Skin, Cutaneous angiosarcoma, HHV8 stain

Cutaneous angiosarcoma often involves the face and scalp of elderly patients in the form of multifocal, ill-defined, bruise-like areas. It spreads rapidly with a poor prognosis: 5-year survival = 10-30%. It is characterized by irregularly anastomosing vascular channels dissecting through the dermis. The vessels may show variable degree of differentiation ranging from flattened innocuous appearance to large, hobnailed, endothelial cells with hyperchromatic nuclei and pleomorphism.

The biopsy shows irregular/atypical vascular spaces involving the superficial dermis with extension deeply and around adnexal structures. The vascular spaces are positive for ERG (vascular marker) and negative for HHV8 (ruling out Kaposi sarcoma).

This slide shows HHV8 stain. See Related Content for ERG and H&E stains.