Needle aspiration cytology and immunocytochemical study in a case of angiosarcoma of the breast

A case of angiosarcoma of breast diagnosed by needle aspiration cytology (NAC) is documented. The significant features which enabled the NAC diagnosis included presence of spindly to polygonal malignant endothelial lining cells appearing as papillary tufts merging with solid areas, branching effects, and presence of microacinar structures lined with abnormal spindly to polygonal cells indicative of vasoformative structures. Immunostaining for factor VIII and vimentin was strongly positive in the malignant spindly polygonal endothelial cells and further supported the NAC diagnosis. Similar findings were also seen in sections of cell blocks from aspirate and excised biopsy tissue from the breast tumor in hematoxylin-eosin stained sections and on immunostaining. Despite the rarity of occurrence of angiosarcoma in the breast it was felt that its cytologic diagnosis is possible especially in cases in which the lesion is extensive because of a good chance of getting a cellular sample on aspiration. This can be of considerable value for deciding an appropriate management and as a possible guide to prognosis.