PMC9376968_01
Morphology and immunohistochemistry result from anastomosing haemangiomas (AH, case 1-3) and angiosarcomas (AS, case 4-6) (x400 magnification). All six cases showed positivity for cyclinD1 and pERK indicating MAPK pathway activation. AHs also showed focal weakly positive for p53 and low MIB-1 positivity, and HIF-1alpha were negative for all three cases. ASs revealed strong, diffuse positivity for p53, significant higher MIB-1 labelling, and multifocal, moderate to strong HIF-1alpha expression.
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F1
Hobnailing of endothelial cells with mild cytologic atypia was also noted (Figure 1 case 1-3). The three angiosarcoma cases (Figure 1 case 4-6), on the contrary, showed bizarre nuclear atypia, infiltrative growth pattern with significant mitosis and tumour necrosis.
Fluorescence in situ hybridization in angiosarcomas ((A): case 4, (B): case 5, (C): case 6) showed of multiple dots for TP53 gene (orange) and chromosome 17 centromere (green) indicating TP53 gene polysomy.
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F2
The three angiosarcoma cases (Figure 1 case 4-6), on the contrary, showed bizarre nuclear atypia, infiltrative growth pattern with significant mitosis and tumour necrosis. To further clarify the difference in p53 expression between AHs and ASs, we carried out a FISH examination which revealed polysomy in all three ASs (Figure 2).
Morphological comparison between anastomosing hemangioma [case 3. (A): x40 magnification. (B): x400 magnification] and angiosarcoma [case 4. (C): x40 magnification. (D): x400 magnification]. Angiosarcoma shows significant cytologic atypia, endothelial cell multilayering and broadly infiltrative pattern.
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F3
The three angiosarcoma cases (Figure 1 case 4-6), on the contrary, showed bizarre nuclear atypia, infiltrative growth pattern with significant mitosis and tumour necrosis.