Vesoulis Z, Cunliffe C
Department of Cytopathology, Summa Health Systems, Akron, Ohio 44304, USA.
Diagn Cytopathol. 2000 Mar;22(3):172-5. doi: 10.1002/(sici)1097-0339(20000301)22:3<172::aid-dc8>3.0.co;2-o.
Angiosarcoma of breast skin and parenchyma is a rarely reported complication of irradiation for breast carcinoma. We report a case of a subareolar epithelioid angiosarcoma arising 8 years subsequent to lumpectomy and irradiation of the ipsilateral breast for infiltrating carcinoma. The epithelioid appearance of the neoplastic cells on fine-needle aspiration biopsy (FNA) biopsy suggested a recurrence of the primary carcinoma. Careful attention to certain cytomorphologic features and cell block immunohistochemistry were useful in the distinction from recurrent carcinoma. Cytologic features that identified this neoplasm as an angiosarcoma included marked cell discohesiveness, elongate cytoplasmic processes or "pseudopodia," heterogeneous cell size, large nucleoli or macronucleoli, and cytoplasmic lumina. Immunohistochemical markers, including Factor VIII antigen, CD31, and CD34, were positive, confirming the vascular nature of the neoplasm. Other markers ruled out morphologically similar neoplasms such as recurrent carcinoma and melanoma. Epithelioid angiosarcoma should be included in the differential diagnosis of a suspected recurrence of breast carcinoma several years postirradiation therapy. Diagn. Cytopathol. 2000;22:172-175.
乳腺皮肤和实质血管肉瘤是一种乳腺癌放疗后很少报道的并发症。我们报告一例乳晕下上皮样血管肉瘤，发生在同侧乳腺因浸润性癌行肿块切除及放疗8年后。细针穿刺活检（FNA）显示肿瘤细胞呈上皮样外观，提示原发性癌复发。仔细关注某些细胞形态学特征及细胞块免疫组化有助于与复发性癌相鉴别。将该肿瘤鉴定为血管肉瘤的细胞特征包括显著的细胞离散性、细长的细胞质突起或“伪足”、细胞大小不均一、大核仁或巨大核仁以及细胞质腔隙。免疫组化标记物，包括第八因子抗原、CD31和CD34呈阳性，证实了肿瘤的血管性质。其他标记物排除了形态学上相似的肿瘤，如复发性癌和黑色素瘤。上皮样血管肉瘤应纳入放疗后数年疑似乳腺癌复发的鉴别诊断中。《诊断细胞病理学》2000年；22:172 - 175。
