Abstract
Background : Uterine angiosarcoma is a very rare disease and the endometrial and pleural fluid cytological features of this disease have not yet been clearly elucidated. Described herein is a reported case of metastatic uterine angiosarcoma to the pleura with its cytopathological features.
Case : A 62-year-old postmenopausal woman was found to have uterine endometrial thickening. The endometrial cytology and biopsy indicated a malignant spindle cell neoplasm, and total hysterectomy was performed. Histologic examination of the resected uterine specimen showed a malignant tumor composed of irregular rudimentary vascular channels and solid small nests. The tumor cells were spindle-shaped or epithelioid, and were immunohistochemically positive for CD31 and D2-40. Based on the findings, the tumor was diagnosed as a uterine angiosarcoma. Chest CT revealed a small pleural effusion on the right side 4 years after the surgery. Pleural fluid cytology showed epithelioid tumor cells in irregular clusters, gland-like arrangement and concentric layers, suggestive of vasoformative features, with some of the cells containing intracytoplasmic vacuoles. The tumor cells were immunocytochemically positive for CD31 and D2-40.
Conclusion : Careful screening for clues suggesting of vasoformative features of the tumor cells is important for the diagnosis of metastatic angiosarcoma, and immunocytochemistry is useful for differential diagnosis.
