Anastomosing hemangioma of the kidney

Anastomosing hemangioma a rare benign vascular tumour that is typically found in the kidney and may mimic angiosarcoma.

Anastomosing hemangioma of the kidney
Diagnosis in short
Anastomosing hemangioma of the kidney. H&E stain.
LM	vascular tumour with architecture similar to splenic sinsoids, hobnailing, +/-hyaline globules, +/-extramedullary hematopoiesis
LM DDx	angiosarcoma, other hemangiomas, other vascular tumours
IHC	CD34 +ve, CD31 +ve, HHV-8
Gross	brown/mahogany lesion, classically centered on medulla of kidney
Site	kidney, other
Associated Dx	+/-end stage renal disease
Prevalence	very rare
Prognosis	benign

General

• Rare - case reports.
• Typically seen in end stage renal disease.

Gross

Features:

• Mahogany/brown - centered on medulla of kidney.

Microscopic

Features:

• Vascular tumour characterized by vessels that fuse/join (anastomose) - also described as splenic sinusoids-like.
  • +/-Hobnail morphology.
  • +/-Cytoplasmic hyaline globules.
• +/-Extramedullary hematopoiesis.
  • Nucleated red blood cells.
  • Megakaryocytes.

Note:

• Tumour may extend into surrounding adipose tissue.

DDx:

• Angiosarcoma - nuclear atypia, more proliferative activity.

Images

• 

  AH - low mag. (WC)

• 

  AH - intermed. mag. (WC)

• 

  AH - high mag. (WC)

• 

  AH - very high mag. (WC)

• 

  AH - extremely low mag. (WC)

• 

  AH - very low mag. (WC)

• 

  AH - low mag. (WC)

• 

  AH - intermed. mag. (WC)

• 

  AH - intermed. mag. (WC)

• 

  AH - high mag. (WC)

IHC

Features:

• CD31 +ve.
• CD34 +ve.
• HHV8 -ve.

See also

• Vascular tumours.