Faculty Collaboration Database

Lymphatic-type "Angiosarcoma" With Prominent Lymphocytic Infiltrate. Am J Surg Pathol 2020 Feb;44(2):271-279

Date

11/07/2019

Pubmed ID

31688141

DOI

10.1097/PAS.0000000000001398

Scopus ID

2-s2.0-85074572550 (requires institutional sign-in at Scopus site)   7 Citations

Abstract

We report 21 cases of a distinctive and unique vascular tumor which we propose to be a pure lymphatic-type angiosarcoma characterized by architectural and growth characteristics of angiosarcoma, cytologic, and immunohistochemical features of lymphatic differentiation, a prominent lymphocytic infiltrate, and variable nuclear grade. Patients included 12 males and 9 females with a median age of 65 years (range: 32 to 95 y). Tumors involved the head and neck (n=11), lower extremities (n=5), trunk (n=4), and upper extremity (n=1) and were located superficially in the dermis and/or subcutis. Tumors were designated "low grade" (n=10) when the nuclear grade was low, and vascular channel formation was evident throughout but with multilayering of endothelium within the vessels. Cases were designated "high grade" (n=11) when nuclei appeared higher grade with more rounded contours and prominent nucleoli and when solid areas predominated over vascular channel formation. A striking feature of both groups was the presence of a dense, lymphocytic infiltrate with occasional germinal center formation. All cases strongly and diffusely expressed at least 1 lymphatic marker (21/21) with podoplanin (17/19) and Prox-1 (11/11) more commonly expressed than LYVE-1 (5/10). No consistent molecular alteration was identified. Follow-up on 17 patients (median: 41 mo, mean: 54 mo) showed 10 patients were alive without disease, 5 were alive with disease, 1 died of other cause, and 1 died of disease. Local recurrence developed in 9 cases and metastasis in 2 cases, although neither correlated with grade as defined. On the basis of clinical follow-up to date, the natural history of lymphatic-type angiosarcoma appears to be more favorable than other forms of cutaneous angiosarcoma.

Author List

Martinez AP, Zapata M, North PE, Folpe AL, Weiss SW

Author

Paula E. North MD, PhD Professor in the Pathology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Biomarkers, Tumor
Female
Follow-Up Studies
Hemangioendothelioma
Hemangiosarcoma
Humans
Lymphangiosarcoma
Lymphatic Vessels
Lymphocytes
Male
Middle Aged
Prognosis
Skin Neoplasms
Soft Tissue Neoplasms
Survival Analysis