Investig Magn Reson Imaging.  2018 Sep;22(3):194-199. 10.13104/imri.2018.22.3.194.

Primary Angiosarcoma of the Breast: MRI Findings

Affiliations
  • 1Department of Radiology, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, College of Medicine, Uijeongbu, Korea. tiger@catholic.ac.kr
  • 2Department of Hospital Pathology, The Catholic University of Korea, Uijeongbu St. Mary's Hospital, College of Medicine, Uijeongbu, Korea.

Abstract

We present image findings, especially rare MRI of a primary breast angiosarcoma with its histopathology, and also analyze the relevant medical literature reports in terms of the MRI findings. As our patient had unique features of a primary breast angiosarcoma, this case could be very helpful for future diagnosis of this rare breast malignancy by MRI.

Keyword

Breast; Angiosarcoma; Breast MRI

MeSH Terms

Breast*
Diagnosis
Hemangiosarcoma*
Humans
Magnetic Resonance Imaging*

Figure

  • Fig. 1. Mammography (a) shows extremely dense breast. Sonography (b) shows irregular indistinct heterogeneous echoic mass of the upper inner quadrant of the left breast. The increased vascularity in the hypoechoic portion of the scanned area is demonstrated by color Doppler scanning (c).

  • Fig. 2. MRI shows an irregularly shaped, 4.9 × 4.5 cm sized, low signal mass on T1WI (a) and several, dot-like, high signals (arrows), suggesting internal hemorrhagic foci within a mass. The mass shows high signal intensity on T2WI (b). The central portion of the mass shows early dynamic-phase enhancement (c) and a washout pattern on the delayed phase (d). The periphery of the mass shows persistent trapping of contrast medium in the irregular enhancing portion and surrounding edema. Large, draining vessels (arrowheads) around the mass are well seen on MIP imaging (e). PET-CT (f) shows the inhomogeneous FDG uptake (SUV = 2.2–2.9) of the mass.

  • Fig. 3. A photomicrograph shows the combination of the numerous, inter-anastomosing vascular spaces and more solid, spindle-cell areas effacing the normal lobular architecture (Hematoxylin & Eosin staining, × 200) (a). On immunohistochemical staining, tumor cells are diffusely and strongly positive for CD34 (b) and focally positive for factor VIII (c). The estimated Ki-67 index in the cellular areas is approximately 40% (× 400) (d).


Reference

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