Cytological Diagnosis of Hepatic Angiosarcoma and Its Histopathologic Correlation

Hepatic angiosarcoma is a rare hepatic malignant tumor. Although diagnosis of hepatic angiosarcoma by FNA cytology has been reported since 1982, followed by several studies, its cytomorphologic features were still not well recognized by cytopathologists because of its clinical rarity and various morphologic features.

We reviewed literatures about cytomorphology of hepatic angiosarcoma by FNA. There are only 11 cases retrieved in 10 articles searched from Medline. The sex M/F ratio was 6/4 (one unknown); age range was 56 to 79 years old. In initial cytological evaluation, four cases got angiosarcoma or consistent/suspicious angiosarcoma diagnosis. Positive for malignancy, sarcoma, and poorly differentiated spindle cell lesion were in one case respectively. One was diagnosed as atypical cells. Remaining three were unavailable by their reports.

In cytological morphologic features, all but one met least 2 of 3 cytological cellular criteria of angiosarcoma cells: spindle cells, epithelioid cells, and pleomorphic cells. In cytological architectural features, 7 of 11 cases showed vasoformative structures; 5 of 11 cases showed intracytoplasmic lumen or erythrophagocytosis. Ten of 11 cases had histologic/pathologic confirmation as angiosarcoma. One case reported interrelation of tumor structures and their own accompanied liver tissue in cell blocks.