Fine needle aspiration biopsy diagnosis of angiosarcoma after breast-conserving therapy for carcinoma supported by use of a cell block and immunohistochemistry: a case report

Background Angiosarcoma is a rare malignant soft tissue tumor occurring at various sites as either a primary or secondary event. Primary angiosarcoma of the breast is an unusual tumor, accounting for 1 in 1,700\u962,000 primary malignant tumors of this organ. An increasing number of secondary angiosarcomas involving skin and breast parenchyma have been reported in women treated in a breast-conserving manner, including irradiation, for breast cancer. Fine needle aspiration biopsy as the first-line diagnostic tool in breast pathology may be very helpful in distinguishing between a recurrence of carcinoma and an angiosarcoma. Case Angiosarcoma arose 6 years after breast-conserving therapy for invasive carcinoma in a 69-year-old woman. Fine needle aspiration of several small, reddish, intradermal nodules over the treated area revealed malignant cells with an endothelial immunophenotype in the cell block, yielding the diagnosis of angiosarcoma, subsequently confirmed in a mastectomy specimen. Conclusion Fine needle aspiration, supported by ancillary techniques, such as cell block and immunohistochemistry, allows the cytologic diagnosis of an angiosarcoma and differentiates it from a carcinoma recurrence