Department of Pathology and Laboratory Medicine, Hartford Hospital, Connecticut 06102-8000, USA.
Arch Pathol Lab Med. 2011 Feb;135(2):268-72. doi: 10.5858/135.2.268.
Epithelioid angiosarcoma is a highly aggressive endothelial cell malignancy, most commonly arising in the deep soft tissues, but a variety of primary sites, including the adrenals, thyroid, skin, and bone, are encountered. On hematoxylin-eosin-stained sections, the pathologist encounters sheets of large, mildly to moderately pleomorphic epithelioid cells, with abundant eosinophilic cytoplasm, vesicular nuclei, and prominent nucleoli. Obvious vasoformative foci may not be present, creating confusion with metastatic carcinomas, malignant mesothelioma, melanoma, anaplastic lymphoma, epithelioid peripheral nerve sheath malignancies, and epithelioid sarcoma. Moreover, malignancies with apparent vascular differentiation must be distinguished from less aggressive vascular neoplasms, including epithelioid hemangioendothelioma. Given the range of clinical presentation, the diversity of primary sites, and the nonspecific initial histopathologic appearance, here we review the histologic findings and immunohistochemical profiles of epithelioid angiosarcoma and neoplasms in its differential diagnosis.
上皮样血管肉瘤是一种高度侵袭性的内皮细胞恶性肿瘤，最常发生于深部软组织，但也可见于各种原发部位，包括肾上腺、甲状腺、皮肤和骨骼。在苏木精-伊红染色切片中，病理学家会遇到大片轻度至中度多形性上皮样细胞，细胞胞质丰富嗜酸性，细胞核泡状，核仁明显。可能不存在明显的血管形成灶，这会与转移性癌、恶性间皮瘤、黑色素瘤、间变性淋巴瘤、上皮样外周神经鞘恶性肿瘤和上皮样肉瘤混淆。此外，具有明显血管分化的恶性肿瘤必须与侵袭性较低的血管肿瘤区分开来，包括上皮样血管内皮细胞瘤。鉴于临床表现的范围、原发部位的多样性以及初始组织病理学表现的非特异性，在此我们回顾上皮样血管肉瘤及其鉴别诊断中的肿瘤的组织学发现和免疫组织化学特征。
