Spindle-cell angiosarcoma

KER, keratin, detected by a mixture of GAMS.2, MAK-6, and AEl /AE3 EMA, epithelial membrane antigen VIM, vimentin DES, desmin MSA, muscle-specific actin SMA, smooth muscle (alpha isoform) actin GALD, h-caldesmon S-IOOP, S-100 protein OCN, osteocalcin LM, laminin UL, Ulex europaeus I lectin binding FS, fibrosarcoma SGRMS, spindle cell rhabdomyosarcoma LMS, leiomyosarcoma MPNST, malignant peripheral nerve sheath tumor MSS, monophasic spindle cell synovial sarcoma SCAS, spindle cell angiosarcoma KS, Kaposi s sarcoma FOS, fibroblastic osteosarcoma. 

A rare histologic manifestation of angiosarcoma is that of a spindle cell neoplasm.Angiosarcomas of that type label with UEAI or EEI-1 in the great majority of cases, but <10% demonstrate vWE reactivity. CD31, CD34, and thrombomodulin are seen in combination with one another in virtually all instances. PPN-reactivity is variable. 

Vascular tumors Adults. Soft tissue and various visceral organs. Angiosarcoma epithelioid and spindle cell tumor, vasoformative areas epithelioid in hemangioendothelioma FVIII+, CD31+, CD34+, FLI1+, thrombomodulin+, patchy keratin+ EM to identify endothelial cells rarely required... 

Attanoos and associates evaluated 31 sarcomatoid mesotheliomas and a spectrum of other spindle cell neoplasms with antibodies directed against cytokeratin, thrombomodulin, calretinin, and CK5/6. Twenty-four of 31 (77%) sarcomatoid mesotheliomas expressed cytokeratin, 9 of 31 (29%) expressed thrombomodulin, 12 of 31 (39%) expressed calretinin, and 9 of 31 (29%) expressed CK5/6. Two of 9 (22%) sarcomas not otherwise specified expressed broad-spectrum cytokeratin and thrombomodulin, and 1 of 9 (11%) expressed CK5/6. As might be expected, 100% of synovial sarcomas expressed broad-spectrum keratin but showed no immu-nostaining for thrombomodulin, calretinin, and CK5/6. Two of 3 (67%) angiosarcomas expressed thrombomodulin, which is not surprising since thrombomodulin... 

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