HEPATIC ANGIOSARCOMA - ASPIRATION BIOPSY CYTOLOGY AND IMMUNOCYTOCHEMICAL CONTRIBUTION

In the absence of previously documented sarcoma, the initial diagnosis of angiosarcoma (AS) on file-needle aspiration (FNA) biopsy of the li ver is difficult. However awareness of its occurrence and the assistan ce of immunocytochemical stains may aid in arriving at the correct dia gnosis. In this paper a 59-yr-old smoker and alcoholic woman presented after a syncopal episode and was found to have a palpable right abdom inal mass. An abdominal CT scan confirmed multiple centrally necrotic liver masses, from which an FNA biopsy was obtained The smears were bl oody with groups of relatively dishesive and singly dispersed spindle cells in a somewhat necrotic background. The nuclei were elongated to ovoid-round with small nucleoli. The cytoplasm was ample and ill-defin ed. The cells were reactive for factor VIII-related antigen and CD31 b ut negative for cytokeratin immunocytochemical stains, and a diagnosis of ''suspicious for angiosarcoma'' was entertained. The patient decli ned further studies or treatment bill presented 4 mo Inter with light- headedness and hypoglycemin. Laparoscopic tissue biopsies of the liver /abdominal masses were obtained and revealed AS. Rarely, liver masses may represent AS. Pathologists should be aware of their cytomorphology and characteristic immunostaining to avoid their misinterpretation. ( C) 1998 Wiley-Liss, Inc.