Difference between revisions of "Hemangioma of the liver"

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| Tx        = usually follow-up, non-conservative if very large
| Tx        = usually follow-up, non-conservative if very large
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'''Hemangioma of the liver''', also '''liver hemangioma''' and '''hepatic hemangioma''', is a benign [[vascular tumour]] of the [[liver]], that may be mistaken for [[metastatic disease]].  
'''Hemangioma of the liver''', also '''liver hemangioma''' and '''hepatic hemangioma''', is a benign [[vascular tumour]] of the [[liver]], that may be mistaken for [[metastatic disease]].<ref name=pmid11039718>{{Cite journal  | last1 = Yamashita | first1 = Y. | last2 = Shimada | first2 = M. | last3 = Taguchi | first3 = K. | last4 = Gion | first4 = T. | last5 = Hasegawa | first5 = H. | last6 = Utsunomiya | first6 = T. | last7 = Hamatsu | first7 = T. | last8 = Matsumata | first8 = T. | last9 = Sugimachi | first9 = K. | title = Hepatic sclerosing hemangioma mimicking a metastatic liver tumor: report of a case. | journal = Surg Today | volume = 30 | issue = 9 | pages = 849-52 | month =  | year = 2000 | doi =  | PMID = 11039718 }}</ref>


''Hemangiomas'', more generally, are dealt with in the ''[[hemangioma]]'' article.
''Hemangiomas'', more generally, are dealt with in the ''[[hemangioma]]'' article.
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==General==
==General==
*Benign.<ref name=pmid26361504>{{Cite journal  | last1 = Bajenaru | first1 = N. | last2 = Balaban | first2 = V. | last3 = Săvulescu | first3 = F. | last4 = Campeanu | first4 = I. | last5 = Patrascu | first5 = T. | title = Hepatic hemangioma -review. | journal = J Med Life | volume = 8 Spec Issue | issue =  | pages = 4-11 | month =  | year = 2015 | doi =  | PMID = 26361504 }}</ref>
*Benign.<ref name=pmid26361504>{{Cite journal  | last1 = Bajenaru | first1 = N. | last2 = Balaban | first2 = V. | last3 = Săvulescu | first3 = F. | last4 = Campeanu | first4 = I. | last5 = Patrascu | first5 = T. | title = Hepatic hemangioma -review. | journal = J Med Life | volume = 8 Spec Issue | issue =  | pages = 4-11 | month =  | year = 2015 | doi =  | PMID = 26361504 }}</ref>
*Usually an incidental finding (incidentaloma) and often asymptomatic.<ref name=pmid26361504/>
**Can be hard to differentiate from metastatic disease on imaging.<ref name=pmid11039718/>
*Large lesions may present with upper abdominal pain.
*May cause [[congestive heart failure]] in infants - if large.<ref name=pmid26322113>{{Cite journal  | last1 = Kayaalp | first1 = C. | last2 = Sabuncuoglu | first2 = MZ. | title = Embolization of Liver Hemangiomas. | journal = Hepat Mon | volume = 15 | issue = 8 | pages = e30334 | month = Aug | year = 2015 | doi = 10.5812/hepatmon.30334 | PMID = 26322113 }}</ref>
*May cause [[congestive heart failure]] in infants - if large.<ref name=pmid26322113>{{Cite journal  | last1 = Kayaalp | first1 = C. | last2 = Sabuncuoglu | first2 = MZ. | title = Embolization of Liver Hemangiomas. | journal = Hepat Mon | volume = 15 | issue = 8 | pages = e30334 | month = Aug | year = 2015 | doi = 10.5812/hepatmon.30334 | PMID = 26322113 }}</ref>
*May rupture and be life-threatening.<ref name=pmid19241936>{{Cite journal  | last1 = Vokaer | first1 = B. | last2 = Kothonidis | first2 = K. | last3 = Delatte | first3 = P. | last4 = De Cooman | first4 = S. | last5 = Pector | first5 = JC. | last6 = Liberale | first6 = G. | title = Should ruptured liver haemangioma be treated by surgery or by conservative means? A case report. | journal = Acta Chir Belg | volume = 108 | issue = 6 | pages = 761-4 | month =  | year =  | doi =  | PMID = 19241936 }}</ref>


Clinical:
Clinical:
*Do not grow in size - can be followed if small or medium size (<10 cm).<ref name=pmid26361504/>
*Do not grow in size - can be followed if small or medium size (<10 cm).<ref name=pmid26361504/>
*Usually an incidental finding (incidentaloma) and often asymptomatic.<ref name=pmid26361504/>
**Large lesions may present with upper abdominal pain.


==Gross==
==Gross==
*Variable size.
*Variable size.
*Well circumscribed.
*Well circumscribed.
*Classically subcapsular.{{fact}}


==Microscopic==
==Microscopic==
Features:
Features:
*Channels lined by benign endothelium containing [[RBC]]s.
*Channels lined by benign endothelium containing [[RBC]]s.
*Surrounding (non-endothelial) cells without significant atypia.


DDx:
DDx:
*[[Epithelioid hemangioendothelioma]].
*[[Epithelioid hemangioendothelioma]] - atypical perivascular cells, classically with cytoplasmic vacuolization ("blister cells").
*[[Angiosarcoma]].
*[[Angiosarcoma]].
*[[Metastatic disease]].
*[[Metastatic disease]].
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- NEGATIVE for malignancy.
- NEGATIVE for malignancy.
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</pre>
===Micro===
The sections show dilated vascular spaces containing red blood cells that are lined by endothelial cells without significant atypia.  The vascular spaces are separated by bland fibrous tissue.
Abnormal perivascular cells are not identified. The background liver is without atypia and does not have appreciable fat.


==See also==
==See also==
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==References==
==References==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Gastrointestinal pathology]]
[[Category:Gastrointestinal pathology]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]
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