Multifocal epithelioid angiosarcoma of bone: a potential pitfall in the differential diagnosis with metastatic carcinoma.
A case of multifocal epithelioid angiosarcoma of the femur, tibia, fibula, and astragalus in a 54-year-old man is reported. The tumor was composed of nests and cords of malignant cells with epithelioid morphology, with foci of vascular differentiation, necrosis, and hemorrhage. By immunohistochemistry, the neoplastic cells showed positivity for endothelial cell markers (CD31, CD34, factor VIII-related antigen, and Ulex europaeus agglutinin I), epithelial markers (cytokeratins and epithelial membrane antigen), and vimentin. The authors' findings point out the need for a panel of antibodies for the careful search of histologic features of vascular differentiation to correctly diagnose vascular bone tumors with epithelioid features, especially in evaluating small core biopsy specimens in which a sheetlike rather than obviously vasoformative architecture may lead to an erroneous diagnosis of metastatic carcinoma.
Santeusanio
Giuseppe
G
Dipartimento di Biopatologia e Diagnostica per Immagini, Sezione di Anatomia Patologica, Università degli Studi di Roma Tor Vergata, Via Montepellier 1, 00133 Rome, Italy. santeusanio@med.uniroma2.it
Bombonati
Alessandro
A
Tarantino
Umberto
U
Craboledda
Paolo
P
Marino
Bonaventura
B
Birbe
Ruth
R
Ortenzi
Angela
A
Villaschi
Sergio
S
D015415:Biomarkers / Q000032:analysis; D003937:Diagnosis, Differential; D004730:Endothelium, Vascular / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology*; D006394:Hemangiosarcoma / Q000737:chemistry / Q000175:diagnosis / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000175:diagnosis / Q000473:pathology; D014746:Vimentin / Q000032:analysis
D015415:Biomarkers; D014746:Vimentin