Bilateral massive bloody pleurisy complicated by angiosarcoma.
Yukiko Moriya1, Tomonori Sugawara, Munefusa Arai
1Division of Respiratory Medicine, Tokyo Metropolitan Geriatric Hospital.
Internal Medicine (Tokyo, Japan)
|February 3, 2007
Summary
This case study highlights angiosarcoma presenting as bilateral massive bloody pleurisy in an elderly woman. Angiosarcoma, particularly pleural involvement, should be considered in spontaneous hemothorax cases.
Area of Science:
- Oncology
- Pathology
- Cardiovascular Research
Background:
- Angiosarcoma is a rare and aggressive malignancy arising from endothelial cells.
- Spontaneous hemothorax, the accumulation of blood in the pleural space without trauma, can be life-threatening.
Observation:
- An 83-year-old woman presented with bilateral massive bloody pleurisy (hematocrit 7.2%).
- Autopsy revealed hemorrhagic tumors infiltrating the diaphragm and peritoneum, originating from a duodenal serosal vessel.
- Histology confirmed angiosarcoma with characteristic immunohistochemical markers (vimentin, CD31, CD34, D2-40, factor VIII-related antigen).
Findings:
- The patient's presentation was complicated by angiosarcoma with extensive hemorrhagic involvement.
- Immunohistochemical analysis confirmed the diagnosis of angiosarcoma.
- The tumor exhibited an anastomosing vascular channel pattern.
Implications:
- Primary or metastatic pleural angiosarcoma is a potential cause of spontaneous hemothorax.
- Consider angiosarcoma in patients with bilateral or intractable hemothorax, especially the elderly.
- This case underscores the importance of thorough investigation in unexplained hemothorax.
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