Zhang Shuhong, Zheng Yuanyuan, Liu Weihua, Yu Xiaomeng
Department of Pathology, Beijing Friendship Hospital, Capital Medical University Beijing, China.
Int J Clin Exp Pathol. 2015 Feb 1;8(2):2153-8. eCollection 2015.
Primary angiosarcoma of the pleura is an extremely rare malignancy. Herein, we report the case of an elderly Chinese patient with primary left pleural epithelioid angiosarcoma. The 76-year-old man presented with a 4-month history of a cough with sputum expectoration and weight loss of 4 kg within one month. A chest scan showed a massive oval-shaped mass in the left pleural cavity. We then performed a left thoracotomy for tumor resection and surgical exploration. Histological examination of the resected specimen showed few viable tumor cells with significant atypia; tumor cells had large nuclei and prominent nucleoli and were arranged in a crack-like, sheeted pattern. Moreover, there was a significant amount of fibrinous exudates, hemorrhage, degeneration, and necrosis. With immunohistochemical analysis, tumor cells had strong expression of CD31, CD34, FLI-1, vimentin. Morphological and immunohistochemical findings supported the diagnosis of epithelioid angiosarcoma.
原发性胸膜血管肉瘤是一种极其罕见的恶性肿瘤。在此，我们报告一例老年中国患者的原发性左胸膜上皮样血管肉瘤病例。该76岁男性患者有4个月咳嗽咳痰病史，且在1个月内体重减轻了4千克。胸部扫描显示左胸腔有一个巨大的椭圆形肿块。随后我们进行了左胸切开术以切除肿瘤并进行手术探查。对切除标本的组织学检查显示，存活的肿瘤细胞很少，且有明显异型性；肿瘤细胞核大，核仁突出，呈裂隙状、片状排列。此外，还有大量纤维蛋白渗出物、出血、变性和坏死。免疫组化分析显示，肿瘤细胞CD31、CD34、FLI-1、波形蛋白呈强表达。形态学和免疫组化结果支持上皮样血管肉瘤的诊断。
