[170] Androgen Receptor Expression in Vascular Neoplasms of the Breast

Richa Jain, Pincas Bitterman, Ihab Lamzabi, Vijaya B Reddy, Paolo Gattuso. Rush University Medical Center, Chicago, IL

Background: Androgen receptors (AR) have been reported to be present in normal breast tissue and breast carcinomas. However, there is no literature regarding expression of AR in vascular breast neoplasms. The following study is undertaken to assess the expression of AR in a subgroup of vascular neoplasms of the breast.
Design: All patients with histologically diagnosed hemangioma, angiolipoma and angiosarcoma of the breast were retrieved from the clinical and pathology database at our institution. The H & E slides were reviewed and immunohistochemical stain for AR (Dako, clone AR441) was performed on paraffin embedded tissue. Any amount of nuclear staining was considered positive. The intensity of staining was graded from 1+ to 3+; 3+ being brightness comparable to positive control. An estimate of the percent of lesional cells staining was made.
Results: There were a total of 32 cases: 10 hemangiomas, 20 angiolipomas and 2 angiosarcomas. Male to female ratio was 1:3.5. The average age at presentation for men was 45 years and for women 56.9 years. AR expression was present in stromal and fat cell nuclei of the angiolipomas, and stromal cells of hemangiomas and angiosarcomas. Interestingly, normal duct epithelium of the breast was positive in 7 out of 24 females and none in males. The pathologic, clinical and immunohistochemical data are summarized in Table 1.

Table 1: Summary of clinic-pathologic and immunohistochemical data

	Positive	1+	2+	3+	% cells staining	Size range / Average size (cm)	Negative
Hemangioma	5/8 (62.5%)	3/8 (37.5%)	2/8 (25%)	0	5-20	0.1-0.9 / F: 0.4; M: 0.7	3/8 (37.5%)
Angiolipoma	11/20 (55%)	8/20 (40%)	2/20 (10%)	1/20 (5%)	5-20	F: 0.2-2.2; M: 0.8-2.7 / F: 1.1; M: 1.7	9/20 (45%)
Angiosarcoma	2/2 (100%)	2/2 (100%)	0	0	5-30	9 and 1.2	0

Conclusions: 1. Androgen expression was present in 62.5% of hemangiomas, 55% of angiolipomas and 100% of angiosarcomas.
2. The majority of the tumors showed a low intensity nuclear expression of androgens, 1+ intensity in 13 cases, with 2+ intensity seen in 2 cases and only one case of angiolipoma showed 3+ expression.
3. All positive cases of angiolipoma (55%) showed AR in adipocytes and stromal cells.
4. Since AR have been reported to be present in human adipocytes and preadipocytes, it is possible that the cell of origin of angiolipoma is a preadipocyte.
5. The expression of AR in hemangioma and angiosarcoma of the breast needs to be further investigated.
Category: Breast

Monday, March 19, 2012 9:30 AM

Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 28, Monday Morning