Pseudolymphomatous Cutaneous Angiosarcoma

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Pseudolymphomatous Cutaneous Angiosarcoma

Postby patoco » Thu Aug 02, 2007 8:05 pm

Pseudolymphomatous Cutaneous Angiosarcoma: A Rare Variant of Cutaneous Angiosarcoma Readily Mistaken for Cutaneous Lymphoma.

Am J Dermatopathol. 2007 Aug

Requena L, Santonja C, Stutz N, Kaddu S, Weenig RH, Kutzner H, Menzel
T, Cerroni L.

From the Departments of *Dermatology (L.R.) and †Pathology (C.S.),
Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain;
‡Department of Dermatology, University of Marburg, Marburg, Germany
(N.S.); §Department of Dermatology, University of Graz, Graz, Austria
(S.K., L.C.); ¶Deparment of Dermatology, Mayo Clinic, Rochester, MN
(R.H.W.); and ∥Dermatopathologische Gemeinschaftspraxis,
Friedrichshafen, Germany (H.K., T.M.).

Cutaneous angiosarcoma is probably the most malignant neoplasm
involving the skin. Three clinical variants of cutaneous angiosarcoma
are recognized, including angiosarcoma of the scalp and face of
elderly patients, angiosarcoma associated with chronic lymphedema,
and postirradiation angiosarcoma.

Histopathologically, these three variants of angiosarcoma show similar features, which consist of poorly circumscribed, irregularly dilated, and anastomosing vascular channels lined by prominent endothelial cells that dissect through the dermis. Focally, neoplastic endothelial cells show large,
hyperchromatic, and pleomorphic nuclei, protruding within vascular
lumina and creating small papillations.

Usually, inflammatory infiltrate is sparse and consists of a patchy, perivascular lymphoid infiltrate around the neoformed vessels. In rare instances, cutaneous angiosarcomas may exhibit prominent inflammatory infiltrate, and the neoplasm may be mistaken for an inflammatory process, both from clinical and histopathologic points of view.

We describe four examples of cutaneous angiosarcomas with dense lymphocytic infiltrates involving the neoplasm. Immunohistochemically,
lymphocytes expressed immunoreactivity for CD3, CD5, and CD45
markers, whereas the germinal centers were positive for CD20, CD79a,
and Bcl-6. The neoplastic endothelial cells expressed
immunoreactivity for the CD31, CD34, podoplanin, Prox-1, Lyve-1, and

We discuss the possible relationship between neoplastic
endothelial lymphatic cells and reactive lymphocytes. Cutaneous
angiosarcoma with prominent lymphocytic infiltrate may be readily
mistaken for cutaneous follicle center cell lymphoma or cutaneous

PMID: 17667166 [PubMed - as supplied by publisher]

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