Anastomosing hemangioma of the kidney
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Anastomosing hemangioma of the kidney a rare benign vascular tumour of kidney that may mimic angiosarcoma.[1]
| Anastomosing hemangioma of the kidney | |
|---|---|
| Diagnosis in short | |
 Anastomosing hemangioma of the kidney. H&E stain. | |
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| Synonyms | renal anastomosing hemangioma |
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| LM | vascular tumour with architecture similar to splenic sinsoids, hobnailing, +/-hyaline globules, +/-extramedullary hematopoiesis |
| LM DDx | angiosarcoma, other hemangiomas, other vascular tumours, angiomyolipoma |
| IHC | CD34 +ve, CD31 +ve, HHV-8 |
| Gross | brown/mahogany lesion, classically centered on medulla of kidney |
| Grossing notes | total nephrectomy for tumour grossing, partial nephrectomy grossing |
| Site | kidney |
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| |
| Associated Dx | +/-end stage renal disease |
| Prevalence | very rare |
| Radiology | may mimic renal cell carcinoma |
| Prognosis | benign |
| Clin. DDx | renal tumours |
| Treatment | excision for definitive diagnosis? |
General
- Rare - case reports.
- The bigger category vascular tumours of the kidney is rare; in the world literature (as of 2015), according to Omiyale, there are approximately 40 angiosarcoma and 220 hemangiomas.[2]
- Typically seen in end stage renal disease.[3]
- May mimic renal cell carcinoma clinically.[4]
Gross
Features:
- Mahogany/brown - centered on medulla of kidney.[3]
Microscopic
Features:
- Vascular tumour characterized by vessels that fuse/join (anastomose); described as splenic sinusoids-like.[3]
- +/-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.
- Angiomyolipoma.
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:[3]
- CD31 +ve.
- CD34 +ve.
- HHV8 -ve.
See also
References
- ↑ Montgomery, E.; Epstein, JI. (Sep 2009). "Anastomosing hemangioma of the genitourinary tract: a lesion mimicking angiosarcoma.". Am J Surg Pathol 33 (9): 1364-9. doi:10.1097/PAS.0b013e3181ad30a7. PMID 19606014.
- ↑ Omiyale, AO. (Jul 2015). "Anastomosing hemangioma of the kidney: a literature review of a rare morphological variant of hemangioma.". Ann Transl Med 3 (11): 151. doi:10.3978/j.issn.2305-5839.2015.06.16. PMID 26244138.
- ↑ 3.0 3.1 3.2 3.3 Kuroda, N.; Ohe, C.; Deepika, S.; Yorita, K.; Mikami, S.; Furuya, M.; Nagashima, Y.; Hes, O. et al. (Jun 2016). "Review of renal anastomosing hemangioma with focus on clinical and pathological aspects.". Pol J Pathol 67 (2): 97-101. PMID 27543862.
- ↑ Silva, MA.; Fonseca, EKUN.; Yamauchi, FI.; Baroni, RH.. "Anastomosing hemangioma simulating renal cell carcinoma.". Int Braz J Urol 43 (5): 987-989. doi:10.1590/S1677-5538.IBJU.2016.0653. PMID 28727378.