Correct!
2. Press for a VATS biopsy

With progressive disease a diagnosis needs to be made. It seems unlikely that switching antifungals, repeating the bronchoscopy or repeating the fungal serologies will be successful. Needle biopsy is a consideration but it was felt that obtaining a definitive diagnosis should be done. The patient agreed to the VATS biopsy which was performed.

The biopsy showed areas of tumor cells and hemorrhage (Figure 3A).
Immunohistochemistry for erythroblast transformation specific related gene (ERG) was strongly positive within the tumor cells confirming the vascular origin of the tumor cells (Figure 3B). Pleural involvement was also seen.

Figure 3. A: High power view showing malignant cells and hemorrhage. B: Immunohistochemistry for ERG.

A diagnosis of angiosarcoma was made.

Which of the following are true regarding angiosarcoma? (Click on the correct answer to be directed to the eighth and final page)

  1. Administration of high doses of recombinant interleukin 1 (rIL‐1) may be effective
  2. Angiosarcomas respond well to chemotherapy
  3. It is the most common cancer seen in the 20-30 age group
  4. Most angiosarcomas originate in the lung
  5. Prognosis with angiosarcoma is poor

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