PMC8565704_01
(A) Gross thyroidectomy specimen including the tumor mass in the left lobe (prior to sectioning). (B) Cut surface of the tumor with solid necrotic areas, cystic degeneration and extensive hemorrhage. The resected infrahyoid muscles are also present (yellow paint).
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Both lobes of the thyroid gland were involved by the tumor along with the isthmus and the infrahyoid muscles (Figure 1).
Microscopical aspect of thyroid angiosarcoma. Vasoformative area of the tumor with large uni- or multinucleated epithelioid tumor cells lining abnormal vascular channels containing papillary fronds (A) or in solid sheets (B). (HE, x200)
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Microscopic examination identified a vasoformative high grade proliferation with large uni- or multinucleated epithelioid cells with prominent eosinophilic nucleoli and abundant eosinophilic cytoplasm lining abnormal vascular channels containing papillary fronds (Figure 2A) or growing in solid sheets (Figure 2B).
Immunohistochemical profile of thyroid angiosarcoma. A: Strong and diffuse membrane positivity for CD31 in solid areas (IHC, anti-CD31 antibody, x200); B: Total negativity for CD34 (IHC, anti-CD34 antibody, x200); C: Total negativity for D2-40 (IHC, anti-D2-40 antibody, x200); D: Positivity for CKAE1/AE3 in vascular channels (IHC, anti-CK AE1/AE3 antibody, x200).
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On immunohistochemistry, among endothelial cell markers, only CD31 showed intense diffuse membrane positivity (Figure 3A). Other two endothelial cell markers (CD34 and D2-40) were negative (Figures 3B and 3C). CK AE1/AE3, an epithelial differentiation marker, was focally positive (Figure 3D).