Zhang Jiaojiao, Gong Huilin, Wang Yuanyuan, Zhang Guanjun, Hou Peng
Department of Pathology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Key Laboratory for Tumor Precision Medicine of Shaanxi Province and Department of Endocrinology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Pathol Res Pract. 2022 Oct;238:154118. doi: 10.1016/j.prp.2022.154118. Epub 2022 Sep 6.
Visceral angiosarcomas are rare malignant tumors with poor prognosis. The pathogenesis remains unclear. Herein, we describe the morphological, immunohistochemical, and C-MYC status of a series of visceral angiosarcomas. We evaluated the clinicopathologic and C-MYC status of visceral angiosarcomas (n = 12) and compared them to a control series of angiosarcomas arising in cutaneous (n = 15) and soft tissue structures (n = 15). Clinical follow-up data were obtained for all patients and exhibited high metastasis and mortality rates. Malignant endothelial cells displayed a range of morphological features including nonepithelioid, epithelioid, and mixed features, forming vasoformative (n = 6), solid (n = 4) or mixed (n = 2) architectures. Epithelioid morphology was present in 4/12 tumors. Mitoses ranged from 3 to 60 per 10 high-power fields. Necrosis was observed in 10/12 tumors. By immunohistochemistry, all angiosarcomas expressed at least 2 markers of endothelial differentiation, including CD31, CD34, vWF, ERG, and Fli-1. Eight cases of C-MYC amplification and 5 cases of C-MYC translocation were detected. Our data showed that visceral angiosarcoma is more common in women, and the clinical presentations of patient age and tumor size were significantly different between the study and control groups. No significant difference in staining between the visceral angiosarcoma and control groups was observed for endothelial markers, while different C-MYC statuses were detected.
内脏血管肉瘤是一种罕见的恶性肿瘤,预后较差。其发病机制尚不清楚。在此,我们描述了一系列内脏血管肉瘤的形态学、免疫组化及C-MYC状态。我们评估了12例内脏血管肉瘤的临床病理及C-MYC状态,并将其与15例皮肤来源及15例软组织来源的血管肉瘤对照组进行比较。获取了所有患者的临床随访数据,结果显示转移率和死亡率均很高。恶性内皮细胞呈现出一系列形态学特征,包括非上皮样、上皮样及混合特征,形成血管样(6例)、实性(4例)或混合性(2例)结构。4/12的肿瘤中存在上皮样形态。每10个高倍视野下的有丝分裂数为3至60个。10/12的肿瘤中观察到坏死。通过免疫组化,所有血管肉瘤均表达至少2种内皮分化标志物,包括CD31、CD34、vWF、ERG和Fli-1。检测到8例C-MYC扩增和5例C-MYC易位。我们的数据显示,内脏血管肉瘤在女性中更为常见,研究组和对照组患者的年龄及肿瘤大小的临床表现存在显著差异。在内皮标志物方面,内脏血管肉瘤组与对照组之间未观察到染色的显著差异,但检测到不同的C-MYC状态。