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Case Reports
. 2013 Jun;5(3):E107-11.
doi: 10.3978/j.issn.2072-1439.2012.10.08.

Pulmonary tumor thrombotic microangiopathy from metastatic epithelioid angiosarcoma

Funda Demirag  1 , Ebru Cakir, Ulku Yazici, Irfan Tastepe
Affiliations
Case Reports

Pulmonary tumor thrombotic microangiopathy from metastatic epithelioid angiosarcoma

Funda Demirag et al. J Thorac Dis. 2013 Jun.

Abstract

The lung is most common site for metastatic disease via hematogenous route. Tumor emboli of the vessels of the lung induces fibrocellular and fibromuscular intimal proliferation. These histopathological changes may cause pulmonary tumor trombotic microangiopaty. Few cases are diagnosed antemortem. We report a 60 year old woman with by metastatic epithelioid angiosarcoma involving the lung. Tumor cells were positive for VEGF and topoisomerase II. VEGF may be involved in the pathogenesis pulmonary tumor trombotic microangioapy and topoisomerase II positivity showed sensitivity against catalytic topoisomerase II inhibitors.

Keywords: Angiosarcoma; Pulmonary tumor thrombotic microangiopathy; Topoisomerase II; Vascular endothelial growth factor.

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Figures

Figure 1
Figure 1
A chest X-ray revealed bilateral nodules.
Figure 2
Figure 2
Chest computed tomography showed tickened interlobular septa and vascular structure.
Figure 3
Figure 3
Fluorine-18 fluordeoxyglucose positron emission tomography showed increased glucose metabolism of multiple lung nodules and pathologic mediastinal lymph nodes.
Figure 4
Figure 4
Fluorine-18 fluordeoxyglucose positron emission tomography showing increased glucose metabolism of the spine.
Figure 5
Figure 5
Tumor emboli showing admixed fibrin thrombi and tumor cells (HE ×400).
Figure 6
Figure 6
Intimal fibrocellular proliferation with tumor cells, causing marked luminal stenosis (HEX100).
Figure 7
Figure 7
Interstitial infiltration (HE HE ×400).
Figure 8
Figure 8
Angiosarcoma cells showed positive reactivity for topoisomerase IIα (topoisomeraseIIα ×400).
See this image and copyright information in PMC

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