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Cardiac Angiosarcoma : Differential

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Differential Diagnosis of Cardiac Angiosarcoma: Metastatic angiosarcoma from other locations, metastatic sarcomas as well as malignancies like renal cell carcinoma, hepatocellular carcinoma, malignant melanoma, and non-Hodgkin lymphoma must be excluded. Primary cardiac tumors usually originate in the endocardium, where as metastases involve pericardium more frequently.

Other primary cardiac sarcomas such as synovial sarcoma, leiomyosarcoma, and myxofibrosarcoma tend to be left-sided. All of these can histologically resemble high-grade angiosarcoma.

Hemangiomas also occur in heart. They may be capillary, cavernous, or mixed types. The vascular spaces are lined by benign endothelium and they lack solid growth, necrosis, cellular pleomorphism or increased mitotic activity.

The image shows large, irregularly-shaped, blood-filled spaces lined by atypial endothelium.

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