Cytologic features of angiosarcoma in fluid specimens: A retrospective study of 22 cases

IF 3.2 3区医学 Q3 ONCOLOGY Cancer Cytopathology Pub Date : 2025-02-24 DOI:10.1002/cncy.70004

Karen Thomas MD, Haley Trinh, Anna Fei, Laila Khazai MD, Hongxia Sun MD, PhD, Qiong (Jenny) Gan MD, PhD

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Abstract

Background

Although histologic and fine-needle aspiration cytologic features of angiosarcoma are well established, little is known about its cytologic features in fluids. This study presents the cytomorphologic features of 22 patients who had angiosarcoma involving pleural, pericardial, ascites, and liver cyst fluids.

Methods

Patient data, including clinical histories, radiology, pathology, treatments, and follow-up, were collected.

Results

Twenty-two angiosarcoma fluid specimens (pleura, n = 17; pericardium, n = 2; ascites, n = 2; and liver cyst, n = 1) were identified. All patients had prior angiosarcoma diagnoses, and 10 (45%) had prior radiation exposure. Cellularity varied, with low cellularity predominant (73%). Cytologic architecture typically consisted of clusters of epithelioid cells (91%), single epithelioid cells (55%), and spindled cells (36%). Malignant nuclear characteristics, such as irregular nuclear membranes, chromatin clumping, and prominent nucleoli, were consistent (100%). Vasoformative features included endothelial wrapping (73%), intracytoplasmic lumina (18%), hemophagocytosis (9%), and intracytoplasmic lumina with cells (5%). Low cellularity samples usually lacked vasoformative features (27%). Prominent nucleoli, often with multiple or club-shaped forms, appeared in all cases (100%). Atypical mitotic figures (45%), associated fibromyxoid material (14%), and possible necrosis (5%) were also observed. The interval between cavity fluid involvement and primary diagnosis averaged 616 days (range, 14–2778 days). The mean time from the first positive fluid to death was 141 days (range, 3–568 days).

Conclusions

Angiosarcoma in fluids is rare. Cytomorphologic features, although nonspecific, include malignant nuclear features, prominent nucleoli, atypical mitoses, and occasional vasoformative features. Accurate diagnosis necessitates a careful review of the patient's history and judicious use of immunohistochemical staining.

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22例液体标本血管肉瘤的细胞学特征回顾性分析

背景：虽然血管肉瘤的组织学和细针穿刺细胞学特征已经确定，但对其在液体中的细胞学特征知之甚少。本研究报告22例血管肉瘤患者的细胞形态学特征，包括胸膜、心包、腹水和肝囊肿液。方法收集患者的临床病史、影像学、病理、治疗及随访资料。结果血管肉瘤液标本22例(胸膜17例；心包，n = 2；腹水，n = 2；肝囊肿，n = 1)。所有患者既往均有血管肉瘤诊断，10例（45%）既往有放射暴露。细胞结构多样，以低细胞结构为主（73%）。细胞学结构通常由上皮样细胞簇（91%）、单个上皮样细胞（55%）和纺锤状细胞（36%）组成。恶性核特征，如不规则核膜，染色质团块，核仁突出，是一致的（100%）。血管形成特征包括内皮包裹（73%）、细胞浆内腔（18%）、噬血细胞（9%）和细胞浆内腔（5%）。低细胞含量样品通常缺乏血管形成特征（27%）。所有病例（100%）均出现核仁突出，常呈多个或棒状。非典型有丝分裂象（45%），相关纤维黏液样物质（14%）和可能的坏死（5%）也被观察到。从腔液受累到初步诊断平均间隔616天（范围14-2778天）。从第一次阳性液体到死亡的平均时间为141天（范围3 ~ 568天）。结论液体血管肉瘤是罕见的。细胞形态学特征，虽然非特异性，包括恶性核特征，核仁突出，非典型有丝分裂和偶尔的血管形成特征。准确的诊断需要仔细回顾患者的病史，并明智地使用免疫组织化学染色。

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来源期刊

Cancer Cytopathology 医学-病理学

CiteScore

7.00

自引率

17.60%

发文量

130

审稿时长

1 months

期刊介绍： Cancer Cytopathology provides a unique forum for interaction and dissemination of original research and educational information relevant to the practice of cytopathology and its related oncologic disciplines. The journal strives to have a positive effect on cancer prevention, early detection, diagnosis, and cure by the publication of high-quality content. The mission of Cancer Cytopathology is to present and inform readers of new applications, technological advances, cutting-edge research, novel applications of molecular techniques, and relevant review articles related to cytopathology.