PMC5818931_01
(a) Coronal view of noncontrast CT demonstrating left abdominal wall mass (arrow). (b) Axial view of noncontrast CT demonstrating left abdominal wall mass measuring approximately 7 cm x 5.5 cm (arrow).
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The patient subsequently underwent a noncontrast CT of abdomen and pelvis, which revealed a large abdominal mass measuring 7 cm x 5.5 cm abutting the mid portion of the transverse colon, with numerous metastatic foci in the liver, lymphadenopathy adjacent to the pancreatic head, a large lytic lesion involving the tenth rib, and scattered lytic areas throughout the spine and left iliac wing (Figure 1).
(a) 100x angiosarcoma H&E demonstrating tumor with high cellularity and prominent vascular network. (b) 400x angiosarcoma H&E demonstrating vasculature lined by plump, pleomorphic, endothelial cells. (c) 100x demonstrating CD31 positivity. (d) 100x demonstrating CD34 positivity.
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The liver biopsy delineated a very hypercellular specimen (Figure 2(a)). The tumor was comprised of a prominent vasoformative network (Figure 2(b)). Since the specimen stained for two vascular immunohistochemical stains (CD31 and CD34) in conjunction with pancytokeratin negativity, a diagnosis of angiosarcoma was rendered (Figures 2(c) and 2(d)).
(a) 400x Romanowsky stain demonstrating epithelioid cluster delineating vasoformative features. (b) 630x Romanowsky stain demonstrating vessel and plump hyperchromatic nuclei and intracytoplasmic lumen (arrow). (c) 100x angiosarcoma H&E demonstrating tumor consisting of anastamosing vascular channels and hobnailing nuclei. (d) 400x Romanowsky stain demonstrating malignant spindle cellular cluster.
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The cytology delineated a hypercellular aspirate (Figure 3).