Key result
Pericardial fluid cytology can be utilized for the early diagnosis of primary cardiac angiosarcoma, despite challenges like the paucity of malignant cells and low clinical suspicion.
Why the study?
Primary cardiac angiosarcoma is challenging to diagnose clinically, and diagnosis based on pericardial fluid has rarely been reported, with patients often diagnosed post-mortem.
Case Report (n=1)
Pericardial fluid cytology can be utilized for the early diagnosis of primary cardiac angiosarcoma, highlighting the importance of proper workup despite the paucity of malignant cells.
Cardiac angiosarcoma diagnosis via pericardial fluid remains uncommon; leaves open the need for refined cytologic criteria in rare cardiac tumors.
Primary cardiac angiosarcoma is an exceedingly rare high-grade malignancy of the heart originating from endothelial cells, with a predilection for the right atrium in male. Clinical diagnosis is extremely challenging because of the nonspecific symptoms and radiological findings. Although almost always presenting with massive recurrent pericardial effusions, cardiac angiosarcoma diagnosed based on pericardial fluid has rarely been reported, either due to the paucity of malignant cells or misdiagnosis due to low familiarity/suspicion and lack of proper workup. Unfortunately, patients with this disease often receive definitive diagnosis post-mortem. We report a case of primary cardiac angiosarcoma initially diagnosed on pericardial fluid. The cytomorphology and immunophenotype of angiosarcoma in fluid, as well as the challenges and practical recommendations in using pericardial fluid cytology for early diagnosis of this deadly disease are discussed.
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Li et al. (2023) conducted a case report in Primary cardiac angiosarcoma (n=1). Pericardial fluid cytology was evaluated on Diagnosis of primary cardiac angiosarcoma. Pericardial fluid cytology can be utilized for the early diagnosis of primary cardiac angiosarcoma, despite challenges like the paucity of malignant cells and low clinical suspicion.
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