[Post-radiation atypical vascular lesions and angiosarcoma: 11 cases].
BACKGROUND
Post-radiation atypical vascular lesions of the skin display clinical and morphological overlap with well-differentiated angiosarcomas, and correct diagnosis may be difficult.


METHODS
We studied clinical, histological and immuno-histochemical aspects (CD31, CD34, D2-40 and VEGFR-3) of eight post-radiation atypical vascular lesions comparatively with three post-radiation angiosarcomas.


RESULTS
All patients were female and received radiation therapy for breast carcinoma. On average, atypical vascular lesions occurred 4.3 years after radiation therapy and presented as small papulonodules or erythematous plaques. The clinical course after simple excision was benign. Histologically, they were relatively circumscribed lesions and showed slit-like vessels dissecting dermal collagen in all cases. On average, angiosarcomas occurred 5 years after radiation therapy and presented as more extensive lesions with a more aggressive clinical course. The lesions showed histological overlap with atypical vascular lesions, but were poorly circumscribed, with deeper invasion, cytological atypia and mitosis. Although the immuno-histochemical profiles were similar, expression of VEGFR-3 was greater in two cases of angiosarcoma.


CONCLUSIONS
Post-radiation atypical vascular lesions are benign lesions that display clinical, histological and immuno-phenotypic overlap with well-differentiated angiosarcoma, and diagnosis requires good clinicopathological correlation. VEGFR-3 may be useful for differential diagnosis, as well as amplification of the MYC gene.
Service d'anatomie et cytologie pathologiques, université Paris-Descartes, hôpital Cochin, Assistance publique-Hôpitaux de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France. r.karkouche@gmail.com
R
R
Karkouche
A
A
Carbonnelle-Puscian
J
J
Rivet
S
S
Fraitag
I
I
Moulonguet
A
A
Carlotti
S
S
Havard
O
O
Vérola
B
B
Cavelier-Balloy
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006394:Hemangiosarcoma / Q000209:etiology* / Q000473:pathology*; D006801:Humans; D009381:Neoplasms, Radiation-Induced / Q000473:pathology*; D011832:Radiation Injuries / Q000473:pathology*; D017445:Skin Diseases, Vascular / Q000209:etiology*; D012878:Skin Neoplasms / Q000209:etiology* / Q000473:pathology*