Splenic Angiosarcoma Diagnosed on Bone Marrow Biopsy: Case Report and Literature Review

Figures

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  Fig. 1. (a) Low power view (40×): Hematoxylin and Eosin (H&E) stained section of hypercellular bone marrow with focal nest of metastatic tumor (yellow arrow). (b) High power view (400×): H&E stained section show fascicles of high grade malignant spindle cells with extensive erythrocyte extravasation (yellow arrow).

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  Fig. 2. Immunohistochemistry: The tumor cells are diffusely positive for CD31 immunostain (vascular endothelial cell marker).

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  Fig. 3. (a) Axial contrast-enhanced CT image demonstrates multiple splenic hypodensities with a dominant 7.0 cm splenic mass with findings suspicious for local invasion of the chest wall (yellow arrow). (b) Coronal contrast-enhanced CT image demonstrates an enlarged spleen with an irregular contour. The dominant mass is also depicted (yellow arrow) with intrinsic heterogeneous enhancement.

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  Fig. 4. (a) Axial contrast-enhanced CT image demonstrates multiple scattered subcentimeter splenic hypodense lesions. (b) Sagittal contrast-enhanced CT image demonstrates multiple splenic hypodensities within an enlarged and irregular spleen. The dominant mass is depicted (yellow arrow) as well as a smaller hypodense mass in the inferior aspect of the spleen.

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  Fig. 5. High power view (200×): H&E stained sections of the splenectomy specimen show splenic angiosarcoma displaying characteristic atypical anastomosing neoplastic vascular channels and pleomorphic nuclei.

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  Fig. 6. High power view (400×): H&E stained section of the splenectomy specimen shows splenic angiosarcoma displaying an atypical mitotic figure (yellow arrow) amongst pleomorphic spindle cells.