Cutaneous angiosarcomas with a starry-sky pattern
Smith, K.J.; Lupton, G.P.; Skelton, H.G.
Archives of Pathology and Laboratory Medicine 121(9): 980-984
1997
ISSN/ISBN: 0003-9985 PMID: 9302932 Document Number: 484034
Objective.- A subgroup of epithelioid angiosarcomas, which we have identified, has a prominent starry-sky histologic pattern. All these neoplasms were evaluated with routine histopathology and with immunohistochemical stains. Clinical follow-up was also obtained to determine whether these angiosarcomas had any other distinctive properties. Design.- Histopathologic features and immunohistochemical stains, including cytokeratin, epithelial membrane antigen, CD34, LCA, factor VIII-related antigen, KP-1, vimentin, HMB-45, and S100 protein were performed on all four neoplasms. Patients.- These angiosarcomas occurred on the extremities of patients with chronic edema as well as on the scalp of elderly patients. Main Outcome.- All patients were dead within 5 years of diagnosis. Of the three patients where angiosarcoma was listed as the cause of death, all were dead within 30 months. Results.- All tumors showed a similar immunohistochemical staining pattern. Vimentin, factor VIII-related antigen, and CD34 were positive in all tumors. The remaining immunohistochemical stains including cytokeratin, which may be positive in other epithelioid angiosarcomas, were negative. Conclusions.- We present a distinctive starry-sky histologic pattern in epithelioid angiosarcomas. Knowledge of this pattern may be important in the early diagnosis of this rapidly fatal neoplasm.