors > Vascular tumors > Angiosarcoma


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