the co-expression of cytokeratin and p63 in epithelioid angiosarcoma of the parotid gland a diagnostic pitfall细胞角蛋白的co-expression和p63腮腺上皮样血管肉瘤的诊断陷阱.pdf

Lin et al. Diagnostic Pathology 2012, 7:118 /content/7/1/118 CASE REPORT Open Access The co-expression of cytokeratin and p63 in epithelioid angiosarcoma of the parotid gland: a diagnostic pitfall Xu-Yong Lin1,2, Yang Liu1,2, Yong Zhang1,2, Juan-Han Yu1,2 and En-Hua Wang1,2* Abstract Summary: Epithelioid angiosarcoma of the parotid gland is rare, and may pose a great diagnostic challenge. We report a case of primary epithelioid angiosarcoma in a 64-year-old male without history of radiation. The histopathological findings demonstrated a high grade epithelioid neoplasm. Immunostaining showed that the tumor was positive for the pan-cytokeratin, p63, cytokeratin18, Vimentin and vascular markers CD31, and was negative for CD34, cytokeratin5/6, cytokeratin7, cytokeratin20, CD68, CD30, S-100, HMB45, desmin, α–SMA and CD45. The tumor was diagnosed as an epithelioid angiosarcoma. To our knowledge, this is the first reported case of angiosarcoma which showed common positivity for cytokeratin and p63. In addition to cytokeratin, p63 is considered a useful marker for carcinoma. The co-expression of cytokeratin and p63 in epithelioid angiosarcoma represents a diagnostic pitfall. Thus, using a panel of antibodies is essential for distinguishing this tumor from poorly differentiated carcinoma. Virtual Slides: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/ vs/6548916707504750 Keywords: Angiosarcoma, Cytokeratin, p63 Background 64-year-old Chinese male without history of radiation to Angiosarcoma predominantly arises in the skin or super- the head and neck. ficial soft tissue. The majority of neoplasms of the parotid gland are epithelial, while angiosarcoma, especially Case hi