Difference between revisions of "Vascular tumours"

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Vascular tumours (view source)

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[[Image:Capillary_hemangioma_-_very_high_mag.jpg|thumb|right|[[Micrograph]] showing a [[capillary hemangioma]], a common type of vascular tumour. [[H&E stain]].]]
This article covers [[soft tissue lesions|soft tissue]] '''vascular tumours'''.  Vascular malformations are covered in the ''[[vascular malformations]]'' article.
This article covers [[soft tissue lesions|soft tissue]] '''vascular tumours'''.  Vascular malformations are covered in the ''[[vascular malformations]]'' article.


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==Hemangioma==
==Hemangioma==
{{Main|Hemangioma}}
{{Main|Hemangioma}}
{{Main|Liver hemangioma}}


==Lymphangioma==
==Lymphangioma==
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===IHC===
===IHC===
Features:<ref name=pmid19098468>{{Cite journal  | last1 = Kalof | first1 = AN. | last2 = Cooper | first2 = K. | title = D2-40 immunohistochemistry--so far! | journal = Adv Anat Pathol | volume = 16 | issue = 1 | pages = 62-4 | month = Jan | year = 2009 | doi = 10.1097/PAP.0b013e3181915e94 | PMID = 19098468 }}</ref><ref name=pmid11950918/>
Features:<ref name=pmid19098468>{{Cite journal  | last1 = Kalof | first1 = AN. | last2 = Cooper | first2 = K. | title = D2-40 immunohistochemistry--so far! | journal = Adv Anat Pathol | volume = 16 | issue = 1 | pages = 62-4 | month = Jan | year = 2009 | doi = 10.1097/PAP.0b013e3181915e94 | PMID = 19098468 }}</ref><ref name=pmid11950918>{{Cite journal  | last1 = Kahn | first1 = HJ. | last2 = Bailey | first2 = D. | last3 = Marks | first3 = A. | title = Monoclonal antibody D2-40, a new marker of lymphatic endothelium, reacts with Kaposi's sarcoma and a subset of angiosarcomas. | journal = Mod Pathol | volume = 15 | issue = 4 | pages = 434-40 | month = Apr | year = 2002 | doi = 10.1038/modpathol.3880543 | PMID = 11950918 }}</ref>
*D2-40 +ve.
*D2-40 +ve.


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*[[AKA]] ''intravascular papillary endothelial hyperplasia''.<ref name=pmid15865098>{{cite journal |author=Korkolis DP, Papaevangelou M, Koulaxouzidis G, Zirganos N, Psichogiou H, Vassilopoulos PP |title=Intravascular papillary endothelial hyperplasia (Masson's hemangioma) presenting as a soft-tissue sarcoma |journal=Anticancer Res. |volume=25 |issue=2B |pages=1409–12 |year=2005 |pmid=15865098 |doi= |url=}}</ref>  
*[[AKA]] ''intravascular papillary endothelial hyperplasia''.<ref name=pmid15865098>{{cite journal |author=Korkolis DP, Papaevangelou M, Koulaxouzidis G, Zirganos N, Psichogiou H, Vassilopoulos PP |title=Intravascular papillary endothelial hyperplasia (Masson's hemangioma) presenting as a soft-tissue sarcoma |journal=Anticancer Res. |volume=25 |issue=2B |pages=1409–12 |year=2005 |pmid=15865098 |doi= |url=}}</ref>  
*[[AKA]] ''Masson tumor''.<ref>URL: [http://path.upmc.edu/cases/case544/dx.html http://path.upmc.edu/cases/case544/dx.html]. Accessed on: 25 January 2012.</ref>
*[[AKA]] ''Masson tumor''.<ref>URL: [http://path.upmc.edu/cases/case544/dx.html http://path.upmc.edu/cases/case544/dx.html]. Accessed on: 25 January 2012.</ref>
===General===
{{Main|intravascular papillary endothelial hyperplasia}}
*Benign non-neoplastic lesion - a vessel that has thrombosed and recanalized.
*Histomorphologically may be confused with low-grade [[angiosarcoma]] or other soft tissue sarcomas.<ref name=pmid15865098/>
===Microscopic===
Features:
*Well-circumscribed - '''key (low power) feature'''.
*Abundant small vascular channels with benign endothelium.
*+/-Papillary formation with a fibrotic core covered by benign endothelium.<ref>URL: [http://path.upmc.edu/cases/case544.html http://path.upmc.edu/cases/case544.html]. Accessed on: 25 January 2012.</ref>
 
Notes:
*Looks like [[Kaposi sarcoma]] at high power.
 
Images:
*[http://path.upmc.edu/cases/case544.html Masson hemangioma - several images (upmc.edu)].


==Angiosarcoma==
==Angiosarcoma==
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==Epithelioid hemangioendothelioma==
==Epithelioid hemangioendothelioma==
*Should '''not''' be confused with ''[[epithelioid hemangioma]]''.
{{Main|Epithelioid hemangioendothelioma}}
===General===
*Malignant.<ref name=Ref_WMSP603>{{Ref WMSP|603}}</ref>
*Adults - wide age range.
*Associated with oral contraceptives, vinyl chloride.<ref name=pmid20165548/>


===Microscopic===
==Retiform hemangioendothelioma==
Features:<ref name=pmid20165548>{{Cite journal  | last1 = Gupta | first1 = R. | last2 = Mathur | first2 = SR. | last3 = Gupta | first3 = SD. | last4 = Durgapal | first4 = P. | last5 = Iyer | first5 = VK. | last6 = Das | first6 = CJ. | last7 = Shalimar | first7 = SK. | last8 = Acharya | first8 = . | title = Hepatic epithelioid hemangioendothelioma: A diagnostic pitfall in aspiration cytology. | journal = Cytojournal | volume = 6 | issue =  | pages = 25 | month =  | year = 2010 | doi = 10.4103/1742-6413.58951 | PMID = 20165548 | URL = http://www.biomedsearch.com/nih/Hepatic-epithelioid-hemangioendothelioma-diagnostic-pitfall/20165548.html }}</ref>
{{Main|Retiform hemangioendothelioma}}
*Large epithelioid perivascular cells with:
**Abundant pale eosinophilic cytoplasm.
**Cytoplasmic vacuolation (some cells) - [[AKA]] "blister cells" - '''key feature'''.
***May form lumen and have RBC within.
**Vesicular nucleus with prominent nucleolus in some cells.
*Tuft-like projections into capillaries.
*Tumour cells may be in well-circumscribed paucicellular nodules ''or'' more cellular poorly formed aggregates.


DDx:
==Intimal sarcoma==
*[[Angiosarcoma]], epithelioid.
{{Main|Intimal sarcoma}}
*[[Hemangioma]].
 
====Images====
<gallery>
Image:Epithelioid_hemangioendothelioma.jpg | Epithelioid hemangioendothelioma. (WC)
</gallery>
www:
*[http://www.flickr.com/photos/pulmonary_pathology/5600772691/in/photostream/ Epithelioid hemangioendothelioma - low mag. (flickr.com/Rosen)].
*[http://www.flickr.com/photos/pulmonary_pathology/5601354962/ Epithelioid hemangioendothelioma - high mag. (flickr.com/Rosen)].
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=20080802170854495 Epithelioid hemangioendothelioma (surgicalpathologyatlas.com)].
 
===IHC===
Features:<ref name=pmid20165548>{{Cite journal  | last1 = Gupta | first1 = R. | last2 = Mathur | first2 = SR. | last3 = Gupta | first3 = SD. | last4 = Durgapal | first4 = P. | last5 = Iyer | first5 = VK. | last6 = Das | first6 = CJ. | last7 = Shalimar | first7 = SK. | last8 = Acharya | first8 = . | title = Hepatic epithelioid hemangioendothelioma: A diagnostic pitfall in aspiration cytology. | journal = Cytojournal | volume = 6 | issue =  | pages = 25 | month =  | year = 2010 | doi = 10.4103/1742-6413.58951 | PMID = 20165548 | URL = http://www.biomedsearch.com/nih/Hepatic-epithelioid-hemangioendothelioma-diagnostic-pitfall/20165548.html }}</ref>
*CD31 +ve.
*CD34 +ve.
*Factor VIII +ve.


=See also=
=See also=
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*[[Vasculitides]].
*[[Vasculitides]].
*[[Soft tissue lesions]].
*[[Soft tissue lesions]].
*[[Cisterna chyli]].


=References=
=References=
Michael
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