Difference between revisions of "Hemangioma"

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#redirect [[Vascular lesions#Hemangioma]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Capillary_hemangioma_-_very_high_mag.jpg
| Width      =
| Caption    = Capillary hemangioma. [[H&E stain]].
| Micro      = channels lined by benign endothelium containing [[RBC]]s
| Subtypes  = soft tissue (capillary, cavernous, arteriovenous, venous, intramuscular, synovial), childhood (tufted, microvenular hemangioma, glomeruloid hemangioma, epithelioid hemangioma (see [[angiolymphoid hyperplasia with eosinophilia‎]]), targetoid hemosideric hemangioma, infantile hemangioma)
| LMDDx      = [[lymphangioma]], [[angiokeratoma]], [[lobular capillary hemangioma]] (pyogenic granuloma).
| Stains    =
| IHC        = CD31 +ve, D2-40 -ve, GLUT-1 +ve -- juvenile hemangioma
| EM        =
| Molecular  =
| IF        =
| Gross      =
| Grossing  =
| Site      = [[soft tissue]], [[skin]], [[liver hemangioma|liver]] (dealt with in separate article), others
| Assdx      = [[Castleman disease]] - for glomeruloid hemangioma
| Syndromes  = [[POEMS syndrome]] - for glomeruloid hemangioma, [[Maffucci's syndrome]]
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = common vascular lesion
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    =
}}
{{ Infobox external links
| Name          = Hemangioma
| EHVSC          = 10172
| pathprotocols  =
| wikipedia      =
| pathoutlines  =
}}
'''Hemangioma''' is a very common benign [[vascular tumour]]. 
 
''Hemangiomas of the [[liver]]'' are dealt with in the article ''[[liver hemangioma]]''.
 
''Anastomosing hemangioma'' is dealt with in the article ''[[anastomosing hemangioma]]''.
 
==General==
Hemangiomas to remember - if you're only going remember a few:
*''Glomeruloid'', ''infantile'', ''cavernous'', ''capillary'', ''arteriovenous'', ''venous'' and ''intramuscular''.
* ICD-O: 9120/0.
 
===Childhood===
Common childhood hemangiomas:<ref name=pmid10410855>{{cite journal |author=Prieto VG, Shea CR |title=Selected cutaneous vascular neoplasms. A review |journal=Dermatol Clin |volume=17 |issue=3 |pages=507–20, viii |year=1999 |month=July |pmid=10410855 |doi= |url=}}</ref>
*Tufted - small clusters of blood vessels.
*Microvenular hemangioma.
*Glomeruloid hemangioma - associated with [[POEMS syndrome]], [[Castleman disease]].<ref name=pmid16860182>{{cite journal |author=Uthup S, Balachandran K, Ammal VA, ''et al.'' |title=Renal involvement in multicentric Castleman disease with glomeruloid hemangioma of skin and plasmacytoma |journal=Am. J. Kidney Dis. |volume=48 |issue=2 |pages=e17–24 |year=2006 |month=August |pmid=16860182 |doi=10.1053/j.ajkd.2006.04.089 |url=}}</ref><ref name=Ref_WMSP618>{{Ref WMSP|618}}</ref>
*Epithelioid hemangioma - see ''[[angiolymphoid hyperplasia with eosinophilia‎]]''.
*Targetoid hemosideric hemangioma.
*Infantile hemangioma (AKA juvenile hemangioma<ref name=pmid10665907>{{Cite journal  | last1 = North | first1 = PE. | last2 = Waner | first2 = M. | last3 = Mizeracki | first3 = A. | last4 = Mihm | first4 = MC. | title = GLUT1: a newly discovered immunohistochemical marker for juvenile hemangiomas. | journal = Hum Pathol | volume = 31 | issue = 1 | pages = 11-22 | month = Jan | year = 2000 | doi =  | PMID = 10665907 }}</ref>) - these tumours are ''GLUT-1'' +ve.  They tumours grow and then spontaneously regress.<ref name=pmid15143338>{{Cite journal  | last1 = Dadras | first1 = SS. | last2 = North | first2 = PE. | last3 = Bertoncini | first3 = J. | last4 = Mihm | first4 = MC. | last5 = Detmar | first5 = M. | title = Infantile hemangiomas are arrested in an early developmental vascular differentiation state. | journal = Mod Pathol | volume = 17 | issue = 9 | pages = 1068-79 | month = Sep | year = 2004 | doi = 10.1038/modpathol.3800153 | PMID = 15143338 }}</ref>
 
===Soft tissue===
Several types are seen in soft tissue:<ref>{{Ref WMSP|602}}</ref>
*Capillary.
*Cavernous.
*Arteriovenous.
*Venous.
*Intramuscular.
*Synovial.
 
====CNS====
Usually from bone, rarely dural and parenchymal hemangiomas.
*Cavernous.
*Capillary.
 
====Syndromic associations====
*[[Maffucci's syndrome]].<ref name=pmid6584817>{{cite journal |authors=Laskaris G, Skouteris C |title=Maffucci's syndrome. Report of a case with oral hemangiomas |journal=Oral Surg Oral Med Oral Pathol |volume=57 |issue=3 |pages=263–6 |date=March 1984 |pmid=6584817 |doi=10.1016/0030-4220(84)90181-6 |url=}}</ref>
*[[POEMS syndrome]].
 
==Microscopic==
Features:
*Channels lined by benign endothelium containing [[RBC]]s.
 
DDx:
*[[Lymphangioma]].
*[[Angiokeratoma]].
*[[Lobular capillary hemangioma]] (pyogenic granuloma).
 
===Images===
<gallery>
Image:Capillary_hemangioma_-_intermed_mag.jpg | Capillary hemangioma - intermed. mag. (WC/Nephron)
Image:Capillary_hemangioma_-_very_high_mag.jpg | Capillary hemangioma - very high mag. (WC/Nephron)
Image:Cavernous_hemangioma_histopathology_(1).jpg | Cavernous hemangioma. (WC/KGH)
Image:Cavernous_hemangioma_histopathology_%282%29.jpg | Cavernous hemangioma. (WC/KGH)
</gallery>
www:
*[http://path.upmc.edu/cases/case277.html Diffuse hemangioma - several images (upmc.edu)].
 
==IHC==
*CD31 +ve.
*D2-40 -ve.<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 | URL = http://www.nature.com/modpathol/journal/v15/n4/full/3880543a.html }}</ref>
 
''Juvenile hemangioma'':<ref name=pmid10665907/>
*GLUT-1 +ve.
 
==Sign out==
<pre>
Subcutaneous Neck Lesion, Left, Excision:
- Cavernous hemangioma.
- NEGATIVE for malignancy.
</pre>
 
===Block letters===
<pre>
SUBCUTANEOUS NECK LESION, LEFT, EXCISION:
- CAVERNOUS HEMANGIOMA.
- NEGATIVE FOR MALIGNANCY.
</pre>
 
<pre>
LESION, LEFT SIDE OF FACE, EXCISION:
- CAPILLARY HEMANGIOMA.
- NEGATIVE FOR MALIGNANCY.
</pre>
 
===Micro - skin===
The sections show hair-bearing skin with abundant small superficial vascular channels containing red blood cells. The endothelial cells of the vascular channels do not have atypia.  No mitotic activity is appreciated. The overlying epidermis is unremarkable. Extensive solar elastosis is present. No nevus is identified.
 
==See also==
*[[Vascular tumours]].
*[[Pneumocytoma]] - previously known as ''sclerosing hemangioma''.
 
==References==
{{Reflist|2}}
 
[[Category:Vascular tumours]]

Latest revision as of 21:13, 16 May 2022

Hemangioma
Diagnosis in short

Capillary hemangioma. H&E stain.
LM channels lined by benign endothelium containing RBCs
Subtypes soft tissue (capillary, cavernous, arteriovenous, venous, intramuscular, synovial), childhood (tufted, microvenular hemangioma, glomeruloid hemangioma, epithelioid hemangioma (see angiolymphoid hyperplasia with eosinophilia‎), targetoid hemosideric hemangioma, infantile hemangioma)
LM DDx lymphangioma, angiokeratoma, lobular capillary hemangioma (pyogenic granuloma).
IHC CD31 +ve, D2-40 -ve, GLUT-1 +ve -- juvenile hemangioma
Site soft tissue, skin, liver (dealt with in separate article), others
Associated Dx Castleman disease - for glomeruloid hemangioma
Syndromes POEMS syndrome - for glomeruloid hemangioma, Maffucci's syndrome
Prevalence common vascular lesion
Prognosis benign
Hemangioma
External resources
EHVSC 10172

Hemangioma is a very common benign vascular tumour.

Hemangiomas of the liver are dealt with in the article liver hemangioma.

Anastomosing hemangioma is dealt with in the article anastomosing hemangioma.

General

Hemangiomas to remember - if you're only going remember a few:

  • Glomeruloid, infantile, cavernous, capillary, arteriovenous, venous and intramuscular.
  • ICD-O: 9120/0.

Childhood

Common childhood hemangiomas:[1]

Soft tissue

Several types are seen in soft tissue:[6]

  • Capillary.
  • Cavernous.
  • Arteriovenous.
  • Venous.
  • Intramuscular.
  • Synovial.

CNS

Usually from bone, rarely dural and parenchymal hemangiomas.

  • Cavernous.
  • Capillary.

Syndromic associations

Microscopic

Features:

  • Channels lined by benign endothelium containing RBCs.

DDx:

Images

  • Capillary hemangioma - intermed. mag. (WC/Nephron)

  • Capillary hemangioma - very high mag. (WC/Nephron)

  • Cavernous hemangioma. (WC/KGH)

  • Cavernous hemangioma. (WC/KGH)

www:

IHC

  • CD31 +ve.
  • D2-40 -ve.[8]

Juvenile hemangioma:[4]

  • GLUT-1 +ve.

Sign out

Subcutaneous Neck Lesion, Left, Excision:
- Cavernous hemangioma.
- NEGATIVE for malignancy.

Block letters

SUBCUTANEOUS NECK LESION, LEFT, EXCISION:
- CAVERNOUS HEMANGIOMA.
- NEGATIVE FOR MALIGNANCY.

LESION, LEFT SIDE OF FACE, EXCISION:
- CAPILLARY HEMANGIOMA.
- NEGATIVE FOR MALIGNANCY.

Micro - skin

The sections show hair-bearing skin with abundant small superficial vascular channels containing red blood cells. The endothelial cells of the vascular channels do not have atypia. No mitotic activity is appreciated. The overlying epidermis is unremarkable. Extensive solar elastosis is present. No nevus is identified.

See also

References

  1. ↑ Prieto VG, Shea CR (July 1999). "Selected cutaneous vascular neoplasms. A review". Dermatol Clin 17 (3): 507–20, viii. PMID 10410855.
  2. ↑ Uthup S, Balachandran K, Ammal VA, et al. (August 2006). "Renal involvement in multicentric Castleman disease with glomeruloid hemangioma of skin and plasmacytoma". Am. J. Kidney Dis. 48 (2): e17–24. doi:10.1053/j.ajkd.2006.04.089. PMID 16860182.
  3. ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 618. ISBN 978-0781765275.
  4. ↑ 4.0 4.1 North, PE.; Waner, M.; Mizeracki, A.; Mihm, MC. (Jan 2000). "GLUT1: a newly discovered immunohistochemical marker for juvenile hemangiomas.". Hum Pathol 31 (1): 11-22. PMID 10665907.
  5. ↑ Dadras, SS.; North, PE.; Bertoncini, J.; Mihm, MC.; Detmar, M. (Sep 2004). "Infantile hemangiomas are arrested in an early developmental vascular differentiation state.". Mod Pathol 17 (9): 1068-79. doi:10.1038/modpathol.3800153. PMID 15143338.
  6. ↑ Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 602. ISBN 978-0781765275.
  7. ↑ Laskaris G, Skouteris C (March 1984). "Maffucci's syndrome. Report of a case with oral hemangiomas". Oral Surg Oral Med Oral Pathol 57 (3): 263–6. doi:10.1016/0030-4220(84)90181-6. PMID 6584817.
  8. ↑ Kahn, HJ.; Bailey, D.; Marks, A. (Apr 2002). "Monoclonal antibody D2-40, a new marker of lymphatic endothelium, reacts with Kaposi's sarcoma and a subset of angiosarcomas.". Mod Pathol 15 (4): 434-40. doi:10.1038/modpathol.3880543. PMID 11950918.
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