A Case of Primary Angiosarcoma of the Lung Presenting as a Hemorrhagic Bronchial Tumor

Seiichi Kakegawa; Osamu Kawashima; Takashi Ibe; Masuo Ujita; Masanori Iwashina; Tetsuhiro Nakano; Kimihiro Shimizu

doi:10.5761/atcs.cr.11.01716

Case Reports

A Case of Primary Angiosarcoma of the Lung Presenting as a Hemorrhagic Bronchial Tumor

Seiichi Kakegawa, Osamu Kawashima, Takashi Ibe, Masuo Ujita, Masanori Iwashina, Tetsuhiro Nakano, Kimihiro Shimizu

Author information

Seiichi Kakegawa
Department of Thoracic Surgery, National Hospital Organization Nishigunma National Hospital, Shibukawa, Gunma, Japan
Osamu Kawashima
Department of Thoracic Surgery, National Hospital Organization Nishigunma National Hospital, Shibukawa, Gunma, Japan
Takashi Ibe
Department of Thoracic Surgery, National Hospital Organization Nishigunma National Hospital, Shibukawa, Gunma, Japan
Masuo Ujita
Department of Radiology, National Hospital Organization Nishigunma National Hospital, Shibukawa, Gunma, Japan
Masanori Iwashina
Department of Clinical Laboratory, National Hospital Organization Nishigunma National Hospital, Shibukawa, Gunma, Japan
Tetsuhiro Nakano
Department of Thoracic and Visceral Organ Surgery, Gunma University, Graduate School of Medicine, Maebashi, Gunma, Japan
Kimihiro Shimizu
Department of Thoracic and Visceral Organ Surgery, Gunma University, Graduate School of Medicine, Maebashi, Gunma, Japan

Keywords: pulmonary angiosarcoma, hemorrhagic bronchial tumor, bronchial arteriography, surgical resection, immunostaining

JOURNAL FREE ACCESS

2012 Volume 18 Issue 4 Pages 347-351

DOI https://doi.org/10.5761/atcs.cr.11.01716

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Abstract

Pulmonary angiosarcomas are usually secondary tumors, and only a few primary cases have been reported. Effective strategies for treating this tumor have not been established, and the prognosis of affected individuals is generally very poor. We report a case of primary angiosarcoma presenting as a hemorrhagic solitary nodule at the bifurcation of the left main bronchus, followed for two years before surgery. Bronchial arteriography revealed a tumor stain sign, and racemose hemangioma of the bronchial artery was excluded. The hemoptysis was not controlled by repeated bronchial artery embolization, and the patient underwent left pneumonectomy with routine mediastinal lymph node dissection. Histopathologically, the excised tissue revealed a highly-cellular growth of atypical spindle cells with a storiform pattern. These atypical cells showed relatively low mitotic activity; the MIB-1 index was 10%. The tumor was diagnosed as a primary angiosarcoma of the lung by the following immunohistological findings: positivity for factor VIII-related antigen and CD31. One year after resection, the patient remains well without signs of recurrence.

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