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Hemangioma of the liver (view source)
Revision as of 16:55, 19 October 2015
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'''Hemangioma of the liver''' is a benign tumour of the liver, that may be mistaken for [[metastatic disease]]. | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = Cavernous liver hemangioma - intermed mag.jpg | |||
| Width = | |||
| Caption = Cavernous liver hemangioma. [[H&E stain]]. | |||
| Synonyms = | |||
| Micro = | |||
| Subtypes = | |||
| LMDDx = [[epithelioid hemangioendothelioma]], [[angiosarcoma]], [[metastatic disease]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[liver]] | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = often an incidental finding | |||
| Signs = | |||
| Symptoms = +/-upper abdominal pain | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = well circumscribed mass | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = [[metastatic disease]] | |||
| Tx = usually follow-up, non-conservative if very large | |||
}} | |||
'''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. | |||
==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> | ||
* | **Can be hard to differentiate from metastatic disease on imaging.<ref name=pmid11039718/> | ||
* | *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== | |||
Features: | |||
*Channels lined by benign endothelium containing [[RBC]]s. | |||
*Surrounding (non-endothelial) cells without significant atypia. | |||
DDx: | |||
*[[Epithelioid hemangioendothelioma]] - atypical perivascular cells, classically with cytoplasmic vacuolization ("blister cells"). | |||
*[[Angiosarcoma]]. | |||
*[[Metastatic disease]]. | |||
===Images=== | |||
<gallery> | |||
Image:Cavernous liver hemangioma - intermed mag.jpg | Cavernous liver hemangioma - intermed. mag. (WC/Nephron) | |||
Image:Cavernous_liver_hemangioma_-_high_mag.jpg | Cavernous liver hemangioma - high mag. (WC/Nephron) | |||
</gallery> | |||
==Sign out== | ==Sign out== | ||
| Line 19: | Line 72: | ||
- NEGATIVE for malignancy. | - NEGATIVE for malignancy. | ||
</pre> | </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== | ||
*[[Hemangioma]]. | *[[Hemangioma]]. | ||
*[[Vascular tumours]]. | |||
==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Gastrointestinal pathology]] | [[Category:Gastrointestinal pathology]] | ||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||