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Erschienen in: Der Pathologe 1/2015

01.02.2015 | Schwerpunkt

Angiosarkome der Haut

Neue Aspekte

verfasst von: T. Brenn, MD, PhD, FRCPath

Erschienen in: Die Pathologie | Ausgabe 1/2015

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Zusammenfassung

Das Angiosarkom der Haut ist ein hochmaligner Endothelzelltumor mit hoher Mortalität, der einer zuverlässigen Diagnose bedarf. Aufgrund der morphologischen Vielfalt des Angiosarkoms und seiner breiten Differenzialdiagnose kann dies jedoch ernsthafte Probleme bereiten. In vielen Fällen beruht die Diagnose auf dem immunhistochemischen Nachweis der Endothelzelldifferenzierung, der sich wegen mangelnder Sensitivität und Spezifität herkömmlicher Endothelzellantikörper als schwierig erweisen kann. Der folgende Artikel behandelt das klinische und histologische Spektrum des kutanen Angiosarkoms und hebt neue Erkenntnisse im Bereich der immunphänotypischen und molekulargenetischen Eigenschaften insbesondere in Bezug auf die relevante Differenzialdiagnose hervor.
Literatur
1.
3.
Zurück zum Zitat Billings SD, Mckenney JK, Folpe AL et al (2004) Cutaneous angiosarcoma following breast-conserving surgery and radiation: an analysis of 27 cases. Am J Surg Pathol 28:781–788PubMedCrossRef Billings SD, Mckenney JK, Folpe AL et al (2004) Cutaneous angiosarcoma following breast-conserving surgery and radiation: an analysis of 27 cases. Am J Surg Pathol 28:781–788PubMedCrossRef
4.
Zurück zum Zitat Brenn T, Fletcher CD (2004) Cutaneous epithelioid angiomatous nodule: a distinct lesion in the morphologic spectrum of epithelioid vascular tumors. Am J Dermatopathol 26:14–21PubMedCrossRef Brenn T, Fletcher CD (2004) Cutaneous epithelioid angiomatous nodule: a distinct lesion in the morphologic spectrum of epithelioid vascular tumors. Am J Dermatopathol 26:14–21PubMedCrossRef
5.
Zurück zum Zitat Brenn T, Fletcher CD (2006) Postradiation vascular proliferations: an increasing problem. Histopathology 48:106–114PubMedCrossRef Brenn T, Fletcher CD (2006) Postradiation vascular proliferations: an increasing problem. Histopathology 48:106–114PubMedCrossRef
6.
Zurück zum Zitat Brenn T, Fletcher CD (2005) Radiation-associated cutaneous atypical vascular lesions and angiosarcoma: clinicopathologic analysis of 42 cases. Am J Surg Pathol 29:983–996PubMed Brenn T, Fletcher CD (2005) Radiation-associated cutaneous atypical vascular lesions and angiosarcoma: clinicopathologic analysis of 42 cases. Am J Surg Pathol 29:983–996PubMed
7.
Zurück zum Zitat Depla AL, Scharloo-Karels CH, De Jong MA et al (2014) Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: a systematic review. Eur J Cancer 50:1779–1788PubMedCrossRef Depla AL, Scharloo-Karels CH, De Jong MA et al (2014) Treatment and prognostic factors of radiation-associated angiosarcoma (RAAS) after primary breast cancer: a systematic review. Eur J Cancer 50:1779–1788PubMedCrossRef
8.
Zurück zum Zitat Deyrup AT, Mckenney JK, Tighiouart M et al (2008) Sporadic cutaneous angiosarcomas: a proposal for risk stratification based on 69 cases. Am J Surg Pathol 32:72–77PubMedCrossRef Deyrup AT, Mckenney JK, Tighiouart M et al (2008) Sporadic cutaneous angiosarcomas: a proposal for risk stratification based on 69 cases. Am J Surg Pathol 32:72–77PubMedCrossRef
9.
Zurück zum Zitat Fernandez AP, Sun Y, Tubbs RR et al (2012) FISH for MYC amplification and anti-MYC immunohistochemistry: useful diagnostic tools in the assessment of secondary angiosarcoma and atypical vascular proliferations. J Cutan Pathol 39:234–242PubMedCrossRef Fernandez AP, Sun Y, Tubbs RR et al (2012) FISH for MYC amplification and anti-MYC immunohistochemistry: useful diagnostic tools in the assessment of secondary angiosarcoma and atypical vascular proliferations. J Cutan Pathol 39:234–242PubMedCrossRef
10.
Zurück zum Zitat Ginter PS, Mosquera JM, Macdonald TY et al (2014) Diagnostic utility of MYC amplification and anti-MYC immunohistochemistry in atypical vascular lesions, primary or radiation-induced mammary angiosarcomas, and primary angiosarcomas of other sites. Hum Pathol 45:709–716PubMedCrossRef Ginter PS, Mosquera JM, Macdonald TY et al (2014) Diagnostic utility of MYC amplification and anti-MYC immunohistochemistry in atypical vascular lesions, primary or radiation-induced mammary angiosarcomas, and primary angiosarcomas of other sites. Hum Pathol 45:709–716PubMedCrossRef
11.
Zurück zum Zitat Hornick JL, Dal Cin P, Fletcher CD (2009) Loss of INI1 expression is characteristic of both conventional and proximal-type epithelioid sarcoma. Am J Surg Pathol 33:542–550PubMedCrossRef Hornick JL, Dal Cin P, Fletcher CD (2009) Loss of INI1 expression is characteristic of both conventional and proximal-type epithelioid sarcoma. Am J Surg Pathol 33:542–550PubMedCrossRef
12.
13.
Zurück zum Zitat Mckay KM, Doyle LA, Lazar AJ et al (2012) Expression of ERG, an Ets family transcription factor, distinguishes cutaneous angiosarcoma from histological mimics. Histopathology 61:989–991PubMedCrossRef Mckay KM, Doyle LA, Lazar AJ et al (2012) Expression of ERG, an Ets family transcription factor, distinguishes cutaneous angiosarcoma from histological mimics. Histopathology 61:989–991PubMedCrossRef
14.
Zurück zum Zitat Mentzel T, Beham A, Calonje E et al (1997) Epithelioid hemangioendothelioma of skin and soft tissues: clinicopathologic and immunohistochemical study of 30 cases. Am J Surg Pathol 21:363–374PubMedCrossRef Mentzel T, Beham A, Calonje E et al (1997) Epithelioid hemangioendothelioma of skin and soft tissues: clinicopathologic and immunohistochemical study of 30 cases. Am J Surg Pathol 21:363–374PubMedCrossRef
15.
Zurück zum Zitat Mentzel T, Schildhaus HU, Palmedo G et al (2012) Postradiation cutaneous angiosarcoma after treatment of breast carcinoma is characterized by MYC amplification in contrast to atypical vascular lesions after radiotherapy and control cases: clinicopathological, immunohistochemical and molecular analysis of 66 cases. Mod Pathol 25:75–85PubMedCrossRef Mentzel T, Schildhaus HU, Palmedo G et al (2012) Postradiation cutaneous angiosarcoma after treatment of breast carcinoma is characterized by MYC amplification in contrast to atypical vascular lesions after radiotherapy and control cases: clinicopathological, immunohistochemical and molecular analysis of 66 cases. Mod Pathol 25:75–85PubMedCrossRef
16.
17.
Zurück zum Zitat Miller K, Goodlad JR, Brenn T (2012) Pleomorphic dermal sarcoma: adverse histologic features predict aggressive behavior and allow distinction from atypical fibroxanthoma. Am J Surg Pathol 36:1317–1326PubMedCrossRef Miller K, Goodlad JR, Brenn T (2012) Pleomorphic dermal sarcoma: adverse histologic features predict aggressive behavior and allow distinction from atypical fibroxanthoma. Am J Surg Pathol 36:1317–1326PubMedCrossRef
18.
Zurück zum Zitat Morgan EA, Kozono DE, Wang Q et al (2012) Cutaneous radiation-associated angiosarcoma of the breast: poor prognosis in a rare secondary malignancy. Ann Surg Oncol 19:3801–3808PubMedCrossRef Morgan EA, Kozono DE, Wang Q et al (2012) Cutaneous radiation-associated angiosarcoma of the breast: poor prognosis in a rare secondary malignancy. Ann Surg Oncol 19:3801–3808PubMedCrossRef
19.
Zurück zum Zitat Morgan MB, Swann M, Somach S et al (2004) Cutaneous angiosarcoma: a case series with prognostic correlation. J Am Acad Dermatol 50:867–874PubMedCrossRef Morgan MB, Swann M, Somach S et al (2004) Cutaneous angiosarcoma: a case series with prognostic correlation. J Am Acad Dermatol 50:867–874PubMedCrossRef
20.
Zurück zum Zitat Patton KT, Deyrup AT, Weiss SW (2008) Atypical vascular lesions after surgery and radiation of the breast: a clinicopathologic study of 32 cases analyzing histologic heterogeneity and association with angiosarcoma. Am J Surg Pathol 32:943–950PubMedCrossRef Patton KT, Deyrup AT, Weiss SW (2008) Atypical vascular lesions after surgery and radiation of the breast: a clinicopathologic study of 32 cases analyzing histologic heterogeneity and association with angiosarcoma. Am J Surg Pathol 32:943–950PubMedCrossRef
21.
Zurück zum Zitat Rao P, Lahat G, Arnold C et al (2013) Angiosarcoma: a tissue microarray study with diagnostic implications. Am J Dermatopathol 35:432–437PubMedCrossRef Rao P, Lahat G, Arnold C et al (2013) Angiosarcoma: a tissue microarray study with diagnostic implications. Am J Dermatopathol 35:432–437PubMedCrossRef
22.
Zurück zum Zitat Roy P, Clark MA, Thomas JM (2004) Stewart-Treves syndrome – treatment and outcome in six patients from a single centre. Eur J Surg Oncol 30:982–986PubMedCrossRef Roy P, Clark MA, Thomas JM (2004) Stewart-Treves syndrome – treatment and outcome in six patients from a single centre. Eur J Surg Oncol 30:982–986PubMedCrossRef
23.
Zurück zum Zitat Salviato T, Bacchi CE, Luzar B et al (2013) Signet ring cell angiosarcoma: a hitherto unreported pitfall in the diagnosis of epithelioid cutaneous malignancies. Am J Dermatopathol 35:671–675PubMedCrossRef Salviato T, Bacchi CE, Luzar B et al (2013) Signet ring cell angiosarcoma: a hitherto unreported pitfall in the diagnosis of epithelioid cutaneous malignancies. Am J Dermatopathol 35:671–675PubMedCrossRef
24.
Zurück zum Zitat Sanz-Motilva V, Martorell-Calatayud A, Rongioletti F et al (2014) Diffuse dermal angiomatosis of the breast: clinical and histopathological features. Int J Dermatol 53:445–449PubMedCrossRef Sanz-Motilva V, Martorell-Calatayud A, Rongioletti F et al (2014) Diffuse dermal angiomatosis of the breast: clinical and histopathological features. Int J Dermatol 53:445–449PubMedCrossRef
25.
Zurück zum Zitat Sharma A, Schwartz RA (2012) Stewart-Treves syndrome: pathogenesis and management. J Am Acad Dermatol 67:1342–1348PubMedCrossRef Sharma A, Schwartz RA (2012) Stewart-Treves syndrome: pathogenesis and management. J Am Acad Dermatol 67:1342–1348PubMedCrossRef
26.
Zurück zum Zitat Shon W, Sukov WR, Jenkins SM et al (2014) MYC amplification and overexpression in primary cutaneous angiosarcoma: a fluorescence in-situ hybridization and immunohistochemical study. Mod Pathol 27:509–515PubMedCrossRef Shon W, Sukov WR, Jenkins SM et al (2014) MYC amplification and overexpression in primary cutaneous angiosarcoma: a fluorescence in-situ hybridization and immunohistochemical study. Mod Pathol 27:509–515PubMedCrossRef
27.
Zurück zum Zitat Stockman DL, Hornick JL, Deavers MT et al (2014) ERG and FLI1 protein expression in epithelioid sarcoma. Mod Pathol 27:496–501PubMedCrossRef Stockman DL, Hornick JL, Deavers MT et al (2014) ERG and FLI1 protein expression in epithelioid sarcoma. Mod Pathol 27:496–501PubMedCrossRef
28.
Zurück zum Zitat Suchak R, Thway K, Zelger B et al (2011) Primary cutaneous epithelioid angiosarcoma: a clinicopathologic study of 13 cases of a rare neoplasm occurring outside the setting of conventional angiosarcomas and with predilection for the limbs. Am J Surg Pathol 35:60–69PubMedCrossRef Suchak R, Thway K, Zelger B et al (2011) Primary cutaneous epithelioid angiosarcoma: a clinicopathologic study of 13 cases of a rare neoplasm occurring outside the setting of conventional angiosarcomas and with predilection for the limbs. Am J Surg Pathol 35:60–69PubMedCrossRef
29.
Zurück zum Zitat Tatsas AD, Keedy VL, Florell SR et al (2010) Foamy cell angiosarcoma: a rare and deceptively bland variant of cutaneous angiosarcoma. J Cutan Pathol 37:901–906PubMedCrossRef Tatsas AD, Keedy VL, Florell SR et al (2010) Foamy cell angiosarcoma: a rare and deceptively bland variant of cutaneous angiosarcoma. J Cutan Pathol 37:901–906PubMedCrossRef
30.
Zurück zum Zitat Thum C, Husain EA, Mulholland K et al (2013) Atypical fibroxanthoma with pseudoangiomatous features: a histological and immunohistochemical mimic of cutaneous angiosarcoma. Ann Diagn Pathol 17:502–507PubMedCrossRef Thum C, Husain EA, Mulholland K et al (2013) Atypical fibroxanthoma with pseudoangiomatous features: a histological and immunohistochemical mimic of cutaneous angiosarcoma. Ann Diagn Pathol 17:502–507PubMedCrossRef
Metadaten
Titel
Angiosarkome der Haut
Neue Aspekte
verfasst von
T. Brenn, MD, PhD, FRCPath
Publikationsdatum
01.02.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
Die Pathologie / Ausgabe 1/2015
Print ISSN: 2731-7188
Elektronische ISSN: 2731-7196
DOI
https://doi.org/10.1007/s00292-014-2002-3

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