Difference between revisions of "Lobular capillary hemangioma"

Revision as of 12:00, 26 December 2013

Lobular capillary hemangioma, also known as pygenic granuloma,^[1] a benign head and neck lesion that can mimic malignancy.

General

Sometimes pregnancy tumour.
Seen in children, young adults, pregnant women.

Clinical:

May grow quickly - clinically suspicious for a malignancy.

Notes:

Name of entity is a misnomer:
- Not pyogenic, i.e. infectious.
- Not granulomatous.
The WMSP advocates the name lobular capillary hemangioma.^[2]

Gross

Features:^[3]

Erythematous.
Hemorrhagic.

Usually location:^[2]

Lips.
Tongue.
Gingiva.

Microscopic

Features:^[4]

Polypoid or peduculated.
Vascular, i.e. many blood vessels, with plump endothelium.
Usu. thinned epithelium^[5] or ulcerated.^[2]
Lobular arrangement of vascular (seen at low power).^[6]

DDx:

Why it is not...

Glomus tumour - cookie cutter arrangement of cells.

Image

Pyogenic granuloma. (WC)

www:

Pyogenic granuloma (sciencephoto.com).

IHC

Features - positive for vascular markers:^[2]

CD34 +ve.
CD31 +ve.
Factor VIII +ve.

Sign out

TONGUE, LEFT LATERAL, BIOPSY:
- LOBULAR CAPILLARY HEMANGIOMA (PYOGENIC GRANULOMA).

Micro

The sections shows a pendunculated vascular lesion with small capillaries arranged in a lobular fashion. The endothelial cells of the lesion show no atypia. The overlying acanthotic epidermis has hyperkeratosis and hypergranulosis, and is focally ulcerated and impetiginized. There is no significant keratocyte atypia. No melanocytic nests are seen. The dermis has a mild perivascular lymphoplasmacytic infiltrate. The lesion is excised in the plane of section.

References

↑ Baglin, AC. (Aug 2011). "[Vascular tumors and pseudotumors. Pyogenic granuloma (lobular capillary hemangioma)].". Ann Pathol 31 (4): 266-70. doi:10.1016/j.annpat.2011.05.014. PMID 21839350.
↑ ^2.0 ^2.1 ^2.2 ^2.3 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 12. ISBN 978-0781765275.
↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 776. ISBN 0-7216-0187-1.
↑ Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 775. ISBN 0-7216-0187-1.
↑ URL: http://basicpathology-histopathology.blogspot.com/2009/10/head-and-neck-oral-cavity-reactive_3282.html. Accessed on: 2 February 2011.
↑ S. Sade. 8 September 2011.
↑ Levy, I.; Rolain, JM.; Lepidi, H.; Raoult, D.; Feinmesser, M.; Lapidoth, M.; Ben-Amitai, D. (Dec 2005). "Is pyogenic granuloma associated with Bartonella infection?". J Am Acad Dermatol 53 (6): 1065-6. doi:10.1016/j.jaad.2005.08.046. PMID 16310070.

[pmid21839350-1] Baglin, AC. (Aug 2011). "[Vascular tumors and pseudotumors. Pyogenic granuloma (lobular capillary hemangioma)].". Ann Pathol 31 (4): 266-70. doi:10.1016/j.annpat.2011.05.014. PMID 21839350.

[Ref_WMSP12-2] 2.0 ^2.1 ^2.2 ^2.3 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 12. ISBN 978-0781765275.

[Ref_PBoD776-3] Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 776. ISBN 0-7216-0187-1.

[Ref_PBoD775-4] Cotran, Ramzi S.; Kumar, Vinay; Fausto, Nelson; Nelso Fausto; Robbins, Stanley L.; Abbas, Abul K. (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, Mo: Elsevier Saunders. pp. 775. ISBN 0-7216-0187-1.

[5] URL: http://basicpathology-histopathology.blogspot.com/2009/10/head-and-neck-oral-cavity-reactive_3282.html. Accessed on: 2 February 2011.

[6] S. Sade. 8 September 2011.

[pmid16310070-7] Levy, I.; Rolain, JM.; Lepidi, H.; Raoult, D.; Feinmesser, M.; Lapidoth, M.; Ben-Amitai, D. (Dec 2005). "Is pyogenic granuloma associated with Bartonella infection?". J Am Acad Dermatol 53 (6): 1065-6. doi:10.1016/j.jaad.2005.08.046. PMID 16310070.

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@@ Line 1: / Line 1: @@
-#redirect [[Head and neck pathology#Pyogenic granuloma]]
+'''Lobular capillary hemangioma''', also known as '''pygenic granuloma''',<ref name=pmid21839350>{{Cite journal  | last1 = Baglin | first1 = AC. | title = [Vascular tumors and pseudotumors. Pyogenic granuloma (lobular capillary hemangioma)]. | journal = Ann Pathol | volume = 31 | issue = 4 | pages = 266-70 | month = Aug | year = 2011 | doi = 10.1016/j.annpat.2011.05.014 | PMID = 21839350 }}</ref> a benign head and neck lesion that can mimic malignancy.
+==General==
+*Sometimes ''pregnancy tumour''.
+*Seen in children, young adults, pregnant women.
+Clinical:
+*May grow quickly - clinically suspicious for a malignancy.
+Notes:
+*[[no truth in names|Name of entity is a misnomer]]:
+**Not pyogenic, i.e. infectious.
+**Not [[granuloma|granulomatous]].
+*The WMSP advocates the name ''lobular capillary hemangioma''.<ref name=Ref_WMSP12>{{Ref WMSP|12}}</ref>
+==Gross==
+Features:<ref name=Ref_PBoD776>{{Ref PBoD|776}}</ref>
+*Erythematous.
+*Hemorrhagic.
+Usually location:<ref name=Ref_WMSP12>{{Ref WMSP|12}}</ref>
+*Lips.
+*[[Tongue]].
+*Gingiva.
+==Microscopic==
+Features:<ref name=Ref_PBoD775>{{Ref PBoD|775}}</ref>
+*Polypoid ''or'' peduculated.
+*Vascular, i.e. many blood vessels, with plump endothelium.
+*Usu. thinned epithelium<ref>URL: [http://basicpathology-histopathology.blogspot.com/2009/10/head-and-neck-oral-cavity-reactive_3282.html http://basicpathology-histopathology.blogspot.com/2009/10/head-and-neck-oral-cavity-reactive_3282.html]. Accessed on: 2 February 2011.</ref> or ulcerated.<ref name=Ref_WMSP12>{{Ref WMSP|12}}</ref>
+*Lobular arrangement of vascular (seen at low power).<ref>S. Sade. 8 September 2011.</ref>
+DDx:
+*[[Capillary hemangioma]].
+*[[Myopericytoma]] (???).
+*[[Bacillary angiomatosis]].<ref name=pmid16310070>{{Cite journal  | last1 = Levy | first1 = I. | last2 = Rolain | first2 = JM. | last3 = Lepidi | first3 = H. | last4 = Raoult | first4 = D. | last5 = Feinmesser | first5 = M. | last6 = Lapidoth | first6 = M. | last7 = Ben-Amitai | first7 = D. | title = Is pyogenic granuloma associated with Bartonella infection? | journal = J Am Acad Dermatol | volume = 53 | issue = 6 | pages = 1065-6 | month = Dec | year = 2005 | doi = 10.1016/j.jaad.2005.08.046 | PMID = 16310070 }}</ref>
+Why it is not...
+*[[Glomus tumour]] - cookie cutter arrangement of cells.
+===Image===
+<gallery>
+Image:SkinTumors-PB061062.JPG | Pyogenic granuloma. (WC)
+</gallery>
+www:
+*[http://www.sciencephoto.com/images/download_lo_res.html?id=670066054 Pyogenic granuloma (sciencephoto.com)].
+==IHC==
+Features - positive for vascular markers:<ref name=Ref_WMSP12>{{Ref WMSP|12}}</ref>
+*CD34 +ve.
+*CD31 +ve.
+*Factor VIII +ve.
+==Sign out==
+<pre>
+TONGUE, LEFT LATERAL, BIOPSY:
+- LOBULAR CAPILLARY HEMANGIOMA (PYOGENIC GRANULOMA).</pre>
+===Micro===
+The sections shows a pendunculated vascular lesion with small capillaries arranged in a lobular fashion. The endothelial cells of the lesion show no atypia.  The overlying acanthotic epidermis has hyperkeratosis and hypergranulosis, and is focally ulcerated and impetiginized. There is no significant keratocyte atypia. No melanocytic nests are seen. The dermis has a mild perivascular lymphoplasmacytic infiltrate. The lesion is excised in the plane of section.
+==See also==
+*[[Head and neck pathology]].
+==References==
+{{Reflist|2}}
+[[Category:Diagnosis]]
+[[Category:Head and neck pathology]]

Difference between revisions of "Lobular capillary hemangioma"

Revision as of 12:00, 26 December 2013

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