H Li1, H X Li, Y Zhu, Z H Zhang, Q H Fan. 1. Department of Pathology, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China.
Abstract
OBJECTIVE: To investigate the clinicopathologic characteristics of primary angiosarcoma in thyroid. METHODS: Three cases of primary angiosarcoma in thyoid were analyzed by gross examination, light microscopy and immunohistochemical staining, as well as related literatures were reviewed. RESULTS: The patients included 2 males and 1 female. The age of patients ranged from 52 to 78 years. The tumors showed an infiltrating histological pattern. Irregular, anastomosing gaping vascular channels were usually evident, and intravascular papillary fronds were occasionally present. In other areas, tumors featured a solid pattern of growth with cells arranged in sheets and nests with no intervening stroma. The neoplastic cells were epithelioid, spindled or polygonal-shaped with abundant eosinophilic cytoplasm and round, large, vesicular nuclei containing prominent nucleoli. The tumors showed brisk mitotic activity and necrosis. Immunohistochemical study revealed that the tumor cells were positive for CD31, ERG, Fli1, CD34, FⅧRAg and CKpan to different extents. CONCLUSIONS: Primary epithelioid angiosarcoma of the thyroid is a rare, high-grade malignancy that may be misdiagnosed as other malignancies, especially anaplastic thyroid carcinoma. Recognizing its clinicopathologic characters and combined application of specific vascular endothelial immunohistochemical markers is important to avoid confusion with other lesions.
OBJECTIVE: To investigate the clinicopathologic characteristics of primary angiosarcoma in thyroid. METHODS: Three cases of primary angiosarcoma in thyoid were analyzed by gross examination, light microscopy and immunohistochemical staining, as well as related literatures were reviewed. RESULTS: The patients included 2 males and 1 female. The age of patients ranged from 52 to 78 years. The tumors showed an infiltrating histological pattern. Irregular, anastomosing gaping vascular channels were usually evident, and intravascular papillary fronds were occasionally present. In other areas, tumors featured a solid pattern of growth with cells arranged in sheets and nests with no intervening stroma. The neoplastic cells were epithelioid, spindled or polygonal-shaped with abundant eosinophilic cytoplasm and round, large, vesicular nuclei containing prominent nucleoli. The tumors showed brisk mitotic activity and necrosis. Immunohistochemical study revealed that the tumor cells were positive for CD31, ERG, Fli1, CD34, FⅧRAg and CKpan to different extents. CONCLUSIONS:Primary epithelioid angiosarcoma of the thyroid is a rare, high-grade malignancy that may be misdiagnosed as other malignancies, especially anaplastic thyroid carcinoma. Recognizing its clinicopathologic characters and combined application of specific vascular endothelial immunohistochemical markers is important to avoid confusion with other lesions.