Fine needle aspiration of metastatic epithelioid angiosarcoma: a report of 2 cases.
BACKGROUND
Epithelioid angiosarcomas (EAs) are uncommon mesenchymal tumors occurring in the thyroid, deep-seated soft tissues, parenchymal organs and, more rarely, superficial soft tissues of the head and neck. Due to their cytologic and immunocytochemical presentation on fine needle aspiration cytology (FNAC) samples, these neoplasms may closely mimic a number of different tumors, potentially causing an erroneous cytopathologic diagnosis unless immunophenotypical markers of vascular differentiation are sought in the cellular material.


METHODS
A 68-year-old man with a 1-year history of total thyroidectomy for EA presented with a suspicious right neck node and underwent FNA. A 63-year-old woman with a history of recurring multiple scalp nodules diagnosed as EA ultimately developed small multiple, bilateral lymph nodes in the neck and underwent FNA. In both cases a cytopathologic diagnosis of metastatic EA was made.


CONCLUSIONS
The cytopathologic diagnosis of EA is a challenge. Knowledge of the clinical history is of great help in diagnosing metastatic lesions. The cytopathologicpicture of metastases is a useful way for cytopathologists to gain confidence with presentaton of this rare entity in primary sites on FNAC samples. Cytopathologic hints of vascular differentiation should be sought in the cytopathologic material when a diagnosis of EA is entertained.
Fulciniti
Franco
F
Cytopathology Service, Section of Pathology, Department of Surgery, National Cancer Center, Fondazione G. Pascale, Naples. franco.fulciniti@gmail.com
Di Mattia
Diana
D
Bove
Patrizia
P
Mastro
Angelo Antonio
AA
De Chiara
Annarosaria
A
Botti
Gerardo
G
Petrillo
Antonella
A
Apice
Gaetano
G
D000368:Aged; D044963:Biopsy, Fine-Needle; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006394:Hemangiosarcoma / Q000175:diagnosis* / Q000556:secondary; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged