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Hepatic Angiosarcoma : Differential

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Differential Diagnosis of Hepatic Angiosarcoma: Small biopsies taken from the edge of the tumor may be mistaken for inflammatory or benign vascular lesions. The presence of cytologic atypia in the endothelial cells lining sinusoids supports angiosarcoma. Hepatocellular carcinoma, epithelioid hemangioendothelioma, Kaposi sarcoma, hepatic metastasis of angiosarcoma arising in another location, and other primary or metastatic sarcomas also enter into the differential diagnosis.

A panel of endothelial markers (CD31, CD34, FLI-1, and ERG) are essential in making the correct diagnosis.

This image shows a well-differentiated focus of primary hepatic angiosarcoma. The left half shows anastomosing vascular channels lined by minimally atypical endothelium. In the right half, the atypical endothelial cells with hyperchromatic nuclei are seen spreading along preexisting sinusoids replacing the normal endothelium.

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