Cytology of angiosarcoma - Findings in fourteen fine-needle aspiration biopsy specimens and one pleural fluid specimen

We report the cytologic features of 15 cases of angiosarcoma from various s ites and include 14 fine-needle aspiration (FNA) biopsy specimens and 1 ple ural fluid specimen. Six were initial diagnoses with histologic confirmatio n; an additional case in the liver was an initial diagnosis without tissue confirmation. One case represented lymph node metastasis from a primary pro static epithelioid angiosarcoma. In 10 cases, immunohistochemical staining for factor VIII-related antigen, CD34, CD31, or Ulex europaeus agglutinin I was performed on the cytology or histology specimen. The aspirates varied in cellularity and the degree of nuclear atypia ranged from relatively blan d in a case of low-grade angiosarcoma of the prostate to highly pleomorphic In a lymph node metastasis from a facial cutaneous angiosarcoma. Vasoforma tive features such as intracellular RBCs, well-formed vessels, attempts at microacinar/lumen formation, and intracytoplasmic lumens were variably pres ent. The background was bloody in all specimens, with necrosis in rare case s. This cytologic series emphasizes that the cytologic features are heterog eneous but that the diagnosis can be suggested by fine-needle aspiration (F NA) when vasoformative features are present. The diagnosis can be made conc lusively by FNA with immunocytochemical confirmation of endothelial differe ntiation.