68Ga-PSMA Uptake in Angiolipoma.

Ga-PSMA PET/CT is an imaging technique used in staging and detection of prostate cancer. However, enhanced uptake on Ga-PSMA PET/CT scan has also been ascribed to other malignant and benign lesions. We report on a case of a 56-year-old man with treated prostate carcinoma who had a Ga-PSMA PET/CT scan for restaging. Ga-PSMA uptakes in the prostatic bed and in multiple subcutaneous lesions were seen. Histopathology of a subcutaneous lesion revealed angiolipoma. It is important to be aware of the existence of the growing amount of reports on enhanced Ga-PSMA uptake unrelated to prostate cancer.

Androgen receptor expression in vascular neoplasms of the breast.

INTRODUCTION: Androgen receptors (AR) have been reported to be present in normal breast tissue and breast carcinomas. The following study was undertaken to assess the expression of AR in vascular neoplasms of the breast. MATERIALS AND METHODS: All patients with histologically diagnosed hemangioma, angiolipoma, atypical vascular proliferation, and angiosarcoma of the breast were retrieved from the clinical and pathology database at Rush University Medical Center. The slides stained with hematoxylin and eosin were reviewed and immunohistochemical staining for AR (Dako; clone AR441) was performed on paraffin-embedded tissue. Any amount of nuclear staining was considered positive and the intensity of staining was graded as 1+ to 3+. An estimate of the percentage of tumor and stromal cells staining was made. RESULTS: There were a total of 36 cases, 10 hemangiomas, 20 angiolipomas, 2 atypical vascular proliferation, and 4 angiosarcomas. The male to female ratio was 1:4.1. The average age at presentation for men was 45 years and for women was 56.9 years. Anti-AR expression was present in stromal and adipocyte nuclei of the angiolipomas and stromal cells of hemangiomas and angiosarcomas. Interestingly, normal duct epithelium of the breast was positive in 7 of the 29 women and none in men. Androgen expression was present in 62.5% of the hemangiomas, 55% of the angiolipomas, and 50% of the angiosarcomas. The majority of tumors showed a low-intensity nuclear expression of androgens, with 1+ intensity in 13 cases and 2+ intensity seen in 2 cases, and only 1 case of angiolipoma showed 3+ expression. All positive cases of angiolipoma (55%) showed AR in adipocytes and stromal cells. CONCLUSIONS: Vascular neoplasms are uncommon tumors in breast and majority of them are benign. Androgen expression is present in >50% of benign vascular neoplasms. Stromal cells and adipocytes typically express AR only in angiolipomas, suggesting a role of androgens in pathogenesis and growth of this neoplasm.

Cellular angiolipoma: a clinicopathological and immunohistochemical study of 12 cases.

Cellular angiolipoma is a rare variant of angiolipoma. To date, only a few reports have been published in the literature. In this report, we analyzed a series of 12 cases to further evaluate this entity. Seven patients were men and 5 were women, aged from 23 to 62 years (average, 39 years). Clinically, the lesions occurred predominantly in the subcutaneous tissue of the extremities and trunk wall, usually as part of multiple small tender nodules. In 5 cases, cellular angioloipoma coexisted with the conventional angiolipoma. Histologically, the tumor differed from its conventional counterpart by containing densely cellular areas that occupied more than 90% of the tumors. By comparison, adipocytic component accounted only for a minimal portion (<10%). CD31 and CD34 immunostainings highlighted the rich vasculature in the cellular areas. In conclusion, the clinical and morphological overlaps between the cellular angiolipoma and its conventional counterpart indicate that they lie within the same spectrum of a single entity.

Distinctive morphology of renal cell carcinomas in tuberous sclerosis.

Tuberous sclerosis complex results from mutations in 1 of 2 interacting gene products, hamartin or tuberin. The syndrome is characterized by hamartomas and neoplastic lesions, including angiomyolipomas of the kidney and other organs. Renal cell carcinoma (RCC) in tuberous sclerosis remains relatively poorly characterized because historical studies were confounded by the inclusion of epithelioid angiomyolipomas. The authors present a patient with tuberous sclerosis and bilateral renal lesions, including multiple minute angiomyolipomas, cortical cysts, and 4 separate RCCs of unclassified type. The carcinomas shared distinctive morphological features, including sheet-like, glandular, trabecular, or cystic architecture and abundant granular eosinophilic cytoplasm. By definition, the carcinomas were keratin positive and negative for HMB-45 and Melan-A. Detailed immunohistochemical analysis revealed heterogeneity among the cortical cysts and carcinomas. The histopathological features of these carcinomas illustrate characteristics of renal carcinoma that are probably related to genetic alterations of tuberous sclerosis.

Hamartomatous angiolipoma of the parotid gland (sialoangiolipoma).

Mesenchymal tumors of the salivary glands are rare and mostly localized to the parotid gland. We report on the clinico-pathological features of a distinct parotid tumor occurred in a newborn, showing glandular structures admixed with mature lipocytes and blood vessels in variable proportions. This was a well-circumscribed and slowly growing nodule of the superficial parotid lobe, mostly reddish in color with white-yellowish striations. Microscopically, a distinct lobular architecture was evident, along with normal-appearing acinar and ductal structures with interposed loose fibrous stroma. The latter contained aggregates of mature lipocytes and variably sized blood vessels. The morphological features of the lesion reported herein recapitulate those of sialolipoma but also include the presence of a prominent vascular component intimately admixed with both the glandular and the adipose tissues. At variance with salivary lipoadenoma, the glandular component in the current case distinctly showed all the cellular components of normal salivary (serous) glands. In consideration of the young age of the patient, the minimal growth rate and the histological features of the lesion, we hypothesize a hamartomatous origin for this lesion and propose the designation of sialoangiolipoma.