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Metastatic Angiosarcoma of the Lung: Spectrum of CT Findings

Ukihide Tateishi1, Tadashi Hasegawa2, Masahiko Kusumoto1, Naoya Yamazaki3, Gen Iinuma1, Yukio Muramatsu1 and Noriyuki Moriyama1

1 Department of Diagnostic Radiology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo 104-0045, Japan.
2 Department of Pathology, National Cancer Center Hospital, Tokyo 104-0045, Japan.
3 Department of Dermatology, National Cancer Center Hospital, Tokyo 104-0045, Japan.



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  		Fig. 1A. —Metastatic angiosarcoma of lung in 32-year-old woman. Chest CT scan (lung window setting) shows solid nodular lesion with surrounding ground-glass attenuation (arrow) in left lower lobe. Note small nodular lesions in adjacent lung parenchyma.

 


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  		Fig. 1B. —Metastatic angiosarcoma of lung in 32-year-old woman. Photomicrograph of histopathologic specimen taken at autopsy shows atypical endothelial cells involving lung parenchyma mixed with marked hemorrhage. (H and E, x200)

 


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  		Fig. 2A. —Metastatic angiosarcoma of lung in 61-year-old woman. Thin-section CT scan (lung window setting) shows solid nodular lesion (arrow) with irregular contour in right lower lobe.

 


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  		Fig. 2B. —Metastatic angiosarcoma of lung in 61-year-old woman. Contrast-enhanced CT scan (mediastinal window setting) shows slightly inhomogeneous enhancement. Note punctate calcification (arrow) in periphery of lesion.

 


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  		Fig. 3. —Metastatic angiosarcoma of lung in 48-year-old woman. Chest CT scan shows multiple solid nodular lesions and ground-glass attenuation. Note septal thickening (arrows) throughout lung, suggesting lymphangitic spread of tumor cells. Poorly demarcated solid nodular lesions (arrowheads) accompanied by ground-glass attenuation are seen in periphery of both lungs.

 


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  		Fig. 4A. —Metastatic angiosarcoma of lung in 78-year-old man. Chest CT scan (lung window setting) shows multiple thin-walled cysts (arrows) with ground-glass attenuation (arrowheads). Air–fluid levels are seen in several cysts.

 


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  		Fig. 4B. —Metastatic angiosarcoma of lung in 78-year-old man. Photograph taken at autopsy of gross histopathologic specimen of right lung shows multiple cystic tumors with marked hemorrhage.

 


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  		Fig. 5A. —Metastatic angiosarcoma of lung in 60-year-old woman with history of mastectomy of left breast for cancer approximately 10 years previously. Chest CT scan (lung window setting) shows thin-walled cyst (arrow) in left upper lobe. Irregular nodule (arrowhead) is also seen in right lower lobe.

 


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  		Fig. 5B. —Metastatic angiosarcoma of lung in 60-year-old woman with history of mastectomy of left breast for cancer approximately 10 years previously. Chest CT scan 10 months later exhibits right hemothorax and enlargement of cyst. Areas of ground-glass attenuation have enlarged diffusely in both lungs. Thickened cyst wall and surrounding hemorrhage (arrows) is noted. Irregular nodule (arrowhead) in right lower lobe has enlarged.

 

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