Metastatic angiosarcoma of the lung with alveolar hemorrhage

Abstract

A case of metastatic angiosarcoma of the lung with alveolar hemorrhage was experienced. A 76-year-old woman was diagnosed as stage IIb uterine cervical cancer. The cancer disappeared after radiotherapy. Five years later, she was readmitted because of severe pain around the right hip joint. Fracture of the neck of the right femur was found on roentgenogram. On chest CT and roentgenogram, spotted or restiform shadows with uncertain margins were found in the peripheral regions of the bilateral lung field. The lesions reached just underneath the pleura, and interstitial shadows such as ground-glass-like shadows and thickening of the interlobular walls were also found. These lesions were rapidly aggravated in the course of 1–2 weeks. She died after a short period of hospitalization (2 months) with pathological fracture. In autopsy, metastases of the tumor were found to bones, lungs, heart, and other organs that mainly occurred hematogenously. No recurrence of the uterine cervical cancer was detected. Tumor cells were polymorphic or ovoid, and occurred scattered individually or showed growth-forming small aggregates. By immunohistochemical staining, CD31, CD34 and Factor VIII were found to be positive, and the tumor was diagnosed as epithelioid angiosarcoma. The main findings in the lungs were intraalveolar hemorrhage consequent to tumor embolization.