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利用印片细胞学和免疫细胞化学对肺肿瘤大体检查诊断的上皮样血管肉瘤 1 例。

A Case of Epithelioid Angiosarcoma Diagnosed From Gross Examination of a Pulmonary Tumor Utilizing Imprint Cytology and Immunocytochemistry.

机构信息

Department of Diagnostic Pathology, Kanazawa University Hospital, Kanazawa, Japan.

出版信息

Cancer Rep (Hoboken). 2024 Oct;7(10):e70014. doi: 10.1002/cnr2.70014.

DOI:10.1002/cnr2.70014
PMID:39441610
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11498060/
Abstract

BACKGROUND

Angiosarcoma, a very rare malignant tumor constituting 2%-4% of soft tissue sarcomas, manifest in diverse organs including skin, soft tissues, and bones. Histologically, angiosarcoma presents a wide range of morphologies, with epithelioid angiosarcoma (EAS) resemblance to carcinoma. The difficulty arises from the shared epithelial-like morphology and expression of epithelial markers in immunohistochemistry.

CASE

This study reports a case where EAS diagnosis was achieved through a combination of gross findings in a lung resection sample, imprint cytology, and immunocytochemistry. Imprint cytology revealed clusters of epithelioid cells, while immunocytochemistry showed positive results for CD31, ERG, Fli-1, and AE1/AE3, proving instrumental in diagnosing EAS. The described immunocytochemical protocol facilitates prompt diagnosis exclusively through cytology samples.

CONCLUSION

This report emphasizes the potential for diagnosing EAS using cytological specimens, which is especially useful in cases where obtaining tissue samples proves challenging.

摘要

背景

血管肉瘤是一种非常罕见的恶性肿瘤,占软组织肉瘤的 2%-4%,可发生于包括皮肤、软组织和骨骼在内的多种器官。组织学上,血管肉瘤具有广泛的形态学特征,上皮样血管肉瘤(EAS)类似于癌。其诊断难点在于免疫组化中上皮样形态和上皮标志物的表达具有相似性。

病例

本研究报告了一例通过肺切除标本的大体观察、印片细胞学和免疫细胞化学相结合而诊断为 EAS 的病例。印片细胞学显示出上皮样细胞簇,免疫细胞化学显示 CD31、ERG、Fli-1 和 AE1/AE3 阳性,有助于诊断 EAS。所描述的免疫细胞化学方案通过细胞学样本即可实现快速诊断。

结论

本报告强调了使用细胞学标本诊断 EAS 的可能性,这在获取组织标本困难的情况下尤为有用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e4a/11498060/f6f9a3361a45/CNR2-7-e70014-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e4a/11498060/8d1d889544ae/CNR2-7-e70014-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e4a/11498060/418b3bdd8bf4/CNR2-7-e70014-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e4a/11498060/a3a506248ac7/CNR2-7-e70014-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e4a/11498060/f6f9a3361a45/CNR2-7-e70014-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e4a/11498060/8d1d889544ae/CNR2-7-e70014-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e4a/11498060/418b3bdd8bf4/CNR2-7-e70014-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e4a/11498060/a3a506248ac7/CNR2-7-e70014-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6e4a/11498060/f6f9a3361a45/CNR2-7-e70014-g002.jpg

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Adv Anat Pathol. 2022 Nov 1;29(6):389-400. doi: 10.1097/PAP.0000000000000358. Epub 2022 Aug 22.
2
CAMTA-1 Expression in 24 Cases of Hepatic Epithelioid Hemangioendothelioma in a Single Institute: Diagnostic Utility for Differential Diagnosis from Hepatic Angiosarcoma.CAMTA-1 表达在单个研究所的 24 例肝上皮样血管内皮细胞瘤中的应用:与肝血管肉瘤的鉴别诊断的诊断效用。
In Vivo. 2019 Nov-Dec;33(6):2293-2297. doi: 10.21873/invivo.11736.
3
Cytologic features of angiosarcoma: A review of 26 cases diagnosed on FNA.
血管肉瘤的细胞学特征:对26例经细针穿刺抽吸活检确诊病例的回顾
Cancer Cytopathol. 2016 Sep;124(9):659-68. doi: 10.1002/cncy.21726. Epub 2016 Apr 18.
4
Epithelioid angiosarcoma: a clinicopathological study of 16 Chinese cases.上皮样血管肉瘤:16例中国病例的临床病理研究
Int J Clin Exp Pathol. 2015 Apr 1;8(4):3901-9. eCollection 2015.
5
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J Clin Pathol. 2015 Jan;68(1):44-50. doi: 10.1136/jclinpath-2014-202629. Epub 2014 Oct 28.
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Diagn Cytopathol. 2014 Oct;42(10):884-9. doi: 10.1002/dc.23068. Epub 2013 Nov 7.
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Angiosarcoma: a tissue microarray study with diagnostic implications.血管肉瘤:一项具有诊断意义的组织芯片研究
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