Jeon Yoon Kyung, Kim Hwal Woong, Choi Hyun Joo, Park In Ae
Department of Pathology, Seoul National University Hospital and Clinical Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea.
Acta Cytol. 2004 Mar-Apr;48(2):223-8. doi: 10.1159/000326321.
Angiosarcoma, because of its rarity and histologic diversity, has been a persistent challenge to cytopathologists. Epithelioid angiosarcomas are often confused with carcinomas, melanomas and other epithelioid sarcomas, both cytologically and histologically. Here we report the cytopathologic features of a case of epithelioid angiosarcoma with prominent nuclear grooves.
A 61-year-old male visited the hospital with a neck mass. On fine needle aspiration the hypercellular smear, with a lymphocytic bloody background, showed variable-sized, round to oval, pleomorphic cells with frequent nuclear grooves, indentations and plump cytoplasm. The cells were diffusely scattered or loosely aggregated, with occasional acinar and cell-in-cell configuration. The case was diagnosed as epithelioid angiosarcoma on excisional biopsy.
Whenever fine needle aspiration cytology, especially in the head and neck area, suggests malignancy composed predominantly of epithelioid cells, epithelioid angiosarcoma should be considered. The differential diagnosis should include metastatic tumors, such as carcinoma, melanoma and primary sarcoma. Nuclear grooves and indentations are 1 of the important diagnostic features of epithelioid angiosarcoma.
血管肉瘤因其罕见性和组织学多样性，一直是细胞病理学家面临的持续挑战。上皮样血管肉瘤在细胞学和组织学上常与癌、黑色素瘤及其他上皮样肉瘤相混淆。在此，我们报告一例具有显著核沟的上皮样血管肉瘤的细胞病理学特征。
一名61岁男性因颈部肿块就诊。细针穿刺涂片显示细胞丰富，伴有淋巴细胞血性背景，可见大小不一、圆形至椭圆形、多形性细胞，有频繁的核沟、凹陷及丰富的细胞质。细胞呈弥漫性散在或松散聚集，偶尔可见腺泡状和细胞内细胞结构。切除活检诊断为上皮样血管肉瘤。
无论何时细针穿刺细胞学检查提示主要由上皮样细胞组成的恶性肿瘤，尤其是在头颈部区域，都应考虑上皮样血管肉瘤。鉴别诊断应包括转移性肿瘤，如癌、黑色素瘤和原发性肉瘤。核沟和凹陷是上皮样血管肉瘤的重要诊断特征之一。
