Pseudomesotheliomatous angiosarcoma: a pleuropulmonary lesion simulating malignant pleural mesothelioma

Our plain-English summary of Pseudomesotheliomatous angiosarcoma: a pleuropulmonary lesion simulating malignant pleural mesothelioma, by G. Falconieri, R. Bussani, M. Mirra, et al (Histopathology, 1997).

The study

• Authors: G. Falconieri, R. Bussani, M. Mirra, M. Zanella
• Journal: Histopathology
• Published: 1997;30(5):419-24
• Type of article: Case report
• Cited by: 34 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

We report two cases of autopsy confirmed angiosarcoma in adult males, presenting as diffuse pleuropulmonary tumours and simulating malignant mesothelioma. Both the lesions grew along the serosal surfaces and were characterized by variably thick rinds of tissue encasing the lung. The pulmonary parenchyma showed diffuse, dark red, subpleural consolidations and multiple cavitations. Histologically, the lesions were composed by atypical spindle and polygonal, epithelioid cells showing rudimentary vascular differentiation and exhibiting strong positivity for factor VIII, CD31, CD34 and vimentin, We conclude that angiosarcoma may present with preponderant or exclusive involvement of pleura and peripheral lung and that it should be added to the list of tumours capable of simulating malignant mesothelioma.

In plain English

This article reported two cases found among about 35,000 autopsies done at Trieste University, Italy, between 1980 and 1994. Both patients were elderly men, aged 70 and 79, whose occupational and medical histories were described as unremarkable. The article does not mention asbestos. Each man had angiosarcoma, a cancer of blood-vessel cells, which spread over the pleura (the lining around the lung) as a grey-white rind and resembled malignant pleural mesothelioma. Before death, one man's bloody pleural fluid tested negative for cancer cells, and the other man's pleural biopsy showed only fibrous tissue. The illness progressed quickly, with death a few weeks after presentation. The tumour cells stained positive for the vessel markers CD31, CD34 and factor VIII and for vimentin. They were negative for keratins and the other markers tested. Autopsy found no primary tumour elsewhere in either man. The authors concluded that angiosarcoma should be added to the list of tumours that can mimic malignant mesothelioma. They said they could not tell whether the tumours began in the pleura or the lung, and that more cases are needed.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Case report of two autopsy-confirmed cases, with immunohistochemistry
• Who was studied: Two elderly men (aged 70 and 79) identified from about 35,000 autopsies at Trieste University, Italy, 1980–1994
• Exposure: Not an exposure study. The authors reviewed the clinical charts for environmental and occupational carcinogen exposure and described both men's occupational and medical history as unremarkable. Cigarette smoking was described as moderate. Asbestos is not mentioned.
• Main results:
  • At autopsy, in both cases, the pleural surfaces were involved by a variably thick rind of grey-white tissue, resembling mesothelioma
  • Case 1 (70-year-old man) had a haemorrhagic pleural effusion with negative cytologic examination
  • Case 2 (79-year-old man) underwent thoracotomy and had a non-diagnostic pleural biopsy, which the text describes as showing only fibrous tissue
  • In both cases, tumour cells were strongly positive for CD31, CD34, vimentin and factor VIII and negative for the other markers tested, including keratins
  • Neither case showed autopsy evidence of a primary tumour elsewhere
• The authors' conclusion: The authors concluded that angiosarcoma may present with mainly or only pleural and peripheral lung involvement, and that it should be added to the list of tumours capable of simulating malignant mesothelioma
• Limitations the authors state:
  • The authors could not definitely determine whether the tumours arose in the pleura or extended from lesions in the outer lung
  • The authors said it was premature to conclude whether this is a specific entity, and that more cases with autopsy confirmation are needed

Topics

The National Library of Medicine indexes this study under subjects our site covers: Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Pleural Mesothelioma, Autopsy, Malignant Mesothelioma, Serosal Surface, Parenchyma, Consolidation, Cavitation, Epithelioid.

Related studies

• Primary pleural epithelioid angiosarcoma. A case report and review of the literature — E. Dainese, B. Pozzi, et al. (2010)
• Primary pleural angiosarcoma associated with pneumoconiosis: An autopsy case — K. Matsuda, T. Yamaryo, et al. (2015)
• Frequent expression of conventional endothelial markers in pleural mesothelioma: usefulness of claudin-5 as well as combined traditional markers to distinguish mesothelioma from angiosarcoma — Y. Nakashima, K. Inamura, et al. (2020)
• Epithelioid angiosarcoma of the pleura: a case report — M.S. Roh, J.Y. Seo, et al. (2001)
• Angiosarcoma of the chest wall — T. Suzuki, S. Suzuki, et al. (1996)
• Malignant epithelioid vascular tumors of the pleura: report of a series and literature review — P.J. Zhang, V.A. Livolsi, et al. (2000)

Browse more research in Histopathology, or return to medical research.