Key result
Flow cytometric analysis of a malignant effusion successfully diagnosed cardiac angiosarcoma and detected dim PDL1 expression when direct tissue biopsy was unsafe.
Case Report (n=1)
No
Advanced flow cytometric analysis of malignant effusion can serve as a safe and effective diagnostic alternative to direct tissue biopsy for cardiac angiosarcoma.
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May support effusion flow cytometry for inoperable mediastinal sarcoma diagnosis; leaves open prospective validation before clinical use.
We present a case of a 32-year-old female presenting with shortness of breath and increasing oxygen requirements. Further imaging discovered a large mass extending circumferentially into the pericardium, cardiac wall, and chambers, involving the anterior and middle mediastinum. Direct tissue biopsy of the mass for a diagnosis was unsafe. Therefore, advanced flow cytometric analysis for tumor marker expression of the malignant effusion was used to differentiate the mass as a vascular sarcoma, consistent with cardiac angiosarcoma. Additionally, cytometric analysis for programmed cell death protein 1 (PD1), programmed death-ligand 1 (PDL1), and cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) was also performed; a study seldom investigated for angiosarcomas but may have advantages over immunohistochemical analysis.
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Kennedy et al. (2022) conducted a case report in Cardiac Angiosarcoma (n=1). Flow cytometric analysis was evaluated on Diagnostic identification of tumor markers and immune checkpoint proteins. Flow cytometric analysis of a malignant effusion successfully diagnosed cardiac angiosarcoma and detected dim PDL1 expression when direct tissue biopsy was unsafe.
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